A majority of White physicians (78%) were very or somewhat satisfied with current levels of workforce diversity, compared with a majority of Black physicians (63%) feeling very or somewhat unsatisfied.
This disconnect was not surprising to Aja McCutchen, MD, a partner at Atlanta Gastroenterology Associates who was not involved in the survey.
“One cannot discount the lived experience of a [person underrepresented in medicine] as it relates to recognizing conscious and unconscious biases, microaggression recognition, and absence of [underrepresented clinicians] in key positions. This is a reality that I do see on a daily basis,” Dr. McCutchen said in an interview.
Dr. Aja McCutchen
Only 35% of respondents felt there is “insufficient racial and ethnic representation in education and training,” and just over a quarter (28%) felt the same about representation in leadership. In fact, most respondents (59.7%) thought that racial and ethnic diversity had increased over the past 5 years even though data show no change, the authors noted.
Although Dr. McCutchen appreciated the broad recognition from respondents, regardless of background, to improve diversity in the pipeline, she noted that “retention of current talent and future talent would also require cultural shifts in understanding the challenges of the [underrepresented] members,” Dr. McCutchen said.
Again, however, the majority of the respondents (64.6%) were themselves not members of underrepresented groups. Nearly half the respondents (48.7%) were non-Hispanic White, and one in five (22.5%) were Asian, Native Hawaiian, or Pacific Islander. The remaining respondents, making up less than a third of the total, were Hispanic (10.6%), Black (9.1%), American Indian or Alaskan Native (0.2%), another race/ethnicity (3.3%), or preferred not to answer (5.7%).
Dr. McCutchen said she had mixed feelings about the survey overall.
“On the one hand, I was eager to read the perceptions of survey respondents as it relates to diversity, equity and inclusion in the GI space as very little cross-organizational data exists,” said Dr. McCutchen. “On the other hand, the responses reminded me that there is a lot of work to be done as I expected more dissatisfaction with the current GI workforce in both academia and private practice respondents.”
She was surprised, for example, that nearly three-quarters of the respondents were somewhat or very satisfied, and that a majority thought racial and ethnic diversity had increased.
Studies on provider-patient concordance have shown that patients feel it’s important to share common ground with their physicians particularly in terms of race, ethnicity and language, the authors noted.
“This patient preference underscores the need to recruit and train a more diverse cohort of trainees into GI and hepatology fellowships if the desired goal is to optimize patient care and combat health disparities,” they wrote. They pointed out that cultural understanding can influence how patients perceive their health, symptoms, and concerns, which can then affect providers’ diagnostic accuracy and treatment recommendations. In turn, patients may have better adherence to treatment recommendations when they share a similar background as their clinician.
“Diversity in medicine also leads to greater diversity in thoughts, better returns on investments, increased scholarly activities related to health equity to name a few,” Dr. McCutchen said.
The top recommendations from respondents for improving representation of currently underrepresented individuals in GI and hepatology were to increase mentorship opportunities for residents (45%) and medical students (43%) from these groups and to increase representation of professionals from these backgrounds in program and professional society leadership (39%). A third of respondents also recommended increasing shadowing opportunities for undergraduate students from these underrepresented populations.
Dr. McCutchen expressed optimism regarding the initiatives to improve diversity, equity and inclusion across the gastroenterology spectrum.
“It is incumbent upon all of us to continue to be the driving force of change, which will be a journey and not a destination,” McCutchen said. “In the future, diversity, equity and inclusion will be the expectation, and we will ultimately move closer to the goal of completely eliminating health care inequities.”
The research was funded by the National Cancer Institute, the UCLA Jonsson Comprehensive Cancer Center, and Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research Ablon Scholars Program. The authors reported no conflicts of interest. Dr. McCutchen disclosed relationships with Bristol-Myers Squibb and Redhill Biopharmaceuticals.