DEI: don’t DOGE it till you try it

There’s something almost Pavlovian about seeing “Equality & Diversity” on a training schedule.

You know the vibe: mandatory, mandatory, mandatory. Usually delivered in a musty seminar room, by a very kind man named Nigel, using slides last updated sometime between the fall of the Berlin Wall and the rise of TikTok.

But here’s the thing — it matters. And if you’re in clinical practice, it matters more than you think. Not just because it’s the law (the Equality Act 2010 will legally pants you if you’re not careful), but because it’s baked into the very thing we claim to care about:

Being a half-decent human being while also holding a prescription pad.

The Legal Stuff (That’s Less Boring Than You Remember)

The Equality Act sets out nine “protected characteristics” — the ones we’re meant to memorise, even if the posters in the hospital corridor are the only reason we still remember them.

But this isn’t just about ticking a box. Systemic inequality in the NHS still translates into worse health outcomes for already marginalised groups — not because we’re all secretly villains, but because systems left unchallenged will always reflect the people who built them.

“I Treat Everyone the Same” — The Dangerous Lie

No, you don’t. And you shouldn’t.

Treating everyone identically ignores the fact that medicine is delivered in a context of power, identity and trust. It erases difference. And it makes us miss critical cues.

A trans patient who’s been misgendered their whole life might not disclose something crucial. A migrant patient might downplay symptoms because they’ve learned to be “grateful” for care. A Muslim colleague might quietly endure isolation because your team socials revolve around pubs and pork scratchings.

If we don’t adjust for context, we compound harm.

Real-Life Pitfalls (Where Good Intentions Die)

Recruitment bias? That “gut feeling” is often your bias whispering in your ear. We know that unconscious bias shows up in shortlisting, hiring, even performance appraisals.

Clinical assumptions? You’ve made them. So have I. Elderly = forgetful. Obese = lazy. “She’s probably just anxious.” It’s baked in — and it affects outcomes.

Form design? Still using “Mr/Mrs” with no “Mx”? Still asking for “maiden name”? Still listing only binary gender options? Then the system is still telling some patients: “This isn’t for you.”

Language fails? A wrong pronoun or deadname might feel like “just a slip” — but can cost you years of trust.

Practical DEI for People Who Hate Acronyms

So what do you actually do, beyond clicking through e-learning slides while eating a yoghurt?

• Reflect: If everyone around you looks, thinks, or votes like you — why?

• Rethink “normal”: Normal is a setting on the washing machine, not a care standard.

• Ask, don’t assume: Most people will tell you what they need, if you give them the dignity of asking.

• Be open to being wrong: Cultural humility isn’t about perfection. It’s about showing up, and staying teachable.

DEI Fatigue Is Real — But It’s a Symptom of Comfort

If you’re bored of hearing about DEI, odds are you’re not the one most harmed by its absence. That’s not a guilt trip. It’s a mirror.

The discomfort you feel when a DEI slide appears?

That’s your worldview being poked. And if that’s happening in a session with Nigel and his Windows XP graphics, fine. It’s still growth.

“This Isn’t My Job” — It Is Now

Whether you’re a GP, an F1, a nurse, a medical student, or a part-time lecturer who also does stand-up on the side (hi), the way you show up shapes care.

When clinicians ignore inequality, it doesn’t go away. It just goes unchallenged — and gets absorbed by the people who already had the least power in the room. That’s not drama. That’s data.

Final Thoughts

DEI isn’t “extra.” It’s part of your clinical toolkit — as essential as knowing how to treat sepsis or prescribe safely.

It’s a skill. It’s a posture. And yes, it’s also a bit of a lifelong uncomfortable journey.

But if we stop treating it like homework — and start treating it like humanity — we’ll build a system that’s safer, fairer, and actually worth showing up for.

And if all else fails, remember: It’s not about being woke. It’s about not being a dick.

Stay accountable.

— DW