AAMC President and CEO David J. Skorton, MD, spoke at a July 30 White House COVID-19 Health Equity Task Force meeting on how the United States can prepare for future public health crises to ensure equitable access to care. Dr. Skorton outlined four priorities: building trust through community engagement and collaboration, addressing racism and diversifying the health workforce, improving health equity data, and increasing access to care via telehealth.
He also highlighted several AAMC resources, including a comprehensive letter submitted to the Senate Health, Education, Labor, and Pensions (HELP) and House Energy and Commerce Committees with recommendations on addressing future pandemics [refer to Washington Highlights, July 1], as well as a paper by AAMC Senior Director for Health Equity Research and Policy Philip Alberti, PhD, titled “Equitable Pandemic Preparedness and Rapid Response: Lessons from COVID-19 for Pandemic Health Equity.”
In his presentation, Dr. Skorton noted, "As we’ve seen, new therapeutics and vaccines cannot be effective as long as health experts are not seen as trustworthy by a significant proportion of people. This lack of trustworthiness affects health and well-being, especially among marginalized and disproportionately impacted communities." He encouraged the task force to consider a set of 10 Principles of Trustworthiness, produced by the new AAMC Center for Health Justice, that any organization can use to demonstrate trustworthiness in any community.
Dr. Skorton continued that "lack of trust is undoubtedly tied to our nation's long history of systemic racism." Referencing a paper co-authored by AAMC Senior Director for Health Equity Partnerships and Programs Malika Fair, MD, titled “Addressing Racial Inequities in Medicine,” he noted that there are many factors contributing to racial and ethnic health inequities, including the social determinants of health and workforce diversity.
Dr. Skorton also raised the AAMC strategic plan and its efforts to "increase the diversity of medical school applicants and matriculants, which requires encouraging young people to consider a career in medicine from a young age." He acknowledged the Health Resources and Services Administration Title VII diversity pathway programs as one example of success.
Regarding data for health equity, Dr. Skorton stated that "we need a national, standardized, comprehensive, and routine collection of sociodemographic data for people and communities, supported by resources, incentives, and community engagement to ensure validity and data collection." He also noted that "this should include disaggregated race and ethnicity data, social risk data for individuals, and social determinant data for communities."
Finally, Dr. Skorton stated that throughout the pandemic, telehealth has been a vital tool to access clinical care, but he outlined many challenges to adoption. He said, “To provide equitable access to needed care for all patients, it is essential that current telehealth waivers be extended beyond the period of the public health emergency, specifically those that allow patients to receive telehealth services in any location, including their home, and to allow payment for audio-only services.”
In response to a question from the task force, Dr. Skorton recognized the stigma of mental health counseling in medicine and praised the Dr. Lorna Breen Health Care Provider Protection Act (S.610, H.R. 1677), which would help create programs to address the burnout and mental health of our providers.