In the first of a series of policy papers, ACP suggests evidence-based solutions to eliminate barriers and inequities in education
Feb. 5, 2021 (ACP) – Racism and discrimination remain common in American medicine, and the American College of Physicians believes it's time for a change. In a new policy paper, ACP offers guidance for creating a more diverse, equitable and inclusive physician workforce to better serve patients and for eliminating disparities at all levels of education to ensure patients achieve health literacy.
“Enhancing education and workforce policies to improve the health literacy and socioeconomic well-being of patients and to have a physician workforce that is representative of the patients it serves is essential to a comprehensive approach in reducing disparities in health and health care,” said Dr. Omar Atiq, chair of the ACP Health and Public Policy Committee. “All arenas of the health care workforce should be incentivized to implement evidence-based best practices in the recruitment, retention and advancement of health professionals affected by discrimination. Above all, we must provide a level playing field where all persons, regardless of their race, ethnicity, religion and personal preferences, should be treated with respect and dignity and provided with equal opportunity.”
ACP offers recommendations in “Understanding and Addressing Disparities and Discrimination in Education and in the Physician Workforce,” one of a series of policy papers self-published on the ACP website. These papers make up the “Comprehensive Policy Framework to Understand and Address Disparities and Discrimination in Health and Health Care” and offer evidence-based policies that seek to eliminate “racial, ethnic, religious, and cultural disparities and discrimination in education and in the medical workplace.”
ACP, which is dedicated to an effective and equitable health care system, believes the grim statistics about the effects of discrimination require urgent action. “Therefore, ACP decided to perform a comprehensive evaluation and suggest evidence-based solutions to these important life-and-death challenges,” Atiq said. “The audience for this report is all the physicians and other health care professionals who have made it their life mission to heal the sick and injured in the most altruistic manner possible; the policymakers who have taken the responsibility of formulating evidence-based policies to create a more perfect union, where all women and men are treated on an equitable footing; and the society at large, which knows that we are as strong as our weakest link.”
In the policy paper, ACP discusses the importance of ensuring a diverse health care workforce to build trust and understanding between patients and health care workers by enhancing the physician pipeline and providing patients with the necessary knowledge and skills to achieve health literacy. “ACP proposes enhanced funding for equitable early education and experience for disadvantaged students,” Atiq said. “We should design health care career pathway programs to engage and connect students affected by discrimination and expose them to medical careers while in school and college. Medical schools should implement programs and policies to attract, recruit, retain and graduate such students.”
ACP proposes the following goals:
- Public policy must support efforts to acknowledge, address and manage preconceived perceptions and implicit biases of physicians and other clinicians.
- Health care facilities and medical schools and their clinicians and students should be incentivized to use patient-centered and culturally appropriate approaches to create a trusted health care system free of unjust and discriminatory practices.
- Institutions and medical schools should implement policies and practices to eliminate racism and discrimination experienced by health care professionals, especially medical students, residents and faculty. Black, Indigenous, Latinx, Asian American, Native Hawaiian, Pacific Islander and other persons affected by discrimination must be treated with respect and dignity; have opportunities for leadership, mentorship and advancement; be empowered to report harassment, abuse and other transgressions; and be ensured action is taken to support them and prevent future abuse.
- Medical and other health professional schools should revitalize and bolster efforts to improve matriculation and graduation rates of racial and ethnic-minority students. Institutions of higher education should appropriately consider race and ethnicity as one factor in determining admission to counter the impact of current discriminatory practices and the legacy of past discrimination practices and better reflect the current composition of the population.
- All arenas of the health care workforce should be incentivized to implement evidence-based best practices in the recruitment, retention and advancement of health professionals affected by discrimination.
- Policymakers must strengthen U.S. education at all levels to improve health, health literacy and diversity in medical education and in the physician workforce. ACP calls for sufficient funding for schools, particularly those in low-income communities, and calls for all students to have equitable access to qualified teachers, a rigorous evidence-based curriculum, extracurricular activities and educational materials and opportunities.
- Transparency and accountability are necessary. Federal and state funding should positively support and incentivize these efforts and hold institutions accountable if they fail to make progress in achieving greater diversity, equity and inclusion.
ACP suggests the following actions to further these goals:
- Develop a hiring diversity strategy to recruit racial and ethnic-minority candidates by drafting open job descriptions, broadly advertising open positions outside of traditional venues, better understanding the pathway of diverse talent and conducting outreach to develop more relationships with diverse candidates.
- Implement health care career pathway programs to engage and connect students affected by discrimination and expose them to and advance their readiness for careers in medicine.
- Support full compliance with Liaison Committee on Medical Education accreditation standards around student and faculty diversity.
- Encourage mentorship and sponsorship and provide training for faculty on how to be effective mentors and sponsors.
- Offer career coaching and leadership development programs for those underrepresented in medicine.
- Require the inclusion of physicians affected by discrimination as job candidates and members of search committees when possible. Members of search committees should receive training and educational resources on implicit biases.
- Ensure diversity on all committees, councils and boards to achieve inclusion, comprehensiveness and mechanisms for accountability.
“As healers and community leaders, members of ACP are the conscience of medicine,” Atiq said. “ACP will continue to strive to give voice to their aspirations in a befitting manner with thorough research and thoughtful solutions.”
The policy paper “Understanding and Addressing Disparities and Discrimination in Education and in the Physician Workforce” is available on the ACP website.