Who gets to work in health care? - Health & Medicine Policy Research Group

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Who gets to work in health care?

May 30, 2023 Written By: Anson Tong

In reference to representation in medicine, Dr. LaMenta Conway pointed out, “You cannot be what you cannot see.” Having personally not seen a doctor until age sixteen, and now working on programs that provide educational support and engagement for students interested in health care professions through the I Am Abel Foundation, Dr. Conway is very familiar with the myriad obstacles stopping many from pursuing careers in health care. Primary care in particular suffers from a severe shortage in staff and would benefit from greater diversity.  

Health & Medicine convened a Forum for Justice in Health Policy on Friday, May 12, 2023 to discuss the primary care crisis. The panel was moderated by Dr. Claudia Fegan, Chief Medical Officer at Cook County Health and board member at Health & Medicine. The speakers were Dr. LaMenta Conway, founder and board president at the I Am Abel Foundation; Dr. Eric Reinhart, political anthropologist, physician, and psychoanalyst at Northwestern University; and Dr. Steven K. Rothschild, department chair of family medicine at Rush Medical College. You can watch a recording of the panel here.  

It means a lot for patients to seek medical care and be seen by health care providers with shared experiences and understandings, who speak their first language, and can make recommendations that consider the many other factors in life that impact what kind of treatments will work. Being a patient is often an experience wrought with vulnerability and uncertainty, and the value of having a relationship with the care team and being validated as a person is immense. 

For this to happen, the work starts far earlier, ensuring that all students have the prerequisite STEM education, that going to college and medical school isn’t shorthand for being consigned to a lifetime of debt. Given the inequities, such as racism and class inequities, in our society and in educational opportunities, the exclusion of some groups people from STEM fields including medicine takes diligent long-term policy change, investment, and programming to begin to make a difference. There are fewer Black men in medicine now than when Dr. Fegan attended medical school in the 1970s. 

Getting medical education itself right also requires reflection and refinement by those working within academic medicine. The conventional ideas around physicians often elide the work done by other members of the care team as well as the work done by community health workers and caregivers. Dr. Rothschild pointed out that, “We train [medical students] to be the hero of their own narrative… none of these problems we just described are going to be solved by some courageous physician. It is collective action that is needed. We’re already rewarding a very narrow band of individuals based on this individualistic ideology.” 

This all points to a struggle in the dynamics of the future of health care for physicians, which Dr. Reinhart highlights: “A lot of the work that we need to do to build effective health systems in the US is work that is going to diminish the revenue and the cultural influence and the economic force of the medical field. And there are lots of disincentives for doing that. And I think that has downstream consequences, really inhibiting us from producing the political forms that we need in order to make the demands that we need which I think have to be around basic social care systems.” 

Physicians have a key role to play in altering the path our health care system is on, and it will involve embracing public health, embracing collective action, and the reality that nobody can solve this crisis on their own. 

If you’re interested in reading more about this subject, Health & Medicine has developed a reading list to help. Health & Medicine has also made a summary of primary care relevant loans and scholarships that exist in Illinois right now.