racial diversity in the health professions in california catherine dower, jd center for the health...
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Racial Diversity in the Health Professions in California
Catherine Dower, JDCenter for the Health Professions, University of California, San Francisco
Sacramento, CA February 23, 2005
2
Center for the Health Professions, UCSF.
Physician WorkforcePhysician Workforce
California by Race/Ethnicity, 2000
31%
7%
12%
49%
White, Non-Hispanic
Hispanic/Latino
Black, Non-Hispanic
Asian/Pacific Islander
Other
70%
4%
3%
20%
3%
Population Physicians
Source: UCSF Center for the Health Professions, 2001
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Center for the Health Professions, UCSF.
Physician WorkforcePhysician Workforce
CA Physicians by Race/Ethnicity, 2000
61%
6%
3%
26%
4%
White, Non-HispanicHispanic/LatinoBlack, Non-HispanicAsian/Pacific IslanderOther
74%
3%
3%
17%3%
Generalists Specialists
Source: UCSF Center for the Health Professions, 2001
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Center for the Health Professions, UCSF.
Physician WorkforcePhysician Workforce
California physicians likelihood of becoming a generalist, by race, 2000
Asian/Pacific Islander 45%
Black, Non-Hispanic35%
White, Non-Hispanic 30%
Hispanic/Latino 49%
Overall total 36%
5
Center for the Health Professions, UCSF.
Physician WorkforcePhysician Workforce
CA physicians by specialty and race/ethnicity, 2000
01020304050607080
White, Non-Hispanic
Mexican American
Generalist
Specialist
6
Center for the Health Professions, UCSF.
Physician WorkforcePhysician Workforce
Medical schools attended by California active, patient-care physicians, 2000
Univesity of California
15%
Private California universities
10%
Other US medical school
51%
Foreign medical schools
24%
Other US medical schools 50%
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Center for the Health Professions, UCSF.
Physician WorkforcePhysician Workforce
US Medical School Matriculants by Race/Ethnicity 1975-2000
0%10%20%30%40%50%60%70%80%90%
100%
1975 1985 1990 1995 2000
Asian/PacificIslander
Black, Non-Hispanic
Hispanic
American Indian/AKnative
White, non-Hispanic
Sources: UCSF Center for Health Professions 2001; AAMC 2000
0%10%20%30%40%50%60%70%80%90%100%
2005US Population 2005
Are Physicians Leaving Medicine?
8
Center for the Health Professions, UCSF.
Physician WorkforcePhysician Workforce
Residency sites of CA physicians, 2000
California residency sites 55%
Non-CA residency sites 45%
9
Center for the Health Professions, UCSF.
Physician WorkforcePhysician Workforce
CA Physicians in Residency/Training, 1998
White, non-Hispanic48%
Hispanic/Latino5%
Black, non-Hispanic4%
Asian/Pacific Islander
27%
Other/unknown16%
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Center for the Health Professions, UCSF.
Physician WorkforcePhysician Workforce
Mitigating Factors
Other professions
Significant proportions of NPs, PAs and CNMs practice in federally designated underserved areas
Fluency in Spanish, 2001
28% of primary care physicians
17% of specialists
11
Center for the Health Professions, UCSF.
Physician WorkforcePhysician Workforce
Exacerbating factors
Other professions’ racial/ethnic diversity
Geographic practice area
New patient enrollment
12
Center for the Health Professions, UCSF.
Physician WorkforcePhysician Workforce
California Supply of Physicians per 100,000 population
100
120
140
160
180
200
220
240
Central Valley/SierraSouth Valley/SierraInland Empire
North CountiesCentral CoastSan Diego
North Valley/SierraBay AreaLos AngelesOrange
COGME Range: 145-185 MDs/100,000 population
How are practice patterns changing?
13
Center for the Health Professions, UCSF.
Physician WorkforcePhysician Workforce
CA Physicians accepting new patients, 2001
0
20
40
60
80
100
Any New Pts New Medicaid
New Uninsured
New HMO
Primary Care
Specialists
How are practice patterns changing?
Source: Grumbach et al, UCSF 2002
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Center for the Health Professions, UCSF.
Physician WorkforcePhysician Workforcehttp://futurehealth.ucsf.edu
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Center for the Health Professions, UCSF.
Physician WorkforcePhysician Workforce Are Physicians Leaving Medicine?
UCSF Center for the Health Professions
3333 California Street, Suite 410San Francisco, CA 94118
415/476-1894415/476-4113
[email protected]://futurehealth.ucsf.edu