The original claim isn’t that trainees are deliberately applying racist stereotypes. The study (Hoffman et al., 2016) found that people who endorsed false biological beliefs about race made less accurate pain assessments and worse treatment recommendations. That’s a finding about cognitive bias, not about conscious malice. So the pushback here is against a reading the source doesn’t really support.

The detour into skin thickness is also a bit beside the point. The cited passage is about pain perception, not dermatology. The fact that there’s equivocal evidence on epidermal thickness doesn’t do much to complicate the finding that believing “Black patients feel less pain” leads to undertreating pain. Those are different claims.

I’d also push back a little on the framing that doctors are “stuck” with blunt epidemiologic classifiers until personalized genomics arrives. The disparity evidence here isn’t about doctors making reasonable inferences from imperfect population-level data. It’s about false beliefs producing worse care. You don’t need a genetic profile to stop believing something that isn’t true. The fix for that is education and awareness, which is considerably more available than whole-genome sequencing.

The point about overcorrection with opioids is fair and worth taking seriously. But “researchers pointing out bias might cause overcorrection” is a reason to be careful about how you design interventions, not a reason to soften the description of the problem itself.