Race Matters in Physician Assistant Education and Clinical Practice

With theUnited States of Americabecomingevenmore visibly divided as a result of the 2016 presidential campaign and subsequent election,manyof the“talkingpoints” in themedia revolve around race in America. One of the numerous conversations that affectsphysician assistant (PA) students and the general public concerns “race matters. ” This is an important conversation that PA educators also should be having with matriculating students, as it relates to self-awareness, cultural competency, health disparities, and patient outcomes. Naturally, there is a fear and/or hesitancy of discussing such a sensitive, emotion-provoking topic. However, the general public depends on nondiscriminatory patient care from a provider who is consciously aware of his or her own implicit or explicit biases concerning race. TheAccreditationReviewCommissiononEducation for the Physician Assistant (ARC-PA) Standard B1.06 places attention on the influence of race (along with ethnicity and socioeconomic status) as it relates to health disparities in an everevolving and robust health care industry. The ARC-PA has found this standard to be important enough that it must be included in the instructional curriculum. The inclusion of such teachings can be accomplished in many different ways. And it should be emphasized that these conversations do not end after one lecture. The PA faculty have a social responsibility to help students explore biases and their potential impact on the well-being of their eventual patient population. Minorities continue to be underrepresented in PA faculty roles and as students enrolled in PA programs. According to the Physician Assistant Education Association’s (PAEA’s) 2014 By the Numbers: Program Report 30, Black, Asian, Multiracial, American Indian or Alaskan Native, Pacific Islander or Native Hawaiian, and“Other” race represented a total of 123 faculty of 1100 respondents. In PAEA’s By theNumbers: Program Report 31 (updated January 2017), racial minorities constitute 1275 first-year PA students (n = 8558) nationwide. The National Commission onCertification of Physician Assistants’ latest data reflect racial minorities representing 13.3% of currently practicing PAs in the United States. These demographics highlight an addedpower disparity among thewhitemajority that affects faculty and racially diverse student relationships and provider and racially diverse patient interactions/outcomes. Although this is a hard truth to accept, most people have a conscious or unconscious racial bias defined as prejudicial thoughts or actions taken related to certain phenotypic characteristics, for example, skin hue or ancestral background. As educators, it is incumbent upon us to delve deeper into cultural competencies. Discussion of racial bias; creation of a safe space for open dialogue and reporting of discrimination; development of an atmosphere of trust, support, and solidarity; and impartation of knowledge to create aworkforce that does not contribute to racial disparities are vital for student success. To accomplish this goal, PA educators will need to examine their current role in academia, unshackle themselves from tradition, champion self-awareness skills, and establish and foster overall trust. By developing and ultimately incorporating targeted competencies into the curriculum, PA educators are demonstrating social responsibility to their students, profession, and the general public.