Diversifying Your Strategy
Building a diverse team can lead to better patient care, increased referrals, and more.
In 2014, Curtiland Deville Jr., MD, assistant professor of radiation oncology and molecular radiation sciences at Johns Hopkins University School of Medicine, in Baltimore, co-authored a paper about diversity in radiology. The researchers found that just 23.5 percent of diagnostic radiologists are women and only 6.5 percent are underrepresented minorities (URMs) in medicine — blacks, Hispanics, American Indians, native Alaskans, native Hawaiians, and Pacific Islanders. But what surprised Deville was that the findings were not new.
The late Leslie L. Alexander, MD, FACR, drew similar conclusions a whopping 40 years earlier.
While diversity has clearly eluded radiology, the profession cannot ignore the issue any longer. Studies show that diverse groups are more innovative, thoughtful, and effective — findings that are encouraging medical practices nationwide to diversify. “Our most important business partners, hospitals and health systems, are deeply committed to improving their diversity, so it would behoove the house of radiology to mirror this [approach],” says Johnson B. Lightfoote, MD, FACR, medical director of the radiology department at Pomona Valley Hospital Medical Center in Pomona, Calif.
Practices that don’t diversify could miss opportunities to increase value and improve patient care. Carolyn C. Meltzer, MD, FACR, chair of the radiology and imaging sciences department and associate dean of research at Emory University School of Medicine, in Atlanta, says, “If we have an environment that isn’t taking advantage of the diversity of talent, whether we’re not attracting the right people or we’re subconsciously not welcoming them due to inherent biases — then we’re the poorer for it.”
The Driving Forces
Exposure is likely one factor contributing to radiology’s uniformity. Most young medical students are not exposed to radiology unless a mentor introduces them to it, says Deville, who is also co-director of the Sibley Prostate Cancer Multidisciplinary Clinic. Women and minorities could have trouble finding such mentors because just 26.1 percent of diagnostic radiology faculty members are women and only 5.9 percent are URMs. “Women and URMs don’t necessarily need female and minority mentors, but they may inherently have fewer opportunities for mentorship connections,” Deville notes.
Perception might also keep women and URMs from pursuing the specialty. For instance, blacks and Hispanics frequently report patient interaction as a primary reason they pursue careers in medicine. But radiologists still have a reputation for sitting alone in a dark room all day. “We need to give radiology a new face so medical students can understand that we do interact with patients and see the importance of radiology in patient care,” says Katarzyna J. Macura, MD, PhD, FACR, associate professor of radiology, urology, and oncology at Johns Hopkins University.
Actual bias is also a hurdle. If identical resumes arrive, one from a man and one from a woman, research shows the hiring manager is more likely to interview and hire the man. Similarly, URMs are less likely to be interviewed and hired because hiring managers (who are less likely to be minorities) are inherently drawn to people like themselves. “It’s a hard thing for people to get past,” says Julia R. Fielding, MD, professor of radiology and chief of abdominal imaging at the University of North Carolina School of Medicine, in Chapel Hill, N.C.
A Diversity Plan
To create a diverse team, practices should first discuss the issue openly and often. At Emory University, Meltzer holds diversity leadership training and highlights the faculty’s gender and minority makeup during her annual state-of-the-department address. “We want people to understand that we are striving to make a more diverse environment,” she explains.
Practices can increase diversity through hiring. “Highly skilled women and minorities are out there,” says David F. Hayes, MD, consulting senior associate for Windsong Radiology Group in Williamsville, N.Y. “If they are aggressively discovered through hiring processes that seek to uncover absolutely all of the very best candidates, those people will be interviewed and hired.” Ultimately, practices should hire the most qualified candidates. “We are not interested in having different standards or lowering our standards,” Macura says. “Diversity is about gifted and qualified women and minorities, talented doctors who can enhance our specialty.”
The ACR has made diversity part of its strategic plan and has formed the Commission for Women and General Diversity to encourage diversity throughout the profession. Macura chairs the commission, while Deville, Fielding, and Lightfoote are among its members. The group is leading a national survey about the barriers preventing women and URMs from joining the profession, developing a pipeline enrichment program to attract women and URMs, and purusing several other projects.
The Virtues of Inclusion
Diverse practices could see significant benefits, including increased patient volumes and improved outcomes. “It has been documented that patients comply and are more satisfied when cared for by physicians who have the understanding, communication skills, and passion that come from diverse cultural backgrounds,” Macura says. “Diverse practices will develop a reputation for better patient care and better outcomes — which means business.”
Practices with diverse teams are also more likely to address public health issues. Research shows that women and URMs more frequently work with patients in underserved communities and engage in research and advocacy around health care disparities — areas that have not been extensively explored in radiology. “Practices that engage in those issues have an opportunity to have a real impact on care,” Deville says.
While radiology won’t become more diverse overnight, more people are talking about the need for greater inclusiveness than ever before. By addressing the issue, radiologists can ensure that when researchers review today’s literature 40 years from now, they will be just as astonished as Deville was when he looked back at Alexander’s 1974 paper. Only, instead of being shocked by how little radiology had changed, they’ll be surprised that diversity was ever an issue at all.
By Jenny Jones, Imaging 3.0 content specialist