As the health care landscape in America continues to change after the enactment of the Affordable Care Act, we are seeing an even more diverse group of patients seeking care across the nation. As rapidly as these demographics are changing, however, there is still progress to be made in diversity of health care providers who treat these patients. For instance, although 13 percent of Americans are of African descent, Black physicians only make up about 4 percent of all physicians in this country.
One way to increase diversity in the health professions is to change how health professional schools are admitting students. A new strategy, holistic review, has emerged as a potential solution to the health care workforce diversity problem. As a current medical student that has had the privilege of attending incredibly diverse public schools while growing up in the Washington, DC suburbs, alongside students from various socioeconomic, ethnic, and religious backgrounds, I can appreciate the value that health professional schools will gain by increasing their use of holistic review.
Holistic review allows admissions committees to evaluate applicants more broadly than in a traditional admissions process, which focuses primarily on grades and test scores. With holistic review, admissions committees balance their consideration of a candidate’s experiences with the candidate’s grades and test scores, ultimately accepting and enrolling a more diverse class of students. And there is evidence to suggest that holistic review works. In a report published by Urban Universities for HEALTH, it was found that health professional schools practicing holistic review reported increased student body diversity, without any corresponding decline in student academic success.
The opportunity to grow up in such a diverse environment has made me appreciate the benefit of my ability to connect with individuals whose backgrounds are different from my own. Communicating with others who have different experiences and perspectives, withholding judgment, and truly listening to and appreciating our different opinions is a skill I could not have developed without exposure to diversity. In the medical school environment, diversity brings a richness to educational experiences that cannot be quantified. Cultural competency can be taught firsthand through interpersonal experiences with classmates as early as years one and two of medical school — before any significant interactions with patients occur.
Physicians, who are experts in their fields, need to be able to translate their knowledge into patient care in a way that is unbiased, and takes into consideration the patient’s background and personal experiences. What good is it to prescribe a medication to a patient that he or she cannot afford, and therefore will not take? How would you be helping a patient from a different cultural background, who is uncomfortable taking certain medications, if you ignore her and prescribe them anyway? Will you simply deem the patient “not compliant” and terminate her from your care? The best time to address problems with future patient encounters is at the beginning of training, when knowledge and behaviors are still malleable.
In order for all students to have fruitful discussions on patient care and cultural competency, it is important to allow students with an array of experiences to have “a seat at the table.” Diversifying the physician workforce will reduce health disparities, which in turn will reduce health care spending. In order to create that workforce, medical schools cannot simply continue admitting traditional medical school applicants. Medical schools must begin to actively seek, recruit, and enroll highly-qualified students from a wide variety of backgrounds and with a range of life experiences.
I think it is safe to say that we all want health care professionals with good knowledge of science and strong analytical skills overseeing our care, but don’t we also want providers who have a proven track record of dedication, perseverance, worldly experiences, and compassion? If these qualities are valued during the admissions process, we will find students who possess them. After all, in the beginning of our medical training when we take the Hippocratic Oath, we acknowledge, swear to uphold, and “remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.”
Valerie Pierre is a medical student.
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