Medicine is a highly homogenous field serving diverse populations—and that’s a problem. Diversity in health care goes far beyond a language barrier. It’s about understanding the mindset of a patient within a larger context of culture, gender, sexual orientation, religious beliefs, and socioeconomic realities.
When a homogenous workforce is tasked with caring for an extremely diverse array of patients, the quality of care can suffer.
Health disparities affect segments of the population differently. Attitudes toward health care and treatment can vary among different populations. Medical professionals need to provide custom care that acknowledges and recognizes these differences. The medical field needs to diversify in order to serve its diverse patient population.
We spoke with a handful of physicians in order to learn more about diversity in health care from the inside out. Keep reading to see what they have to say on the topic.
The homogenous origins of medicine
“Once upon a time, the American medical profession was comprised almost exclusively of white, male doctors,” explains Dr. Bernard Remakus, an internist and author. He adds that in time, white females were gradually allowed to enter the medical field, but the profession continued to grow as a male-dominated institution.
"Once upon a time, the American medical profession was comprised almost exclusively of white, male doctors."
“Health care diversity was a foreign concept to Americans of this era who never dreamed the day would come when patients would be able to choose from a wide assortment of male and female doctors who had different colors, creeds, nationalities, specialties, and even sexual orientations,” Dr. Remakus says.
Over time, the homogeneity of the medical profession eroded. Medical schools began accepting more female applicants, as well as more racial and ethnic minority applicants. The field has come a long way, but it is still far from diverse and, even more troubling, far from a true reflection of the patient population.
Today’s medical demographics
To understand the topic further, let’s take a look at the landscape of the medical profession today. Physicians and surgeons in the US are predominantly Christian, white males who come from high socioeconomic backgrounds.
Racial and ethnic minorities are disproportionately absent from medicine. Almost three-quarters of physicians and surgeons are white. About 20 percent are Asian. Less than five percent are black. Hispanic and native populations comprise even less.
Almost two-thirds of practicing physicians and surgeons are male. However, that distribution may even out over time. This is because the gap between male and female medical school graduates has changed significantly over the past few decades.
Additionally, the majority of medical students come from affluent, higher socioeconomic status backgrounds. Not only are students from low socioeconomic status families underrepresented, but they are also more likely to leave medical school within the first two years.
In terms of faith, medicine remains a largely Christian profession. Almost two-thirds of physicians and surgeons in the US identify as Christian, followed by 14 percent Jewish, seven percent unaffiliated, five percent Hindu, and three percent Muslim.
Sexual and gender diversity in the medical field is lacking extensive research, though one study conducted by Stanford University found that about one-third of sexual minorities chose not to disclose that information while in medical school, with 40 percent admitting they feared discrimination. However, several medical schools have recently made efforts to ensure LGBTQ applicants were represented in their candidate pool and have since reported an uptick in the enrollment of students who identify as such.
While it’s true the medical profession is making great strides in welcoming a broader spectrum of doctors, there is still a ways to go. And the lack of diversity in health care can have detrimental effects on patients.
Why diversity in health care is needed
A lack of diversity in medicine proves troubling for patients seeking physicians who are knowledgeable about their specific needs. For example, consider the medical needs of a transgender patient.
“The more diverse the people are who provide medical care, the better they can respectfully and knowledgeably assist their patients.”
“As a transgender person, it's very difficult to access health care with competent providers knowledgeable about transgender health care,” explains Jordan Rubenstein of UJA-Federation of New York. “The more diverse the people are who provide medical care, the better they can respectfully and knowledgeably assist their patients.”
A homogenous workforce limits the capabilities of medicine, containing it within the parameters of a single lens and a particular set of values. The medical workforce should instead reflect the variety of patients for which they provide care.
“Diversity in nearly every profession is important. In health care, doctors and other health care workers from different cultures and backgrounds bring their unique perspectives to share with colleagues and patients. This helps improve our processes for providing care and helps us be more understanding and responsive to our patients’ needs,” explains Dr. Lisa Doggett, a family physician in Austin, Texas.
“It is important for physicians to be diverse in large part because our patients are diverse,” she adds. “If we can understand our patients’ belief systems and values, we will be able to provide better care for them.”
When a patient cannot find providers that resemble them, their beliefs, their culture, or other facets of their life, it may delay or prevent them from seeking care.
"Where there is no diversity, it may make it more intimidating for some patients to seek medical care."
“It is difficult enough for many patients to see a doctor. Where there is no diversity, it may make it more intimidating for some patients to seek medical care, thus causing them harm,” says Dr. Linda Girgis, a family physician and graduate of the St. George’s University School of Medicine. “Additionally, people from different cultures may perceive diseases and treatments in different ways.”
Increasing the diversity of health care providers can help dismantle these barriers some patients face when seeking care—and it can even contribute to a greater quality of care for all.
The ramifications of homogenous medicine
Homogenous healthcare is dangerous — and it disproportionately affects some patients more than others. For example, of those diagnosed with breast cancer, it is much more likely to be fatal for African American women than for white women. Hispanic and African American patients are more likely to die from diabetes than white patients. And the wait for African American patients needing a kidney transplant is almost twice as long as the wait for white patients.
"We run the risk of becoming short-sighted or boxed in to a particular way of thinking when everyone is the same."
“We run the risk of becoming short-sighted or boxed in to a particular way of thinking when everyone is the same,” Dr. Doggett explains. “We lose a certain richness and opportunity to learn from one another. We, as individual clinicians, are certainly affected when there is a lack of diversity, but our patients are impacted even more.”
The solution is clear—healthcare needs to diversify for the sake of its patients. Increased diversity of the health care workforce can lead to improved satisfaction for racial and ethnic minority patients. Patients who are treated by physicians of their own racial or ethnic background are more likely to report receiving higher quality care. This preference is evident in the fact that patients are more likely to choose a physician of similar background when given an option.
Increasing diversity in health care also makes it more accessible to underserved patients—African American, Hispanic, and Native American physicians are much more likely to work in underserved communities than their white counterparts. Additionally, African-American and Hispanic physicians, as well as women, are more likely to care for patients on Medicaid.
Diversity in health care starts at the beginning
Diversity in health care starts in medical school. When classes are more diverse, all classmates benefit from broadened perspectives. In fact, diversity in medical education environments can improve learning outcomes for all students. Diverse classrooms help students improve active thinking, intellectual engagement, social skills, empathy, and racial understanding — all critical components to a physician's education.
"Doctors of today need a global competence to understand the diverse populations they serve."
“Doctors are required to be competent not only in medicine but also in communication and caring for people with different disease burdens, socio-cultural realities, expectations, values, and beliefs,” explains Dr. Satesh Bidaisee, a professor of public health and preventive medicine and assistant dean for the School of Graduate Studies at St. George’s University. "Doctors of today need a global competence to understand the diverse populations they serve. Global competence for diverse populations is exactly what medical schools need to provide for their students, who in turn will provide nuanced care for patients of all walks of life.”
Diversity in health care matters
Diversity in health care isn’t about filling seats with mandated numbers. It’s about ensuring all backgrounds, beliefs, ethnicities, and perspectives are adequately represented in the medical field. It’s about providing the best possible care for a variety of patients by enlisting a variety of providers. And at the end of the day, it’s about providing the best possible care for all patients.
If you’re interested in a career in medicine and want to gain an edge with a global perspective, then learn more by reading our article, “6 Little-Known Perks of Attending an International Medical School.”
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