New commission targets health care disparities

Washington -- A major effort to ensure that members of all racial and ethnic groups have equal access to the best health care has to offer was launched Jan. 31 by the AMA, the National Medical Assn. and the National Hispanic Medical Assn.

"We'll use our skills and the science and art of medicine in ways that have not been used before," said AMA President John C. Nelson, MD, MPH, at a press briefing to announce the Commission to End Health Care Disparities. "Our nation's physicians must strive to ensure that all patients can receive the highest quality of health care."

The three physicians' groups have joined with more than 30 other health-related organizations to form the commission, which intends to educate physicians and other health professionals about existing gaps in care and to develop and disseminate strategies to help bridge those gaps.

The health disparities are very real, Dr. Nelson said. For example, while state-of-the-art clot-buster drugs are used 59% of the time among white male heart attack patients, the rate is 44% for African-American females.

The issue is also one of quality of care, and substandard care is costly in terms of dollars as well as lives lost, Dr. Nelson said.

"To close gaps in health care that are based on race and culture, we must honestly and effectively confront and eliminate them at their source," said Randall W. Maxey, MD, PhD, immediate past president of the NMA.

Two projects are already under way, Dr. Maxey said. The commission has sent out surveys to 2,000 physicians to gather information about what works and what doesn't in physicians' interactions with patients from racial or cultural minority groups. "The survey will help us to understand what doctors can do and what they are doing," he said.

Diversity among physicians

The survey results will provide a basis for guidelines so physicians "will know what to do when someone with a different background walks through their door," Dr. Maxey said.

The commission also is promoting selected training programs that use case studies, self-assessment activities and videos to improve physicians' cultural competency, he added.

"A one-size-fits-all approach to medicine does not recognize the special needs of our diverse patient population," said NHMA President and CEO Elena Rios, MD, MSPH.

Plus, the nation's population is growing more diverse, said Louis Sullivan, MD, former Health and Human Services Secretary and head of the Sullivan Commission on Diversity in the Healthcare Workforce. Of the 8 million people in New York City, for example, 3.2 million are members of minority groups that include recent immigrants from the Dominican Republic and Bangladesh, said Dr. Sullivan, who spoke at the briefing.

The Sullivan Commission's report, "Missing Persons: Minorities in the Health Professions," offers recommendations to boost the number of minority doctors in the work force. Now fewer than 10% of doctors in the nation are minorities, while 25% of the patient population is African-American, Hispanic-American or American Indian, according to the report.

The new commission has been in the planning stages for a year and a half, said Dr. Nelson. Discussions began shortly after the release of the 2002 Institute of Medicine report, "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care." The committee that produced that report was headed by former AMA President Alan R. Nelson, MD.