Patients benefit when people like them are represented in the workforce that takes care of them. That includes Hispanic and Latinx patients benefiting from having people of their own race and ethnicity as practicing oncologists. The benefits include improved access, enhanced culturally and linguistically competent care, minimization of health disparities, and overall better care. But there are significant gaps in representation of Hispanic and Latinx people in the general U.S. population and the oncology workforce. Addressing them will take action at the individual and institutional levels. That's the bottom line in a new article on the topic published in the JCO Oncology Practice earlier this year (2022; doi: 10.1200/OP.22.00153).
In an interview with Oncology Times, Sybil R. Green, JD, RPh, MHA, ASCO's Chief Equity, Diversity, and Inclusion Officer, as well as co-author of the article, explained what actions need to be taken by large organizations like the American Society of Clinical Oncology and others, as well as by individual providers-and why they'll help.
1 Why was it important to write this paper now?
"Persons of Hispanic/Latinx origin comprise 18.7 percent of the population and 16.8 percent of the adult population in the United States, but are only 4.7 percent of practicing oncologists. We know that patients are deprived of the benefits of a representative workforce, such as improved access to care, enhanced culturally and linguistically competent care, and minimization of health disparities.
"ASCO has released its Equity, Diversity, and Inclusion (EDI) Action Plan, which sets a specific goal to create an oncology workforce that better reflects the diversity of the U.S. population. So, this is a critical issue when considering how to provide the highest quality of care to our patients."
2 What are some of the factors driving the gap between Hispanic/Latinx representation in the overall population and Hispanic/Latinx representation in the cancer care workforce?
"Qualitative and quantitative studies have repeatedly found common obstacles and challenges to the professional success of underrepresented in medical students and trainees. Some of the most common obstacles include a lack of support and minority role models; implicit and explicit discrimination and bias; incompatibility of students' cultural beliefs and the culture of the dominant institutions; testing and test scores; problems with self-efficacy and self-limitation; and financial burdens."
3 What are key takeaways for current oncologists and cancer care providers in terms of how to address this representation gap?
"To see consistent improvement and change in the number of persons of Hispanic/Latinx origin in oncology, there must be systemic, institutional changes and individual efforts. While this paper discusses the effort to increase representation in the workforce, it is still the responsibility of all physicians to address the needs of Hispanic/Latinx patients.
"ASCO is taking on some of the institutional and systemic changes by offering a portfolio of awards and programs focused on longitudinal support and career development of underrepresented in medicine medical students and residents. The Medical Student Rotation for Underrepresented Populations, for example, supports a 4-plus week clinical or clinical research rotation for U.S. medical students underrepresented in medicine populations with interest in oncology. Participants are matched with a mentor who oversees their rotation, guides and supervises their research activities, and provides ongoing career mentorship following the rotation.
"That is just one example of ASCO's programming. There are also ASCO's Oncology Summer Internship, ASCO's Diversity Mentoring Program, and the Latina Women Who Conquer Cancer Young Investigator Award.
"ASCO also established goals for increasing the number of underrepresented in medicine members who apply for its professional development programs, ensuring the organization's leadership positions are representative of its membership, and to improve the way members earn points toward the 'Fellow of the American Society of Clinical Oncology' designation.
"In the publication, there is a chart that has several actions that can be taken at the individual level. [Those include calling on] physicians to make an effort to:
* create a mutually inclusive work environment for all by listening actively to issues related to the work environment and becoming an upstander when members of the team face microaggressions or discrimination;
* become a mentor for all by providing opportunities for all members of the team equally and actively seeking to mentor students, fellows, and junior faculty from under-represented groups in medicine, and
* focus on strong recruitment and retention techniques [by facilitating transparency for all the steps in the recruitment process and creating an inclusive environment during rounds, teaching, and other clinical care]."