Doctors use problematic race-based algorithms to guide care every day. Why are they so hard to change?

^{Photo by Hush Naidoo Jade Photography on Unsplash}

Pediatrician Alexandra Epee-Bounya had had enough. In her 20 years caring for children in Boston, she had seen hundreds of kids with suspected urinary tract infections. Each time, she’d turn to a calculator, used by all Boston Children’s Hospital clinicians, to judge the youngest children’s risk. Did the infant have a high fever? Add a point. Was she a girl? Add two points. 

As she went down the list, one of the factors tripped her up every time: Was the child Black? If not, add a point. The more points, the higher the risk of a UTI, which meant the child would get follow up testing. How could it be that the color of a child’s skin dictated their care? 

“It always rubbed me the wrong way,” said Epee-Bounya, whose mother was from France and father is from Cameroon. She considers herself mixed race, but “in this country — I came when I was 16 — I learned that I was Black,” she said. How would a doctor categorize her, or her...