• New Research Addresses Inequities in FP Workforce

    Family Physicians Seek Ways to Improve Diversity and Equity

    January 19, 2022, 4:02 p.m. Michael Devitt — Chalk one up for the power of collaboration.

    teamwork puzzle concept

    The AAFP, the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, and the American Board of Family Medicine have teamed up to participate in an ongoing research initiative to examine key issues related to diversity and equity in primary care policy and practice. Building on the results of previous efforts, researchers from all three organizations will work together to study current trends in the family medicine workforce and develop policies aimed at improving diversity and equity in the specialty.

    “The significance of this collaboration is that it creates a mechanism by which complex issues of diversity and equity can be addressed in a way that actually moves family medicine forward,” said Danielle Jones, Ph.D., M.P.H., director of the Academy’s Center for Diversity and Health Equity. “By bringing together the parts of the specialty that can simultaneously generate, disseminate and implement strong evidence, we’re able to move the needle quicker and further than any of us operating alone. This series will guide the Academy as it implements its strategic priorities and continues to be a leader in this area.”

    Under the initiative, research will be published as a series of policy briefs, commentaries and related items in the Journal of the American Board of Family Medicine. The first collection appears in the January/February issue of JABFM and includes several items of interest.

    “Informing Equity & Diversity in Primary Care Policy and Practice: Introducing a New Series of Policy Briefs, Commentaries, and Voices in JABFM" is a commentary co-authored by Jones and others that informs readers about the issues the initiative intends to address and the potential policy implications associated with family medicine becoming a more equitable and diverse specialty.

    Story Highlights

    “Family Physicians Increasingly Deliver Care in Diverse Languages” covers a topic that has received little attention: the importance of family physicians, if not all health care professionals, being able to provide language-concordant care — that is, have clinical encounters in which the health care professional and patient speak the same language. In their study, researchers used data from the ABFM’s Family Medicine Certification Examination registration questionnaire over an eight-year period, during which family physicians were asked whether they used a language other than English to interact with patients (from 2013 to 2016) or whether they personally provided care in a language other than English (from 2017 to 2020). The researchers found that during that time, about 22% of FPs reported providing care in Spanish, while the proportion of FPs providing care in languages other than Spanish more than doubled (from 7.6% in 2013 to 15.8% in 2020).

    In an accompanying commentary, researchers point to recent census data that suggests about 22% of U.S residents speak a primarily language other than English at home. They also cite a 2017 study that indicated patients seen by language-concordant health professionals have better health outcomes. “This language concordance should not be viewed simply as a perk; instead, it is quickly becoming an essential aspect of our care delivery,” they wrote, adding that health care professionals in general and FPs in particular “need to be nimbler in adapting to reflect the needs of the patients that we serve.”

    “Family Medicine’s Gender Pay Gap” reports on data from the 2019 ABFM National Graduate Survey, which was administered to diplomates three years after completing residency. Findings indicated that while female FPs earned $79 per hour, male FPs earned $94 per hour, a difference in hourly pay of roughly 16% that, if perpetuated, would lead to significant financial disparities in career earnings. To combat the issue, the authors call for additional research along with work toward developing “tangible solutions to ensure equal pay for an increasingly female workforce.”

    The authors of an accompanying commentary note that in 2019, 41.3% of family physicians were female, up from 31.3% in 2008 — a development that “makes exploring the cause of the gender pay gap and addressing gender equity a priority for our field.” They suggest a number of steps that can be taken to achieve pay equity immediately, while calling for more research to address the gender pay gap going forward.

    The researchers intend to publish a minimum of nine policy briefs and paired commentaries on various workforce-related diversity and equity topics. Members are encouraged to visit the JABFM website as more items in the series become available.

    Other AAFP Member Resources

    The Academy continues to advance the specialty and improve member well-being, both physically and otherwise. While the initiative with ABFM and the Robert Graham Center exemplifies the benefits of collaboration, the Academy has developed several member resources on its own, as well.

    On Jan. 20, at 4:30 p.m. CT, the AAFP will present a livestream event for resident members. Ericka Adler, J.D., L.L.M., will discuss best practices for FPs in negotiating their first contract after residency. Adler, who also helped develop an Academy guide on employment contracts, specializes in regulatory and transactional health care law, and has devoted much of her practice to advising professionals about contracts and compensation arrangements. The event will be available for replay after the livestream.

    The AAFP has also created several resources on health equity and inclusion. Outlets such as the Center for Diversity and Health Equity and The EveryONE Project support research and provide members with clinical tools, while patient-focused resources such as the Neighborhood Navigator help FPs identify patients’ social needs and improve their health outcomes.

    Additional resources include a listing of policies on health equity issues, CME courses and an FPM topic collection on health equity, diversity and social determinants of health.