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Opinion: Doctors Are Infrastructure

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Our health care system needs to be examined. The COVID-19 pandemic has exposed immense inequities across our health care systems, from coverage gaps to preexisting health conditions. The pandemic has also inspired us to be more forward looking and to take a real look—not just at what’s in front of us but also at how we can look beyond to address needs now so they don’t intensify problems later.

Recently, the American Association of Medical Colleges released a report detailing an impending physician shortage crisis. Report findings predict that by 2034, there will be a shortage of 124,000 doctors, with much of the shortage occurring in the field of primary care. With COVID-19 exposing immense inequity throughout our health care infrastructure, it is imperative that our lawmakers take action now, not only by thinking about reducing shortages but reducing them in the right way that ensures quality access for all. 

Disparities in our healthcare system have always been felt most acutely by communities of color. As the country grows more diverse, the impact of our failing systems will be felt more than ever. This is especially true when we think about the need for a healthy workforce to carry us into the future. The health and wellbeing of all Americans is dependent on trusted messengers and robust provider access in communities currently underserved by our healthcare systems. Thus, it is imperative that the physician shortage be addressed with the aim of both increasing physician numbers and diversifying the field to include more doctors who share language, ethnicity and cultural norms with their patients.  

When physicians share ethnicity or language with patients, they are able to build trust more easily, resulting in more time spent with patients, increased medication adherence, greater shared decision making, less skepticism of treatment, and a decrease in implicit bias. Yet, while the United States has grown more ethnically diverse, the medical field has not. Today, people of color represent about 40 percent of the U.S. population, and their numbers are only growing. By 2043, the nation’s population is projected to be majority-minority. 

Communities of color remain underrepresented in health and medical occupations. This bodes poorly for the future health of our nation. According to the Association of American Medical Colleges, only 6 percent of active physicians are Latino. In contrast, more than half of all physicians are white. 

The crisis is most acute in California. Latinos are the state’s largest ethnic group, but there are only 5.4 Latino resident physicians for every 100,000 Latino residents. But even among peer states like New York, Florida and Texas, the picture is far from bright. New York, which has the highest rates of Latino physicians per population, is still 22 percent below the national average. But it’s not just Latinos that are being impacted by a lack of diversity. It’s Asian and Black communities too. Only 5 percent of all doctors are Black, and a UCLA study found significant underrepresentation of doctors who shared language with their Southeast Asian patients in California

People of color, and Latinos in particular, are essential to the future of America. They are, and will continue to be, our economic backbone, and they have kept showing up to work throughout the pandemic to keep shelves stocked and maintain our communities, despite low wages and a lack of health insurance. 

As we emerge from the COVID-19 pandemic and policymakers explore how to strengthen our failed systems and reduce racial disparities, expanding and diversifying our physician pool is a necessary infrastructure investment. To do this, we must increase opportunities for all Americans to enter health professions, especially physician roles. We can do so by expanding federal scholarships for qualified students from underrepresented communities. Further, grant funding should prioritize language-capable students committed to serving in medically underserved areas, and include funds to support bilingual training in Spanish and a subset of Asian languages. We must also ensure the success of a diverse student base by expanding professional opportunities and financial resources to students committed to primary care by expanding medical residencies across the states. 

These steps are just the beginning to creating an effective healthcare system that works for all Americans. With smart policy, we can create a pathway to good jobs that allows more mature Americans to age with dignity and ensure our youthful and diverse workforce is healthy for years to come.

Sonja Diaz is the founding director of the UCLA Latino Policy and Politics Initiative.

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