CommonSpirit and Morehouse Addressing Underrepresented Physicians and Health Equity

The health system and medical school have teamed up to increase the number of physicians who are people of color and to boost medical training in health equity, racial disparities, and healthcare access.

CommonSpirit Health and Morehouse School of Medicine have formed the More in Common Alliance, a 10-year, $100 million initiative to address health equity and expand medical education to build a more diverse physician workforce.

People of color are underrepresented in the physician ranks. For example, Black communities account for 12.4% of the population but account for only 5% of the physician workforce, according to the U.S. Census Bureau and CommonSpirit.

"Physicians who are Black make up 5% of the physician workforce. In terms of medical students who are Black, they make up 7% of medical students. There are other physicians and medical students of color such as Hispanics making up a significant group; but, in general, people of color are underrepresented in both our general provider community and in the training community in terms of medical students," says Gary Greensweig, DO, system senior vice president and chief physician executive of physician enterprise for Chicago-based CommonSpirit.

The dearth of physicians who are people of color has negative consequences for clinical care, he says. "When we look at our population, it is quite diverse and becoming more diverse. There is clear data that from a cultural standpoint, from a lived experience standpoint, and from a trust and outcomes standpoint that having people of color underrepresented in the healthcare provider space affects patients and contributes to health inequities and poor outcomes. In general, patients like to receive care from people who are similar."

CommonSpirit, which operates 140 hospitals in 21 states, and Atlanta-based Morehouse School of Medicine launched the first phase of the More in Common Alliance in November. The first phase of the initiative features three undergraduate education sites at CommonSpirit hospitals in Chattanooga, Tennessee; Lexington, Kentucky; and Seattle. Additionally, there are four graduate medical education sites in California that will feature post-graduate residencies and fellowships.

The focus of the More in Common Alliance is twofold, Greensweig says.

"Number One, if you think about where we have all journeyed in the past two years, it has been a twin pandemic. We have had COVID-19, and we have had a pandemic of racial disparities and poor outcomes for patients of color. We hope to address that second pandemic," he says. "Number Two, we want to increase the number of Black and other underrepresented healthcare providers. It is not just a matter of increasing the numbers of those persons, it is a matter of ensuring that those persons who graduate from Morehouse and the training programs that CommonSpirit is creating will have a special focus on healthcare inequities, racial disparities, and healthcare access. Not only do we want to train people of color to be good physicians, physician assistants, and advanced practice providers, we want them to have special skills."

Expanding undergraduate and graduate medical education

Education is an essential element of the More in Common Alliance, Greensweig says.

"We need more access to undergraduate medical student training sites. At several CommonSpirit facilities, we are starting to train medical students as part of their third- and fourth-year medical student rotations. To the extent that Morehouse can have more of those student slots, they can accept more students in year one and two. If after year one and two, at the end of their classroom work, they do not have a place for them to go and be clinical students—it's a problem. If we are going to have more students, we need to have more places to train them," he says.

Graduate medical education is equally important, Greensweig says. "Once these students graduate, they need places to go and learn to be primary care doctors and specialists. That is where residencies occur. We need to expand the pool of available residencies, and we need to be sure that these residencies align with the concepts of health equity, healthcare access, and racial disparities."

CommonSpirit and Morehouse will be working in concert to expand graduate medical education opportunities, he says. "CommonSpirit has created waves of programs that we will start in the next couple of years—some on the West Coast, some in the Midwest—where we are starting to build and fund new programs. Those programs will have academic sponsorship with the Morehouse School of Medicine. Morehouse already operates several residency programs, but they will be expanding their graduate medical education services to add more residency slots for students from Morehouse and students from elsewhere who have an interest and a focus on health equity and taking care of the underserved."

Committed partners

CommonSpirit and Morehouse are committed financially and philosophically to their partnership, Greensweig says. "The $100 million does not define the relationship, but those dollars do represent a significant level of commitment. The relationship is based on the goals such as ensuring appropriate healthcare access for the underserved, ensuring that we increase the number of providers who are people of color, and improving healthcare outcomes in underserved communities."

CommonSpirit and Morehouse will be funding the initiative in conjunction with philanthropy support, he says. "We have made a 10-year commitment to help fund this initiative. The money will come from two sources—one will be operations at CommonSpirit Health and the Morehouse School of Medicine, and the other will be through an active philanthropy project which is already underway to fund some of our needs. It is an operations expense and there are people from across the country who want to support this effort with philanthropic dollars."

Commitment is essential to rise to the challenges of addressing health equity, Greensweig says. "If we had this on a roadmap and asked, 'How far of the journey have we gone?' I think we have gone about 10% to 15% of the journey. There are a lot of people in the country who have woken up and concluded that we have work to do on health equity. But there is 85% to 90% of the work remaining in front of us. We have a long way to go."