Is dermatology on the right path for diversity?
Acta Eruditorum
Dr. Schwarzenberger is the former physician editor of DermWorld. She interviews the author of a recent study each month.
By Kathryn Schwarzenberger, MD, August 1, 2018
In this month’s Acta Eruditorum column, Physician Editor Kathryn Schwarzenberger, MD, talks with Henry W. Lim, MD, and E. Nikki Pritchett, MD, MPH, about their recent Journal of the American Academy of Dermatology article, “Diversity in Dermatology: Roadmap for Improvement.”
Dr. Schwarzenberger: Dr. Lim, you identified diversity in dermatology as a key area of focus during your recent AAD presidency. Thank you for championing this critically important issue. We appreciate the outstanding work you and your colleagues have done in this area, which is beautifully detailed in your recent JAAD publication. How did you become so passionate about the topic?
Dr. Lim: It is because of my own life experience. I grew up in Indonesia, went to college in Canada, attended medical school and did residency in New York. I have practiced in New York City, San Diego, and now in Detroit. The diversity of culture and individuals that I have been exposed to in my life journey gives me a great appreciation of the importance and the strength of diversity in health care, which leads us to deliver excellent care to our patients.
Dr. Schwarzenberger: Does dermatology have a diversity problem and, if so, what are possible ramifications that may result from this?
Dr. Lim: I approach this issue as an opportunity for improvement. Among all specialties, dermatology currently ranks second to last in the percentage of those who are underrepresented in medicine (UIM). It is well recognized that diversity in the physician workforce improves outcomes not only for minorities but for all patients. In addition, multiple studies have shown that UIM physicians are more likely to practice in areas where health care disparities exist.
Dr. Schwarzenberger: What is the AAD doing to help rectify the problem?
Dr. Lim: The Academy organized the President’s Conference on Diversity in Dermatology, held Aug. 5, 2017. Participants included leaders of Association of Professors of Dermatology, Society for Investigative Dermatology, Skin of Color Society, and American Dermatological Association. For the first time, AAD, along with APD, SID, and SOCS, participated in the National Student Medical Association annual meeting in March 2018. The Academy has also formed an intersociety workgroup (AAD, APD, SID, and SOCS), working with the Diversity Task Force, to continue to address this topic; a Diversity Champions retreat is currently being planned. The AAD Diversity Task Force, under the leadership of Amit Pandya, MD, has facilitated outreach effort to college and medical students to generate their interest in medicine as a profession, and dermatology as a specialty.
Dr. Schwarzenberger: It appears that most of the efforts described are centered in the academic world. Since most of our members work in non-academic settings, is there anything they can do to help increase diversity in dermatology?
Dr. Pritchett: Dermatologists in nonacademic settings can be instrumental in addressing two key factors that contribute to decreased diversity in dermatology: Lack of exposure and the narrow pipeline from elementary to medical school. Dermatologists can mentor students either formally through programs offered by the AAD or other dermatology societies, or informally by allowing interested students to shadow them in clinic. They can also participate in school career days or other community-based activities in order to increase awareness of dermatology as a specialty. Finally, they can discuss what it’s like to be a doctor and their reasons for choosing dermatology with their younger patients, which may spark their interest.
Dr. Schwarzenberger: How will we know when we are there? Does the AAD have specific goals in mind that we hope to achieve?
Dr. Lim: This is going to be a multi-year effort. The action items suggested by the Diversity Conference of increasing the pipeline of UIM students applying to medical school, increasing the exposure and level of interest of UIM medical students in dermatology, and increasing the number of UIM students recruited into dermatology residency programs will require sustained effort by all of us to succeed. An early metric that can be assessed would be the number of UIM applicants to dermatology, and the number of UIM in dermatology residency programs.
Dr. Schwarzenberger: Your efforts so far have focused primarily on racial and ethnic diversity in the specialty; however, there are other real and potential disparities in dermatology (LGBT, rural vs. urban, etc.) that may impact our workforce and, as a result, the care that we provide our patients. Can you comment on any of these and share any relevant AAD activities?
Dr. Pritchett: There are multiple underrepresented groups that deserve culturally competent care and an understanding of their specific dermatologic issues. As mentioned, one group is LGBT. The AAD has formed an Expert Resource Group for Lesbian, Gay, Bisexual, and Transgender/Sexual and Gender Minority (LGBT/SGM) Health. This group promotes research, advocates policies that enhance health, and encourages professional development of dermatologists caring for LGBT/SGM communities. Additionally, there have been LGBT health-related sessions at Annual and Summer scientific AAD meetings and the online Basic Dermatology Curriculum is being revised to include more LGBT health-related content.
Dr. Lim: In the selection of candidates for Board of Directors, effort is made to achieve a balance among candidates from different geographic areas, gender, academic/private practice, etc. The Scientific Assembly Committee also makes a strong effort in promoting younger members to participate as speakers.
Dr. Lim is the former president of the AAD and chair emeritus of the Henry Ford Hospital department of dermatology. Dr. Pritchett is a dermatologist at Henry Ford Hospital. Their article appeared in the Journal of the American Academy of Dermatology. doi: 10.1016/j.jaad.2018.04.003.