The Compelling Case for Diversifying Medicine

Why Medicine Needs You

While it is certainly true that being a physician has the potential to change your life in so many positive ways, the impact of you becoming a practicing physician can have on the wider public cannot be understated. This effect of a more diverse physician workforce on vulnerable communities in particular cannot be understated. Why? Because the science shows that physicians from diverse backgrounds simply practice differently than “mainstream” doctors. They practice where most doctors won’t. They ask different questions. They research what most mainstream doctors don’t think to. Patients connect to them differently. They lead differently. They simply exist in the world, and hence the healthcare field, differently.

An Increasingly Diverse Nation, a Homogenous Physician Workforce

And that’s important. Because modern US medicine, for all its positive aspects, is a relatively homogenous. And that remains the case, even while the U.S. becomes increasingly diverse. According to 2017 census projections (based on 2010 Census data), the nation will be “minority white” in 2045. At that point, whites will comprise roughly 49.7% of the population compared to 24.6% of Hispanics and 13.1% of blacks, 7.9% of Asians and 3.8% multiracial.

Today, 8.9% of physicians in total identify as Black or African-American, Hispanic or Latino, and American Indian or Alaska Native. Africans comprise 13% of the nation but account for 4% of the physician population. Black men in medicine are particularly scarce, with roughly two-thirds of Black or African-American applicants are women (AAMC Data Warehouse: Minority Physician Database, AMA Masterfile, and other AAMC data sources).

What’s more, the racial and ethnic breakdown of medical school graduates have remained consistent over time despite large demographic shifts in America. According to the Association of American Medical College (AAMC), Whites and Asians represent the largest proportion of medical school graduates. At 58.8% and 19.8% of graduating medical students (respectively), these two groups comprised over three-quarters of medical students graduating in 2015. That same year, Black or African American comprised 5.7% and Hispanic or Latinos 4.6% of medical student graduates, despite being 13.4% and 18.1%, respectively, of the U.S population that same year.

Sure enough, medicine has not made gains in the area of diversity for decades. Some sobering facts:

  • Since 1978, there has only been a 4% increase in the proportion of Hispanic medical graduates, and less than a 2% increase in black graduates
  • The number of black men in medical school has DECLINED since the 1990s. Black women outnumber black men 2 to 1 in medical school.
  • During the period from 1980 to 2016, applications from all groups increased. The admission rate remains notably lower for black applicants than for other applicants, with 35.4% of Black/African-Americans gaining acceptance compared to 44.4% of Whites, 42.6% of Asians and 42.2% of Hispanics or Latinos.
  • Only 54 Native American students enrolled in medical school in 2016.

Diversity as an Antidote Poor Health Outcomes

Meanwhile, there is good evidence that a more diverse medical workforce will improve health outcomes. Black, Hispanic and immigrant physicians are much more likely to practice in underserved areas and care for the uninsured and patients on Medicaid. They also are more likely to pursue specialties with critical doctor shortages such as primary care. Nearly a quarter of American Indians or Alaska Natives (22.5%) practice family medicine.

Importantly, a more diverse workforce would also shift the field of medicine in more subtle ways. More women, LGBTQ and underrepresented minorities in medicine, especially in leadership position means new perspectives, ideas, and more innovative ways of practicing medicine. It means more structural biases and inequalities are recognized and addressed. It means the research questions that are being asked and studied are broadened. And in time, with a shift in the physician workforce, the status quo will change.

And let’s be honest…It needs to.

Because right now…the US Healthcare system is failing. Badly.

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Dr. Brittani James

Brittani James, MD is an Attending Family Medicine Physician who practices on Chicago's South Side. She co-founded Med Like Me with her twin sister, Dr. Brandi, as a passion project. She is dedicated to working with underserved and vulnerable populations and mentoring the next generation of diverse physicians.

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