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.”