Infectious Disease

ABIM presents options to handle the “deserved mistrust” within the medical group

February 04, 2021

3 min read

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Source:
Healio interview

Disclosure:
Baron does not report any relevant financial information. Khullar reports receiving grants from Arnold Ventures, AMA, and the Patient-Centered Outcomes Research Institute outside of the work submitted.

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Public confidence in the medical community is starting to wane, but health professionals can take steps to restore it, ABIM President and CEO Richard J. Baron, MD, MACP, said Healio Primary Care.

“In the past few years we’ve seen many harmful attempts to undermine science and sow doubts about medical evidence,” he said. “Everyone in the healthcare system needs to be better able to build trust in order to successfully include patients who approach the current system with deserved distrust and who often do not benefit from the best that medicine can offer.

“Suspicion is a breeding ground for poor results and, in the current environment, a prolonged, deadlier pandemic,” Baron continued. “None of us want that.”

To address this issue, the ABIM Foundation focused its Forum 2020 on building trust and improving health equity. Baron and Dhruv Khullar, MD, A hospital doctor at Weill Cornell Medicine in New York recently co-authored an article in the Annals of Internal Medicine highlighting some of the strategies featured at the forum, including:

  • a virtual reality program designed to simulate the experience of being black so users can develop more empathy;
  • an artificial intelligence algorithm that aims to reduce bias as current AI systems have been shown to favor white patients over black patients;
  • a session on humility about why disadvantaged groups such as the homeless may not trust doctors; and
  • a strategy to increase public health resources with the aim of reducing the structural inequalities that lead to health inequalities.

Below, Baron discusses some of the key takeaways from the forum.

Q: Which strategies presented at the forum appear to be the most promising?

A: The forum wanted to bring together health care leaders who are working on promising initiatives to eradicate health inequalities.

Diversifying our workforce and strengthening our public health system would have tremendous reach and implications for patients and physicians across the health system and for society at large. The four interventions described in the Annals of Internal Medicine article are good examples of areas that can have a real impact in a variety of ways.

One project we found particularly new was using virtual reality to allow someone to experience bias from a first-person perspective. We believe this could help ensure that those who were not themselves biased have greater empathy with those who did, and potentially become more open to initiatives aimed at addressing them.

Q: How will these strategies you have identified create a fairer health system?

A: All of these strategies support better care for people who are often poorly served by our existing system. They would improve access to care for people who are homeless or lack resources in the community, and improve the quality of care for members of underserved populations who may lack confidence in the care they are receiving. A common theme is examples of how health systems can build trust everywhere. This is important if you want to better serve your communities. Taken together, these strategies could move us towards a more equitable system.

Q: What financial and human resources are needed to implement these strategies? What financial support programs are there to support these strategies?

A: Many of these projects require institutional leaders working at the local level to better understand their communities and their needs. Different institutions will be able to use different existing resources and will likely need to figure out what new resources they may need.

An overarching problem in the United States is the ongoing shortage of public health funds, which now represent less than 3% of all dollars spent on health care. By strengthening public health capacities, we know we can address many of the underlying social determinants that can undermine health in underserved communities and collectively improve the health of our nation.

There are some organizations working to financially support these strategies, but it will certainly take more than was foreseen in the past. That’s why ABIM and the ABIM Foundation, together with the Alliance for Academic Medicine, ACP, and the Josiah Macy Jr. Foundation, are supporting a US $ 300,000 scholarship program to help build trust in by supporting projects to improve diversity, equity, and inclusion to build up training in internal medicine.

Reference:

Baron RJ, Khullar D. Ann Intern Med. 2021; doi: 10.7326 / M20-6984.

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