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What Arizona Docs are Saying...Diversity in Medicine

From Print Issue - Spring 2021
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Acknowledging physicians of different colors, beliefs, sexuality, backgrounds—and appreciating the differences. We can learn to practice better medicine by not having a one-fits-all approach. – Sara Kertz, DO

Diversity of ideas. Race is irrelevant. – Anonymous, MD

I think diversity means understanding the uniqueness each physician brings to his or her practice based on their ethnicity, gender, upbringing, education, and philosophies. We need to be more accepting of different points of view and stop the cancel culture. – Anne Garrett, MD

Inclusion, humanity, and compassion. - Monica Faria, MD

Having a variety of doctors - people of color, differing physical abilities, and LGTBQ variety. – Jacqueline May Carter, MD

Diversity in medicine means having representatives from all groups at the table including but not limited to ethnic minorities, people with disabilities, and women. This should include the clinicians as well as healthcare executives and policy makers. – Traci N. Fitzhugh, MD, FACOG

Acceptance and inclusion of people from all demographics including race, sex, religion, and disability status WITHOUT BARRIER. – Veronica Ruston, DO

It means hearing from a plurality of voices, including different ages, genders, races, ethnicities, and backgrounds in medical practice. – Melanie Cloonan-Schulte, MD

Diversity means to have people who come from different backgrounds and have different ways of thinking. Diversity is not static, it is dynamic. Diversity reflects our humanity. - Ricardo Correa, MD

It implies there is an adequate (ideally optimal) representation of different genders, races, religions, sexual orientations, and cultures among healthcare workers. – Neil Fernandes, MD

Diversity in medicine means being knowledgeable and open to treating a broad spectrum of patients from various races, socioeconomic backgrounds, religious beliefs, and sexual orientations. It means giving the highest quality of care to all my patients because they have bestowed their trust in me. – Anne Maiden-Hope, DO

Q1: What diversity in medicine mean to you?

Meet the Participating Physicians:
Traci Fitzhugh, MD, FACOG

Southwest Contemporary Women's Care

(480) 820-6657

swcwc.net

Jacqueline May Carter, MD

Crossover Health

(602) 451-1702

crossoverhealth.com

Ann Cheri Foxx Leach, MD

Nocio Interventional Pain Management

(480) 818-4314

nociopain.com

Q2: Would greater diversity of physicians lead to improved care for patients?

Of course! We need to learn that some medications don’t work well for certain groups of people, or that certain treatment plans wouldn’t fly in particular cultures. Because our patients are so diverse, we need to understand their backgrounds. Physicians of different races, genders, etc., are great knowledge sources! – Sara Kertz, DO

No. Greater diversity of race, ethnicity, gender, sexual orientation, culture, or tribe does not necessarily facilitate greater diversity of ideas. To the contrary, measures to re-distribute opportunities along these lines only stifles free ideas, creates division among doctors and lowers quality across the system, directly harming patients’ outcomes. – Anonymous, MD

Yes. Our experiences and background can prejudice our judgement and actions as well as provide cultural sensitivity, empathy, and understanding. – Robert Dixon, MD

I look forward to a time we do not judge people on their gender, race etc. and look at their accomplishments and their unique abilities. – Ann Garrett, MD

Yes. Patients would feel like they could identify more with their doctor/feel understood. – Monica Faria, MD

Studies have shown black doctors treat Black patients differently than Caucasian patients with better outcomes. – Jacqueline May Carter, MD

Absolutely, we all tend to be a bit myopic when informing our perceptions of the world. Greater diversity limits the impact of this by having a variety of perspectives contributing to patient care as well as differing viewpoints to challenge individual biases and stereotypes. – Traci N. Fitzhugh, MD, FACOG

I have interacted with many physicians who have treated me with less respect because of my gender, ethnicity, and disability status. I have been discriminated against and prevented from working. Those who have not been treated this way cannot understand the large and most underserved part of our population. They are comfortable enough to not tolerate and accept those who struggle and need more help than others. These comfortable physicians are egocentric and unable to empathize. – Veronica Ruston, DO

Diversity among physicians leads to improvements, but it may be in subtle ways. However, the clearer way it may lead to improved care is if more diverse patient populations feel comfortable accessing medical care because someone "like them" is providing it. - Melanie Cloonan-Schulte, MD

Sadly, not necessarily. People can stereotype their own race etc. Attitudes need to change via education and experience. - Victoria Horstman, RN, BSN, MD

Yes. Physicians have a big impact in the health care of their patients, and they can provide better care if they understand the backgrounds of patients. For example, physicians who know what the typical food of that population is can help in decreasing obesity as per certain studies. Physicians from diverse backgrounds usually address social determinants of health. – Ricardo Correa, MD

Having diversity among their peers inevitably challenges physicians to explore and understand the unique issues facing patients of all skin types and cultures. – Neil Fernandes, MD, FAAD

If patients can recognize a kindred spirit, they may engage more in the medical system, have a higher utilization of preventative care services, and hopefully have better health outcomes. Not too long ago, women were a minority in the field of medicine. While we have made strides as a society, there is still more work to be done. – Anne Maiden-Hope, DO

Meet the Participating Physicians:
Veronica Jean Ruston, DO

Best Life Medicine

(623) 232-0082

bestlifefamilymedicine.com

Monica Faria, MD

Arizona Professionals Health Program

(602) 429-8447

arizonaphp.net

Ricardo Correa, MD, EdD

Phoenix VA Health Care System

(602) 277-5551

phoenix.va.gov

 

 

 

The U.S. is diverse, so our leaders should be as such! We miss out on different ideas. People who would otherwise be significant contributors to society may not be given the same opportunities to succeed. – Sara Kertz, DO

It provides better access, innovation, and outcomes in healthcare. – Robert Dixon, MD

A more diverse workface brings more ideas and better understanding of the people we serve and care for in our daily lives. – Ann Garrett, MD

Because we are a melting pot of cultures and races. – Monica Faria, MD

Our patients are diverse, and we know that your background influences how you relate to people and the care you provide, so more variety equals more choices for patients. – Jacqueline May Carter, MD

Representation matters when decisions are being made. It is important that decision makers and clinicians have diverse backgrounds so that they can meet the needs of all the people for whom they care. – Traci N. Fitzhugh, MD, FACOG

To broaden the mainstream, narrow-lensed medical care that is so commonly practiced. – Veronica Ruston, DO

For patient comfort in receiving care and information. – Judith Barnes Clark, MD, FAAP

Like in any community, it adds to the richness and varied experience, which may help with relating to patients of varied backgrounds as well as help to ensure certain viewpoints are not the only ones at the table for decision-making. – Melanie Cloonan-Schulte, MD

Multiple studies show patients feel more comfortable with physicians who look like them. Those studies showed there is an improvement in the management and diagnosis of a disease when handled by a physician who understands the culture of the patient. – Ricardo Correa, MD

A more diverse medical workforce enhances our ability to provide the best care possible to our diverse population of patients. Although I truly believe that any healthcare worker can provide excellent care to any patient, observing diversity among those who take care of them inspires confidence in patients that their unique needs are being considered and met appropriately. – Neil Fernandes, MD, FAAD

A more diverse workforce is a mirror of a more diverse society. – Anne Maiden-Hope, DO

Q3: Why is a more diverse workforce important to the medical community?

Meet the Participating Physicians:
Judith Barnes Clark, MD, FAAP

Hip Kids Pediatrics

(480) 477-9490

hipkidspediatrics.com

James Bertz, MD, FACS

Scottsdale Facial and Oral Surgery

(480) 941-5005

scottsdaleoms.com

Neil Fernandes, MD, FAAD

Skin and Cancer Center of Arizona

(480) 899-7546

skinandcancercenterofarizona.com

Q4: Do you believe leadership positions in practices and hospitals are available to all physicians, regardless of race, ethnicity, gender, or sexual orientation?

We still have a loooong way to go. Medicine is full of preconceived notions about race and gender. When we see diverse leaders, our work will be done. – Sara Kertz, DO

Yes. – Anonymous, MD

In Phoenix, yes. – Robert Dixon, MD

Yes, I do. – Ann Garrett, MD

Unknown, but probably not. – James E. Bertz, MD, FACS

No. – Monica Faria, MD

Nope. Women lose time for childbearing and part-time positions for caregiving. And there is clearly bias around color and perceived strength/education. – Jacqueline May Carter, MD

Every organization is different - some are trying hard to be inclusive and equitable. Other organizations seem content to maintain the status quo. – Ann Cheri Foxx, MD

No. Often recruiting for these positions is internal and by word of mouth. This automatically creates a selection bias. – Traci N. Fitzhugh, MD, FACOG

No, they are available to whoever knows whoever else. Leadership positions are positions of abuse of power and that abuse is often welded, even since someone is in medical school up until they are practicing as a staff physician. It is a system more based upon prejudice and discrimination than many other professions. – Veronica Ruston, DO

Largely - however, there is some degree of strain on working parents. For example, I am a single parent with a deceased spouse and have two middle school and high school-aged children. – Judith Barnes Clark, MD, FAAP

I suspect so, but there may be subtle barriers that make leadership positions less likely for certain demographics. – Melanie Cloonan-Schulte, MD

It depends on the person, although I have heard of large practices and surgical groups where women still feel underappreciated and passed over for advances. – Victoria Horstman, RN, BSN, MD

The greatest human need is to feel appreciated. Any company that does so will have loyal and dedicated employees. Senior positions in practices and hospitals should be made available to the best candidate, including non-white physicians. Leadership should be fostered and recognized. – Anne Maiden-Hope, DO 

Meet the Participating Physicians:
Melanie Cloonan-Schulte, MD, FACP

Melanie D. Cloonan-Schulte

(480) 821-0788

drmcloonan-schulte.com

Robert Dixon, MD

District Medical Group

(719) 337-7281

dmgaz.org

Sara Kertz, DO

Phoenix Children's Pediatrics - Paradise Valley

(602) 996-0190

phoenixchildrenspediatrics.org/paradise

Q5: How can practicing physicians recruit and retain a more diverse workforce?

Mentoring is always a great option. Outreach in underserved communities not only builds trust with the medical community, but also can show a five-year-old that she, too, can be a doctor. – Sara Kertz, DO

Diversity of ideas can be encouraged by allowing people to freely express their ideas regardless of their race, gender, religious group, or tribe. – Anonymous, MD

Mentor someone who does not look, act, believe as, or come from where you do. – Robert Dixon, MD

By setting a good example - respecting excellence. – Ann Garrett, MD

Through better understanding and hiring workers who best match the practice profile. – James E. Bertz, MD, FACS

Educate themselves, work on clear and focused communication, embrace the humanities. – Monica Faria, MD

This is difficult. – Jacqueline May Carter, MD

Mentor physicians who are early in their career. Be an advocate for physicians who may be challenged to find support in an organization that lacks diversity. Decide to be the change - especially the physicians who are in their mid- to late careers and have the influence. – Ann Cheri Foxx, MD

Practicing physicians can recruit and retain a more diverse workforce by expanding the searches beyond their tight circles. This includes reaching out to residency programs that train more underrepresented minorities and coordinating with minority medical associations. Another pool of talent is existing physicians who are members of underrepresented communities. – Traci N. Fitzhugh, MD, FACOG

Have more than one pathway to becoming board certified. Stop board certification as an absolute necessary standard of "intelligence" when it is just a private organization's way to make money. Board certification has nothing to do with medical abilities. – Veronica Ruston, DO

Word of mouth among patients and peers - professional and personal. – Judith Barnes Clark, MD, FAAP

Just being attentive to the issue and having it on the radar when hiring is the first step, but advertising in ways that may reach out to certain populations. It also helps to have some diversity in the interview process so potential employees see they are joining an organization committed to diversity. – Melanie Cloonan-Schulte, MD

It depends on the proximity of the workplace to a diverse community. – Victoria Horstman, RN, BSN, MD

The first thing is to do an analysis of the patient population. Then, we need to stimulate high school students to seek a career in medicine, offering them rewards for staying in hard-to-fill locations. Over time, those new physicians will create the diversity by attracting more doctors like them. If we do not work from the pipeline, then we will not have a diverse workforce. – Ricardo Correa, MD

Diversity outreach programs and mentorship are key to recruiting and retaining a more diverse workforce. Prioritizing initiatives such as these is crucial in achieving diversity among healthcare workers. – Neil Fernandes, MD

Practicing physicians can recruit and retain a more diverse workforce by perpetuating a culture of acceptance and tolerance while maintaining a high standard of excellence. By having a culture that puts wellness first and prioritizes work/life balance, any employee would thrive because morale would be high. – Anne Maiden, DO

Meet the Participating Physicians:
Anne Maiden-Hope, DO

Midwestern University Arizona College of Osteopathic Medicine

(602) 618-0002

midwestern.edu

Victoria Horstman, MD, RN

Care Access

(480) 570-7843

careaccess.com

Q6: What policies or systemic changes are needed for greater diversity among physicians?

Searching and hiring good leaders with diverse backgrounds. – Sara Kertz, DO

Medicine does not need to expand resources dedicated to top-down influence over tribalistic diversity.  Freedom of ideas, objectively measured excellence in delivering ideal patient outcomes should be the singular goals of medicine. – Anonymous, MD

Access to education; starting with pre-school. We also need low-cost higher education and medical school. – Robert Dixon, MD

Embrace that it is okay to disagree. Hire based on accomplishments and talents rather than just the color of one's skin, gender, or sexual orientation. – Ann Garrett, MD

It must start with the doctor. The rest will follow. – James E. Bertz, MD, FACS

Perhaps understanding differences in values, learning styles, and what would help persons feel supported in an educational institution or the workforce itself. – Monica Faria, MD

For greater gender diversity, we need parental leave. For racial diversity, we need pre-med mentoring programs for underserved and to recruit at colleges. We also need mentoring and greater diversity in leadership roles so they can support the next generation. – Jacqueline May Carter, MD

Providing every child with an excellent early/primary education. Supporting families to successfully nurture their children until adulthood. Mentoring young people from diverse backgrounds to pursue higher education, continuing to provide support throughout college. Invest in medical school students from diverse backgrounds to unload some of the economic burden of new graduates from medical school. Hire and support physicians from diverse backgrounds - enlist a team of organizational influencers to create a safe place for newly hired physicians to learn and grow. Train all members of the healthcare continuum about issues of diversity, equity, and inclusion. – Ann Cheri Foxx, MD

This is such an immense, multi-faceted problem. We could start by taking a deep dive to look at educational and community engagement opportunities that offer exposure to varying healthcare career pathways. This includes offering paid internships beginning at least at the high school level so that those with economic disparities can consider such opportunities. Programs that expose young people to careers in healthcare policy, leadership and administration are just as important as ones that encourage clinical pursuits. Also, funding needs to be available to make higher education more accessible. It goes without saying that we need to broadcast these programs among broader circles. – Traci N. Fitzhugh, MD, FACOG

More pathways to board certification or dissolution of board certification, especially for those in primary care. There are not enough residencies, and many slots each year are given to IMGs or to those who have already completed one or two residencies. Often those who do not know the right people, who aren't white males, or who haven't been deemed disadvantaged enough to become advantaged are ostracized and unable to survive. Social stratification continues to filter out those who have the most in common with the largest demographic of our patient population in the middle class. Due process needs to be due process and not just farces hiding the escalations of abuses of power. – Veronica Ruston, DO

Open eyes. Form quality committees. Host regular debriefings to present information among colleague forums. – Judith Barnes Clark, MD, FAAP

I suppose it begins with who becomes a physician in the first place. There is a lot of diversity currently among physicians in terms of ethnicity, age, and gender, but some groups remain underrepresented. - Melanie Cloonan-Schulte, MD

It needs to start from someone in the family, a mentor, or a teacher telling a child he or she is smart and could become a physician. Also, they need to be a good example of the "golden rule." Then the system that favors US graduates for residencies regardless of merit is bad – for everyone. Plus, we need more residency seats. Multilingual physicians are an asset, but foreign graduates must speak fluent English so patients can safely understand them. – Victoria Horstman, RN, BSN, MD

We need to change the way entering medicine and residency is approached. We should focus more on the person than on the score. We need to have diversity officers at every level who focus on decreasing selection bias by admissions committees. We need to have more department chairs in medical schools who come from diverse background to stimulate more people like them to continue in medicine. We need to decrease the bullying of underrepresented minorities in medicine. We need to work together to create programs that represent the population we are serving. – Ricardo Correa, MD

Community partnerships, so we can communicate to the public that diversity in medicine is something the medical community prioritizes and is willing to work hard to achieve. – Neil Fernandes, MD, FAAD

The policies or systemic changes needed include reaching out to underrepresented communities to establish mentorship and scholarship programs and provide more opportunities for S.T.E.M. courses in primary and high school. Having a dedicated role model to champion and support potential candidates through their own journey is powerful and effective. – Anne Maiden-Hope, DO

DON'T FORGET TO CHECK OUT THE CONTINUING SERIES,WHAT ARIZONA DOCS ARE SAYING IN THE SUMMER 2021 ISSUE OF ARIZONA PHYSICIAN!

Interested in having your voice heard by your fellow peer physicians in Arizona? Please contact us at info@arizonaphysician.com