According to government data, in 2016, 84.6 percent of American adults and 92.7 percent of children visited the doctor. While visiting the doctor is a common event, for those from diverse populations, the experiences may differ. Multiple studies indicate that patients of color, female patients, LGBT patients, and other patients outside of the dominant culture often receive poor treatment from healthcare providers. This poor treatment often leads to poor health outcomes. To avoid this result, medical professionals must learn and implement the principles of equity, diversity, and inclusion.
Diversity in the Medical Profession
Each year, America becomes more diverse. At some point in the next few decades, America will no longer have a white majority. As the population becomes more diverse, the patients that doctors treat will become more diverse as well. At this point, the medical profession will be ill-equipped to handle the coming changes.
By any measure, the medical profession lacks diversity. According to the latest data, 4.1 percent of U.S. doctors are African American, 4.4 percent are Latinx, and 0.4 percent are Native American. Women are just 35 percent of all doctors. Worse, while female doctors are overrepresented in specialties such as family practice, pediatrics, obstetrics, and gynecology, they are nearly non-existent in fields such as surgery, cardiology, or neurology. There are few LGBT doctors, and those that do practice sometimes keep their orientation a secret to protect them from patients or coworkers.
The medical profession’s diversity troubles extend beyond doctors. Nursing also struggles with racial diversity and other forms of diversity. Most hospital boards and executive suites lack diversity as well. Clearly, the medical profession has not yet reached its diverse representation goals.
Diversity in the medical profession matters more than in other sectors. While diversity might help businesses make money, diversity in the medical profession saves lives. Researchers have repeatedly found that patients from diverse backgrounds usually choose and are more satisfied with doctors with the same background. For instance, a study released this summer found that Black male patients had better outcomes when they were treated by Black male doctors. Many report that they are more comfortable sharing information more openly with doctors with whom they share an affinity. Conversely, doctors who are more similar to or familiar with their patients ask more probing questions or questions that are more culturally-nuanced. This additional layer of probing and sharing leads to increased chances of earlier or more accurate diagnosis. Plainly, diversity in the medical profession saves lives.
Inclusion in the Medical Profession
As previously mentioned on this blog, diversity is only part of the puzzle. Diversity brings people into the fold, but inclusion makes them feel welcomed. So, while diversity is a step in the right direction, without inclusion, a hospital’s diversity efforts are doomed to fail. Health care organizations must make their patients feel welcome so they will feel comfortable sharing confidential, life-saving information.
A healthcare provider’s interactions with a patient can make him or her feel welcomed or feel excluded. Unfortunately, many doctors treat patients who differ from them in ways that make the patients uncomfortable. For instance, a 2016 study found that white doctors engaged in the same verbal communication with patients of color, their nonverbal communication was far different. When interacting with patients of color, the white doctors stood farther away, were less likely to touch the patients, used closed body language (crossed arms, etc.), and spent less time with the patients overall. While these differences may seem minor, the study’s authors noted that these minor cues led to higher dissatisfaction and worse outcomes for patients of color.
While the behaviors above are likely the result of implicit bias, explicit bias persists in the medical profession. Dr. Mark Shuster, a pediatrician and medical school professor, told students at Harvard Medical School about a time when a doctor refused to operate on a lesbian patient. Though Dr. Shuster’s story occurred in the 1980s, the same problems persist today. More recently, nurse Janet Boivin wrote about her observations of casual homophobia in her workplace.
Until both explicit and implicit biases are eliminated, hospitals will continue to struggle with inclusion.
Equity in the Medical Profession
While diversity and inclusion focus on who is hired and how they are treated, equity focuses on eliminating the structural barriers faced by those in marginalized groups. Equity requires attention to historical issues and current barriers. To provide effective care for all, health care professionals must pursue equity with a passion.
Historically, the medical profession has mistreated people of color. Doctors used enslaved African Americans in experiments. From the 1930s to the 1970s, the government-sanctioned Tuskegee experiment subjected an entire town to disease. As recently as the 1970s, Native American women were sterilized without their consent. LGBT patients still recall the indifference many medical providers displayed in the early days of the AIDS crisis. The profession must work to regain the trust of its patients by setting a new, more transparent course.
Today, the medical profession has many standards and practices that harm disenfranchised groups. Though patients in clinical trials often receive more innovative treatments, these studies often exclude women and people of color. For years, doctors assumed that the symptoms of heart attack were the same for everyone. Later research revealed that women’s heart attack symptoms differ from men’s in important ways. If health care leaders want to provide the best in patient care, these barriers and others must be eradicated.
Health care providers promise to “do no harm.” But a provider’s failure to understand diversity, equity, and inclusion can cause great harm. Health care personnel can learn more about equity, inclusion, and diversity in the medical profession by enrolling in The Equity Toolkit. This progressive course will give healthcare professionals the tools they need to be effective in an increasingly diverse world.