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By Phyllis Hanlon
When the University of Michigan Law School emerged victorious in
the fight to consider race and ethnicity as part of the admission
process, the W. K. Kellogg Foundation commissioned the Institute
of Medicine (IOM) to conduct a study to evaluate how health care
could benefit from greater diversity. A committee comprised of doctors,
dentists, nurses, a psychologist and other healthcare experts, assessed
the potential benefits of greater diversity in healthcare and recommended
institutional and policy-level strategies as well as effective implementation
mechanisms to help increase it.
The committee first presented evidence demonstrating a link between
improved access to care and greater diversity among healthcare providers.
They also noted a correlation between greater patient choice and
satisfaction, enhanced patient-provider communication and more positive
educational experiences when minorities have access to a diverse
panel of healthcare professionals.
In order to level the academic playing field, the committee recommended
that health professions educational institutions (HPEIs) issue a
mission statement and explicit policies that recognize the importance
of diversity. Additionally, they suggested an admissions committee
comprising underrepresented groups should consider both quantitative
and qualitative data before making final selections.
The committee also proposed that academic institutions involve
under-represented minorities (URMs) in the process of developing
and enforcing diversity-related standards and criteria for accreditation.
Sanctions should be applied, they suggested, if these standards
and criteria are not met.
Another recommendation advised regular reviews of institutional
diversity improvement strategies as well as partnering with community-based
health facilities, which will draw more culturally diverse individuals
to the field. At the same time, students, house staff and faculty
should be engaged and trained in the diversity-related policies
and expectations of the institution on a regular basis. The committee
proposed the creation of an informal, confidential mediation process
for those confronting barriers to achieving institutional diversity
goals.
Since finances present a major obstacle to education, the committee
recommended increasing federal funding for programs aimed at improving
diversity as well as creating new programs such as loan forgiveness
and repayment, tuition reimbursement and encouraging public-private
collaboration. They also promote Health Resources and Services Administration
training programs for health professions to maximize URM participation.
As far as HPEIs and relevant public and private groups are concerned,
the committee recommended that they develop and reinforce collaborative
efforts to increase diversity in the healthcare workforce. Steps
should be taken to bring awareness of diversity initiatives to the
general public, especially to community leaders. New standards should
be developed that will facilitate the implementation of community
benefit principles.
Finally, the report mentioned specific mechanisms to help promote
diversity efforts, including more research and data collection on
diversity and its benefits and concerted efforts to deepen community
understanding of what should be done to increase diversity in the
healthcare profession as well as educational initiatives driven
by HPEIs. The report encouraged business leaders and several other
organizations to establish coalitions to act as advocates for diversity.
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