Diversity in Medicine Saves Lives
Diversity in the doctor’s office literally saves lives.
That’s the finding of a recent study from Harvard. Researchers at the T.H. Chan School of Public Health examined outcomes for over 1.2 million Medicare patients treated by 44,000 internists at American hospitals. Patients treated by foreign medical graduates had better 30-day survival rates than patients treated by U.S.-educated physicians.
The study is only the latest to show that racial, socioeconomic, and international diversity aren’t just nice things to have within America’s physician workforce. They’re matters of life and death.
More than 31 percent of the U.S. population is Hispanic, Native American, or African-American. Yet people from these ethnic groups account for just 6 percent of practicing physicians. This racial disparity isn’t likely to change any time soon. Fewer than 14 percent of students admitted to medical school for the 2017-18 school year were black, Hispanic, or Native American.
Schools also lack economic diversity. About three in four medical students come from the richest 40 percent of families. Only one in twenty come from the poorest 20 percent of families.
It’s tempting to argue that an applicant’s race or socioeconomic background should be irrelevant in the medical school admissions process. Doctors are in the business of saving lives, after all. So why should we consider anything beyond smarts and skills when choosing the next generation of physicians?
In reality, a doctor’s background — his or her race, socioeconomic status, and country of origin — can have more impact on patient health than even the best academic credentials.
Consider that black, Hispanic, and Native American patients are more likely than whites to suffer from chronic diseases. And they’re more likely to put off or forgo needed medical care.
When people of color do seek medical care, they disproportionately turn to nonwhite physicians. Sometimes, they do so for language reasons. Two in five Hispanic patients consider whether a doctor can speak Spanish before choosing to visit. Other times, they do so because they’re more comfortable with doctors who look like them and may have shared similar experiences. Black patients report higher satisfaction ratings when treated by black doctors, according to a Department of Veterans Affairs study. Hispanic patients are likewise more satisfied with Latino doctors.
As a result, nonwhite doctors care for over 53 percent of minority patients and over 70 percent of non-English-speaking patients, according to a recent study in the journal JAMA Internal Medicine. The study concludes that “racial and ethnic diversity of the physician workforce may be key to meeting national goals to eliminate health disparities.”
Researchers at UCLA concur. In a recent study, they found that graduates of racially diverse medical schools feel they’re better equipped to address the unique health needs of minority patient populations.
Socioeconomic diversity is equally important. Doctors with parents who make less than $100,000 per year are more likely to enter family medicine, according to a meta-analysis of 57 different studies. Currently, there is a severe shortage of family medicine physicians and other primary care doctors. The shortfall hurts poor patients the most. Recruiting more poor and middle-class medical students would increase the number of doctors dedicated to treating disadvantaged populations.
Diversity of national origin is also crucial, especially as America’s immigrant population continues to swell. Since 1990, the number of foreign-born U.S. residents has more than doubled, to roughly 42 million.
The growth in the diversity of our nation’s population coincides with chronic doctor shortages across the United States. The Association of American Medical Colleges predicts a shortage of about 105,000 doctors by 2030. More than 40 percent of that gap could be in primary care.
Doctors trained abroad will play an outsized role in closing that shortfall. That’s in part because American medical school graduates refuse to do so. Only 15 percent of U.S. medical school graduates go into internal medicine, according to an Immigrant Learning Center report. Nearly half of international graduates choose the specialty.
Diversity is a top priority at the medical school I lead, St. George’s University in Grenada. Our students currently hail from 104 different countries. Eighty percent receive financial aid. Roughly three-quarters of our graduates go into primary care.
If the Harvard study is right that international medical graduates offer better care than their domestically trained counterparts, then the United States should holds its doors wide open to doctors from abroad.
Policies that block these doctors from practicing in the United States put Americans at risk by undermining their ability to access quality health care.
Richard Olds, M.D., is President of St. George’s University (www.sgu.edu). He was founding Dean of the University of California, Riverside, School of Medicine.