Doctors who relate

Hospitals work to narrow the gap between patients and physicians

As an African American physician, Dr. Alden Landry is used to walking into a hospital room and seeing a look of surprise on a black patient's face. Often they'll say, "I wasn't expecting to have a black doctor," says the emergency medicine physician at Beth Israel Deaconess Medical Center (BIDMC) and chair of the hospital's Diversity Committee. "Then they say they are glad to see me because they think I will take better care of them. They feel more comfortable when the doctor looks like them, can talk like them, and can relate to them."

Indeed, studies show that African American patients who visit physicians of the same race rate their visits as more satisfying and participatory than do those who see physicians of other races, according to an article in the Archives of Internal Medicine. Meanwhile, a 2002 Institute of Medicine report found that racial bias, historical mistrust, and communication barriers between healthcare workers and patients are associated with differential treatment standards, low patient satisfaction, and poor long-term health outcomes. Although minority groups comprise 30 percent of the total U.S. population, ethnically and culturally they are represented by less than 10 percent of all U.S. physicians.

In Boston, where the population is 24 percent African American and 14 percent Hispanic, the CEOs of Beth Israel Deaconess, Brigham and Women's Hospital, Massachusetts General Hospital, and Dana Farber Cancer Institute have been making diversity a top priority.

In his blog called "Running a hospital," Dr. Paul Levy, president and CEO of Beth Israel Deaconess, explored the need for physician diversity in entries posted last December. "I think there is an inherent value in diversity," he wrote in response to a skeptic. "I think there is a value to patients if, for no other reason, it can make them feel more comfortable to see more people of their race in a clinical setting. There may also be actual clinical improvements if patients and doctors are able to better relate to one another."

At Brigham and Women's Hospital, "the past few years have been really challenging," with regard to recruiting minority residents, says Dr. Nora Osman, assistant program director for the Department of Medicine's Office of Minority Affairs. "When I started my residency in 2004, the minority class was 20 percent," she recalls. Since then, the number dropped to a low of 3 percent. But over the last year and a half, thanks to more extensive outreach efforts and a refined message, Osman's office has managed to reverse the trend. This year, the number of minority residents is back up to 20 percent, and the class includes immigrants from Nigeria, Mexico, and Venezuela, residents from historically black medical schools, and one resident who is part Choctaw Indian.

Meanwhile, at the hospital's Office of Multicultural Faculty Careers, Jabbar Bennett is leading efforts to recruit, retain, and advance the careers of underrepresented minority physicians and PhDs. Among the office's initiatives are professional development programs and networking opportunities that bring together minority doctors from across the institution.

Bennett, a PhD who is black, became interested in promoting diversity in medicine while doing research for a postdoctoral fellow in the Harvard Medical School Pathology Department. "I enjoyed my research and the environment," he says, "but I realized I was the only African American in the lab and seemingly in my department. I decided that I wanted to make a contribution by helping recruit and retain more MDs and PhDs of color in medicine and the biomedical sciences." At Beth Israel Deaconess diversity-promoting initiatives focus on the doctors of tomorrow as well as those of today, says Landry.

This includes introducing high school and college students to medicine as a career, helping them stay in school,

and giving them an opportunity to shadow physicians and participate in research and summer programs. Ideally, when these students graduate and become physicians they'll return to their communities and provide similar outreach, Landry says. "This creates a pipeline of people helping each other, from high school students to medical school students to residents to physicians." At MGH, a Diversity Committee co-chaired by its president, Dr. Peter Slavin, and Dr. David Torchiana, chairman and CEO of the Massachusetts General Physicians Organization, is working to integrate diversity into its ongoing strategic objectives, increase numbers of under-represented minorities and women physicians and scientists, and offer pipelines and career ladders for support service employees.

"Every hospital should be doing something to eliminate health disparities," observes BIDMC's Landry. "As we start to do more of these projects, I think we will be doing more for our community and the result will be good for Greater Boston as a whole."