By Gayle Bennett, Marketing Director, Philips Healthcare
Until recently, Judy Brown was a physician recruiter at Children’s Hospitals and Clinics of Minnesota. “Our Minneapolis campus was in the midst of a neighborhood with a large Somali immigrant population, so it was an extremely diverse patient population,” she says. “But when you looked at the medical staff, it didn’t always reflect the people who were walking in through the doors.”
It’s not that Brown, who is now manager of recruitment at Midwest Dental Support Center in Minneapolis, wasn’t trying to attract minority physicians to the hospital. She was, but unfortunately there’s a numbers game that isn’t working in recruiters’ favor: The diversity of the physician population has not grown anywhere near as quickly as the diversity of the U.S. population as a whole.
For example, while 13 percent of the U.S. population is African American, only 4 percent of physicians are African American, according to Diversity in the Physician Workforce: Facts & Figures 2014 from the Association of American Medical Colleges (AAMC). So if an Equal Employment Opportunity Commission (EEOC) affirmative action plan calls for the racial and ethnic makeup of the physician population to match that of the community, and the community’s minority population far outpaces that of the physician population, parity can be hard to achieve.
But, beyond meeting affirmative action plan targets, bridging racial and ethnic disparity among the patient and physician populations is important for two key reasons:
- It improves patient health and the bottom line success of healthcare organizations.
- A multipronged diversity effort can help physician recruiters move closer to reaching racial and ethnic parity with the patient population being served.
The importance of diverse physicians
According to the AAMC report, “Research indicates that diversity in the physician workforce impacts the quality of care received by patients. For example, race concordance between patient and physician results in longer visits and increased patient satisfaction, and language concordance has been positively associated with adherence to treatment among certain racial or ethnic groups.”
Scott Manning, director of human resources and provider recruitment at District Medical Group in Phoenix, Ariz., sees this firsthand. “It’s easier for physicians who are the same race or ethnicity as their patients to communicate with them and ensure they understand their care plans,” he says. Conversely, “Patients appreciate having doctors of similar backgrounds they can communicate with,” he says. Manning estimates that at least half of the 400 full-time and 200 part-time physicians in the practice are minorities and mainly Hispanic, which matches the makeup of the Phoenix population.
There’s also a business case to be made for diversity. “In healthcare we can do only so much cultural competency training,” says James Barron, program manager of the Office of Diversity at Cleveland Clinic in Ohio. “If patients are still seeing people they don’t feel understand their culture and don’t look or sound like them, then they will think of other options of where to get their care.”
Also, “Diversity in any workforce in general is going to get you to a better decision making outcome,” Barron says. That’s because people from different backgrounds approach problems from different angles, allowing the organization to reach better solutions. “That really is the fundamental business case for diversity,” he says.
Best practices for recruiting more diverse candidates
Recognizing the importance of recruiting a diverse pool of candidates for each physician opening is one thing. Making it happen can be another. Many recruiters, like Brown when she was at Children’s Hospital in Minneapolis, struggle to find and attract racial and ethnic minorities that match the patient population.
Following are some best practices for physician recruiters looking to attract more diverse candidates:
Understand the data. Physician recruiters need to understand the demographics of the individual physician specialties and sub-specialties to know what’s reasonable to expect in recruitment. “There might only be 3 percent of minorities who are orthopedic surgeons. So if you are looking for the best 10 candidates and you have one minority, you are doing quite well,” Barron says.
Work with HR on the affirmative action plan. Whether or not physician recruitment is housed in HR and involved in the EEOC affirmative action plan depends on the hospital or healthcare organization. “A lot of times when I talk to my colleagues, they aren’t involved in developing the affirmative action plans,” Brown says. HR and recruiters should work together to ensure that accurate information is regularly submitted to the EEOC.
Regularly review your candidate pools and goals. From year to year or quarter to quarter, it’s important to track and understand the diversity of the candidate pools for every open position, particularly if the organization is not meeting its community parity goals. “If you start diving into those occasions when you didn’t meet the goal, you are starting to look at your sources,” Barron says. “You might find all of your candidates are coming from a particular source, so you might need to think of other places to go to meet the needs of the patient population.”
Target minority-serving medical schools. Barron says that Cleveland Clinic reaches out to the medical schools at historically black colleges and universities (HBCUs) to let those students and residents know they are welcome at Cleveland Clinic, and Brown did the same at Children’s Hospital. AAMC data shows that from 1980 to 2012, Howard University College of Medicine and Meharry Medical College graduated the highest number of black medical students by far. The top three U.S. medical schools for Hispanic graduates are all in Puerto Rico: University of Puerto Rico, Universidad Central del Caribe, and Ponce School of Medicine and Health Sciences.
Market your organization to minority organizations and advertise openings on minority job boards. At Children’s Hospital, Brown regularly advertised on the African-American-focused National Medical Association’s website and exhibited at the organization’s annual conference. The American Medical Association maintains a directory of ethnic medical associations. In addition, Brown suggests posting all openings on diversityjobs.com and diversitymd.com.
Find a diversity recruitment champion on staff. When Brown was at Children’s Hospital, she had a physician tasked with helping her attract minority physicians to the hospital. “She recognized she was one of the few African-American faces on our medical staff, and she knew that was a stumbling block for us from a recruitment perspective,” Brown says. Brown worked with her diversity champion on how to sell the hospital to other black pediatricians and pediatric specialists when they came in for interviews.
Think about the long-term. “You can also look at the talent pool of your own staff,” Brown suggests. Are there current non-physicians on staff who might be interested in going to medical school? “You might want to approach them and encourage them,” she says. Developing scholarship and loan payback programs for identified minority candidates both internally and externally can also help create a more diverse staff over the long term.
Physician diversity, as a recruitment issue, is only going to become more prominent in the future. One of the main goals of the Affordable Care Act (ACA) is to eliminate racial healthcare disparities, and according to data from the U.S. Department of Health and Human Services, about half of those receiving insurance via the ACA are minorities. In addition, demographers predict that the United States will be a majority minority country by 2050, just 35 years from now.
“You are going to need physicians who understand those populations,” Brown says. “Those populations will be more compliant if they know they have a physician who understands them.”