Improving physician diversity and inclusion benefits physicians and patients

Abstract

A diverse physician workforce in the Canadian health care system would result in more cultural competence, greater patient satisfaction, and improved population health. However, increasing representation and diversity does not automatically resolve issues of inequity, inequality, and discrimination. In this article, we discuss three broad areas of health care — the clinical environment, academic advancement, and leadership — that require intentional, systemic change if we are to make a lasting impact in terms of increasing the diversity and inclusion of underrepresented groups in medicine, and consequently, improve health outcomes. Inclusive and equitable practices to target pay inequity, unconscious bias, opposition to career advancement, and sexual harassment are integral to diverse physician recruitment and retention. Equity strategies and checks to remediate systemic biases in academic advancement through grant funding, academic criteria of merit for promotion, and the acknowledgment of differences of experience can be employed to improve equity in academic medicine. The long-standing culture, policies, and traditions of institutions within the medical establishment must be combated with a collaborative effort to foster equity through the engagement of academics and physicians from underrepresented minority groups, and the implementation of implicit bias training and meaningful accountability for creating a safe, equitable work environment for diverse physicians. Any proposed solution to improve equity and diversity should not be taken as a fixed principle to follow uncritically, but rather as a starting point for understanding and implementing the unique changes required in various local contexts.