Though California is among the most diverse places in the nation, its doctors, unfortunately, don’t reflect the demographics of the state. Overall, physicians here are older, whiter and more likely to be male than their patients, and that’s just one of several ways in which California’s health care lags the demands of the market, not to mention patients’ needs.
So it’s welcome news that the giant health system Kaiser Permanente plans to open its own medical school by 2019, and that one of its prime goals will be diversity.
The Oakland-based system, which combines a nonprofit insurance plan with the operation of 38 hospitals nationally, most of them in California, has been a leader in health reform in the age of the Affordable Care Act. Nearly 8 million Californians are enrolled in Kaiser health plans, more than a fifth of the state’s population.
Kaiser specializes in the integrated care that has become a national model, encouraging doctors to work in teams and use technology to control costs and give patients better coordinated treatment. Its medical school will train physicians from scratch in the Kaiser way of doing business, from electronic medical records to online doctor visits. It will emphasize educating primary care doctors.
Graduates will know how to work within the ACA’s tenets, which encourage doctors to keep patients out of the hospital and to stress preventive health care. That’s good, within reason.
Even better, however, is Kaiser’s plan to recruit more black and Latino medical students, a goal that has eluded other medical schools here.
Latinos officially passed whites last year as the largest ethnic group in the state, with 38.6 percent of the population. At the University of California medical schools, however, only 12 percent of last year’s students were Latino. At USC’s Keck School of Medicine, Latinos represented only 8 percent.
The consequences of such disparities aren’t just about fairness. In places with large immigrant communities like Los Angeles and the Central Valley, doctor-patient communication is hampered by the shortage of physicians who speak the same languages as people they’re treating.
Doctors who “no hablan” in a way that can be immediately understood by patients waste precious time scouring halls in search of bilingual aides who can translate. Budgets get stretched to pay premiums for practitioners who are bilingual. Unfamiliar with a patient’s culture, physicians ask the wrong questions.
Kaiser’s program, the size and location of which are being worked out, won’t be the only one pushing the boundaries of the traditional model. The ACA has prompted adjustments in medical schools nationwide.
Some may fear the new school will emphasize efficiency too much. That’s a danger worth watching. But if Kaiser can produce doctors who are easier for California patients to relate to, we’ll all be healthier.
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