By Sabrina Espinoza
With the aim of providing healthcare to help people live healthily and fulfillingly, the medical and health field is meant to serve all populations. Quality healthcare has to be given to everyone, regardless of characteristics like race, ethnicity, gender, nationality, and socioeconomic status. Every group should have a chance for an improved quality of life.
Still, this goal can become difficult if the medical and health field lacks diversity. If the field’s workforce does not have a variety of people, groups can become underrepresented, and the patient-physician relationship can suffer. In addition, there could be less perspectives, understanding, and communication.
While the medical field was largely homogenous in the past (white and male), there have been some changes as the field has progressed. The AAMC report from 2019 displays some of these changes:
- In applying to medical school, the percentage of women has not only become equal with that of men, but has also surpassed it.
- Although 64.1% of physicians were male in 2018, 35.8% of physicians were female. While this shows that women were still underrepresented in the medical field compared to men, it still signifies that more women were entering the workforce.
- 56.2% of active physicians in 2018 were white; however, 17.1% were Asian. There were less African-American and Hispanic physicians, at 5.0% and 5.8% respectively. Again, while white physicians continued to be dominant, the data displays that other races/ethnicities are gradually entering the workforce.
Interestingly, a more recent study has discovered that in the US, 44% of physicians were white and male in 2019, down from 54% in 2000. This decrease was attributed to the increase in women entering the medical field (mainly white and Asian).
Still, similar to the AAMC 2019 report, there was a continued lack of Hispanic and African-American physicians, with only a small increase for women in these groups and virtually no change for men.
These studies provide some hope that the medical field is slowly becoming more diverse, with groups like women and minorities becoming physicians. However, it’s clear that the medical workforce is still mainly composed of white men. Moreover, there continues to be a worrying lack of Asian, Hispanic, and African-American physicians.
Besides this pattern of underrepresentation, some physicians have faced discrimination or unequal treatment due to their gender, race, language, etc. In one 2020 study on Family Medicine that sought to document racism experienced by 71 physicians of color, it was discovered 23.3% of participants had been refused care by a patient due to their race. Similarly, participants who spoke English as a second language reported significantly more instances of racism from patients compared to participants who spoke it as a first language.
Some qualitative answers from participants included moments where they “were treated differently compared to [their] other non-black counterparts and overlooked for leadership positions” and “denied away rotations as a medical student with a foreign-sounding name from a foreign medical school.” Some participants also discussed experiencing microaggressions, such as when a nurse assumed a participant “was not a physician because of [their] race.”
Other specific moments can be found in the study page ranging from patients making assumptions about physicians to differential treatment from both nurses and patients.
This poor treatment can even extend to underrepresented physicians trying to be part of a hospital’s administrative team: an article from Modern Healthcare brings up a valid point about black professional healthcare workers not being able to speak up concerning issues of diversity, as they have the potential to be seen as “angry or difficult,” thus hindering them from gaining a leadership position.
Clearly, physicians in underrepresented groups, whether it be based on nationality, ethnicity, or race, continue to face discrimination, bias, and harmful stereotypes. This is an issue that not only negatively affects underrepresented medical students and physicians, but also the healthcare field in general.
Poor treatment and lack of opportunities can discourage these groups from pursuing a medical career, potentially resulting in a homogenous health field. Diseases and other conditions do not discriminate: the patient population is incredibly diverse, and the healthcare field should reflect this large number of perspectives and experiences in order to help patients feel comfortable and listened to.
So, how can more groups be encouraged to enter the medical field? While there is no guaranteed answer, ideas have ranged from increasing accessibility for these groups through low-cost/free introductory medical programs (ex. Stanford Medical Youth) to diversity training that can create a more welcoming clinical environment.
Ultimately, information and guidance concerning the pre-med process and the exploration of career paths in medicine needs to be spread to these groups to garner interest, as well as to show individuals that they have the possibility of becoming a physician regardless of their background. This could be done through free webinars, presentations, summer medical programs, mentors, online communities, etc.
It’s important to note that the incredibly high expenses of medical school also serve as a barrier to people with fewer resources. Scholarships, financial aid, accessible paid work, and a lowering of costs could help decrease the severity of this issue, though it could take a long time.
Clearly, diversity is necessary in a healthcare environment. It is not just for the “sake of diversity,” but to ensure that patients can feel comfortable and receive the most quality, effective care possible.
