Professional medical associations have taken public steps to address bias in 2020. In January, the American Academy of Family Physicians (AAFP) released an implicit bias training guide for physicians and health professionals. In June, the ACR issued a position statement on its commitment to promote inclusivity and address racial disparities specific to rheumatic disease patients, such as higher mortality among Black patients with lupus, which specifically stated that racial inequality impacts the lives of ACR/ARP members and their patients.
More diversity and cultural competence in medical school programs and the physician workforce may benefit racial and ethnic minorities, women and LGBTQ patient populations, although this remains a theory, said Dr. Nivet. “This would create an environment where it’s not just individuals benefiting from the chance to go to medical school, but as healthcare providers, to bring their backgrounds and experiences to patients or to underserved communities.” Non-minority students and clinicians may benefit from exposure to different perspectives from peers who are from different racial, ethnic, socioeconomic or other backgrounds, he said.
Retention & Satisfaction
Diverse hiring and student recruitment programs, as well as implicit bias training courses, are only the first steps to more inclusivity.
“What do we want diversity to accomplish? We want to elevate our rationales and approaches to create more equitable, inclusive environments,” said Dr. Nivet. “We should not just focus on recruitment or retention, [which may mean] keeping people on staff even if they’re unhappy or not thriving in their programs.”
Next steps for institutional leaders include creating cultures that encourage individuals from diverse backgrounds to stay and achieve success benchmarks, which may need to be created by said leaders. Benchmarks may include medical students graduating, residents finding jobs or academic professionals attaining tenure. Find ways to assess, measure and track the satisfaction levels of students, educators and researchers, so you know that any investments in implicit bias training or diversity efforts are really working, he said.
What do terms like bias, diversity & inclusivity really mean?
“Focus on your institution’s culture and mindsets. Diversity can go from an adjunct concept on the periphery to a core principle of your institution when you think of excellence in optimal patient care delivery, research or education,” Dr. Nivet said. Leaders must ask deeper questions about the fruits of their diversity efforts in training and research. For example, what if residency program graduates are working only in suburban areas, not rural or other underserved areas? “What about your research agenda? Are you still primarily valuing the basic sciences, or are you giving equal weight to translational, community engagement or comparative effectiveness research? Are people thriving in promotion and tenure only in basic sciences, or is this happening in other areas?”
