SUO 2020: Addressing Disparities Through Workforce Diversity, Equity, and Inclusion Initiatives

(UroToday.com) In this discussion, Dr. Jones gave an overview of racial disparities through healthcare workforce diversity.

There are significant racial disparities occurring in healthcare, and the Institute of Medicine report recommends increasing the underrepresented minority groups in the healthcare workforce¹.

Table 1 demonstrates the diversity in healthcare providers in 2018, showing significant disparities.

There are several factors that contribute to health inequity. These include:

• Wealth and education gaps
• Housing
• Healthcare access and utilization
• Insurance status
• Discrimination
• Patient preferences

A systematic review across seven retrievable databases from 1995-2016 examined the effect of Blacks and racial concordance on patient-physician communication. A total of 40 peer-reviewed articles were reviewed with a focus on racial concordance in patient-physician communication. This systematic review found that Black patients experience poor communication quality. Moreover, Black patient participation and participatory decision-making were less when compared to White patients. The authors concluded that more attention/training should go to improving patient-physician communication, patients centeredness, partnership-building, particularly with Black and racially discordant patients².

There is data demonstrating that African American patients who have a race-concordant physician are more likely to rate their medical care to be more positive and be more participatory. This could also affect the quality of care.

The Agency for Healthcare and Research and Quality (AHRQ) ongoing nationally representative survey (the Medical Expenditure Panel Survey – MEPS) includes adults between the age of 18 and 64 from the years 2002-2012. This study examined the quality of patient-provider communication. The main findings³ included:

• Due to the current makeup of US healthcare providers, White providers care for more minorities than do minority providers.
• Patient-provider racial concordance does not have a significant role in patient ratings for communication
• Racial concordance does not have a significant effect on Black patient’s rating on the physician’s communication.

Dr. Jones concluded his talk with several suggested implementations to address this problematic matter. These include the need for preparedness and mentorship resources to help elementary and high school students, particularly Black students, to see the possibilities of becoming health care providers.

It is also important to encourage workforce diversity programs to support minority students and healthcare faculty. There is a need to implement ongoing cultural humility and communication training in the healthcare providers’ annual learning and competence modules. Lastly, it is important to conduct research, which focuses on healthcare provider and patient interaction and communication surrounding quality of care and patient satisfaction.

Presented by: Randy Jones, Ph.D., RN, FAAN, Professor at the School of Nursing, University of Virginia

Written by: Hanan Goldberg, MD, MSc, Assistant Professor, Urology Department, SUNY Upstate Medical University, Syracuse, NY, USA, @GoldbergHanan during the 2020 Society of Urologic Oncology Annual Meeting – December 2-5, 2020 – Washington, DC