Black medical professionals are being courted by the Senate to help fill gaps caused by a health care worker shortage that is projected to leave the U.S. with more than 100,000 fewer physicians over the next decade.
But Black doctors are pointing out the major deterrents for breaking into and staying in the industry, including a “broken” system that perpetuates mounting debt, unfair compensation, lack of investment in Black medical students and the mistreatment of medical professionals during the height of the COVID-19 pandemic.
“Our system is broken, and we, as resident physicians, are not fairly compensated for our time spent saving lives while sacrificing our own well-being,” Samuel Cook, a resident physician at the Morehouse School of Medicine said during a roundtable discussion led by Sen. Bernie Sanders, I-Vt. at the Atlanta-based school.
“For far too long, we have fallen through the cracks of a health care system that blatantly, and openly, abuses our binding investments into this field, and it is high time that our plight is heard, appreciated, and acted upon,” Cook continued.
What’s the crisis?
According to the Association of American Medical Colleges (AAMC), there will be an estimated physician shortage of up to 124,000 physicians by 2034. The demand for doctors is expected to outpace the placement of doctors due to an aging U.S. population.
A 2022 report from Definitive Healthcare, a company that tracks health care data and analytics, reveals about 230,000 health care professionals — physicians, nurse practitioners, physician assistants, physical therapists and licensed clinical social workers — left the industry in the fourth quarter of 2021.
Medical professionals say mental, physical and emotional burnout from the COVID-19 pandemic caused workers to leave the profession in order to avoid the risk of unknown dangers of an unprecedented medical crisis.
“Hospital managers treated RNs and other hospital staff as expendable during the pandemic, not caring if we lived or died, refusing to provide lifesaving personal protective equipment until they were forced to do so, and now they wonder why nurses have fled the bedside,” Deborah Burger, a registered nurse and president of National Nurses United, said in a statement to Yahoo News.
Surveys predict that about 47% of health care workers will quit their jobs by 2025. Sanders seeks to address the concern that the U.S. may not be ready for another pandemic because of the shortage.
“We don’t have the public health infrastructure that we need state by state. We surely don’t have the doctors and the nurses that we need,” Sanders said during the roundtable discussion. “So what we are trying to do now is to bring forth legislation, which will create more doctors and more nurses, more dentists.”
What’s the disparity among Black doctors?
Currently, Black doctors make up just 5.7% of physicians in the U.S.
The AAMC says one reason for the lack of Black doctors can be traced back to the Flexner Report of 1910, commissioned by the American Medical Association and the Carnegie Foundation to establish a gold standard of medical training. The report caused over half of American medical schools in the early 1900s to shut down. This included five of the seven historically Black medical schools.
“The shortage is particularly acute in rural and medically underserved communities, where access to quality health care is often limited,” Jeannette E. South-Paul, executive vice president and provost at Meharry Medical College in Nashville, told Sanders during her testimony.
Meharry Medical College is one of only four historically Black medical schools. According to the AAMC, HBCUs make up less than 3% of all MD-degree granting institutions, but have pumped out more than half of all Black graduates in the medical field.
The pandemic also exposed the chronic health care disparities in minority communities such as access to medical treatment and premature death due to existing conditions, which put a disproportionate burden on Black and brown communities.
“HBCU medical schools are uniquely positioned to address this shortage, given our long-standing commitment to training health care professionals from diverse backgrounds who are dedicated to serving in these underserved areas,” Dr. Valerie Montgomery Rice, president of the Morehouse School of Medicine, told CNN.
What’s the solution?
Sanders has said there needs to be a greater effort to attract diverse candidates into the medical profession by creating a pipeline from high school to college. But Black physicians and heads of Black medical schools want to ensure that Black medical professionals are set up for success.
Many schools have backed a bipartisan Congressional proposal, the Resident Physician Shortage Reduction Act of 2023, which adds to the number of Medicare-financed residency slots by 14,000 over seven years. Leaders of the schools support the plan.
Sanders has proposed canceling $1.6 trillion in student loan debt, which he says will “cut the racial wealth gap for young Americans by more than half” and “free up doctors and nurses to work in communities that need care the most.”
Additionally, Congress’s "Pathway to Practice" proposal and National Medical Corps Act scholarship programs would prioritize the applications from HBCUs, Minority-Serving Institutions (MSI), and underserved communities.
AAMC also encourages increasing federal investment into MSIs to help tackle debt for students who are underrepresented in medicine and to expand medical schools.
“But also, the other 150-plus medical schools, beyond our four historically Black medical schools, owe it to the country to increase the diversity of the students that they train,” Rice emphasized, which would help reduce inequities in impacted communities.
Health care professionals also support efforts to alleviate burnout, an issue Congress sought to address with a 2022 law aimed at improving mental and behavioral health.