By Ronnie Cohen

(Reuters Health) – If U.S. medical schools tripled
enrollment of Black students and quadrupled enrollment of
Hispanics every year, it would still take another 30 years for
the physician workforce to look like the nation, a new study
shows.

Calculated another way, the number of Black and Hispanic
medical students who matriculated in 2015 would have to double
every year for 66 years to correct Black physician
underrepresentation and every year for 92 years to correct
Hispanic physician underrepresentation, the study found.

“I might not even be alive long enough to see that happen,”
said lead author Dr. Hector Mora, a 28-year-old resident at the
Hospital of the University of Pennsylvania.

Mora is Hispanic, and his co-authors on the research letter
published in JAMA Network Open are Black. As patients, medical
students and physicians, they have been painfully aware of being
in a minority.

What they did not know, could not find in prior research and
set out to determine was just how long it would take for the
physician workforce to reflect the racial and ethnic makeup of
the U.S. population.

Medical schools have admitted more Black and Hispanic
students in recent years. But underrepresentation is widening
because the increases have failed to keep pace with the changing
face of the American population, previous research has found.

Mora and his team used data from the U.S. Census Bureau and
the Association of American Medical Colleges to estimate the
number of years needed to eliminate the projected deficit of
Black and Hispanic allopathic doctors.

In 2015, of nearly 1 million practicing U.S. physicians,
46,133 were Black and 60,549 were Hispanic – in both cases
roughly one-third of the number necessary to be representative
of the population, the study found. At the same time, of some
20,000 allopathic medical school students, only 1,228 were Black
and 1,231 were Hispanic.

The researchers calculated a deficit of more than 190 Black
and Hispanic physicians per 100,000 Black and Hispanic people in
the U.S. Based on the numbers, they estimated that even if
medical schools quadrupled Black and Hispanic enrollment, it
would take more than 20 years for Blacks and 30 years for
Hispanic doctors to reflect the makeup of the U.S. population.

The numbers shocked and upset Dr. Mora.

“I don’t want to spend an entire career without seeing some
real progress made towards these issues,” he told Reuters Health
in a phone interview. “I hope that my children and my
grandchildren can have access to physicians that look like them
and they can identify with.”

The growing deficit, however, came as no surprise to Dr.
Danielle Laraque-Arena, a pediatrician and senior scholar in
residence at The New York Academy of Medicine, who was not
involved with the research.

“We know these facts,” she said in a phone interview. “And
yet the punch line, the main message, is we cannot continue what
we’re doing. We must fundamentally address this problem.”

The American Medical Association recognizes that racial and
ethnic diversity among health professionals promotes better
access to care and improves healthcare quality for underserved
populations.

Dr. Laraque-Arena was raised in Queens, home to Elmhust
Hospital, where patients frequently feel most comfortable
speaking a language other than English.

“In medicine, the most important thing is to take a good
history, listening carefully to the patient,” she said. “If you
don’t understand your patient’s symptoms and their environment,
then you won’t get the diagnosis or the patient’s understanding
of their own illness.”

Dr. Mora has seen his Spanish-speaking patients become more
open when he talks to them in their native language. “I’ve
noticed that sometimes it’s a little bit easier gaining their
trust,” he said. “And I’ve noticed that even as a patient.”

The study demonstrates that the medical establishment must
change if it wants the physician workforce to reflect the
nation’s diversity, Dr. Laraque-Arena said.

“It’s not by accident that we have a deficit in physicians.
It’s not. A system gives the result that it’s designed to give,”
she said.

“A system is organized with structural and racial inequities
built in, and then we’re surprised about the results,” she said.
“We have built the system.”

SOURCE: https://bit.ly/3NSxVHa JAMA Network Open, June 1,
2022.