Inclusivity in Medicine

By Tejaswini Ashok and Chetana Rajesh

They say medicine is constantly evolving and in this era of rapidly evolving technology, more often than not this is the case. But it’s not just technology and treatment that medicine has to evolve in. To truly achieve the goal of healthcare for all , medicine has to ensure that it caters beyond the binary.

We are often reminded that each one of us is unique in our own way. However, medicine often fails to make provisions for these differences. The most glaring being its failure to recognise the spectrum of gender and the challenges faced by differently abled. Drawing from our own experiences in internship seeing patients presenting quite late in the course of a disease that could have completely and easily resolved if the patient had come earlier but couldn’t as they were held back by fear of lack of acceptability and accessibility in a binary heavy healthcare system. We’ve also seen patients and attendees getting agitated over the lack of easy accesibility to different facets of healthcare for the differently abled. As medical professionals in such situations, one often feels helpless because while we know a change needle to be made, no one really knows how distant this particular change is.

The changing curriculum and increasing awareness has helped make a few strides toward this much-needed change yet unless the conversations continue to flow, inclusivity in healthcare is a goal that we are far from achieving.  Being a part of the upcoming generation of doctors, it’s time to draw from the experiences of the past to work toward a brighter future. The recent news of the first transgender ward opening in a hospital at Delhi shows that if we work towards it, slowly but surely we can achieve our goal of inclusivity in healthcare. Yet in many ways this is just the beginning.

A visit to a medical facility may create anxiety for a multitude of reasons. Some people may be hesitant to disclose sensitive information to health care professionals who need it to conduct specialized services, whilst others may find it difficult to discuss personal health difficulties. Making these meetings more pleasant for the patient is an essential objective for all health care practitioners. Since health care is for everyone, we must be prepared to serve people of different colours, ethnicities, religions, ages, and backgrounds. Our potential to enhance health care for all is limited by our failure to recruit, engage, and develop individuals for careers in medicine from all segments of our society.

  • The LGBTQ+ Community

LGBTQ+ individuals have historically been marginalised, resulting in inequitable health care and inferior outcomes. To effectively serve LGBTQ+ patients, we must first understand their cultural background and then alter our methods, behaviour, and language to be inclusive, non-judgmental, and supportive at all times. Therefore, a physician workforce that is reflective of the demographic served is crucial.  As clinicians, we are frequently concerned on the inclusion of our LGBTQ+ patient population, but we are behind in addressing LGBTQ+ medical students and physicians. Although finally embracing the need for LGBTQ+ curriculum in medical education is a significant step forward, it is not sufficient. As per The Association of American Medical Colleges (AAMC), from 2017 to 2019, the percentage of graduating medical students who identified as bisexual went from 4.2% to 5%, while those who identified as gay or lesbian climbed from 3.6% to 3.8%. In India, the major absence of LGBTQ+ representation in medicine might be attributed to an actual numerical shortage of LGBTQ+ physicians, LGBTQ+ physicians avoiding publicly self-identifying owing to anti-LGBTQ+ emotions and reactions, or a combination of the two. According to a 2017 study, positive role modelling by LGBTQ physicians and increasing engagement with them reduced both implicit and explicit prejudice among medical students against the LGBTQ+ patients they treat [1]. It is critical that medical school faculty and staff develop a more inclusive environment for students, challenging the dominance of heteronormative standards and showing their support for LGBTQ+ students in order for them to find allies and establish supportive networks. These relationships may motivate students to achieve professional success while also instilling confidence and positive thoughts about their identities.

  • Race and Ethnicity

Disparities remain among numerous demographics in the United States, with racial and ethnic minority populations having less access to treatment and poorer outcomes than white counterparts. Recently, the crisis of the fall of black males entering medicine has been covered in a number of articles [2]. Also, it is noticed that physicians from traditionally underrepresented racial and ethnic groups are much more likely than white physicians to perform primary care, and they are more likely to practise in impoverished and medically underserved areas. Language concordance is favourably connected with treatment adherence among particular racial or ethnic groups, while race concordance leads in longer visits and better patient satisfaction.

The value of diversity and inclusion in medicine cannot be overstated. It will lessen health inequalities and result in better patient care and trainee education. As healthcare professionals, we must assist to enhance access and quality of care for minority populations by bringing together a diverse and culturally sensitive pool of physicians who collaborate with other health-care providers.




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