GE Foundation on Closing the Diversity Gap in Medicine

Executive thought leadership piece on the changing face of medicine, ghost written for GE Foundation Executive Director David Barash.

The Changing Face of Medicine

“When I look around, the vast majority of medical students and the vast majority of doctors don't look anything like me,” says Destinee Shipley, a first-year medical student at Morehouse School of Medicine in Atlanta and an African American woman.

Her experience isn’t unique. While there have been slow gains in recent years, the medical community struggles to grow a representative pipeline of doctors, nurses and other healthcare providers from underrepresented minority groups. For example, while African Americans comprise 13.4 percent of the U.S. population, they make up only 5 percent of doctors. Latinos are 18.5 percent of the country, but only 5.8 percent of physicians and 4 percent of nurses.

Today, there is an increasing focus in the medical field on closing this diversity gap. Destinee is a scholar in the National Medical Fellowships, Inc. (NMF) Primary Care Leadership Program (PCLP) — an effort co-founded by GE Foundation that aims to improve diversity in medicine and expand access to primary care in underserved communities. Programs like this are playing an important role in improving representation in medicine and making a real impact in minority patient care.

Minority communities disproportionately face barriers to healthcare. These include a higher likelihood of being uninsured; language barriers; lack of access to childcare, transportation or time off work; cultural differences with providers; as well as discrimination within the healthcare system.

Patient access to minority healthcare professionals can help address some of these barriers — but we need more of these diverse providers to enter the medical field. Programs like the NMF Primary Care Leadership Program play a key role in encouraging and elevating these diverse candidates who often later give back to their own communities.

“Growing up, I know that my family had a lot of different experiences with doctors. A lot of my family members are afraid to go to the doctor; they don't trust doctors because of the long history of problems and inequities in the medical field,” says Destinee on why she’s pursuing a career in medicine. “And so, for me, I want to make changes. I want to leave a positive legacy in the medical field.”

The data backs up the importance of diverse medical providers. Black patients are more likely to engage and to consent to preventive services with black physicians than they are when served by non-black physicians. Considering that black patients overall have markedly worse health outcomes than white patients, access to black doctors could help improve black patients’ care experiences. In fact, research suggests that by providing black patients with black physicians, the black-white mortality gap could be reduced by 19 percent.

“Having a diverse healthcare workforce is critical to promoting health equity. We know that underrepresented minority providers are more likely to serve in communities that are underserved by the medical system,” says Dr. Joy Jones, Director of NMF Scholarships and Programs. “These minority providers are more likely to have a higher degree of cultural competence and understanding of where [minority] patients are coming from and what their lived experiences are.”

Since 2012, the six-week Primary Care Leadership Program has provided students in the healthcare field from diverse backgrounds the opportunity to experience the challenges and rewards of primary care in community health centers across the United States.

In underserved communities, community health centers (CHCs) are a lifeline. They provide health services to the neediest Americans and offer strong primary care capabilities that decrease health care costs overall. While primary care physicians are the driving force within CHCs, the Association of American Medical Colleges (AAMC) predicts that the United States could see an estimated shortage of between 21,400 and 55,200 primary care physicians by 2033. This means programs like the PCLP that build a pipeline of primary care providers are more important than ever.

This year’s class of PCLP students completed their externships virtually due to the COVID-19 pandemic. They were given access to mentors and performed research projects using sensitive data to learn about the realities of primary care. Under typical, non-pandemic circumstances, scholars are assigned to community health centers where they participate in intensive, immersive experiences. Students participate in primary care service rotations through their CHC’s various departments, undergo leadership training and conduct a team-based service project that is truly valuable to actual site operations. For example, last year PCLP scholars at Lynn Community Health Center in Lynn, Mass. embedded with a homeless outreach project, which allowed them to work in the clinic seeing patients alongside a nurse practitioner and venture out into the field in the afternoons and evenings to conduct outreach.

“I think working for a social justice institution, where they can sort of see their ideals in play, is very formative for them, and really increases significantly the chances that they'll be involved in a social justice institution in the future,” says Dr. Kiame Mahaniah, CEO of Lynn Community Health Center and a champion of the Primary Care Leadership Program. “In fact, we're creating our own pipeline for future leaders within the community health center movement.”

Since the start of the program, National Medical Fellowships has provided more than 565 scholarships. Students come from a variety of backgrounds — 52 percent are African American, 21 percent Latino, 15 percent Asian American, 10 percent Caucasian (including students who are the first generation in their families to go to college and students from socioeconomically stressed households), and 1 percent native American.

“The Primary Care Leadership Program to me is not just about developing, good physicians. It's also about developing good leaders,” said John Paul Mauriello, a first-year student at Alabama College of Osteopathic Medicine who completed his PCLP externship at Lynn Community Health Center. “What I learned from my mentors at the Lynn Community Health Center is to be open, not just to experiences and ideas, but to people. And not only will that help you be a better physician, but it can also help you become a leader in your community.”

Applications for the 2021 PCLP are open through February 5, 2021. Eligible medical students, and graduate-level nursing and physician assistant students are encouraged to apply here: https://bit.ly/2KhyaQK