Health Equity

Why does representation in medicine matter? AMA members speak out

Andis Robeznieks , Senior News Writer

A diverse physician workforce is stronger and better able to serve the U.S. patient population. But the physicians whose presence helps create that diversity can often feel isolated or burdened by the task of having to be a representative for their historically marginalized group.

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“I want to continue to be and live in this space and promote diversity because I always think: If not me, who then? Who would do this?” said Ciciley Littlewolf, MD, a Native American who grew up on the Northern Cheyenne reservation.

Dr. Littlewolf spoke during an episode of the “AMA Prioritizing Equity” video series examining the experiences of AMA member physicians from historically marginalized groups and discussing their experiences, challenges and successes in medicine.

“It's so important that patients see doctors who look like them, come from the same cultural background, because it increases trust—but also that cultural awareness,” said Dr. Littlewolf.  She is a hospitalist in Fargo, North Dakota, with Sanford Health, which is a member of the AMA Health System Program that provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.

“I went from being maybe insecure about who I was and where I came from, to being very proud of who I am and where I'm from and being able to be a resource not only to my peers, but to the faculty and staff here,” said Dr. Littlewolf, who serves as an academic adviser at the University of North Dakota School of Medicine and Health Sciences.

Javier Guevara Jr., MD, a family physician working as an emergency room hospitalist at Northwestern Memorial Hospital, was born in Mexico. As one of only two Latinos in his class, he remembers attending a study session with Student National Medical Association and feeling underrepresented.

“To have that experience, to feel like not belonging—it was really shocking to me,” Dr. Guevara said.

Now Dr. Guevara is an active member at the Northwestern University Feinberg School of Medicine Alumni Association Board. He recently created the Inclusion & Allyship Committee to engage other fellow underrepresented graduates to help support more diversity efforts within the school.

“You can see that there are so many individuals who, unfortunately, have felt very disconnected and disfranchised, and who should be re-engaged,” Dr. Guevara said.

It is critical for physicians from historically marginalized groups to “open up and talk and advocate for changes and share their stories, because that would help change,” he added.

Explore the AMA Center for Health Equity and consider applying to become a Medical Justice in Advocacy Fellow. The deadline is March 15.

For Nicole Riddle, MD, MSHI, her experiences as a wheelchair user include two different kinds of barriers.

“For people with differing abilities, it's literally about trying to change the actual physical structure or architecture of a workplace—not only people's minds, opinions and actions,” said Dr. Riddle, a pathologist at Tampa General Hospital and a representative of the U.S. and Canadian Academy of Pathology in the AMA House of Delegates.

Anyone who lives with something outside the norm is going to have stories of times where they were surprised how poorly—or how well—somebody dealt with whatever that difference is,” Dr. Riddle said, adding that she is glad to have raised awareness and made people think differently.

On those occasions when patients or colleagues laud Dr. Riddle as a good physician despite her disability or the fact that she uses a wheelchair, she spots an opportunity to make a difference for other physicians with disabilities.

“Anytime you can nicely redirect or correct that, I think that, hopefully, helps move things incrementally further along so that then it will hopefully be a little less difficult for the next group,” Dr. Riddle explained.

Learn more about Drs. Littlewolf, Guevara and Riddle, who were among the AMA members profiled in the video series, “Our Legacy in Practice: A Physician’s Story.”