This article appears in the January 2010 edition of The Providence American newspaper. Portions of this article appeared in a December 2009 Urban Health Watch blog post called “Train the Trainer Opportunity: Talk About Jobs in Healthcare.”
by Reza Corinne Clifton
PROVIDENCE, RI – Whether it’s a health reform dialogue, a workforce development presentation, or a conversation about ways to engage youth, it’s hard not to hear about the nation and state’s impending labor shortages in medicine. This is even more apparent if you are having conversations or doing analysis about doctors and physicians that identify as people of color.
Take just a month ago, on December 3, 2009, when, during a speech at a conference in Atlanta, the then newly inaugurated U.S. Surgeon General, Dr. Regina Benjamin called for more minorities in “medical, dental and nursing schools.” According to the Atlanta Journal-Constitution, she cited data showing “there were more [African American] physicians per capita” in 1910 “than there are today,” a figure that sounded similar to what some were saying in 2008.
Making the claim a year and a half ago was Dr. Nelson Adams of the National Medical Association, an organization of African American physicians, and Dr. Ronald Davis, who, at that time was the immediate past president of the American Medical Association. The two appeared together on the PBS “Newshour” show on July 10, 2008, for an apology by Dr. Davis on behalf of AMA for more than half a century of institutionalized racism his organization carried out. Acknowledging that African Americans were largely forbade from joining the member organization, Dr. Davis and Dr. Adams united to discuss the “‘stain left by a legacy of discrimination.’”
One ‘stain’ cited by Jeffrey Brown, the interviewer on the program, was the fact that “less than 3 percent of the country’s doctors and med students are black” when their population size is at 13 percent. Still, the workforce shortage problems and lack of culturally reflective staff are not unique to doctors and physicians.
According to a 2007 “skills gap” analysis done by Quality Partners of Rhode Island (QPRI), the rate of ethnic minority residents in long-term care facilities jumped during the last decade while “[RI] nursing homes are fast approaching a…shortage of certified nursing assistants and licensed professional staff.” However, according to authors of a 2008 analysis of skills gaps in nursing, “there are serious limits on the number of [nursing school] enrollees that can be accepted due to faculty shortages, budget constraints and limited physical space.”
How can RI and the community position themselves to properly respond to these shortages? To help address barriers potentially associated with school costs, the AMA gives scholarships, explains Dr. Davis, to “deal with rising tuition and growing indebtedness that medical students face.” After all he says, the average student graduating faces “$130,000 of indebtedness.”
Yet somewhere between physicians and CNA’s are a number of positions that, like their bookends, are forecasted to have openings: registered nurses, medical assistants, and other “frontline” health care workers. To get there, though, most employers and licensing guidelines require candidates to have post-secondary degrees and experience in the field. But these advancements should be supported, in part, by stakeholders and agencies that already employ healthcare workers according to a study called “From the Entry Level to Licensed Practical Nurse.”
Strategies presented in the report’s four case studies included working directly with employers; offering remedial instruction in math and literacy; assisting student-employees with college-readiness programming and financial aid resources like funds from Department of Labor, the Workforce Investment Act and federal scholarships; and creating mechanisms to identify, support, and retain learners with different levels of academic achievement.
According to Dr. Adams of the NMA, the key is addressing what has to be done, “in a culturally competent, culturally sensitive, and culturally congruent way.”
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