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Transforming Clinical Practice to Eliminate Racial–Ethnic Disparities in Healthcare

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Racial–ethnic minorities receive lower quality and intensity of health care compared with whites across a wide range of preventive, diagnostic, and therapeutic services and disease entities. These disparities in health care contribute to continuing racial–ethnic disparities in the burden of illness and death. Several national medical organizations and the Institute of Medicine have issued position papers and recommendations for the elimination of health care disparities. However, physicians in practice are often at a loss for how to translate these principles and recommendations into specific interventions in their own clinical practices. This paper serves as a blueprint for translating principles for the elimination of racial–ethnic disparities in health care into specific actions that are relevant for individual clinical practices. We describe what is known about reducing racial–ethnic disparities in clinical practice and make recommendations for how clinician leaders can apply this evidence to transform their own practices.

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Acknowledgements

The authors gratefully acknowledge Judy Ann Bigby, Society of General Internal Medicine (SGIM) past President, who originated the idea for this paper, and members of the SGIM Disparities Task Force for valuable reflection and feedback. Drs. Washington (#RCD-00-017), Saha (#RCD-00-028), and Moody (#RCD-03-183) are supported by career development awards from the Department of Veterans Affairs, Health Services Research and Development Service. Dr. Saha is supported by a Generalist Physician Faculty Scholar award from the Robert Wood Johnson Foundation (RWJF). Drs. Horowitz (#P60 MD00270) and Brown (#P20MD00148) are supported by grants from the National Center on Minority Health and Health Disparities (NCMHD). Dr. Brown also received support from the University of California, Los Angeles, Resource Center in Minority Aging Research (#AG02004) and the Beeson Career Development Award (#AG26748). Dr. Cooper is supported by a grant from the National Heart, Lung, and Blood Institute (NHLBI) (K24HL083113). The views expressed within are solely those of the authors and do not necessarily reflect the views of the Department of Veterans Affairs, the RWJF, NCMHD, or NHLBI.

Conflict of Interest

Dr. Stone reports both consultancies for and receiving honoraria from Pfizer, Gilead Sciences, Bristol Myers Squibb, and Abbott Labs. Dr. Stone has also received honoraria from GlaxoSmithKline. Dr. Cooper has received research grant funding from Amgen. No other authors have conflicts of interest to report.

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Authors and Affiliations

  1. Division of General Internal Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA

    Donna L. Washington MD, MPH & Jacqueline Bowles MD, MSCE

  2. Department of Medicine, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA

    Donna L. Washington MD, MPH, Jacqueline Bowles MD, MSCE & Arleen F. Brown MD, PhD

  3. Section of General Internal Medicine, Portland Veterans Affairs Medical Center, Portland, OR, USA

    Somnath Saha MD, MPH

  4. Department of Medicine, Oregon Health & Science University, Portland, OR, USA

    Somnath Saha MD, MPH

  5. Departments of Health Policy and Medicine, Mount Sinai School of Medicine, New York, NY, USA

    Carol R. Horowitz MD, MPH

  6. Department of Medicine, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, San Francisco, CA, USA

    Sandra Moody-Ayers MD

  7. General Medicine Unit, Massachusetts General Hospital, Boston, MA, USA

    Valerie E. Stone MD, MPH

  8. Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Lisa A. Cooper MD, MPH

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  1. Donna L. Washington MD, MPH
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  2. Jacqueline Bowles MD, MSCE
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  3. Somnath Saha MD, MPH
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  4. Carol R. Horowitz MD, MPH
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  5. Sandra Moody-Ayers MD
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  6. Arleen F. Brown MD, PhD
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  7. Valerie E. Stone MD, MPH
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  8. Lisa A. Cooper MD, MPH
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Writing group for the Society of General Internal Medicine, Disparities in Health Task Force

Corresponding author

Correspondence to Donna L. Washington MD, MPH.

Additional information

Funding: Drs. Washington (#RCD-00-017), Saha (#RCD-00-028), and Moody (#RCD-03-183) are supported by grants from the Department of Veterans Affairs, Health Services Research and Development Service. Dr. Saha is supported by a Generalist Physician Faculty Scholar award from the Robert Wood Johnson Foundation. Drs. Horowitz (#P60 MD00270) and Brown (#P20MD00148) are supported by grants from the National Center on Minority Health and Health Disparities. Dr. Brown also received support from the University of California, Los Angeles, Resource Center in Minority Aging Research (#AG02004) and the Beeson Career Development Award (#AG26748). Dr. Cooper is supported by a grant from the National Heart, Lung, and Blood Institute (K24HL083113).

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Washington, D.L., Bowles, J., Saha, S. et al. Transforming Clinical Practice to Eliminate Racial–Ethnic Disparities in Healthcare. J GEN INTERN MED 23, 685–691 (2008). https://doi.org/10.1007/s11606-007-0481-0

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  • DOI: https://doi.org/10.1007/s11606-007-0481-0

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