A diverse healthcare workforce reflective of the U.S. population is needed to address health disparities. This is especially the case for patients of color, who tend to be less healthy than the U.S. majority, experience less access to care, and receive a lower quality of care due to systemic racism and accompanying systems of oppression. Achieving a more diverse family medicine workforce is essential to improve patient outcomes and society’s overall health.
The AAFP supports the following actions to help build the diverse workforce America needs:
1. Lead and strengthen efforts that develop and maintain a diverse family medicine workforce, where diversity includes the full spectrum of attributes within population groups.
These attributes include but are not limited to diversity in race, ethnicity, cultural characteristics, language, disability status, religious or spiritual beliefs, gender identity, generational identity, sexual orientation and sexual identity, socioeconomic origin, rurality, family educational background, and medical training environment. These attributes are considered based on current and historical categorical prejudices and exclusions resulting in the unjust inequities experienced today
2. Encourage diversity, equity, and inclusion initiatives throughout all levels of medical education.
Academic health centers, medical institutions, medical organizations, and the U.S. health care system need to address the spectrum of challenges faced by those underrepresented in medicine (UIM or URM) and their downward causation. Accountability to attain workforce diversity goals is essential.
3. Diversify learners in medical education by expanding recruitment efforts focused on those UIM, facilitating the medical school application process, and enhancing the success of UIM applicants.
Institutions should consider a portfolio of interventions, such as holistic admissions, holistic student affairs, and pathway partner institutions. Effective pathway organizations and longitudinal programs focus on academic enrichment (science and mathematics), admissions preparation, mentoring, financial support, psychosocial support, and professional opportunities. Structural barriers that need addressing are the overemphasis on Medical College Admission Test (MCAT) scores and science grade point average and the implicit bias of admissions committee members.
4. Support efforts that empower the practice of structurally competent care.
All medical students, residents, and family physicians must be able to interact respectfully and provide care that is culturally effective and responsive to the needs of each patient, regardless of differences in personal and cultural attributes between them. Deliberate educational interventions spanning the continuum from pre-healthcare schooling to continuing medical education are required to achieve cultural awareness and cultural sensitivity. Education focused on interpersonal and communication skills, personal identity and attributes, and implicit bias recognition and management can result in cultural humility and balance the power in patient-physician relationships.
5. Recognize all family physicians share the responsibility to advocate for and build a diverse family medicine workforce.
Those with privilege should support efforts aimed to include and promote those historically excluded and systemically oppressed in medicine. People with high levels of influence can support policies and programs that articulate the value of diversity and how it benefits all participants.
6. Advocate for justice-oriented changes and dismantle barriers that prevent proper health for all both inside and outside the healthcare setting.
The systems and institutions in which our patients, communities, and profession operate consist of historical and present injustices and inequalities that extend beyond healthcare. As influential stakeholders in our communities, family physicians must be strong advocates.
7. Cultivate a family medicine workforce that not only represents diversity but sincerely embraces, celebrates, and promotes diversity in all forms.
A family medicine workforce reflective of the population supports innovation, addresses the disproportionate involvement of systemically oppressed communities, results in better educational outcomes at all levels of training, and improves understanding of health or lack thereof outside of the exam room. A diverse family medicine workforce enables all family physicians to provide more accessible, inclusive, comprehensive, responsive, and culturally effective care to reduce or eliminate health disparities. (2005) (September 2022 COD)