October 25, 2023

In The News: Diversity in Medicine Necessary to Meet Needs of Patients, Provide ‘Culturally Effective Care’

Healio details a racial and gender bias in health care presentation from a recent pulmonary meeting that has medicine-wide implications. While more women and underrepresented in medicine groups have gone into the field, bias and discrimination persist and can lead to poorer care for patients. The presentation looked at underrepresentation across years, challenges and obstacles people from such groups face, and explored possible ways to address the underrepresented shortfalls.

The Association of American Medical Colleges includes African American/Black, Native Hawaiian/Pacific Islander, American Indian/Alaska Native, and Hispanic individuals as underrepresented groups in medicine relative to their numbers among the general U.S. population. In a 20-year span (2000-2020), a cross sectional study compared the percentage of underrepresented faculty to the U.S. population for racially/ethnically concordant children. The study researchers concluded pediatric faculty diversity at medical schools did not reflect the growing diversity of patients.

When looking at women in health care, a study from 2008-2009 reported more men moved up from a new assistant or associate professor position after seven years than women. And while the number of department chairs held by women has increased, they sill occupy less than 20% of all chairs. When accounting for women from underrepresented groups, the percentage of full-time faculty increased from 12% to just 13% between 2008 and 2018, and most were at the assistant professor rank. Women who have attained full professor rank are 75% white, all of which points to missing advancement and positions of leadership for women and underrepresented in medicine groups. Women also account for only one-third of NIH-funded research.

Salary inequities, work-life imbalance, burnout rates, lack of mentorship, bias, and support for research were all listed among the contributing challenges faced by women and underrepresented racial groups. As these issues persevere, the effects intensify. Recruitment and retention of women and underrepresented groups can lead to better serving the diversity needs among the patient population, particularly when considering physicians from the underrepresented groups are more likely to provide care in underserved areas.

Combatting the issues women and underrepresented in medicine groups face requires everyone to recognize the existence of implicit biases that may affect care. The presenter also makes the case for greater mentorship and education to aid in moving people up through the ranks. Diversifying the medical workforce can improve outcomes, access, and the future of medical care.

PIDS IDA&E Task Force vice chair, Tanya Rogo, commented, “The current Pediatric ID workforce is not representative of the general U.S. population’s racial and ethnic diversity. Furthermore, Pediatric ID is one of three pediatric subspecialty fields to have a significantly decreased trend over time in URiMs entering Pediatric ID fellowship since 2007. Pathways to Pediatric ID first require a diverse pool of students to enter medicine, therefore cultures of inclusivity must be created and fostered along the entire spectrum of medical training. We are all role models in the spaces that we work and see patients in, so it is imperative for all members of the Peds ID workforce to receive training to recognize and mitigate implicit bias, foster cultural humility and create inclusive environments for ourselves, our trainees, and our patients. Through the IDA&E Taskforce and other initiatives, PIDS has demonstrated a commitment to improving representation at all levels within the subspeciality and professional society.”

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