How physicians are tackling health care disparities

Robert M. Wah, MD , Former President

Recently I attended the National Indian Health Board’s annual meeting, where about 1,000 people from 500 tribes across the country met to discuss Native American health care issues, advocacy and policy. I was able to learn about the unique challenges Native American physicians and their patients face.

One physician stood up and said that he spent 30 years practicing on a reservation, and that he believed Native Americans’ health issues stem primarily from poverty. Native communities continue to lag far behind other communities in basic resources and services. This means that though Native Americans face the same prevalent health issues as the rest of the country—diabetes and cardiovascular disease—their problems are magnified. And this can’t simply be addressed in our mainstream health care. We need different, customized strategies that acknowledge the particular challenges our patient populations face.

I also recently attended the Korean American Medical Association meeting, and heard about one of their prime issues— gastric cancer in Asian American populations. There is no guideline for early gastric cancer screening in our country for this population, but in Korea, early detection and survival are much better because of screening at early age. Making a similar change here will require education, policy and payment changes.

As physicians, we all see disparities like this in our own work. We know there are racial and ethnic disparities in chronic diseases and health care, and we’re working to better understand and address these disparities in ambulatory clinical practices through the Commission to End Health Care Disparities, which met last month in Chicago.

The commission is determining better ways to collect and use patient-level data, including patient race, ethnicity, preferred language and LGBT status, which will be helpful in improving the quality of care we provide for all patients. It’s also working to educate organized medicine on why a diversified health care workforce is crucial to eliminating disparities, as studies show that minority health professionals are more likely to serve minority and medically underserved populations.

Health care disparities can feel like an overwhelming problem for the average physician, but there are things we are doing to make progress towards more equitable care. As an educator, I firmly believe that teaching our medical students about the disparities that exist, and ways to counteract these disparities, is the best first step.

Our country also made forward strides in expanding health care coverage to more Americans, giving many more patients access to the care they need. In caring for our patients, physicians should be aware that racial and ethnic disparities exist, and that we can support policy and advocacy efforts aimed at eliminating these disparities.

The commission has resources for physicians to learn more about health care disparities.

You tell me: How are you addressing health care disparities in your practice? Post a comment below at AMA Wire® or on the AMA’s Facebook page.