That's the finding of a recent study from Harvard.
Researchers at the T.H. Chan School of Public Health examined outcomes for over
1.2 million Medicare patients treated by 44,000 internists at American
hospitals. Patients treated by foreign medical graduates had better 30-day
survival rates than patients treated by U.S.-educated physicians.
The study is the latest to show that racial, socioeconomic,
and international diversity aren't just nice things to have within America's
physician workforce. They're matters of life and death.
More than 31 percent of the U.S. population is Hispanic,
Native American, or African-American. Yet people from these ethnic groups
account for just 6 percent of practicing physicians.
This racial disparity isn't likely to change. Fewer than 14
percent of students admitted to medical school for the 2017-18 school year were
black, Hispanic, or Native American.
Schools also lack economic diversity. Three in four medical
students come from the richest 40 percent of families. Only one in twenty come
from the poorest 20 percent of families.
It's tempting to argue that an applicant's race or
socioeconomic background should be irrelevant in the medical school admissions
In reality, a doctor's background can have more impact on
patient health than even the best academic credentials.
When people of color do seek medical care, they turn to
nonwhite physicians. Sometimes, for language reasons. Two in five Hispanic
patients consider whether a doctor can speak Spanish before choosing to visit.
Sometimes they do so because they're more comfortable with
doctors who look like them and may have similar experiences. Black patients
report higher satisfaction ratings when treated by black doctors.
As a result, nonwhite doctors care for over 53 percent of
minority patients and over 70 percent of non-English-speaking patients,
according to a study in JAMA Internal Medicine. The study concludes
"racial and ethnic diversity of the physician workforce may be key to
meeting national goals to eliminate health disparities."
Socioeconomic diversity is equally important. Doctors with
parents who make less than $100,000 per year are more likely to enter family
medicine, according to a meta-analysis of 57 different studies.
Diversity of national origin is also crucial, especially as
America's immigrant population continues to swell. Since 1990, the number of
foreign-born U.S. residents has more than doubled, to roughly 42 million.
The growth in the diversity of our nation's population
coincides with doctor shortages across the United States. The Association of
American Medical Colleges predicts a shortage of about 105,000 doctors by 2030.
More than 40 percent of that gap could be in primary care.
Doctors trained abroad will play an outsized role in closing
that shortfall. That's in part because American medical school graduates refuse
to do so. Only 15 percent of U.S. medical school graduates go into internal
medicine. Nearly half of international graduates choose the specialty.
Diversity is a top priority at the medical school I lead,
St. George's University in Grenada. Our students currently hail from 104
different countries. Eighty percent receive financial aid. Roughly three-quarters
of our graduates go into primary care.
If the Harvard study is right that international medical
graduates offer better care than their domestically trained counterparts, then
the United States should holds its doors wide open to doctors from abroad.
Policies that block these doctors from practicing in the
United States put Americans at risk by undermining their ability to access
quality health care.
G. Richard Olds, M.D., is President of St. George's
University (www.sgu.edu). He was founding Dean of the University of California,
Riverside, School of Medicine.
Diversity Saves Lives
By Dr. G. Richard Olds