When I think of diversity from the aspect of healthcare delivery, I think of it as reflecting the balance between the healthcare workforce and the patients that it serves. Diversity across the healthcare spectrum is critically important to ensuring we can better represent and better serve the needs of our patients.
The American Medical Student Association (AMSA) reports that while 26 percent of the American population is Black or African American, Native American or Latino, only 6 percent of practicing physicians are of the same racial or ethnic background.
According to AMSA, part of the problem is a lack of minority faculty at medical schools in the U.S. Only 20 percent of the nation’s minority faculty are at three predominantly minority medical schools in the U.S., and three medical schools cited in Puerto Rico.
The situation is not much better in the physician assistant (PA) population. According to data from the Physician Assistant Education Association (PAEA), over 80 percent of matriculating students from PA programs are white. Hispanic and Latino students compose 6 percent of the matriculating PA students and Native American and African American matriculating students compose a little over 3 percent. On the PA faculty side, more than 80 percent of those who reported are white, a little over 5 percent are Black or African American, with just under 4 percent Hispanic / Latino. While there are limitations in that all might not choose to disclose ethnicity, it is clear that we are facing disparities in representation in our workforce.
The issue of diversity goes well beyond race and ethnicity — although, new data from the Association of American Medical Colleges (AAMC) and PAEA show respectively the newer upward trend of women in the physician and PA workforce. Gender, age, and LGBT representation all should be considered when talking about diversity of the healthcare system in U.S. While strides are being made to ensure that our provider workforce is more culturally, racially, and ethnically sensitive to the patients that rely on them for their care, it is clear that more needs to be done
So, what can we do? There are no easy answers. From my perspective, there are a number of things that will ensure a diverse workforce in coming years.
1. We need to continue outreach to potential medical students in all communities. One thing that PAs have led is called Project Access. This is a grassroots outreach program that AAPA and PAEA have developed, and PAEA leads. They created the Project Access toolkit, which is a resource to help PA students reach out to schools and community organizations to get students involved in medicine.
Higher education in medicine has two components. Opportunity (or the means and resources to achieve success), and Possibility (the awareness of a profession like medicine presented in a manner to make young underrepresented minorities aspire to reach beyond what them may seem are overwhelming obstacles to a graduate level education).
2. To recruit more students from diverse backgrounds, we must also enable them to succeed in their education, recognizing that a diverse workforce is essential to improving healthcare delivery. The PA Foundation offers several scholarship opportunities to underrepresented or disadvantaged students in order to assist them in pursuing their dreams of studying medicine.
Additionally, the Tour for Diversity visits schools of all levels about the country to educate, inspire, and cultivate future physicians and dentists of diverse racial and ethnic backgrounds by forming local connections in order to fulfill a national need. Raising awareness of these programs and utilizing them to nurture future students will be key in creating a diverse future workforce.
3. We need to focus on underrepresented minorities in faculty recruitment also. The student population needs mentors and role models from their neighborhoods and communities among their faculty to reflect their life experience and to see directly the picture of success.
4. Community providers and faculty in medical education programs need continual diversity education to improve understanding and awareness of complex diverse communities and diversity issues that they will confront throughout their professional life times. The AAMC has several free resources on diversity training.
This is a challenging problem affecting all levels of the medical educational system. I've been a PA for 34 years and progress in this area seems slow. It is my hope that the more aware we are regarding diversity issues throughout our healthcare system, the more we can do to create a system that better serves our patients who rely on us. These first steps are worth taking and necessary on the journey of addressing diversity issues.