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I’ve heard from doctors who’ve been reported to their departments for criticizing residents for being late. (It was seen by their trainees as an act of racism.) I’ve heard from doctors who’ve stopped giving trainees honest feedback for fear of retaliation. I’ve spoken to those who have seen clinicians and residents refuse to treat patients based on their race or their perceived conservative politics.

Some of these doctors say that there is a “purge” underway in the world of American medicine: question the current orthodoxy and you will be pushed out. They are so worried about the dangers of speaking out about their concerns that they will not let me identify them except by the region of the country where they work.

“People are afraid to speak honestly,” said a doctor who immigrated to the U.S. from the Soviet Union. “It’s like back to the USSR, where you could only speak to the ones you trust.” If the authorities found out, you could lose your job, your status, you could go to jail or worse. The fear here is not dissimilar.

When doctors do speak out, shared another, “the reaction is savage. And you better be tenured and you better have very thick skin.”

“We’re afraid of what's happening to other people happening to us,” a doctor on the West Coast told me. “We are seeing people being fired. We are seeing people's reputations being sullied. There are members of our group who say, ‘I will be asked to leave a board. I will endanger the work of the nonprofit that I lead if this comes out.’ People are at risk of being totally marginalized and having to leave their institutions.”

While the hyper focus on identity is seen by many proponents of social justice ideology as a necessary corrective to America’s past sins, some people working in medicine are deeply concerned by what “justice” and “equity” actually look like in practice.

“The intellectual foundation for this movement is the Marxist view of the world, but stripped of economics and replaced with race determinism,” one psychologist explained. “Because you have a huge group of people, mostly people of color, who have been underserved, it was inevitable that this model was going to be applied to the world of medicine. And it has been.”