PERSPECTIVE

Promoting Health Equity on the Front-Lines

Creating an equitable health system takes a village. As a front-line clinician, you may feel like there’s little you can do to effect system-level change. But the truth is, your organization can’t do it without you. Creating equitable health systems takes a true partnership between executives (who set the vision) and front-line clinicians (who care for patients daily).

As someone who’s worked in both roles, previously as an emergency department medical director and now as Vituity’s Diversity, Equity, and Inclusion (DEI) physician director, I want you to realize how much your efforts and passion matter. Here are some practical ways front-line clinicians can collaborate with their health systems to drive the health equity mission.

Maureen Bell , MD, FACEP

Physician Director, Health Equity

Published August 30, 2023

An Infinite Goal

According to author Simon Sinek, infinite thinkers see their goal as “a constantly evolving and never-ending game with a higher purpose.” I think this is a helpful mindset with which to approach health equity.

Simply defined, health equity is a state of fair and just opportunity where every person can attain their highest level of health. Unfortunately, not everyone in our society has the same access to high-quality, compassionate care. Maternal mortality is a timely example; Black mothers are three times more likely to die from pregnancy-related causes than white mothers.

To achieve health equity, society must remove barriers to care, correct historical injustices, and distribute resources fairly. And many patients expect health systems to lead the way. Up to 87% of millennials and 94% of Generation Z expect companies to take a stance on social issues, including health disparities, racism, and women’s and LGBTQ+ rights.

So, as clinicians, how can we help to move the needle?

Advocating for Health Equity

I believe that individual hearts and minds (of both clinicians and administrators) form the foundation of systemic health equity. Together, we can create a more inclusive healthcare environment by treating each patient with empathy and respect, regardless of their background. Here are three action steps we can take today to gain forward momentum.

First, we must develop awareness around our own implicit biases and how these influence the care we provide. For example, a 2016 survey found that 40% of medical students believed Black patients were less sensitive to pain than patients of other races and ethnicities. And even when clinicians understand the truth intellectually, unconscious biases may cause them to take Black patients’ pain less seriously. (Black patients are 22% less likely than white patients to receive any pain medication.)
Clinicians can also make a difference by staying mindful of the social determinants of health that impact our patients. This allows us to tailor our care to their specific needs and connect them with appropriate resources. Community partnerships and culturally sensitive communication are essential to ensure patients receive the whole-person care they deserve.
Finally, clinicians can take individual action to address health disparities in our communities. My colleague Omar Guzman, MD, an ED medical director in California’s underserved Central Valley, established a doctor’s academy for local (mostly Latinx) high school students and a street medicine program that visits encampments to care for unhoused people. In turn, these activities generate trust and goodwill for the hospital.

Health Equity at Vituity

Hear from Vituity clinicians on how they are impacting health equity in their communities.

Partnering with Health Systems

Of course, our healthcare organizations are also responsible for actively promoting health equity in our communities. Health systems and physician groups have the resources and clout to effect change on a wider, systemic level. And it’s sometimes easy to forget that they need and want our help in that mission.

Clinicians are every health system’s greatest health equity asset. You are the face of the organization and closest to its patients. You understand the barriers that keep many patients from getting the high-quality, compassionate care they deserve. So your participation is crucial to fulfilling the organization’s mission.

So how can you partner with your health system? First, I encourage you to engage with DEI initiatives across your organization. For example, Vituity is currently piloting Health Equity Rounds, which foster conversation around disparities and health equity at our practice sites. You could also consider joining a DEI committee or affinity group, offering educational opportunities, or volunteering for initiatives like street medicine.

Consider also that one of the most effective ways health systems can fight disparities is through community partnerships. Do you have connections to a nonprofit or community organization that can help to address health-related needs? If so, you might be the bridge your organization needs to extend its impact.

Imperatives for the Healthcare Industry

While it’s been a long time coming, we're finally seeing an industry-wide shift toward health equity. The Joint Commission’s first health equity standards were enacted in January 2023. All accredited hospitals must now maintain written plans to address at least one care disparity in their patient populations. They must also assess patients’ social determinants of health and provide appropriate resources.

These new standards create fresh opportunities for physicians to truly partner with their hospitals. Maybe you know of a community organization that could help your health system fulfill its health equity goals. Or you might enjoy volunteering at a street medicine clinic providing clinical care, language assistance, or practical support, like food resources or Medicaid enrollment.

As clinicians, we must commit to ongoing self-assessment, education, and action. By continuously working to eliminate barriers to care and reduce disparities, we can make significant strides toward achieving health equity for all.

Partnering to improve patient lives

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