When doctors look more like their patients, it can save lives | Expert Opinion

A few years ago, I was counseling a new mom, explaining why she ought to allow me to give her infant vaccinations to prevent life-threatening illnesses such as measles and mumps.

I was making exactly zero progress.

A third-year medical student quietly sat in a chair in a corner of the examination room, watching me fail to get the mom’s consent to vaccines.

My student asked me if he could stay with the family, while I gathered printed information on the vaccines I hoped the mom might find more compelling than my arguments.

Studies show that families of color are less likely to accept vaccines for a variety of reasons, including the history of racism in medicine. Plus, vaccine hesitancy is on the rise generally, so I wasn’t surprised that I’d need to work a bit harder to convince this mom, who is Black.

But just a few minutes later, I returned to discover that she had changed her mind and was entirely ready to get her baby vaccinated.

Later, I asked the student how he did it.

“I told her about my own mother’s initial hesitancy for vaccines, which I did receive,” he calmly explained.

Did our young patient’s mother just need a few more minutes? Unlikely.

I’m as certain as I can be that she was more open to the words of a care provider who also is Black and so looks more like her family than a white physician ever could.

Science backs me up. Racial concordance, when a professional has the same racial or ethnic identity as their patient, client, customer or student, has been shown to have benefits in many sectors. Racial concordance in teaching leads to better student outcomes and even lower stress in teachers. Racial concordance in the judicial system has yielded fairer sentences for Black and brown defendants.

And in medicine, it can save lives.

On June 29, 2023, the Supreme Court of the United States overturned four decades of precedent significantly limiting the use of race status in college admissions.

That’s why health-care providers like me, who serve mostly marginalized, under-resourced communities, are so concerned about new evidence showing the impact of the court’s decision limiting the role of racial status in college admissions.

At St. Christopher’s Hospital for Children, which takes care of the highest percentage of Medicaid patients of any pediatric academic medical center in the United States, over 82% of our families identify as Black or brown.

Four in 10 Philadelphians identify as Black, compared with fewer than two in 10 nationally. Yet this picture is changing rapidly: By 2060, it’s estimated that a majority of American children will identify as Latino, Black, Asian, Native American, or multiracial.

How will this diverse population match with the physician workforce?

Not well. Only 5.4% of physicians in America are Black and 7% are Latino.

At St. Christopher’s, 82% of physicians, physician assistants, and nurse practitioners, are white or Asian, the mirror opposite of our patient population.

When health practitioners look more like their patients, the benefits far outlive the pediatric years.

A large study looked at patient-physician concordance in adult patients with diabetes who were at high risk of cardiovascular disease, the number one killer of Americans. It established that Black patients who received treatment from Black physicians and Spanish-speaking patients who could speak their own language with their provider were far more likely to take the medications they need to manage their serious health conditions.

A large Florida study published in Pediatrics showed that when Black newborns are cared for by Black physicians, their chance of dying is half of what the study found among Black infants with white providers. This is critical information, given that the Black community suffers three times the infant mortality rate as white Americans.

These studies and many others explain why the American Academy of Pediatrics supports affirmative-action programs to boost numbers of underrepresented minority students into medical school.

But since the 2023 Supreme Court ruling, many colleges and universities have reported changes in enrollments showing declines in enrollment among the very students our medical workforce so badly needs.

Just this month, new data from the Association of American Medical Colleges (AAMC) is showing what many in medicine feared after the decision. Concordance and with it potentially the health of underrepresented communities is on the decline.

In 2024, the number of Black first-year medical students declined 11.6% and the Latino drop was nearly as bad at 10.8%.

So the first medical school class selected since the court’s decision means the worst fears of health experts who value the care of underrepresented Americans may be coming true.

On the other hand, the American Association of Colleges of Osteopathic Medicine showed small improvements, with Black students increasing from 3.9% to 4.7% and Hispanic students rising from 7% to 9%. But considering that there are fewer than one-third as many osteopathic medical schools as allopathic institutions, that’s hardly going to solve the problem.

Long term, reaching out to elementary and high school students with appropriate support to get them interested in the sciences and medical education might help. So it is critical that institutions of higher learning support such pathways programs and use effective race-neutral admissions practices to increase matriculation of underrepresented students.

Another idea: Increase minority representation in hospital governance and leadership positions. But at a time of political and business backlash against diversity, equity, and inclusion policies, making strides is all the more challenging.

But there is no denying the mounting medical evidence in favor of concordance in medicine.

“It’s critical for everyone to understand, this is not about racial preferences,” said Norma Poll-Hunter, senior director of equity, diversity, and inclusion for the AAMC. “This is about the nation’s health.”

This is about the health of the most vulnerable among us. This is about saving lives.

Daniel R. Taylor is an associate professor at Drexel University School of Medicine and pediatrician at St. Christopher’s Hospital for Children.