Advancing and Strengthening Racial Equity, Diversity, and Inclusion in the Biomedical Research Workforce and Advancing Health Disparities and Health Equity Research(response to rfi not-od-21-066)
The Beyond Flexner Alliance community is deeply heartbroken by the loss of George Floyd, Tony McDade, Ahmaud Arbery, and Breonna Taylor – and so many others in America’s black communities - who have suffered discrimination and inexcusable losses because of racism, violence and injustice. Racism pervades all sectors of society. Healthcare and education is no exception. The Beyond Flexner Alliance is built on the principle of dismantling racism and injustices in health professions education, health systems, and society. We are committed to continuing our work to integrate anti-racist curricula; support and advance health workforce diversity; and provide multidimensional, sustained professional learning experiences for providers, educators, and administrators that advance the health of all racial and ethnic groups. Let us highlight the final words of the Beyond Flexner Alliance’s founder, Dr. Fitzhugh Mullan, as he reflected on his life as a civil rights doctor and the need for medical schools – and all health professions schools – to reform.
"The civil rights doctor and many others have spent careers in pursuit of what we now call health equity, but the world has not moved as far as he would have wanted. Racism is still very much with us, as are massive and growing disparities in health and wealth. These disheartening realities account for tens of thousands of deaths and uncounted days of unnecessary pain and suffering every year. The civil rights doctor’s mission turned out to be changing the culture of medicine, making the idea of health equity central to the character of medicine, and positioning medicine as an agent of social as well as individual healing. Choices physicians make about where and how to practice can bring more compassion to the system but, ultimately, it is the U.S. medical education community that can do the most. Large, resourceful, and distributed, the nation’s medical schools and teaching hospitals have early and strong leverage to change the culture of medicine. The civil rights doctor may have worked hard and with purpose but it is only with a forceful, enduring, and community-wide commitment to social mission that medical education will realize its full 21st century capabilities to build a healing profession."
Fitzhugh Mullan, MD
The Civil Rights Doctor Revisited (Dec. 17, 2019). Academic Medicine
Medical Schools Do Need an Overhaul. Doctors need to be trained in public health, health equity, and social justice.
COVID-19 is laying bare society’s underlying structural inequities that increase the risk of exposure, infection, and death for minority and disadvantaged communities across the US. The pandemic is also disproportionately affecting healthcare workers, who continue to work despite insufficient personal protective equipment and further, face disciplinary actions for speaking out.
Despite these realities, Dr. Stanley Goldfarb in his April 13 commentary suggests “doctors should be trained in pandemics, not injustice,” and that “the medical profession should abandon the fantasy that physicians can be trained to solve the problems of poverty, food insecurity and racism.” Clinical care is estimated to account for only 10-20% of what ultimately impacts health outcomes. Social determinants of health – health behaviors, social and economic factors, and the physical environment – account for the other 80-90% (National Academy of Medicine). The attitude that physicians should focus solely on clinical care aims to disempower the profession and frankly, is dangerous.