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ASCO releases ‘critically important’ strategic plan to increase racial, ethnic diversity in oncology workforce

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Karen Winkfield

The U.S. population is growing increasingly diverse, yet that racial and ethnic diversity is not reflected among health care providers.

The gap is particularly pronounced in oncology.

ASCO released a strategic plan designed to promote the development of a culturally competent oncology workforce that is equipped to care for the diverse population of patients with cancer.

“With this strategic plan, ASCO is strengthening its commitment to provide meaningful opportunities for medical students, residents, fellows and practicing oncologists from underrepresented racial and ethnic minorities to participate and shape our priorities and activities,” society President Daniel F. Hayes, MD, FACP, FASCO, said in a press release. “As a professional medical society, we can do much more to support the recruitment, training and retention of oncologists from diverse backgrounds, particularly those who are underrepresented in oncology. This is a critically important step in that direction.”

The plan is guided by three primary goals: the establishment of a pathway to increase workforce diversity; enhancing diversity within ASCO leadership; and integrating a focus on diversity across ASCO programs and policies.

“A more diverse oncology workforce will help ensure access to high-quality care and greater opportunities to participate in life-extending clinical research for minority patients with cancer, both of which are needed to address the persistent disparities in treatment options and health outcomes,” Karen Winkfield, MD, PhD, immediate past chair of ASCO’s Health Disparities Committee, said in the press release. “This strategic plan will be a clear guidepost for ongoing ASCO efforts to develop a physician workforce that reflects the diversity of the patient population we serve.”

HemOnc Today spoke with Winkfield about the need for this type of plan, its potential impact and how the oncology workforce can help contribute to this effort.

Question: Can you describe the need for this strategic plan?

Answer: There is a lack of diversity in the oncology workforce, and the United States is becoming more diverse. There are estimates that, by the year 2040, we will be tipping over into a ‘majority-minority country’ — which means non-Hispanic whites will account for less than 50% of the population. Although we are curing patients with cancer, they are living longer, and they will need providers to care for them. We have had data for a while that suggest patients do better when they are cared for by providers who look like them. They feel more comfortable and are more likely to follow recommendations from someone who looks like them, because there is trust between the patient and the care provider.

Q: How much — or how little — diversity is there in the oncology workforce ?

A : Only about 2% of the oncology workforce is black, and Hispanics comprise about 3%. We have some work to do — not only to care for our patients, but also to help one another as specialists. I learn so much from my colleagues who are from various backgrounds. There are cultural and religious differences, and we need to make sure we are providing care that is sensitive to various cultures and their specific needs.

Q: What are the goals of this strategic plan?

A : It has been suggested that there may be a ‘pipeline issue’ concerning diversity in the oncology workforce. Although I do not like this analogy, it is reflective of the real issue. The number of black individuals graduating from medical school has not changed in decades. Although ASCO may not directly influence that, this strategic plan drives home the message about the importance of workforce diversity; that alone is important. We can raise awareness nationally and focus attention on the need to have a physician workforce that is representative of our population.

There are three primary goals of the plan.

1. Establish a pathway for workforce diversity by providing opportunities for minorities to not only have mentoring, but also clinical exposures to oncology early on in medicine. We need to ensure we are doing our best as they move along the pipeline to provide opportunities for mentoring.

2. Enhance diversity within ASCO leadership. If diversity is important for patient care and for the way we operationalize medicine, then we need to make sure ASCO as an organization reflects this.

3. Integrate a focus on diversity and disparities throughout ASCO programs and policy. We know that when we look around outside of medicine, every business will tell you that diversity breeds innovation.

If ASCO is going to be the best possible organization, diversity needs to be a focus. We must make sure our policies are concordant with our messaging. We also need to make sure that the ASCO Annual Meeting contains sessions focused on understanding cancer disparities and sharing best practices for addressing the roots of health care disparities.

Q: How will ASCO meet these goals?

A: This 3-year plan comprises goals that we believe are attainable. We are now formulating a working group of volunteers across several different committees at ASCO that will help to put ‘a little more meat on the bones’ and create an implementation plan that will be executed over the next few years.

Q: How can members of t he oncology workforce contribute to this effort?

A: I encourage ASCO members and nonmembers to think about becoming a mentor. Everyone needs mentoring, so those of us who have been practicing oncology for a while can reach back and provide it. ASCO will establish a mentoring program, but even mentoring at the local level is helpful to encourage people to look at oncology in a different way. We need to be out in our communities talking about the work we do, especially for those who may be near minority-serving institutions or historically black colleges and universities, where we can encourage individuals to consider a career in oncology. ASCO also has a new volunteer core, which is a wonderful way for those interested in helping ASCO achieve this goal to assist in a more structured way. Finally, directors of oncology training programs can lead the way by creating diverse and inclusive residencies and fellowships.

Q: Is there anything else that you would like to mention ?

A: The important thing is that we work together to provide the best care for everyone in our diverse population. The strategic plan is a way to help with this. The ultimate goal of this initiative is to ensure everyone has the same chance to survive cancer, regardless of who they are and where they come from. – by Jennifer Southall

Reference:

Winkfield KM, et al. J Clin Oncol. 2017;doi:10.1200/JCO.2017.73.1372.

For more information:

Karen M. Winkeld, MD, PhD, can be reached at Wake Forest Baptist Medical Center, 1 Medical Center Blvd., Winston-Salem, NC 27157; email: kwinkfie@wakehealth.edu.

Disclosure: Winkfield reports a consultant role with Novartis.