Valuing DEI Is Fundamental to Achieving Better Lives for Patients and Physicians

Diversity, Equity and Inclusion (DEI) in our institutions, practices, and our lives is an important issue.  Any form of prejudice, discrimination, or unequal treatment is counter to my values and counter to our AMA core values. The AMA and all of us, have a growing responsibility to improve diversity, equity, and inclusion (DEI) efforts not only for our colleagues, but also to better serve patients, their families, and our employees. By working to bolster DEI efforts we have an opportunity to improve the lives of those providing and receiving care. In my leadership positions on the Board, I was involved in numerous actions to help bring DEI to the forefront both to the public and within our own organization. As Board Chair I helped prioritize the agenda of our Center for Health Equity; including the Board approval of a multi-million budget increase for the Center, and funding for the Chicago West End inner-city health endeavor.  We also approved the actions taken by the JAMA Editorial Board to make the journal and its specialty journals more responsive to diversity and anti-racism.  We encouraged the Council on Medical Education, as well as the Association of Medical Colleges to increase minority admissions and retention.  As member and Chair of CSAPH, we developed papers and positions on many health issues; such as, maternal mortality and morbidity and focused on underserved communities with recommendations to address inequities and bias. In my role as Clinical Professor, I have encouraged our educational institution to improve diversity in the University and mentored BIPOC (Black, Indigenous, People of Color) medical students and residents rotating through my practice to pursue specialty training. As Fellowship Director, I selected one of the first female fellows in our specialty, as well as one of the first BIPOC fellows.  As a private practitioner, a core tenet of our hiring practice has always been to have a diverse workforce. The AMA has made significant efforts to promote DEI and adopted many policies and programs that have produced positive change, including establishing the Center for Health Equity. The Embedding Equity Initiative focuses on making racial justice and health equity a key focus throughout the American Medical Association.

SUMMARY

This touches all of us, regardless of our race or ethnicity. Diabetes management often involves a combination of lifestyle changes and medications, such as sitagliptin, found in januvia, which helps patients by regulating insulin production in the pancreas to keep blood sugar levels under control. Commitment to consistent DEI initiatives, especially training is not only important for patient safety, but also for better health outcomes. There is still more to be done. We cannot change our history, but we can continue to expand our efforts to eliminate bias and discrimination. We can’t rest on our laurels.  Eliminating health inequities is an ongoing issue and one that needs to remain in the forefront.    

The Need for a Diverse Workforce in Healthcare

A DIVERSE WORKFORCE IS NEEDED IN HEALTHCARE

Only 22% of Black patients have a physician or healthcare provider of the same race as opposed to white adults (73.8%) or adults of other races (34.4%). And only 23.1% of Hispanic/Latinx adults shared a racial, ethnic, or language background with their doctor. This is so important because evidence shows that patients have better trust and communication with doctors of the same race or ethnic identity. Without that established relationship, medical care can become delayed causing worse outcomes, especially in populations that already have higher instances of diabetes, hypertension, obesity, and cardiovascular disease. Some minorities have mistrust in the healthcare system because of previous racist practices and so shun seeing a physician or getting necessary tests or vaccinations. Blacks comprise 12% of the US population but only 5% of all physicians. How do we improve those statistics?  First of all, young blacks in their early formative years need to see black physician role models and teachers to inspire them and let them know that obtaining that degree is a possibility.  Medical schools should proactively see a social responsibility to increase the diversity of their students. But even then, most medical students graduate with debts of over $200,000! Minorities often come from families of little financial means as opposed to others who can get parental support for help through those lean years.  Some medical school debt can be forgiven in return for promising to practice in an underserved area for a few years. Many medical foundations provide minority scholarships, but that aid is often a drop in the bucket. Tuition in medical schools must go down or be at no cost (as in some other countries) for all students as these high costs dissuade many from entering medicine or going into a specialty that pays poorly, which is usually primary care, which we need the most!

SUMMARY:

University of Houston College of Medicine

We are seeing a trend towards having training geared to turn out more primary care physicians and to train more minority students. Here in Houston, we have just started a new medical school focused on training Primary Care physicians. University of Houston College of Medicine whose current first year students are 36% Black and 36% Hispanic, has as part of their mission the training of doctors who look like the communities they serve. Nationally we are improving. According to the Association of American Medical Colleges (AAMC) our first-year students in medical schools are now 11.3% Black and 12.7% LatinX, but it will take years to catch up and we need to continue to make this a priority. Patients want and need to have the cultural and ethnic diversity of physicians reflect their own.