I am an emergency room physician who has worked at Atlanta’s Grady Memorial Hospital for 17 years. I am also the first black woman to ever be hired as a faculty member, and thus have had the opportunity to teach students and doctors in training. Given that 85% of the patients of the 120,000 patients that cross our threshold annually are black, my hiring carried enormous symbolic weight.
Though we can’t yet confirm that physicians and patients of the same race improve health for minorities , we can still argue that increasing diversity in the healthcare professions is a worthy goal. We must move to a place where physicians can comfortably care for people of all cultures and patients can feel comfortable being cared for physicians from different cultures.
In my own experience, African-American grandmothers, mothers, sisters, aunts all want to give me a hug when they see me walk in the room to treat them or their loved ones: “Go ahead sister,” they might say, “we’re so glad and proud to see you”. I have also had many black patients tell me they were more comfortable talking with me about their history of abuse or addiction. That kind of rapport leads to better care and a healthier population.
If the Supreme Court had ruled in favor of Abigail Fisher in Fisher vs. The University of Texas today, which they did not, opportunities for physicians of color who could establish that rapport might have been significantly diminished.
To eliminate or significantly weaken affirmative action, which would have been the result of a Fisher victory, would deal a significant blow to the ability of undergraduate programs to recruit and create a diverse student population—some of whom will continue on to medical school. To be sure, that blow would weaken medical schools nationwide.
The American Association of Medical Colleges, the organization that includes all 138 accredited U.S and 17 accredited Canadian medical schools, nearly 400 major teaching hospitals like Grady also agree. The organization appealed to the Supreme Court to uphold the Grutter v Bollinger case.
Fisher’s case contends that she was denied admission to the University of Texas in because she is white. She and the groups that brought the case were asking for the Supreme Court’s ruling of ten years ago on this matter, in the case of Grutter v. Bollinger to be overturned.
In this landmark case, the United States Supreme Court upheld the affirmative action admissions policy of the University of Michigan Law School. Justice Sandra Day O’Connor, writing for the majority in a 5-4 decision, ruled that the University of Michigan Law School had a compelling interest in promoting class diversity.
There is clear evidence that Justice O’Connor was correct. In a review of multiple studies and noted in The Rationale for Diversity in the Health Professions: A review of the Evidence, minority patients tend to relate better to practitioners of their own race or ethnicity.
Dr. Joseph Betancourt, a senior scientist and program director at the Multicultural Affairs Office at the Massachusetts General Hospital, and an expert on culture and race, argues that doctors must be “culturally competent,” meaning that they a familiar with the cultural norms of their patients in order to better understand their health beliefs and behaviors of their patients. He emphasizes that doctors who are familiar with the cultural norms of their patients can better offer or explain the care those patients need.
It is estimated that by 2015 there will be a shortage of 63,000 physicians in the United States, a number that is projected to rise to 130,000 by 2025. This two-fold increase in the physician shortage would affect people of all races but mostly Black and Hispanic Physicians of color because the percentage of aspiring black and Hispanic physicians of color admitted to medical school has had minimal change in the past 30 years—affirmative action which impacts admission to college and universities is necessary to have any hope of raising those numbers.
In 2012, only 15% of students in U.S. medical schools and 23% of nursing students were underrepresented minorities, while such minorities comprise 36% of the total U.S. population. By 2042, people of color will be the majority population in the US, making cultural competence even more important.
Twenty years ago, I graduated from Howard University School of Medicine, a historically black institution with many classmates who look like me. But while historically black institutions like Meharry, Morehouse, and Howard are vital institutions, they do not produce enough African-American graduates to fill our growing needs, nor should they be the only institutions that produce African-American physicians—and we need physicians of all races and ethnicities. To return to the pre-affirmative action standards would only hurt us all. We can’t turn back the clock.
Sheryl Heron, MD is an associate professor in emergency medicine at Emory University and a Public Voices fellow with The OpEd Project. She practices at Grady Memorial Hospital in Atlanta.