UCSF Health Workforce Center Pinpoints Shortage of Minority Doctors
By Liz Burdick
New data on California physicians confirm that there is vast ethnic disparity in the state's physician workforce when compared to the state's population, particularly for Latinos and African Americans.
While Latinos represent one third of the state's adult population, only 5% of California physicians are Latino. While African Americans represent 7% of the state's population, only 3% of California's physicians are African American.
The data also highlight why physician diversity is a critical public health issue, demonstrating that non-white physicians play a critical role in access to care for Californians by being more likely than their white counterparts to work in primary care fields and practice in underserved communities.
The report, "Physician Diversity in California: New Findings from the California Medical Board Survey" was released today by the Center for California Health Workforce Studies at the University of California, San Francisco. This is the first analysis of data compiled by the California Medical Board following enactment of a law requiring the Board to collect detailed information on physicians' work hours, specialties, ethnicity, languages spoken and practice location upon a physician's license renewal every two years. The bill was sponsored by the California Medical Association due to concerns about the lack of reliable data on the physician workforce. This first report focuses on ethnic disparities in California's physician supply, but the Center intends to continue analyzing data in several categories.
"Californians have been worried about problems in access to care due to lack of insurance coverage and recent cuts in Medi-Cal payments to physicians. Another important dimension to the access problem is 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," said 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. "In a state where 40% of the population is either Latino or African American, it is disturbing to find that fewer than 10% 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."
Grumbach expressed concern about recent budget cuts to federal programs that support minority students to prepare for careers in medicine and other health professions. In 2006, the federal government reduced funding by 89% for the Health Careers Opportunity Program and by 65% 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 stated. He called on federal and state policymakers to focus on the disparities in the physician workforce and invest in a physician workforce in California that will better serve the state's residents.
"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," said Satinder Swaroop, MD, Chair of the CMA Foundation's Network of Ethnic Physician Organizations. "Increasing workforce diversity through mentoring programs and alliances is a top priority for NEPO, and we hope to see this important data confirming that ethnic disparities exist in the state's physician workforce spark swift corrective action in many sectors of business and health care."
The report also includes in its recommendations an increase in incentives for physicians to work in underserved communities, such as the Steven M. Thompson Physician Loan Repayment Program. A bill pending before the legislature and sponsored by the CMA would secure permanent funding for that program.
In a state of more than 35 million people, the report finds there are only about 2,000 African American and 3,000 Latino physicians engaged in patient care in California. The ethnic disparities are more pronounced in certain areas of the state. In the Inland Empire, Los Angeles, and South Central Valley, where the Latino population is 40% or more, the Latino physician population is 6-8%.
The report also found that while Asians as a whole are not underrepresented in medicine in California, some particular Asian ethnicities are markedly underrepresented among physicians. These groups include Samoans, Hmong/Laotians, and Cambodians.
Other findings of the study:
- • Service to the Underserved: Ethnic physicians are more likely to serve in underserved areas than their white counterparts, and more than 40% of ethnic physicians work in primary care.
- • Languages: Spanish is the most common self-reported second language spoken among doctors, and is spoken by one fifth of all doctors in a wide variety of ethnicities. Of physicians who speak East Asian languages, 97% are Asian physicians.
- • Female Physicians: A slightly larger percentage of ethnic physicians are women, compared to white physicians.