Doctors are worried that a new admissions policy forced on Texas Tech’s medical school by the Trump administration is a step backward in increasing diversity in the physician workforce.
A number of physicians are speaking out at the news that the Texas Tech University Health Sciences Center School of Medicine will be required not to consider race as a factor in its admissions process. That requirement was part of an agreement with the U.S. Department of Education Office of Civil Rights the school entered into in February.
It’s significant, because it marks the first time the Trump administration has asked a school to curtail affirmative action practices.
And that has the American Medical Association (AMA), the country’s largest physician organization, as well as individual doctors, worried about the impact on the diversity of the physician workforce and health disparities.
“The strength of our medical workforce—and our nation—is rooted in diversity,” wrote the group’s president, Barbara L. McAneny, M.D., in an opinion piece on the organization’s website.
To advance health equity, there needs to be greater diversity among medical school applicants and enrollees, she said.
“We know from research and experience that all patients, but particularly those from marginalized communities, benefit from a diverse physician workforce and are even likely to see improved outcomes,” McAneny said.
Yet, the physician workforce is not representative of the country’s racial and ethnic diversity. Less than 10% of physicians are African Americans, Latinos, Native Americans or Alaskan Natives, she noted.
The Texas Tech agreement does not set a legal precedent, but McAneny said the Trump administration should clarify such policy changes. The AMA does not want to see further voluntary acts or agreements that remove race considerations from the admissions process, she said.
The agreement ended a 14-year investigation by the government into the university’s use of race in admissions.
Writing in an opinion piece published in Stat, two doctors said the agreement is a “step backward for improving healthcare in the United States.”
“The agreement is, however, consistent with the current administration’s advocacy of “race-neutral” admissions policies as well as its efforts to rescind Obama-era policies on affirmative action,” wrote Marcella Alsan, M.D., an associate professor of medicine at Stanford University, and Owen Garrick, M.D., CEO of Bridge Clinical Research, which aims to diversify clinical trials.
Last summer, the Trump administration announced it would no longer support guidance created under the Obama administration encouraging schools to take a student's race into account in their admissions. Schools and universities will be allowed to take a race-neutral approach in admissions and enrollment decisions.
The Texas Tech agreement comes at the same time new research shows that greater minority representation in medicine can improve health for African Americans.
They note that the AMA, the Association of American Medical Colleges and the National Academies of Medicine all have policies that call for an increase in the number of minority physicians to better reflect the U.S. population and help reduce health disparities.
“Doctors with similar backgrounds to those they serve might be more efficient at building trust and communicating with patients—crucial components to medical care,” they wrote, noting that only about 4% of U.S. physicians are African American, while that group makes up 13% of the U.S. population. The gap is wider for Hispanics, who make up 4% of physicians and 18% of the country’s population.
They described a study they conducted in which they recruited more than 1,300 African American men to attend a free health clinic in Oakland, California. The men were randomly assigned to a male doctor who was either African American or white or Asian.
After meeting with the doctor, those who saw African American doctors were much more likely to take up preventive services. The study found a 49% increase in blood tests to screen for diabetes and a 71% increase in cholesterol testing.
“Better communication was the primary driver of the results. During clinic encounters, participants were more likely to discuss their health problems with an African American doctor, and African American doctors were more likely to write detailed notes about their patients,” the doctors said.
They estimated that increasing the supply of minority physicians has the potential to reduce the number of African American men dying from cardiovascular disease by 19%.
“More young people of color should be encouraged to pursue the field of medicine. Policies designed to increase diversity in the physician workforce should be protected, not dismantled,” they argued.