How Can Physicians Close the Disparity Gap?

 
 "We have a committed program," he says of Massachusetts General Hospital. " We have a guilty-'til-proven-innocent mentality regarding diversity issues. It's not about blame, but knowing there are gaps to fill."

The Massachusetts General Hospital established a disparities committee in 2002 after the IOM issued its report documenting the disparity problem nationally. According to Betancourt, the MGH committee continues to identify and address disparity issues "wherever they may exist" at the hospital. The committee receives information from subcommittees that target "experience, education and awareness" involving racial and ethnic issues, he says.  On a regular basis, the committee's planning and findings are presented to the MGH board, executive council and other hospital leadership officials. Their reports range from non-adherence to policies, educational programs and data collection issues.

The hospital established cross-cultural training as well as interactive learning programs to allow them to "provide quality to patients of diverse cultural backgrounds," Betancourt says.

As a result, the hospital program resulted in significant awareness improvements among physicians after training 3,000 front line staff.

"If a certain group of diabetic patients are doing less well, maybe you can find some explanation, maybe it's a [literacy]  issue, maybe it's a cultural issue, and then you can target interventions to meet those patient needs," Betancourt says.

Coaching programs and patient navigators who are important tools to overcome racial and disparity issues, he says. While a doctor visit may be about 15 minutes, the coach may then spend an hour with a patient, Betancourt says.