Primary Care Doctors Need Help to Achieve Health Equity

Stressing social needs and creating a more diverse workforce can aid those on the front lines of the fight for health equity.

Article By: Tochi Iroku-Malize, M.D., MPH, MBA, FAAFP

Blog Source From : https://www.usnews.com/

I am a family physician, but I also have been a patient impacted by discrimination and inequities in our national health care system. I’ve experienced times when my symptoms were dismissed, and I was denied appropriate care due to bias.

READ: An Rx for Racialized Health Care

My story is not uncommon, and that fact alone should be concerning – yet another sign that we are long overdue for a paradigm shift in health care, one in which we recognize, understand and address bias and inequity in medicine.

Fortunately, the best resources to move us toward this goal are already embedded within our health care system: family physicians.

Family physicians form close relationships with patients and their families throughout their lives. We are a trusted source of help and hope for our patients, and we bear witness to social and structural inequities impacting their health. We have a keen awareness of their communities and environments, and because of this, we are uniquely positioned to help bridge equity gaps.

Still, there are essential steps that need to be taken to support primary care in the U.S. as we work to build these bridges. The U.S. health care system has to recognize the social needs that exist, adequately train physicians to help meet those needs, and secure a more robust and diverse workforce.

I know all too well that many patients experience stark inequities long before they even visit a doctor. Research indicates some 80% of a patient’s health is determined by socioeconomic factors, health-related behaviors and the physical environment. To that end, our health care system needs to improve its efforts to recognize how social determinants of health – environmental factors that can give rise to health inequity, including where you live, what you eat, your education level, your housing situation and your access to transportation – affect patients’ lives. Meeting patients where they are can help improve health outcomes and reduce care gaps.

Additionally, it’s critical that we have a physician workforce reflective of the country’s diverse population. Survey results indicate majorities of patients from racial or ethnic minority groups believe it is at least slightly or somewhat important to have a doctor who shares or understands their culture. Patients may be less likely to forgo care if they feel connected with and understood by their physician, and clinicians from diverse backgrounds may have additional insight into specific needs of minority patients. To achieve a more diverse family medicine workforce, we must encourage diversity, equity and inclusion initiatives throughout medical education and cultivate workplaces that not only represent diversity but sincerely embrace, celebrate and promote it as well.

However, we cannot address disparities in health care if there simply aren’t enough physicians working in communities that need care the most. We have to invest in programs that will encourage more medical students to choose primary care as a specialty, particularly family medicine. We also need to create opportunities for more physicians to train and work in underserved areas, and increase funding for federal programs that support underserved communities, such as the Public Service Loan Forgiveness program and National Health Service Corps.

MORE: Parkinson’s Gaps for Black Americans

Patients gaining better access to health care is just the first step. They also need to understand their health and what services are available to them to make informed decisions about their care needs. Past estimates indicate that while a majority of U.S. adults possessed an intermediate level of health literacy – the ability to obtain and comprehend information to make informed decisions about their health – only 12% were proficient. These gaps – compounded by bias, discrimination and a pressing need for a diverse physician workforce – create barriers that can be difficult to overcome.

That is why it has never been more important to invest in primary care. The first-ever national primary care scorecard – authored by researchers with the Robert Graham Center and published earlier this year – highlighted that “historic underinvestment and projected workforce shortages threaten the positive impact that primary care can have on the health of the nation.” It is a warning that should be heeded.

I believe health care is a human right. I hope that one day in the future we will have equity across our U.S. health care system,and that social, political, economic and cultural issues will no longer be a barrier to high-quality care.

Family physicians are on the front lines of the fight for health equity – but we can’t do it alone.

Tags: doctors, patients, health care, health equity, family health