A new report finds a “vast ethnic disparity in the state’s physician workforce, particularly for Latinos and African Americans,” when compared to the distribution of minority groups in the state’s population.
The study said that Latinos represented one-third of the state’s adult population, but only 5 percent of its physicians. African Americans represented 7 percent of the state’s population, but only 3 percent of physicians, it found.
The report, “Physician Diversity in California: New Findings from the California Medical Board Survey” was released April 2 by the Center for California Health Workforce Studies at the University of California, San Francisco.
In a state of more than 35 million people, the report found that about 2,000 African American and 3,000 Latino physicians were engaged in patient care in California. The report also found that while Asians as a whole were not underrepresented in medicine in California, certain Asian ethnicities were markedly underrepresented, including Samoans, Hmong/Laotians, and Cambodians.
Lack of diversity among doctors reduces access to care for patients because studies have found that physicians from minority backgrounds were more likely than their white, non-Hispanic, counterparts to work in primary-care fields and practice in underserved communities, the report noted.
The Center’s report is the first analysis of data compiled by the California Medical Board under a new law that requires it to collect data on physicians’ work hours, specialties, ethnicity, languages spoken and practice location when physician’s licenses are renewed every
two years. The California Medical Association had pressed for the legislation because it was concerned about inadequate data on the physician workforce. While the first report focuses on ethnic disparities, the Center said it plans further analysis of other issues including denial of access to care because of lack of insurance coverage and recent cuts in Medi-Cal payments to physicians.
Kevin Grumbach, MD, Professor and Chair of the Department of Family and Community Medicine at UCSF and Director of the UCSF Center for California Health Workforce Studies said access is affected as well by “the lack of physicians who reflect the ethnic and language diversity of the state’s population and who are committed to working in underserved communities.”
“In a state where 40 percent of the population is either Latino or African American, it is disturbing to find that fewer than 10 percent of California physicians are Latino or African
American. Our findings also confirm the vital role played by minority physicians in California. They are more likely to work in communities with shortages of physicians and to practice in low-income and minority communities.”
“We have a massive problem,” Dr. Jose Bolanos, a Stanford-trained obstetrician-gynecologist and native of El Salvador told the San Jose Mercury News. “The Hispanic physicians who came through the ‘affirmative-action’ programs with me are out in the trenches, delivering the best possible care to the poor — the patients who don’t have the ability to drive to Valley Med. But we need 10 times more doctors than we have.”
Grumbach expressed concern about recent budget cuts to federal programs that support minority
students preparing for careers in medicine and other health professions. In 2006, the federal
government reduced funding by 89 percent for the Health Careers Opportunity Program and by 65 percent for the Centers of Excellence Program, costing California several million dollars annually in federal support for programs to support minority and disadvantaged students in pre-med tracks.
“At a time when the need for these programs is so great, it is alarming to see federal support withdrawn,” Grumbach added. He called on federal and state policymakers to focus on the disparities and invest in a physician workforce in California that will better serve the state’s residents.
Satinder Swaroop, MD, chair of the CMA Foundation’s Network of Ethnic Physician Organizations, said, “Ethnic physicians are vital to the health of California, as they often care for the most vulnerable patients and are able to provide the most culturally competent care in this very diverse state.”
The report also includes recommendations to increase incentives for physicians to work in underserved communities, such as the Steven M. Thompson Physician Loan Repayment Program. CMA is supporting a bill pending before the legislature to secure permanent funding for that program.
“We offer a world of difference,” said Dr. Anthony C. Lopez, a cardiologist quoted by the Mercury News. “Patients feel comfortable. They are more expressive and less fearful. They are able to ask questions about their symptoms and the disease process.”
The report is available at www.calmedfoundation.org/publications/pubs.pressreleases.aspx
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