Why We Need More Minority Doctors

Updated at 1:23 PM, February 10, 2012

Dr. Alden Landry

Dr. Alden Landry

“I’m an ER physician,” Dr. Alden Landry told me. “When I walk into patients’ rooms and start speaking to them and introduce myself as their doctor, often older black women will say, ‘Thank you for being my doctor! I’m so proud of you. I’m glad you’re going to be taking care of me.’ They say they feel more comfortable with me as their physician.”

Dr. Alden Landry practices emergency medicine at Beth Israel Deaconess Medical Center, but he’s more than just a doctor — he’s helping lead the movement to diversify medicine. He heads up projects on the issue at Beth IsraelMassachusetts General Hospital, and Harvard Medical School

“It’s not always a rosy picture talking to my patients,” he explained. “Early in my career, there was a patient — an older black man — [who] had been in the emergency department for a number of hours, and they’d placed him in the hallway to wait. I went over to talk to him and ask him if he needed anything. ‘Why do they always put the black patients in the hallway?’ he asked me.” I can’t necessarily say he was placed there because of his race – but when you hear comments like that, it shows that patients don’t feel appreciated when they’re receiving medical care, that they feel like second- or even third-class citizens, that their concerns are being overlooked.”

Dr. Landry, among many in the medical field, feels there’s a way to help solve this problem: recruit more African-Americans and Hispanics to be doctors. That’s why he’s heading up the Tour for Diversity as its co-director. The tour is a new initiative funded by the Aetna Foundation – and, yes, it is an actual tour. Later this month, Dr. Landry will join four other doctors, four medical students, a dentist, and a health professions advisor on a bus tour to five historically black colleges and universities in the South where he and the team will hold sessions about applying to medical school, encourage mentorship and connect with student organizations.

The Importance Of Diversity

So how pressing is the need for more minority doctors? It turns out the physician workforce is a far way from reflecting the diversity of the general population. While 1 in 8 Americans is African American, only 1 in 15 doctors is. And though 1 in 6 Americans identifies as Hispanic/Latino, only 1 in 20 doctors does. (For more detailed diversity data, check out the 2010 U.S. Census and the American Medical Association’s Diversity in the Physician Workforce: Facts and Figures 2010.)

Dr. Samantha Kaplan

Dr. Samantha Kaplan

After speaking with Dr. Landry, I decided to have a chat with Dr. Samantha Kaplan, an obstetrician gynecologist and professor at Boston University School of Medicine, where she is the assistant dean for Diversity and Multicultural Affairs and the director of the Early Medical School Selection Program. If Dr. Landry’s Tour for Diversity helps stimulate interest in medical school, Dr. Kaplan’s program helps sustain and cultivate that interest. Her program partners with historically black colleges and universities as well, offering undergraduate students a chance to take courses at the BU School of Medicine and participate in summer and year-long programs that help them transition to medical school.

I felt an instant rapport with Dr. Kaplan. She’s of mixed heritage too, ambigously brown like myself. She told me a story of her early days at the adolescent gynecology clinic at Boston Medical Center: “I’m of small frame, and I looked kind of like a kid. I looked younger than I was — between that and skin color, I had an amazing affinity for patients and they for me. I could get them to open up and to listen to me and to entertain with some seriousness the advice I gave them. I felt like a buddy, a sister — I could tease them, and they didn’t feel judged.”

Dr. Kaplan offered four reasons why we need more minority doctors. Here she is, paraphrased:

  • To serve those who need it most: “Underrepresented minorities are more likely to go back and serve in their communities. This means more physicians are treating populations that are traditionally underserved in medicine. Our country has a discouraging history of not being able to make care accessible to minority groups — whether it’s because of lack of insurance, limited physical access (such as not having a clinic nearby, inadequate transportation, limited time), or even racism. It’s important to put physicians into communities who need care.”
  • To encourage a sense of affinity: “There’s research on how patients respond to physicians with whom they feel some concordance — whether it’s culture, race, language, gender. Conversations are more patient-centered; the patients ask more questions, and more data about what’s actually bothering them can be extracted, leading to better outcomes.”
  • To offer cultural understanding: “We know that different cultures have different belief systems around health. While it’s not necessarily true that all people from one culture think the same thing, it’s reasonable to assume that, if you as the patient feel affinity with your doctor and you feel safe and you don’t feel judged, there might be more connection.”
  • To enhance the field of medicine overall: “Imagine you have a room with five people who are exactly the same — conversation is limited. But if you have five people who are entirely different, you’re going to encourage much greater learning. All five will leave the room with a much broader understanding. The population we serve is diverse. In order for all of us to leave our education, our grand rounds, our office, with a broader understanding of how to approach our patients, we need our colleagues to reflect our population.”

The Data

Dr. Kaplan’s points are backed up by a number of studies. For instance, research has shown that minority doctors are more likely to work with underserved and indigent populations (for a summary table, see pages 2-3 of the Commonwealth Fund’s report on disparities). These are the same populations who bear disproportionate rates of disease and who have the most limited access to care. (For more, see the CDC Health Disparities & Inequalities Report.)

The sense of affinity and understanding that Dr. Kaplan spoke of is captured in studies focusing on patient-physician concordance. Time and time again, it’s been shown that feeling a sense of familiarity enhances communication and patient satisfaction. Here’s the conclusion from just one of the studies:

The physician-patient relationship is strengthened when patients see themselves as similar to their physicians in personal beliefs, values, and communication. Perceived personal similarity is associated with higher ratings of trust, satisfaction, and intention to adhere. Race concordance is the primary predictor of perceived ethnic similarity, but several factors affect perceived personal similarity, including physicians’ use of patient-centered communication.

Finally, a study published in JAMA found that the more underrepresented minorities there are in a medical school’s student body, the more likely it is that students from that medical school (regardless of their own race) will “rate themselves as highly prepared to care for minority populations.”

What The Future Holds

Fast forward to 2050 — that’s only two generations away. According to projections by The Pew Research Center, the U.S. will look much different by that time: more than half of Americans will be people of color. As our population increasingly diversifies, so too should our medical workforce.

“We need to make sure there’s equity in care,” Dr. Landry explained. “You want to make sure patients don’t feel overlooked in the health care system. Unfortunately there’s an unconscious bias that may exist; there are systems that are in place that may disenfranchise one group of patients over the other. We want to level the playing field for all patients.”

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  • myhealth

    wow that’s such a racist statement Dr. Alden Landry
    So the need for more minority is to better comfort your own kind and the flip side would be whites rather see a white doctor instead of a black doctor?

    • ThatGuy

      It’s not racist. Data shows that blacks have distrust of medical professionals. Simply look back at the Tuskegee experiment and how the US gov treated blacks and their health. Plus, I’m sure there are whites that are distrustful of minority physicians.

  • Harsh Patel

    I am using this article in my Research paper for Composition II and as a current college student and future medical student, I believe that diversity is very important and fully support the claim mentioned in this article. It’s a great article! Definitely going in my Annotated Bibliography!

  • HR

    i feel like by “minorit” you mean black. especially in higher echelon med schools, harvard for ex, 75% of students are minorities- by which i mean, indian, east asian, and jewish- this is not a surprise and the pts don’t thank us. this article seems to clearly mean black or possibly latino
    ps dr. kaplan is probably jewish too so very much like a lot of her fellow grads

    • Jh

      also dr. kaplan’s arguments are kind of ridiculous- being of a different race didn’t let her “tease” the patients more or be a buddy; that is due to personal charm. As well,having people of different races have a “conversation” doesn’t add to a medical discussion. What we as professionals, discuss is evidence based approaches as i would hope you would expect from your doctors. we don’t sit around and talk about race..  This is the worst kind of journalism; it’s like the most cursory approaches to feminism- we as women or as “minorities” earned the right to be equals in the profession not to waste time talking about race. I expect no less from someone with no science background ( an anthropology degree and a masters in health journalism is an embarassing lack of credentials- it’s not the brownness that’s ambiguous; it’s your understanding)

    • klm

      the “minority” they are referring to here is really “underrepresented minority” which they defined as black and latino though many smaller sub-groups fall into that as well.

  • John

    It seems as if most black doctors are from upper class families and/or Caribbean families.  At the same time, a giant proportion of the medical workforce is from India and Pakistan and it’s very politically incorrect to say that FMG’s “can’t speak the language” or are otherwise less able than American born grads.

    • HR

      yes, much like the rare (African Canadian)  hockey players, their parents actualy have to, you know, send them to school/training and not out to the street corner or wherever

  • http://twitter.com/MNAHEC Minnesota AHEC

    Wonderful thoughts. As our healthcare system changes we will need a changing and diverse workforce to meet these complex needs.

  • Anonymous

    We patients want to be listened to and believed. Having culturally competent health care providers is key. Reading that some people will take back what they learn to their community is encouraging. If they have a doctor or nurse who can speak their language or knows their culture, than accurate health information is more likely to be passed along and actually put to use.

  • http://mrepidemiology.com/ Mr Epidemiology

    One thing I will add to the above is that minority doctors may also be able to speak the language (literally) of their patients – especially older patients who may only be able to express themselves in their own language and not be able to translate. For example, my grandmother came to visit when I was a kid, and was glad when she could speak to our doctor directly and didn’t need a translator.

    Great piece!

    • Jack

      EVERYONE should Speak English

      • Liberated Mocha

        your statement is the very seed of racism and discrimination

        • BostonBeauty

          Racism? Because someone thinks you should speak ENGLISH in a country where ENGLISH is the official language!?!?!? People are always trying to be so damn politically correct. As an American, when I travel abroad to countries where ENGLISH is NOT the official language, I’m just out of luck… I work in a town with a big population of Hispanics. During the day, they’ll speak to each other in Spanish, in front of clients and other staff. I’ll complain every time. Speak ENGLISH in America or quit…

          You can’t even express an opinion nowadays without someone calling you a bully, or racist, or some type of name…

          Our soft society cries about everything… MAN UP!!!

          Oh yeah… Full disclosure: I’m a Black woman…

  • MizMac

    Wow, can’t you read?  This article is not about science, not intended to be.  It is about  ‘health disparities,’ and what some right-thinking medical professionals are trying to do about it.  And what are you doing to help address ineqities in healthcare?  Anything?

    • http://twitter.com/aayesha Aayesha Siddiqui

      Thanks for your support, MizMac!  

      And you’re spot on about the importance of health disparities! Minorities and low-income groups disproportionately suffer from disease and have limited access to the care they need. Dr. Kaplan’s first point above is that minority doctors are more likely to serve the communities who need it most. So, by having more minority doctors, we’d be increasing access to care for those who normally have very little access – and this is one step to reducing health disparities overall.

      For those readers who are research-curious, there have been several papers that converge on the point that minority doctors go and work in underserved communities and with indigent populations. For a great review of the literature on the subject, see pages 2-3 of the Commonwealth Fund’s report: http://bit.ly/yTr6fY (PDF)

      The take home point? Minority doctors help reduce health disparities (disproportionate rates of disease, limited access to care) by going into the communities that need it most. 

      Thanks again, MizMac, for your input!

      • MizMac

        Thank you, but my remark was not directed to you, the author, Ms. Siddiqui. Someone else had commented to say that your article wasn’t “scientific” and that is what I reacted to and posted my reply about.  I see that the person has now removed the original comment, which in turn may have rendered my reply moot.

        • http://twitter.com/aayesha Aayesha Siddiqui

          Hi again, MizMac! Yep, I understand that it wasn’t in response to me, but I just wanted to address the first comment’s curiosity about the science.

          • http://www.schweitzerfellowship.org/ Patrice Taddonio

            Thank you for this thoughtful and terrific piece — it’s highly relevant to our work at The Albert Schweitzer Fellowship to train culturally competent and service-minded health professionals with the skills and dedication to meet the health needs of populations that have been traditionally underserved.

      • JH

        well, the “science”, or facts are still poor. For example, what does it add to say that students self-identify as better able to deal with minorities when they go to school with them? that adds absolutely nothing. ii doesn’t mean that they actually are better able, or more understanding, or more effective, or anything!!!

        • Harsh Patel

          Dude, let me step in. Please.

          I would like you to read this book: Making the Most of College (Students Speak Their Minds) by Richard J. Light. Refer to chapter 3: Suggestions from Students pg. 23 as it highlights the need for diversity and will clear some things in your mind and answer the question: “what does it add to say that students self-identify as better able to deal with minorities when they go to school with them?” And, it is a Harvard University Press book, so it’s extremely credible!