Pediatric Reflections Summer 2021

George Dalembert, MD, MSHP, is a pediatrician in CHOP’s Cobbs Creek Primary Care practice and Associate Program Director for the Pediatrics Residency Program.

“The United States is rapidly becoming a more diverse nation [but…] the representation of many [racial/ethnic groups] within health professions [is] far below their representation in the general population.”

You’d be forgiven for thinking that quote was pulled from a recent report on the state of the healthcare workforce. It’s actually from the 2003 Institute of Medicine report Unequal Treatment. Now, 18 years later, there’s still a lot of work to do improving workforce diversity. According to the Sullivan Commission on Diversity in the Health Workforce, the workforce diversity gap—only 14% of pediatric physicians in 2019 were from underrepresented racial/ethnic backgrounds—contributes more to health disparities than even differential access to care.

CHOP aims to be the “world leader in the advancement of healthcare for children.” This requires actively embracing the critical importance of a diverse workforce. All of us have a role to play within our spheres of influence to foster an inclusive environment that promotes a diverse workforce. We must bring our privilege and resources to bear in our pursuit of excellence.

Maybe that means talking to a patient about how they can become a doctor even if they’ve never seen one who looks like them. Maybe it’s taking time to serve as a mentor to a young person and bringing them into our world to see how fulfilling our work is. Maybe you’re in a position to share treasure more than time and can establish scholarships to support underrepresented individuals across the pipeline. Maybe you can foster a clinical environment that does not tolerate microaggressions and holds us to the highest standards of inclusive partnership. Maybe you’re in a position to recruit, promote, or hire an applicant who looks different than the stereotypical person with whom our biases might lead us to fill the role. It’s on all of us to reflect; identify what we can do; and do it.

At 18 years old, the IOM report should be aging out of our pediatric practice. Only together can we make progress toward creating the healthcare systems that our patients deserve and that will deliver the health equity breakthroughs that CHOP is committed to.

References and further readings

Institute of Medicine Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Smedley BD, Stith AY, Nelson AR, editors. Washington (DC): National Academies Press; 2003. Accessed April 27, 2021.

Evans M. Healthcare’s minority report. Sullivan Commission, IOM try to make patient, hospital staff make up more reflective of the nation’s ever-changing population. Mod Healthc. 2004;34(39):6-7, 14, 1.

American Association of Medical Colleges. Diversity in Medicine: Facts & Figures 2019. Accessed May 5, 2021.