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Op-Ed: COVID-19 showed we need a more
diverse doctor workforce
[The Center Square] Robert Grant | St.
George's University School of Medicine
Deaths related to COVID-19 were more than twice as high
among Black, Latino, and Native American people as among whites in 2020,
according to new research out from the National Cancer Institute. |
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 It's only the latest reminder of the glaring inequity that
plagues the U.S. healthcare system. Addressing that inequity will require
boosting access to care among people from marginalized groups.
That's partially a supply problem – the United States needs more doctors,
especially doctors who hail from historically underserved communities. Research
shows that doctors from these communities are not only more likely to return
there to practice but more likely to deliver better outcomes for their patients.
Over 83.7 million Americans live in places with limited access to primary care
doctors, according to the Kaiser Family Foundation. They're disproportionately
people of color.
Unfortunately, that figure will likely increase. A June 2021 report from the
Association of American Medical Colleges estimates that the United States could
be short 124,000 physicians by 2034.
Research has consistently shown a link between access to physicians and health
outcomes. Life expectancies in areas with fewer doctors are, on average, lower
than those in areas that have more. About 7,000 U.S. lives could be saved every
year simply by narrowing care gaps in the country's most underserved
communities.
To sustainably address the doctor shortage, we must recruit from the communities
that are most acutely experiencing it. Numerous studies have found that a
doctor's race or ethnicity is a strong indicator of where they eventually return
to practice. The same goes for language, family income, and whether the doctor
comes from a rural or urban area.
Patients also fare better when they can relate with the physician treating them.
A 2018 National Bureau of Economic Research study found that Black men had
significantly better health outcomes when treated by Black doctors.
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This was also true for preventative care. Black men
treated by Black doctors were 10% more likely to receive a flu shot
and nearly 30% more likely to submit to cholesterol tests.
It's on medical schools to produce the doctors that historically
marginalized communities need. Sadly, they haven't done a very good
job of that. Black and Hispanic people make up more
than 31% of the U.S. population -- but only a smidge over 20% of the
student population at U.S. medical schools.
Incoming medical students hail from disproportionately wealthy
families, too. Last year, the median income of parents of medical
school matriculants was $140,000 – double the overall median
household income in this country.
International medical schools, by contrast, have made addressing
inequity a priority. One-quarter of America's doctors attended
medical school outside the country. In low-income communities,
international medical graduates are one-third of the doctor
workforce. And in areas where the population is majority non-white,
IMGs are even more prevalent.
Graduates of international medical schools are also more likely to
go into primary care, where the need, especially in underserved
communities, is greatest. Of the U.S.-born international medical
graduates who matched into residency programs last year, roughly 70%
entered into primary care specialties.
The disparate racial impact of COVID-19 is a tragic example of those
inequities. Developing a more diverse doctor workforce is one small
way to work toward ending them
Robert Grant, MD, is the senior associate dean for clinical studies
at St. George's University School of Medicine, the largest sources
of physicians for the United States (www.sgu.edu).
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