Minority providers
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Minority providers Presentation Transcript

  • 1. “Importance of and Unique Role ofProviders of Color in AddressingDisparities, Health Equity, andDelivering Quality Care”Luther A. Virgil, Jr., MDChief Executive Officer,Chief Medical Officer,National Minority Clinical Research Association (NMCRA)Atlanta, GA
  • 2. Objectives• At the completion of this presentation, the participants should be able to:2.Describe the current state of the HIV workforce and specifically the state of minority providers and HIV3.Discuss the factors motivating and restricting providers of color in addressing the needs of their respective communities of color4.Describe the critical importance of providers of color in terms of access, stigma, and quality of care
  • 3. Objectives• At the completion of this presentation, the participants should be able to:2.Describe strategies and recommendations for addressing health disparities and health equity as they pertain to providers of color.3.Propose strategies by which providers can SYNC their efforts, practices, organizations, and professional groups to address disparities and health equity for communities of color and other disproportionately affected groups (gay men of color, women, transgender, etc.)
  • 4. The Current State of the HIV Workforce
  • 5. State of the HIV Primary Care Provider Workforce • The HIV workforce is not well defined • The current HIV medical workforce is largely composed of the first generation of HIV medical providers who entered the field more than 20 years ago.1 • One-third of current HIV providers are in the last quarter of their careers and plan to retire within 10 years11. HIV Medicine Association. Averting a Crisis in HIV Care. The Body.com. June 2009. http://www.thebody.com/content/art52526.html
  • 6. State of the HIV Primary CareProvider Workforce
  • 7. The Current State of the Minority HIVPrimary Care Provider Workforce
  • 8. State of the Minority HIV Primary Care Provider Workforce • A 2004 report on health disparities, found that although 25 percent of the nations population is minority, only 6 percent of its physicians are minority. Thats the same percentage found in the Flexner report, which was published in 1910.1 • African-American and Hispanic medical school graduates represent just one-tenth the number of White graduates, according to the Association of American Medical Colleges.21. Regina Benjamin. Surgeon general calls for more minority health professionals. The Chart. December 5th, 2009. http://pagingdrgupta.blogs.cnn.com/2009/12/05/surgeon-general-calls-for-more-minority-health-professionals/2. HRSA CARE Action Newsletter. Workforce Capacity in HIV. April 2010. pg. 6, http://hab.hrsa.gov/newspublications/careactionnewsletter/april2010.pdf
  • 9. State of the Minority HIV Primary Care Provider Workforce • In 2007, African Americans comprised 48 percent of reported AIDS cases in the U.S., and Latinos comprised 19 percent, However, among the HIVMA membership only 4 percent are African American and 6 percent are Latino1 • In 2007, among the AAHIVM membership only 8 percent are African American and 7 percent are Latino.11. HIV Medicine Association. Averting a Crisis in HIV Care. The Body.com. June 2009. http://www.thebody.com/content/art52526.html
  • 10. State of the Minority HIV Primary Care Provider Workforce • Summer of 2008, HIVMA and Forum for Collaborative Research survey revealed that nearly 70 percent of Ryan White Part C-funded HIV programs reported difficulty recruiting HIV clinicians, with particular difficulty in recruiting African American and Latino clinicians11. HIV Medicine Association. Averting a Crisis in HIV Care. The Body.com. June 2009. http://www.thebody.com/content/art52526.html
  • 11. State of the Minority HIV Primary Care Provider Workforce • The shortage of health care providers in HIV/AIDS care is part of the larger primary care crisis in this country1 • Supply of providers will not meet the demand for services over time (due to population growth, aging, and other factors)1 • Failure to promptly address HIV medical workforce issues could lead to the collapse of the HIV care system21. 2008 Health Resources and Services Administration HIV/AIDS Workforce Meeting. http://hab.hrsa.gov/care/keythemesworkforce.htm2. HIV Medicine Association. Averting a Crisis in HIV Care. The Body.com. June 2009. http://www.thebody.com/content/art52526.html
  • 12. Factors Restricting and MotivatingProviders of Color
  • 13. Causes of the Current Status  The number of patients has increased but the number of providers is decreasing or remaining stable (depending on location)1  Stigma remains a concern in treating HIV/AIDS especially for providers in rural and remote areas1. 2008 Health Resources and Services Administration HIV/AIDS Workforce Meeting. http://hab.hrsa.gov/care/keythemesworkforce.htm
  • 14. Causes of the Current Status  The health care workforce is aging and retiring at rates higher than new providers are entering the workforce. (Some HIV experts claim this situation is even more pronounced with clinicians serving HIV/ AIDS patients)1  A lack of qualified HIV clinicians and reimbursement were identified as the major barriers to recruiting and retaining HIV clinicians21. 2008 Health Resources and Services Administration HIV/AIDS Workforce Meeting. http://hab.hrsa.gov/care/keythemesworkforce.htm2. HIV Medicine Association. Averting a Crisis in HIV Care. The Body.com. June 2009. http://www.thebody.com/content/art52526.html
  • 15. What Motivates Providers of Color? Common reasons shared by minority doctors: •Helping Others - The most common reason given by applicants to med school •Easing Suffering •Improving Care - 77% of African American physicians and 52% of Latino physicians say unfair treatment based on race or ethnicity happens in minority communities1 •Making Medical Miracles •Giving to the Community •Gaining Respect •Making Money •Continuing the Family Tradition1. The Kaiser Family Foundation. “National Survey of Physicians Part I: Doctors on Disparities in Medical Care”. March 2002.http://www.kff.org/minorityhealth/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=13955
  • 16. The Critical Importance of Providers ofColor
  • 17. Role of Minority Providers in Addressing Health Disparities • Studies document improved outcomes when patients see physicians of the same race, including for those with HIV1,2 • Data suggests that in general, more effective care is provided when clinicians and patients have similar cultural backgrounds and speak the same language1 • Minority health providers "are significantly more likely than their white peers to serve minority and medically underserved communities,“3 • In 2010, Minorities comprised approximately 70 percent of reported AIDS cases in the U.S.41. Cooper LA et al. Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med, 139(11):907-15.2. King W et al. Does racial concordance between HIV-positive patients and their physicians affect the time to receipt of protease inhibitors? J GenIntern Med, 19(11):1146-1153.3. Kaiser Network.U.S. Medical Profession Does Not Reflect Growing Minority Population. February 6, 2004.http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=220764. CDC. HIV Surveillance by Race/Ethnicity (through 2010). http://www.cdc.gov/hiv/topics/surveillance/resources/slides/race-ethnicity/index.htm
  • 18. Role of Minority Providers in AddressingHealth DisparitiesTherefore:• The availability of Minority health providers is a necessary component to provide quality healthcare to underserved health related populations
  • 19. Strategies for Addressing HealthDisparities Related to Providers of Color
  • 20. Increasing the Number of Minority HIV Primary Care Providers • Policy makers, professional societies, social organizations, medical providers, community groups, patient’s rights groups, advocates, and others must work together to address the medical workforce issues: 1. Secure National Data on the State of the HIV Medical Workforce federally funded major national study of the HIV medical workforce1. HIV Medicine Association. Averting a Crisis in HIV Care. The Body.com. June 2009. http://www.thebody.com/content/art52526.html
  • 21. Increasing the Number of Minority HIV Primary Care Providers 1. Attract and Recruit new HIV Clinicians with a special focus on recruiting Minority HIV Medical Providers incentives which improve reimbursement and reduced administrative burden Support full funding of the Health Professions Title VII and VIII programs.1. HIV Medicine Association. Averting a Crisis in HIV Care. The Body.com. June 2009. http://www.thebody.com/content/art52526.html
  • 22. Increasing the Number of Minority HIV Primary Care Providers 1. Build a strong HIV Medical Workforce Training Pipeline1  provide students, residents, and post graduate clinicians with opportunities to provide HIV care in both inpatient and outpatient settings  provide supportive learning through teleconferences, live and web-based programs to increase competence and confidence 2. Ensure that the reformed health care system provides support for HIV physicians11. HIV Medicine Association. Averting a Crisis in HIV Care. The Body.com. June 2009. http://www.thebody.com/content/art52526.html
  • 23. Effective Strategies in Retaining Minority HIV Primary Care Providers 1. Establish a comprehensive data collection system which identifies the needs of Minority HIV primary care providers1 2. Policy makers, professional societies, social organizations, medical providers, community groups, patient’s rights groups, advocates, and others must work together to address the identified needs 3. Incentives which improve reimbursement and reduce administrative burden must be continuous and flexible11. 2008 Health Resources and Services Administration HIV/AIDS Workforce Meeting. http://hab.hrsa.gov/care/keythemesworkforce.htm
  • 24. Effective Strategies in Retaining Minority HIV Primary Care Providers 1. To reduce burnout, define productivity standards, including defining norms for staffing and use of inter- and multi-disciplinary teams1 2. In the context of coordinating patient care, link supportive services directly to clinical teams to avoid burnout and enhance retention1 3. Employ a multi-faceted approach to retain those who are currently in the field.1. 2008 Health Resources and Services Administration HIV/AIDS Workforce Meeting. http://hab.hrsa.gov/care/keythemesworkforce.htm
  • 25. SYNC’ing Efforts to Address Disparitiesfor Communities of Color
  • 26. SYNC’ing Efforts to Address Disparities• Establish a harmonious relationship between:
  • 27. Summary• The HIV workforce is not well defined• Those providing care to the HIV-infected need additional expertise in HIV medicine• Those providing care to the HIV-infected must have sensitivity to the particular issues of stigma and concerns of special populations• Racial and ethnic minorities are a necessary component to provide quality healthcare to the HIV population
  • 28. Summary• Racial and ethnic minorities are still underrepresented in health care professions• Supply of providers will not meet the demand for services over time• Failure to promptly address HIV medical workforce issues could lead to the collapse of the HIV care system
  • 29. Summary• To address HIV medical workforce issues: 1. Secure National Data on the State of the HIV Medical Workforce 2. Attract and Recruit new HIV Clinicians 3. Build a strong HIV Medical Workforce Training Pipeline 4. Ensure that health reform measures provide support for HIV physicians 5. Ensure that a comprehensive coalition of organizations work together to address the medical workforce issues 6. Employ a multi-faceted approach to retain those serving in and those who enter the HIV field
  • 30. The End