We’ve been told as medical students and doctors to “stay in our lane.” We’ve heard time and time again that race and ethnicity should have nothing to do with education and the workplace. The most recent reminder came with President Trump’s recent executive order in which asserted that diversity and inclusion training is unneeded since it is based on the notion that America is racist.
As healthcare providers and Latinx minorities ourselves who have been victim to small and large acts of racism during our education and work, we are insulted by the claim that our country — our schools, our universities, our teachers, or that we ourselves — have no more work to do in becoming more diverse or inclusive.
We have been asked whether we are “from somewhere” because we pronounced words correctly in languages other than English.
We have been asked to take out the trash in a patient room when we were there to perform a skilled medical procedure.
We have been volunteered to lead diversity sessions because we represented the “diversity” in our classes and in professional circles even when our area of expertise was something else.
Yet we have been proud to take on roles above and beyond our initial expectations because we know that diverse teams actually provide better care to patients. To say that our work in diversity and inclusion in higher education — including education for doctors — is unnecessary has the potential to worsen health and safety for the millions of Americans who suffer health disparities because of the color of their skin or the languages they speak.
For example, in the United States, Latinx comprise almost 20% of the population, yet Latinx physicians only account for less than 6% of licensed physicians. Coupled with the lack of Latinx representation in medicine, certain diseases affect Latinx disproportionately: 29% of Hispanic individuals have diabetes compared to 16% of non-Hispanic white people; 15% of Hispanic people suffer from chronic kidney disease and liver cirrhosis compared to 10% of non-Hispanic white individuals. And three times more Latinx and Black people are infected with COVID-19 compared to white people despite lower testing rates in these groups.
How can we provide better care for our communities if we do not consider their communication needs regarding language and culture? From the doctor’s perspective, it is an impossible task. We are trained to ask questions like detectives and come up with the correct diagnoses. If we can’t communicate with the person in front of us — a prospect which is even more challenging while wearing facemasks or looking through the telehealth screen — then we simply cannot give the patient the best possible care.
All of us — Latinx or not — represent our own individual sets of experiences, practices, languages, and identities, and the more we embrace and acknowledge each other by not just what language we speak or words we use, but by the uniqueness of who we individually are, the more we can foster a community that is united and free from the exclusion of some of its members. For example, the Latinx community itself is not homogeneous, but rather it is a diverse and historically rich community that contains an even more diverse myriad of languages, ranging from, but not limited to Spanish, Portuguese, French, English, Mayan, Quechua, and other indigenous languages.
But how can we learn all of this and become better health care professionals if our educational institutions are not selecting students, educators, or doctors with the diverse skill sets necessary to care for the most vulnerable patients? No one doctor will know every patient’s language or culture intimately, but the more diverse our doctor workforce is, the closer it will be to matching and representing the people that we serve.
The reason that our doctor workforce is not currently sufficiently diverse is not because we lack enough talented, intelligent, motivated, or scientific-minded Black and brown students. Let us not kid ourselves into thinking that in the United States everyone has the same opportunities. Like other minority groups, language, economic struggles, violence, gentrification, and other factors have significantly impacted Latinos’ access to education. As doctors who want to heal our diverse community, we must be fluent not only in the language of medicine but also in the language of cultural humility and awareness of the diversity that surrounds and enriches us. We can come closer to cultural humility both through diversity training and by increasing the recruitment and retention of Latinx and other underrepresented students, educators, and physicians.
The question is not whether we are a racist country, but rather, how can we thwart racist actions and ideals from permeating our education, careers, and personal lives? When we begin to believe that we are no longer a country that needs to deal with these questions, then we are perpetuating the gaps in education, the health and economic injustices, and our history of inequity. There is no question that racism and suppression of diversity and diversity training threatens health. If something threatens health, then be assured that it is fully in our lane — as doctors, educators, and humans.
We are a country that struggles with racism, both structural and interpersonal, but we can become a country that rises to the challenge and recognizes that our diversity is what will inspire systems and individuals to think creatively on how to create a better future.
Pilar Ortega, MD, is an emergency physician and clinical assistant professor of emergency medicine and medical education at the University of Illinois College of Medicine in Chicago, and founder and immediate past president of the Medical Organization for Latino Advancement (MOLA). Itzel López Hinojosa is a third-year medical student at the University of Chicago Pritzker School of Medicine. José Alberto Figueroa is a pre-medical student and intern at MOLA.
Last Updated October 30, 2020