If you’ve ever watched the medical sitcom ‘The Good Doctor’, you may have noticed that a large part of the story’s narrative features diversity and inclusion. Whether it is racial profiling or a serious representation of women’s issues, the show is an eye-opener into why the healthcare industry needs diverse representation.
According to a report last month in ET HealthWorld, India harbours more genetic diversity than other global regions. Add to this the vast cultural differences, religious beliefs, barriers of language and dialect, and the stark variation between socio-economic strata, geography, lifestyle, and food cultures of the population. Migration from one region to another and one state to another, as well as medical travel and tourism, has resulted in patients that are diverse.
However, this representation of varied demographics doesn’t extend to healthcare providers. Most often, hospitals and clinics do not look beyond qualifications, degrees, and work experience – which results in the focus being only on a certain kind of doctor.
Dr J Ilakkiya, a senior GP (General Practitioner) who works with a private hospital in Chennai, says, “It is crucial to have equal representation in healthcare, especially if you are part of a larger hospital that welcomes and treats patients across all demographics. For instance, we get patients from Tamil Nadu’s rural and far-flung areas, who don’t know how to navigate the systems in the hospital. Many patients also visit from West Bengal and Orissa for medical aid. Most of them do not speak any language other than Bengali or Odiya. Around a decade ago, the doctors hired here were well-versed only in Tamil, English, and a smattering of Hindi. Besides language, even cultural and diet differences were difficult to get past when suggesting a course of treatment.”
Ilakkiya says that since then hospitals have made a conscious effort to include doctors and support staff who can treat them effectively. They have also learnt that when patients find someone who can identify with or relate to them, they communicate more freely and are also more open to suggested courses of treatment. “We have also hired some incredible talent over the last few years just by widening our network, and this has also helped us with fresh insights and perspectives in the medical field,” she adds.
“You’re imagining things. It’s all in your head. Learn to live with it.” Does any of this sound familiar? A 2019 study by Forbes stated that 52 per cent of women believe that gender discrimination negatively impacts medical care. Research also shows that women have to push longer and harder for a diagnosis. Women make up the bulk of the healthcare sector in India. However, as per a study published in the medical journal Lancelet in 2021, they make up just 30 per cent of doctors and 80 per cent of nurses and midwives. They are not put in decision-making roles that can benefit other women who come to them.
Dr Jacinda Thomas, a gynaecologist based in Shillong, says, “Women have not just been excluded from clinical trials and research, but also from being doctors in the healthcare workforce. This doesn’t bode well. After all, diversity advocate Verma Myers articulated it well, ‘Diversity is being invited to the party; Inclusion is being asked to dance’. Women doctors need to be put in positions of power where they can actively understand and treat women patients who come to them. There is definitely bias in the medical community regarding diagnosing women – not just in India, but around the world.”
Dr Jacinda says that symptoms are often put down to psychosomatic triggers and there is a tendency to dismiss them, rather than investigate and address them seriously. Unless there are more women doctors out there, who understand firsthand the struggles of the female body and take complaints seriously, this prejudice isn’t going away in a hurry.
“India has one of the brightest potential female medical workforces,” she adds. “We should ideally look towards upskilling these women from nurses and lab assistants to doctors, and give them the confidence and mentorship they need. This way, there is more representation for female patients who walk in through the door. If 50 per cent of your patients are female, it only stands to reason that 50 per cent of your doctors should be as well!”
The benefits of a diverse healthcare group are increased comfort levels, an understanding of indigenous value systems, better trust between the patient and caregiver, and a reduction in health disparities. This has to start at the higher education stage, encouraging people to actively pursue medicine, regardless of caste, religion, gender, gender identity, or ethnicity. Colleges and universities must stay committed to the idea of inclusivity in healthcare.
Further, it isn’t enough to just hire people to ensure a diverse healthcare workforce. One also needs to make sure that the environment is welcoming and inclusive in the truest sense, with policies that do not allow for discrimination of any kind. Conduct training programmes for the workforce in existence, to teach them how to deal with cultural differences and nonconscious biases, even if they’re treating someone they can’t culturally relate to.
A study by McKinsey and Company, entitled ‘Why Diversity Matters’, revealed that gender-diverse companies perform 15 per cent better than those that are not, and ethnically-diverse companies are 35 per cent more likely to outperform those with minimal diversity. But the real purpose is not the top line or showing off a more diverse workforce; it is to have a happier work environment, with leadership roles for everyone and, most importantly, better quality of treatment for every single patient who walks in.