Black Representation among Physicians

Michael Levin (1997) argues that black people are largely over-represented among American physicians, so much so that it is probably lowering the quality of care. This case is also presented by Kirkegaard (2019) and Levin largely takes the argument from Gottfredson (1986). Since I’ve been re-reading sections of Levin’s book, I’ll just quote his take, however.

Take the rows marked Physicians and Engineers. As determined by the General Intelligence Scale of the General Ability Test Battery, used by the U.S. Department of Labor in studies of job performance, column (2) indicates that male physicians and engineers are recruited from the population whose IQ is 114 or above, a range with no ceiling. Columns (3) and (4) give the proportions of the black and white populations above that cutoff, using a white IQ mean of 101.8, a white SD of 16.4, a black mean of 83.4 and a black SD of 13.4, derived from Hitchcock (1976). Observe that SDB = .81 SDW. 114 is .743 SDW above the white mean and 2.28 SD B above the black mean; 23% of the white population and 1.1% of the black population lie above that point. Columns (5) and (6) indicate the proportions of the populations within the recruitment range for physicians and engineers, which, since this range has no ceiling, are again 1.1 and 23. The ratio of blacks to whites in that range is then 1.1/23, rounded to .05 in column (7); this is the number of black physicians there would be for every white physician, holding population size constant, were physicians recruited solely by intelligence. Using Census Bureau data, columns (8) and (9) display the actual ratios of black to white physicians in 1970 and 1980, again with populations constant.
The actual ratio of black to white physicians in 1970, shown in column (8), was .23, or 23% of the proportion required by racial parity, and, coincidentally, the “absurdly small” number Dworkin cites as showing the need for affirmative action (1977a: 140–141). Yet 23 is more than four times greater than the proportion expected were the recruitment of blacks based solely on intelligence. The same effect is seen elsewhere. Comparing columns (7) and (8) to (9), in 16 of 18 cases blacks are more numerous than they would be if recruitment were based solely on intelligence. . . .
This overprediction is clarifed in column (10), the expected black/white ratios when blacks are recruited for jobs from an IQ range whose cutoff is .5 SDW below the cutoff of the white range for those same jobs. Take the “Physician” row again, once more holding population size constant; there are about 100 whites whose IQs are 114 or over for every 22 blacks whose IQs are 107 or over. So, if white doctors were recruited from the IQ range 114+, and black doctors from the IQ range 107+, there would, according to column (10), be about .22 black doctors for every one white doctor. That is near the actual 1970 ratio.

The table he cites is this:

Table 8.1 levin

The most important part of this, which largely corresponds to Kirkegaard’s argument, is Column 10. Levin argues you need an IQ of above 114 to generally handle the job of being a physician. But, due to the need to fill hospital staff with black people, they have to lower their standards of intelligence by half a standard deviation. The result is probably worse medical care for the sake of diversity. See Kirkegaard’s post for some sources regarding IQ and job performance as well as the relationship between race and job performance.

Since the IQ-job performance relationship is mediated by job complexity, it’s probable the same happens for race. In fact, this was shown by McKay and McDaniel (2006). Jobs which were more cognitively demanding had larger racial gaps in performance.

The fact you can be only a bit above moderately intelligent to become a physician – if you’re black, that is – is probably worrying to most people. And the benefit of black people is not just being of greater occupational status. The average United States physician makes $223,000 a year (O’Connell, 2018). That is over $150,000 more than the median income in the United States. What is this in addition to? Levin calculates some of the other economic benefits of being black, saying,

A moderately bright white child scoring slightly above the white mean on standardized tests would, were he black, be eligible for a program called “Prep for Prep,” which pays all costs of attendance at elite private elementary schools. Value: at least $30,000. He would then get to go to an elite private preparatory school for four years, again at no cost. Value: at least $60,000. College scholarships available to him that are unavailable to similarly able whites may conservatively be estimated to be worth another $50,000. Even before entering the job market, where affirmative action kicks in, being black is, at a conservative estimate, worth $130,000. Speaking purely behaviorally, blacks in current American society are more highly valued than whites.

One can simply add $150,000 per living year (obviously, it would start lower but go higher over time) as the person in Levin’s scenario is the requirement for black physicians, but probably under-experienced to be a white physician.

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