Minority Medical Students are Crucial to the Future of Healthcare in America
At the first sign of a foreign invader, the body quickly selects and nurtures specialized cells, the ones best suited for the mission, and provides them the resources to overcome the invasion and reestablish health. Many times, an overwhelming and proactive assault eliminates the problem promptly and effectively. The importance of primary care physicians, consisting of general and family medicine, general pediatrics, and geriatric medicine, is unsurpassed in the American healthcare system. Their role allows them to be the first line of defense in disease prevention and diagnosis, improving the quality of everyday life and decreasing costly and unnecessary trips to the ER.
Considering the importance of these practitioners, it’s alarming that there will be a shortfall between 12,500 and 30,000 primary care physicians by 2025. This shortage will be especially pronounced in low income underserved areas where recruiting and retaining primary care physicians is particularly difficult considering the long hours and frequent on calls. With a deficiency of this magnitude, a significant decline in the quality and availability of health care provided to the American public will become a reality in the near future.
Mirroring how the body handles a crisis, the most effective solution is to select and educate the physicians most likely to reduce the shortage. In this case, the focus should be aimed towards the recruitment of minority physicians.
Dr. Lyndonna Marrast, the lead author of a study regarding the role of minority physicians’ care of underserved patients, argues that recruiting more minority doctors works because experience has shown that underrepresented minority status is more predictive of serving the underserved than socioeconomic status and rural or urban upbringing.
The study further confirmed that patients, who have low incomes, are from racial and ethnic minority backgrounds, have Medicaid insurance, or do not speak English – groups that generally have trouble accessing medical care – are substantially more likely to receive their care from a minority physician.
According to projections by The Pew Research Center, more than half of Americans will be people of color in 2050. As the population continues to diversify, the physician workforce should follow accordingly. Furthermore, many minority patients prefer to be treated by minority physicians. Several studies indicate that the physician patient relationship is strengthened when patients are able to see themselves in their physician. Patients generally feel more comfortable being treated by a physician who is the same color, speaks the same dialect, or comes from the same cultural background. This connection is crucial to forming rapport that encourages patients to ask more questions, which can lead to helpful conversations and successful diagnostics.
For the solution presented above to be effective, there are fundamental challenges that must first be overcome regarding the education of minority students, several of whom are first generation would be physicians. Many of these students are generally not prepared in public high school for the intensity of the premedical curricula in college. This rift requires them to seek additional post-baccalaureate training (incurring even more debt in addition to what was the incurred for the bachelor’s degree) to improve their credentials with hopes of attending medical school.
Without including undergraduate education, the average medical student in 2013 graduated with $169,901 debt. Combining the exorbitant cost associated with medical school and the fact that primary care physicians’ have much lower salaries than doctors who specialize, it’s easy to understand why minority students may prefer to go into specialties more lucrative than primary care.
With the recent drastic change in healthcare, the Affordable Care Act has expanded insurance coverage for low-income, uninsured patients, many of whom are minorities. Danny McCormick, a physician at Cambridge Health Alliance, and an associate professor of medicine at Harvard Medical School further explains, “There is a lot of concern that there will not be enough physicians willing and able to care for them” and that “medical schools will need to more fully consider the physician workforce needs of the healthcare system as a whole in admissions decisions.”
Further commentary in JAMA encourages medical schools to admit more minority applicants, even if some of their science and other academic scores are lower, because minority physicians show more commitment to serving poor and minority populations.
Currently, feasible loan repayment and forgiveness programs do exist for those going into primary care with a commitment to serve underprivileged communities, but they must be increased in magnitude. In addition, health care policy should be revised to boost workforce diversity by funding programs that encourage the recruitment of minority students and medical faculty. Increasing the racial and cultural diversity of physicians’ in the U.S. will be critical to providing the highest quality care for members of all socioeconomic classes. Since minority medical students are more likely to become primary care physicians that work with underserved population in their role as first line defenders, it’s imperative that actions be taken now to ensure there are enough of them in the future.