Experts tell lawmakers to champion diversity in health care workers

Why does California need a more diverse health care workforce, and how can such initiatives improve patient access, experience, and outcomes? Health Workforce Experts, Physicians , a community-based organization, addressed these questions during a Feb. 20 Congressional Health Committee information hearing chaired by Rep. Mia Bonta (D-Oakland). Their main message is that legislators should develop policies that champion representation and diversity in the health care workforce.

Lawmakers heard from representatives from the California Healthcare Foundation (CHCF), the California Pan-Ethnic Health Network, the California Black Health Network (CBHN), the Latino Coalition for a Healthy California, and the California Health Care Access and Information Authority (HCAI). heard. Leader of Roots Community Health Center, Altamed Health Services, and many other health care providers.

Kathryn E. Phillips, deputy director of CHCF's Access Improvement Team, believes that only coordinated and continued investment in education and training will ensure that all Californians receive high-quality access from professionals ready to meet their needs. He testified that we can build a medical workforce that will ensure access to care.

“There are no spot fixes,” Phillips said. “Our health care workers are critical infrastructure. It's the infrastructure of care. Just like roads and bridges, they need regular assessments. We need infrastructure upgrades. Our workforce deserves more. It's worth it. Our patients deserve care.”

Experts pointed to a variety of factors that need to be addressed in California to ensure patients receive fair care, including:

• Nearly half of California residents identify as Latinx/x or Black, but only 14% of UC medical school graduates and less than 9% of active health care workers identify as Latinx/x or Black doing.
• More than half (52%) of licensed providers speak only English, but 19% of California households have limited English proficiency.
• Although only 3.6% of behavioral health providers are Asian Pacific Islander (API) speakers, API speakers make up nearly 10% of the state's population.
• Latinos, who make up 39% of California's population, are underrepresented among licensees in 47 health professions in every region of the state.

The issue of employee representation is a personal one for Ilan Shapiro, MD, MBA, chief medical correspondent and medical affairs director at Los Angeles-based Altamed. Shapiro, who graduated from medical school in Mexico City and now works as a pediatrician in Los Angeles, told lawmakers that speaking the same language as patients increases positive patient responses and improves medical outcomes. .

“When patients actually come to me, they hear those words. [Spanish]And you feel the culture as well as the language,” he said. “And I can actually talk about vaccines. Tess —therapeutic tea—and actually connects with parents as well as children. This is the future of our community. ”

If the program is successful, the number of representatives will increase.

Shapiro pointed to programs such as the Certified Physician Pilot Program from Mexico, which imports physicians to federally qualified medical centers in California to provide care in areas where there is a consistent shortage of Spanish-speaking physicians. noted success. Currently, 24 doctors from Mexico serve a predominantly Latino and farmworker population at clinics in Monterey, San Benito, Tulare and Los Angeles counties. Each physician is licensed by the California Medical Board (PDF) to practice in the state for three years.

As of December 2022, physicians have treated tens of thousands of Californians and met quality and safety expectations. Shapiro told lawmakers California has an opportunity to build on these gains.

“Is there a solution to everything?” Shapiro said. “Unfortunately, that's not the case. But I think we're on the right path in terms of bringing in doctors who actually understand the language and are culturally attuned. That could make a big difference. There is a sex.”

Meron Agonafar, policy and legislative affairs manager at CBHN, said the underrepresentation of Black health care workers perpetuates long-standing health disparities. She pointed to the CHCF study. Hear the stories of black Californians One in four Black Californians avoids care for fear of being abused or disrespected, research shows.

In response to that study, CBHN launched the “HOW DO I…” campaign to help Black Californians navigate the health care system, advocate for family, friends and themselves, and take action when faced with discrimination. It was started.

“Black Californians have clearly stated that they are more likely to seek treatment and adhere to treatment plans when their care is provided by people who look like them and reflect their communities,” Agonafer said. said.

Challenges related to diversity in the medical workforce

Panelists suggested to lawmakers that state leaders could expand on existing efforts to increase diversity and representation.

• Improve data disaggregation to better understand the language needs of Medi-Cal patients and the impact of the lack of providers fluent in languages ​​other than English.
• Increase funding for academic scholarships and student loan repayments for early career professionals who want to work in underserved communities similar to the ones they come from.
• Advancing a comprehensive admissions process for all California health professional schools, especially medicine, dentistry, and pharmacy programs, allowing more students to practice in rural and low-income areas without leaving the state.
• Strengthen partnerships between California Community Colleges and California State University campuses to provide students from underrepresented communities with an affordable path to allied health professions. These systems have greatly increased the diversity of the nursing workforce.

Experts at the hearing highlighted recent successes by states and philanthropic organizations in diversifying the health care workforce.

• Establish an HCAI that plays a key role in talent investment, data collection, and reporting.
• Supports pipeline programs such as UC Programs in Medical Education (UC PRIME) and the California Medicine Scholars Program. These programs identify, recruit, and support students from underrepresented backgrounds, including students of color, rural students, and first-generation college students.
• Expanding support to schools that improve students' life experiences and have admissions practices similar to California's medical population, such as Charles R. Drew School of Medicine and the University of California, Davis School of Medicine.

“[As a state] We need to work together better to get resources to the programs and communities that need them most, and we need to start rewarding those agencies that deliver the results our state values ​​most,” Phillips said. said. “We need bold action, not just incremental progress.”