Melinda K. Abrams, Anne Beal
Healthcare Workforce Diversity: Developing Physician Leaders, Testimony before the Sullivan Commission on Diversity in the Healthcare Workforce, Anne C. Beal, M.D., Melinda Abrams, M.S., and Jolene Saul, The Commonwealth Fund, October 2003
Thank you for this invitation to testify regarding the importance of workforce diversity in healthcare. My name is Anne Beal. I am a physician and a Senior Program Officer for the Commonwealth Fund. I commend Dr Sullivan for convening this special commission, and for bringing attention to the issue of diversity in the healthcare workforce. This is a critical time to develop a healthcare system that is responsive to, and reflects, the reality of American racial and ethnic diversity.
Racial disparities in clinical care and health outcomes are a well-described public health problem in the United States. While diversity in the health care workforce is a crucial mechanism for improving the health system's ability to care for minority patients, we should also pay attention to diversity among physician leaders.
Physician leaders develop health policies that influence regulation, financing and delivery of health care. In addition, those who serve as medical school faculty set research agendas, influence medical education, and serve as role models for the recruitment and retention of both minority and majority students. These physician leaders do more to address disparities than individually care for patients; they are in positions to address disparities by influencing healthcare training and health systems as a whole.
The Commonwealth Fund's commitment to eliminating disparities in health and healthcare is demonstrated through our program work, much of which is being conducted by minority medical faculty. The Fund recognizes that they contribute work that addresses disparities, while we contribute to the advancement of their careers.
All of these projects are being led by minority medical faculty, and they provide valuable contributions to our understanding of the prevalence of disparities and, more importantly, to the mechanisms by which they may be eliminated.
The Commonwealth Fund's single greatest contribution to promoting minority physician leadership is the Commonwealth Fund/Harvard University Fellowship in Minority Health Policy. Several years ago, our president, Karen Davis, decided that she no longer wanted to attend high-level health policy meetings at which no minorities were "sitting at the table." Recognizing that there were no training programs to prepare healthcare professionals to enter public health and health policy leadership positions, the Fund's board of directors approved the establishment of the fellowship. Under the leadership of Dr. Joan Reede, Dean for Diversity and Community Partnership at Harvard Medical School, the fellowship was initiated in 1996.
The fellowship combines an intensive year of training in health policy, public health, and management with special programs focused on minority health issues. In addition, our fellows must also complete a practicum. Some of the topics have included
At present, 35 alumni physician fellows are actively engaged as leaders in health policy, research, and service delivery to minority communities. Among our alumni are:
As can be seen from the work of the physicians we have mentioned, they are addressing disparities in care at a level that can impact more patients than any one physician can serve. The potential contributions of future minority physician leaders will be critical to our ability to address disparities, and we must do all that is possible to support and promote their careers. Therefore, I would make the following recommendations:
My remarks today have focused on physician leaders, however, diversification of the health care workforce must occur across the all health professions. Development of physician leadership is critical, but is only one important step toward providing more appropriate care to the US population. The Fund has a longstanding history of supporting projects to improve the health of minority Americans. We stand ready to partner with others to make a difference in eliminating racial and ethnic health disparities.
The Commonwealth Fund/Harvard University Fellowship in Minority Health Policy
Cultural Competence in Health Care Website
Cultural Competence in Health Care: Emerging Frameworks and Practical Approaches, Joseph R. Betancourt et al., October 2002.
Diverse Communities, Common Concerns: Assessing Health Care Quality for Minority Americans, Karen Scott Collins, et al., March 2002.
Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, Institute of Medicine, 2002