Is your group a meritocracy or a rigged system?
Letter to the Editor

Is your group a meritocracy or a rigged system?

Peter Kalina

Department of Radiology, Mayo Clinic, Rochester, MN, USA

Correspondence to: Peter Kalina, MD, MBA, FACR. Department of Radiology, Mayo Clinic, Rochester, MN, USA. Email:

Received: 05 February 2020; Accepted: 28 February 2020; Published: 25 March 2020.

doi: 10.21037/jhmhp.2020.02.03

Yale law school professor Daniel Markovits’ recently published bestseller, “The Meritocracy Trap”, has a radical message for society—our system is rigged. He describes how, in a utopian world, meritocracy is an axiom of life, where advantage is earned through merit, ability, talent and effort; where social and economic reward follows achievement. It’s an ideal that is supposed to promote fairness, and sustain “the American dream”. Yet, Markovits claims, it’s actually a false promise because the “elites” that live and work among us form dynasties in which they concentrate and transmit privilege among themselves. This effectively serves to render any hope of upward mobility for everyone else—a mere fantasy.

Does your practice include working with colleagues who consider themselves “elites”? Do certain co-workers exude an air of importance and self-flattery? Perhaps you’ve had an equal, a peer who’s stumbled upon an administrative role. Do they now refer condescendingly to you as “my clinical colleague”? What are they now—hospital administrators? Ever hear a colleague, when asked why everyone in the group can’t share in the administrative duties, boldly claim; “well, not everyone has my skill set”. Really? Exactly what objective skill set is that? Markovits adds that many will undoubtedly recognize themselves in his unflattering portrait of the workplace ruling class; exuding arrogance, condescendence and contempt.

Professor Markovits’ book describes how some people are willing to unabashedly monopolize the best roles, thereby, effectively rendering them unattainable by everyone else. While the few benefit, the rest are devalued and demoralized. These “elites” tip the scales in their favor over other equally (if not more) highly qualified colleagues.

In a just society, acceptances at the most prestigious colleges and universities would go to the smartest kids. Recent events suggest this does not always occur. Similarly, positions in departments or groups would be given to those most-skilled for a particular role. Again—we know this does not always occur. Entrance into the elite ranks is too often rigged in favor of the privileged, at the expense of intelligent hard-working colleagues. Power is concentrated in a narrower few. Markovits adds that squeezing through that proverbial “narrow door” for the potential of advancement is extremely difficult. In fact, the possibility of making it through extends well beyond the reality (or even the imagination) of most.

A “caste system” is created, says Markovits; generating inequality and divisiveness. The cycle creates a snowball effect; forming a divide between those who are now able to do even more, and an idle group whose work is effectively rendered redundant. Not afforded the opportunity to acquire unique skills, the excluded become interchangeable. To make matters worse, the “system” convinces them that their situation is their own fault. They are led to believe that their exclusion is a result of their individual failure, rather than a system failure. While the impact of this lack of inclusion is difficult to directly measure, it clearly coincides with increasing rates of physician burnout.

So, what is the solution? Make the workplace promotion ladder more transparent, fair, accessible, nondiscriminatory and equitable. Make “the narrow door” wider so as to broaden participation and benefit from everyone’s unique perspective and unique value. Create a more democratic, egalitarian, inclusive and meritocratic workplace.

We all want to believe that inclusion and meritocracy reign supreme in our groups. We also all want to believe that we practice in an environment that promises opportunities for all. Ability and hard work must be justly rewarded. If they are, health care organizations will see increased mobility, decreased competition, decreased burnout, increased wellness and better value. Organizations will also realize an improved business bottom line. Most importantly, they will experience better patient care outcomes.


Funding: None.


Provenance and Peer Review: This article was a standard to the journal. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at The author has no conflicts of interest to declare.

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Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See:

doi: 10.21037/jhmhp.2020.02.03
Cite this article as: Kalina P. Is your group a meritocracy or a rigged system? J Hosp Manag Health Policy 2020;4:8.

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