Hispanic Physicians Research Articles

Examining Black and Hispanic physicians and other healthcare providers’ attitudes toward the COVID-19 vaccine

ObjectivesRecognizing that the voice delivering the message is as important as the information being shared, we examined vaccine perceptions and willingness to encourage patients to obtain COVID-19 vaccinations among Black and Hispanic healthcare providers. MethodsWe conducted a cross-sectional, online survey of Black and Hispanic healthcare providers who were members of the National Medical Association (NMA), National Hispanic Medical Association (NHMA), and National Pharmaceutical Association (NPhA) between January 11 – March 3, 2021, shortly after emergency use authorization (EUA) for the Pfizer and Moderna COVID-19 vaccines. Three multivariable logistic regression models were used to determine factors associated with the willingness to encourage COVID-19 vaccination. ResultsThe analytic sample consisted of 542 fully completed surveys. Pharmacists reported intent to take the vaccine (75.0% “as soon as you can” vs 91.4% for MD/DOs; p<0.001) and encouraged patients to get vaccinated (78.6% vs 91.0% for MD/DOs; p = 0.01). Providers in a suburban practice location were less likely to recommend vaccines to patients (OR=0.43, 95%CI: 0.22–0.87) and personal family (OR=0.45, 95%CI: 0.22–0.92) compared to those practicing in urban areas. Providers over age 45 were also more likely to report intent to take the vaccine themselves as soon as it was available (OR=3.72, 95%CI: 1.30–10.64). ConclusionsThis is likely the first cross-sectional study in the United States demonstrating the substantial vaccine confidence among Black and Hispanic healthcare providers who serve minoritized communities that have borne the greatest risk of adverse COVID-related outcomes.

Bridging the Racial, Ethnic, and Gender Gap in Gastroenterology

Bridging the Racial, Ethnic, and Gender Gap in Gastroenterology

The National Deficit of Black and Hispanic Physicians in the US and Projected Estimates of Time to Correction

This cross-sectional study of US population and physician workforce data projects rates at which medical school matriculation would have to increase for Black and Hispanic medical students to reach equal representation in the workforce.

Workforce solutions to address health disparities.

This review focuses on physician workforce racial & ethnic diversity as a solution to improve perioperative and peripartum health equity. Black, Indigenous, and Hispanic physicians remain underrepresented in medicine (URiM) and anesthesiology, and efforts to expand this workforce have had limited impact. Psychological forces, including implicit bias, aversive racism, outgroup bias, racial attention bias, stereotype threat, and imposter syndrome all act to reinforce structural racism and decrease opportunity for advancement. Evidence based solutions are emerging, but require institutional commitment and widespread engagement of the entire medical community. Academic medicine has recognized the need to diversify the physician workforce for more than 50 years, and yet Black, Indigenous, and Hispanic physicians remain URiM. Foundational assumptions and power structures in medicine limit entry, advancement, and retention of URiM physicians. Solutions require leadership and institutional commitment to change the policies, procedures, priorities, and culture of academic medicine.

Racial, Ethnic, and Gender Representation in Leadership Positions at National Cancer Institute–Designated Cancer Centers

Increasing diversity is beneficial for the health care system and patient outcomes; however, the current leadership gap in oncology remains largely unquantified. To evaluate the gender, racial, and ethnic makeup of the leadership teams of National Cancer Institute (NCI)-designated cancer centers and compare with the city populations served by each center. This retrospective cross-sectional study examined gender, race, and ethnicity of leadership teams via publicly available information for NCI-designated cancer centers and compared results with national and city US census population characteristics, as well as active physician data. Data were analyzed in August 2020. Racial, ethnic, and gender diversity (identified via facial recognition software and manual review) of leadership teams compared with institution rank, location, team member degree(s), and h-index. All 63 NCI cancer centers were included in analysis, and all had identifiable leadership teams, with a total of 856 members. Photographs were not identified for 12 leaders (1.4%); of the remaining 844 leaders, race/ethnicity could not be identified for 7 (0.8%). Women make up 50.8% of the US population and 35.9% of active physicians; in NCI cancer centers, 36.3% (306 women) of cancer center leaders were women. Non-Hispanic White individuals comprise 60.6% of the US population and 56.2% of active physicians, but 82.2% of cancer center leaders (688 individuals) were non-Hispanic White. Both Black and Hispanic physicians were underrepresented when compared with their census populations (Black: 12.7% of US population, 5.0% of active physicians; Hispanic: 18.1% of US population, 5.8% of active physicians); however, Black and Hispanic individuals were even less represented in cancer center leadership positions (29 Black leaders [3.5%]; 32 Hispanic leaders [3.8%]). Asian physicians were overrepresented compared with their census population (5.6% of US population, 17.1% of active physicians); however, Asian individuals were underrepresented in leadership positions (92 Asian individuals [11.0%]). A total of 23 NCI cancer centers (36.5%) did not have a single Black or Hispanic member of their leadership team; 8 cancer centers (12.7%) had an all non-Hispanic White leadership team. A multivariate model found that leadership teams with more women (adjusted odds ratio, 1.73 [95% CI, 1.02-2.93]; P = .04) and institutions in the South (adjusted odds ratio, 2.31 [95% CI, 1.15 to 4.77]; P = .02) were more likely to have at least 1 Black or Hispanic leader. Pearson correlation analysis showed weak to moderate correlation between city Hispanic population and Hispanic representation on leadership teams (R = 0.5; P < .001), but no significant association between Black population and Black leadership was found. This cross-sectional study found that significant racial and ethnic disparities were present in cancer center leadership positions. Establishing policy, as well as pipeline programs, to address these disparities is essential for change.

Hispanic Identity and Its Inclusion in the Race Discrimination Discourse in the United States.

As protests against racism occur all over the United States and medical institutions face calls to incorporate antiracism and health equity curricula into professional training and patient care, the antiracism discourse has largely occurred through a Black/African American and White lens. Hispanics, an umbrella category created by the U.S. government to include all people of Spanish-speaking descent, are the largest minority group in the country. Hispanics are considered an ethnic rather than a racial group, although some Hispanics self-identify their race in terms of their ethnicity and/or country of origin while other Hispanics self-identify with any of the 5 racial categories used by the U.S. government (White, Black/African American, American Indian or Alaska Native, Asian, or Native Hawaiian or Other Pacific Islander). Expanding the antiracism discourse in medicine to include Hispanic perspectives and the diversity of histories and health outcomes among Hispanic groups is crucial to addressing inequities and disparities in health and medical training. A lack of inclusion of Hispanics has contributed to a growing shortage of Hispanic physicians and medical school faculty in the United States as well as discrimination against Hispanic physicians, trainees, and patients. To reverse this negative trend and advance a health care equity and antiracist agenda, the authors offer steps that medical schools, academic medical centers, and medical accreditation and licensing bodies must take to increase the representation of Hispanics and foster their engagement in this evolving antiracism discourse.

Diversity, Equity, and Inclusion: A strategic priority for the American Pediatric Surgical Association

Diversity, Equity, and Inclusion: A strategic priority for the American Pediatric Surgical Association

Women and Minorities Underrepresented in Academic Cardiothoracic Surgery: It’s Time for Next Steps

Women and racial and ethnic minorities are underrepresented among U.S. physicians, but are limited data on cardiothoracic surgery diversity. This study characterizes current racial and ethnic and gender diversity in academic cardiothoracic surgery. Accreditation Council for Graduate Medical Education and Association of American Medical Colleges databases were queried for racial and ethnic and gender demographics of residents and faculty. Cardiothoracic surgery was compared with other surgical subspecialties and medicine overall. A total of 17% of cardiothoracic faculty were women, compared with 27% of surgical faculty (P < .01) and 43% of clinical faculty (P < .01). A total of 63% of cardiothoracic faculty were White, compared with 70% of surgical faculty (P < .01) and 66% of clinical faculty (P= .10). A total of 24% of cardiothoracic faculty were Asian American/Pacific Islander, compared with 18% of surgical faculty (P < .01) and 20% of clinical faculty (P= .03). Black/African American and Hispanic physicians composed 3% and 5% of cardiothoracic faculty, respectively, similar to surgical and clinical faculty. A total of 24% of cardiothoracic trainees were women, compared with 36% of surgical residents (P < .01) and 46% of all residents (P < .01). A total of 66% of cardiothoracic residents were White, compared with 55% of residents overall (P < .01) and 65% of surgery residents (P= .68). A total of 18% of cardiothoracic residents were Asian American/Pacific Islander, compared with 17% of surgery residents (P= .87) and 24% of residents overall (P < .01). Black/African American and Hispanic residents composed 4% and 5% of cardiothoracic residents, respectively, similar to surgery and residents overall. Women and racial and ethnic minorities are significantly underrepresented among trainees and faculty in academic cardiothoracic surgery compared with surgery and medicine overall, demonstrating a need for concerted action.

Race, ethnicity, and gender in academic obstetrics and gynecology: 12-year trends

Diversity among healthcare teams enhances team function and improves the quality of patient care and outcomes. Women and racial minorities are historically underrepresented in medicine. However, the representation of gender and racial or ethnic groups in academic obstetrics and gynecology in the United States has not been described in recent years. This study aimed to describe the recent state and trends in gender and racial or ethnic disparities in academic obstetrics and gynecology. Data from the Association of American Medical Colleges between 2007 and 2018 were analyzed to describe the trends in the representation of women and racial (white, Asian, black) or ethnic (Hispanic) groups. The 12-year trends in representation by academic ranks (all academic physicians, full professor, associate professor, instructor), leadership positions (chairperson), and tenure (not on track for tenure, on track for tenure, or tenured) were depicted. The 12-year trends were assessed using linear regression to determine whether the slope depicting the change in representation of each group from 2007 to 2018 was significantly nonzero. In addition, average representation of each group across the 12-year period was compared using a Student t test (for gender) or analysis of variance (for race and ethnicity). In 2018, there were 152 institutions and 6302 academic physicians included in the data set. On average across the 12-year period, academic physicians in obstetrics and gynecology were 43% male, 57% female, 68% white, 12% Asian, 8% black, and 5% Hispanic. Across the 12-year period, there was an increase in the total number of physicians from 4755 to 6302 (+166 per year; 95% confidence interval, 146-186; P<.0001), a 15% increase in the proportion of women (+1.38% per year; 95% confidence interval, 1.08%-1.68%; P<.0001), and an increase in the proportion of physicians from racial minorities (Asian,+0.11% per year; 95% confidence interval, 0.08-0.15; P<.0001; black,+0.07% per year; 95% confidence interval, 0.04-0.09; P=.0002; Hispanic,+0.06% per year; 95% confidence interval, 0.02-0.1; P=.0039). There was a greater proportion of white physicians in higher academic ranks (eg, full professor), leadership positions (eg, chairperson), and tenure than the proportion of white physicians overall, whereas the opposite was true for black and Hispanic physicians. Although women now make up 64% of all academic physicians in obstetrics and gynecology, there remains a far higher proportion of males in leadership positions (chairperson) and higher academic ranks (full professor). Similarly, a greater proportion of males were tenured than females. Across the 12-year period, the representation of women and racial minorities has increased in academic obstetrics and gynecology in the United States. There is now a predominance of women, but there remains a trend for a predominance of white and male physicians in higher academic ranks, leadership positions, and tenure. It will be important to assess how these groups are represented in the coming years as the changing demographics of incoming cohorts progress through their careers to more senior positions. Promoting diversity in medical schools, leadership positions, and higher academic ranks may be an important area of focus.

Abstract WMP86: Persistent Gender and Racial Disparities Among Neurology Residents and Vascular Neurology Fellows Over the Past 10 Years

Introduction: Women and minorities are underrepresented in academic medicine. There is little in the literature about gender and racial disparities among neurology or vascular neurology trainees. At the International Stroke Conference, women overall and women physicians have been underrepresented as invited speakers and abstract first authors, and there is recent momentum for improvement. Methods: Data were collected from the Accreditation Council for Graduate Medical Education public website. Dataset included neurology resident and vascular neurology fellow gender data from 2007 to 2017 and race data from 2011 to 2017. Data were analyzed by chi-square test and one-sample proportion test. Results: From 2007-2017, women represented 45% of all neurology trainees and only 33% of all vascular neurology fellows, both significantly lower than 50% (p&lt;0.0001). There was no trend in the proportion of gender by year for vascular fellows (p=0.11) or neurology trainees (p=0.39). However, each year, except for 2012-2013 and 2015-2016 for vascular fellows, varied significantly by gender where men represented the largest proportion. Race varied by year for vascular fellows (p=0.03) and neurology trainees (p=0.017). Blacks and Hispanics represented the lowest proportions and Whites represented the highest proportion of both vascular and neurology trainees. When comparing Whites vs Non-Whites for both fellows (43% vs 57%; p=0.76) and residents (50% vs 50%; p=0.14), there was no trend in the proportions by year. Conclusions: Women, Black and Hispanic physicians remain underrepresented as vascular neurology trainees. The low representation of women and underrepresented minorities has not changed in the last decade. Addressing gender and racial disparities among trainees should be a high national priority for future medical and scientific contributions from these groups.

Playing doctor on TV: physician portrayals and interactions on medical drama, comedy, and reality shows

ABSTRACT Based on genre theory, this quantitative content analysis compares physician portrayals, behaviors, and patient-centered communication practices in 2,658 scenes from medical drama (Grey ’s Anatomy), comedy (Scrubs), and reality (New York Med) shows. Significant differences among the programs’ portrayals of television doctors notwithstanding, the overall results indicate that Black, women, and younger physicians were over-represented while Asian, Hispanic, international, and older physicians were under-represented. Further, the reality show portrayed fewer negative behaviors and more patient-centered communication practices than the comedy or drama. As the first comparative analysis to include a medical comedy and to parse programs by scene instead of episode, the results provide important implications for genre-specific cultivation effects. Moreover, the results identify particular issues in physician portrayals that television producers may use as suggestions for improving programming and that medical educators may use to teach patient-centered communication practices.

Differences in salaries of physician assistants in the USA by race, ethnicity and sex.

Objectives Data from the Academy of American Physician Assistants have suggested there are no differences in salaries by race and ethnic group. Our objective was to compare salaries of physician assistants for different racial and ethnic groups and sexes using another data source. Methods Data from the American Community Surveys (2010-2012) to examine pay differentials of physician assistants. Ordinary least squares regression analysis to compare the salaries of males and females, and those of racial and ethnic groups. Results The majority of physician assistants in recent decades have been women. Their salaries are substantially below those of their male counterparts. The number from racial and ethnic minorities remains low. American Community Surveys data show salaries to be lower than that reported by the American Academy of Physician Assistants. The salaries of Black and Hispanic physician assistants lag significantly behind the salaries of those who are White. Conclusions American Community Surveys data suggest that previously published Academy of American Physician Assistants survey data may have been biased with a low percentage of physician assistants from racial and ethnic minorities which suggests that the Academy of American Physician Assistants need to focus on recruiting greater numbers of minorities.

New Medical School Hopes to Address Community’s Mental Health Needs

Back to table of contents Previous article Next article Education and TrainingFull AccessNew Medical School Hopes to Address Community’s Mental Health NeedsEve BenderEve BenderSearch for more papers by this authorPublished Online:2 Jun 2015https://doi.org/10.1176/appi.pn.2015.5b20AbstractPsychiatrist Francisco Fernandez, M.D., the first dean of the University of Texas Rio Grande Valley School of Medicine and a recent recipient of the National Hispanic Medical Association’s Physician of the Year Award, describes his hopes for the new school.Francisco Fernandez, M.D., has a vision that one day the Rio Grande Valley at the southernmost tip of Texas will not only shake its reputation as one of the sickest regions in the nation—known for its staggering obesity and diabetes rates affecting a mostly Mexican-American population—but also become one of the healthiest places in the United States.For his contributions to the health of Hispanic communities, Francisco Fernandez, M.D., was named Physician of the Year at the National Hispanic Medical Association’s (NHMA) Leadership Awards Gala in March. Fernandez, who is the founding dean of the University of Texas Rio Grande Valley School of Medicine, is flanked by Elena Rios, M.D. (left), president and CEO of the NHMA, and Sam Arce, M.D., chair of the NHMA board of directors.Justin RamirezFernandez is the inaugural dean and vice president for health affairs at the newly established University of Texas Rio Grande Valley (UTRGV) School of Medicine. He is also a professor of psychiatry.Prior to accepting his new post, Fernandez spent 12 years as the chair of psychiatry and behavioral neurosciences and a professor of community and family health at the University of South Florida Morsani College of Medicine in Tampa, Fla.Fernandez recently traveled to Washington, D.C., to accept the National Hispanic Medical Association’s (NHMA) Physician of the Year Award to a standing ovation at the organization’s 19th Annual Leadership Awards Gala. The NHMA is a nonprofit association based in Washington, D.C., that represents the interests of about 50,000 licensed Hispanic physicians in the United States. “We presented the award to Dr. Fernandez based on his longstanding career as an academic physician, [his accomplishments as] the third Hispanic dean of a medical school on the U.S. mainland,” and his leadership in creating a medical school in the Rio Grande Valley that will enhance care of many Hispanics, NMHA President and CEO Elena Rios, M.D., M.S.P.H., told Psychiatric News. Fernandez told Psychiatric News that he values his years of membership and work with the NHMA. “So many people here have been enormously supportive of my work in HIV and have served as role models for me,” he noted. The coming months will be filled with activity related to the startup of the medical school, including a site visit by the Liaison Committee of Medical Education, the organization responsible for granting accreditation status to the school. Once approval is granted, the first medical school class could matriculate as early as the summer of 2016. Fernandez will also work with the Accreditation Council for Graduate Medical Education to obtain accreditation for the school’s residency programs. Part of the mission for UTRGV, Fernandez said, will be to find solutions to the area’s health problems, which include drug and alcohol dependence, depression, degenerative disorders, and domestic violence in addition to complications related to obesity. He noted that the area’s residents are poor and largely underserved in terms of access to health services.He also noted that all those involved in the existing Rio Grande Valley academic community, including students, staff, and educators, “define community engagement in their actions and carry the mission of the medical school in their hearts day in and day out.” ■ ISSUES NewArchived

Physician-Patient Race Concordance from the Physician Perspective

The benefits of racial/ethnic physician-patient concordance have been cited to support increasing the number of minority physicians. Few studies have examined the rates at which physicians of different race/ethnicity groups or specialties see concordant visits. We aim to determine whether differences exist in rates at which physicians of different race/ethnicity groups and physician specialties see visits by patients of concordant race/ethnicity. We used data from the National Ambulatory Medical Care Survey, 2001-2006, a nationally representative survey of visits to private physician's offices. For physicians of each race/ethnicity group, the percentage of visits by patients in each race/ethnicity group was calculated. A concordant visit was defined as one in which a physician in a particular race/ethnicity group saw a patient of the some race/ethnicity group. Concordance rates were calculated overall, and for visits to primary care, medical specialties, and surgical specialties individually. White physicians see a higher percentage of concordant visits than any other race/ethnicity of physician (84.3%, p < 0.001 vs. all others), followed by Hispanic physicians and non-Hispanic black physicians, who had statistically similar rates (50.0%, and 46.8%, p > 0.05 for comparison), with non-Hispanic Asian physicians having the lowest rate of concordant visits (14.5%, p < 0.001 vs. all others). Minority surgical and medical specialists have significantly lower rates of concordant visits (33.4% and 33.6% respectively) compared to minority primary care physicians (49.5%, p < 0.001 for both comparisons). Concordance rates from the physician perspective differ by physician race/ethnicity and by physician specialty.

Georgetown University School of Medicine

Georgetown University School of Medicine

Abstract ED06-02: Effective resources for recruitment for cancer prevention research

Abstract ED06-02: Effective resources for recruitment for cancer prevention research

Primary Care Physicians' Attitudes and Practices Regarding Discussing Organ Donation With Their Patients

Among the general population, discussing organ donation with a primary care provider may be associated with increased willingness to donate. However, the frequency with which primary care providers hold these discussions with their patients has not been reported. Cross-sectional mail and an Internet survey of validated questions regarding organ donation were done. A national sample of 831 primary care physicians. black, and Hispanic physicians were oversampled. Few physicians reported receiving formal training in donation (17%). Only 5% of physicians have donor cards available in their practice, and only 11% have donation information available in their practice. While 30% of physicians reported discussing end-of-life care with their patients, fewer than 4% reported discussing donation with their patients. However, only 36% felt that discussing donation was outside of their scope of practice. In a multivariate regression model, predictors of discussing donation with patients included having received formal education about organ donation (odds ratio [OR], 2.6; p < .05) and discussing end-of-life care with patients (OR, 12.8; p < .001). Very few primary care physicians reported discussing organ donation with their patients despite the majority agreeing that it was within their scope of practice. Primary care physicians who had received education on the subject or who regularly discuss end-of-life care with their patients were more likely to discuss donation. Efforts to improve donation in the general population should include a focus on understanding and improving communication about organ donation between providers and their patients.

Does the Under‐ or Overrepresentation of Minority Physicians across Geographical Areas Affect the Location Decisions of Minority Physicians?

To determine whether variation in the representation of minority physicians across geographical areas in California affects the location decisions of minority physicians. We analyzed data on 9,806 residents and 53,606 patient-care physicians from the 1997-2003 American Medical Association Masterfiles for California along with data from the California Department of Finance, RAND, and other sources. We estimated departure models using linear probability models and destination models using conditional logit. Each model controlled for physician and county characteristics. Parameters of interest include the interactions of physician race/ethnicity with area-level minority physician representation for the corresponding race/ethnicity. Departure models show that black and Hispanic physicians are more likely to remain in an area as the level of representation of physicians from their respective groups worsens. The destination models show that black, Asian, and Hispanic physicians tend to move to areas where the level of representation is similar to that of their previous location. Black and Hispanic physicians are influenced by the level of representation of physicians from their respective groups in their location decisions and tend to locate where needed.

The illusion of minority status

It is common to think in terms of ‘minority’ admissions when considering displaced Natives (First Nations peoples) or populations who capture lower percentages of total physicians when compared with their percentage of the population. In America, the African American, rural, Hispanic, and lower income origin physicians are all ‘underrepresented’. Each group captures less than 10% of total physician graduates. The use of the terms ‘minority’ or ‘diverse’ should be recognized as a construct of those shaping workforce studies. It is a perception and a series of observations, typically from past tradition or based on majority status.

Which physicians have access to electronic prescribing and which ones end up using it?

This study examines the availability of electronic prescription and the utilization of e-prescribing by physicians in the US. Nationally representative data from the 2004-2005 Community Tracking Study Physician Survey were used to identify which subgroups of physicians have access to e-prescribing technology and which subgroups are using this technology more or less intensively. Exhaustive Chi-squared Automatic Interaction Detection (CHAID) was employed for statistical data segmentation. Results indicate that the rapidly increasing adoption of electronic prescription is diminished by relatively low physician utilization. E-prescription utilization was segmented among practice size and type. There were also differences in e-prescription use by age, gender, and ethnicity/race in some subgroups. Actual use of e-prescription was very low for female physicians in surgical specialties, psychiatry, and obstetrics/gynecology, and for Hispanic physicians in pediatrics, internal medicine, and family/general practice in solo/two physician practices, medical schools, and hospitals. Insights from segmentation analyses could be used to identify adoption barriers and to develop targeted interventions to accelerate the implementation of e-prescription systems in physician practices.