How organized medicine is reducing health care disparities

Ardis Dee Hoven, MD , Former President

When I participated in the National Hispanic Medical Association’s (NHMA) annual meeting several weeks ago, I was struck by the tangible sense of unity in the air. 

The group is keenly focused on improving health care delivery for Hispanic populations, diving into areas such as diabetes and cardiovascular disease outcomes, which we know affect minority populations in disproportionately higher rates.

At the AMA, we’re working to address these diseases through our Improving Health Outcomes initiative, and now joining this effort is the Commission to End Health Care Disparities, which recently realigned its strategic plan to focus more sharply on reducing disparities tied to these two deadly diseases. The commission will collaborate with the AMA’s existing initiative, and will leverage the results from our pilot programs to prevent type 2 diabetes and heart disease. 

The commission—a group of more than 70 member organizations led by the AMA, the National Medical Association and the NHMA—also is starting its own pilot program in the Chicago area. It is centered on improving the collection and reporting of accurate and reliable data about patient race, ethnicity and preferred language. 

Robust data such as this can help us better understand and address health care disparities in ambulatory settings. By this time next year, the commission expects to have a toolkit that any physician can use to improve data collection and reduce disparities in their practice.

Reducing disparities doesn’t happen only at the patient level, however. Our workforce should reflect the populations we serve, and the commission is setting its sights on improved promotion of diversity in the health care workforce as well.

Minority patients tend to choose minority physicians, and in general find it easier to build more trust and understanding with them. I learned at the NHMA meeting that less than 3 percent of U.S. physicians are Hispanic, even though people of this ethnicity make up about 17 percent of the U.S. population. 

Looking at all underrepresented minorities, just 9 percent of U.S. physicians are African-American, Hispanic, American Indian, Native Hawaiian or Alaskan Native, even though nearly 30 percent of the U.S. population is from these ethnic groups. 

That’s not an accurate reflection of the population we serve, but the commission’s work will get us closer, especially with initiatives like the AMA’s Doctors Back to School program, which connects practicing physicians with schools in underserved areas in their communities. These volunteer physicians serve as role models to minority kids, encouraging them to pursue a career in medicine.

Other medical associations are addressing health disparities in a variety of ways. For instance, the American Academy of Family Physicians (AAFP) has developed principles of cultural proficiency to offer suggestions on how the medical community can better work across cultures. AAFP worked with the AMA to adapt the Doctors Back to School program for use by family physicians. The American Academy of Pediatrics also is delving into improved access to care for minority children at the community level. 

Fewer disparities in health care and a more diverse workforce should lead to better health outcomes for our minority populations. It will take a lot of work—including greater education of patients, increased health literacy and higher community involvement—but groups like NHMA and the Commission to End Health Care Disparities are getting us there.