Managing Healthcare Workforce Diversity in American Hospitals - Assignment Example

Managing Healthcare Workforce Diversity in American Hospitals Abstract Diversity is a major issue in the United States today. This is because many feel that the opportunities for minorities or those who are underrepresented in the workforce are lacking, something that is particularly problematic in industries which could benefit from having a more diverse workforce, for example, healthcare. Patients have been shown to prefer physicians and nurses that they identify with, not least because of the cultural sensitivities that may need to be addressed in such a personal context. The purpose of this paper is to examine the case for managing diversity amongst the healthcare workforce in America. To do this efficiently, the paper examines the state of diversity within American hospitals within recent years and how this affects patient care. Following this, it is necessary to understand the need for improving diversity in the American healthcare workforce as without sufficient motivation, many human resource managers may find it unnecessary to engage in positive discrimination or other diversity increasing techniques. Finally, a general overview of how to manage these issues in diversity is covered from a human resource perspective as this allows for in-depth discussion of the techniques employed by these managers in the hiring and firing of certain employees in the context of diversity. MANAGING HEALTHCARE WORKFORCE DIVERSITY Introduction Workforce diversity is a greatly debated issue within any area of human resources as it is generally deemed necessary to ensure the equality in the way that people are hired and fired for fairness. Within the healthcare workforce, this becomes increasingly important as many patients may feel that they have cultural issues or cultural sensitivities that need to be addressed by someone of a similar background. As healthcare is such a personal and private thing, it is necessary that the needs of the patients and customers are met from a human resources perspective. Having a wide range of diversities amongst staff members will lead patients to feel more comfortable and perhaps to have a better and shorter recovery time. This is important from a business perspective as the healthcare industry in the US is primarily based upon a similar set of principles as a standard business, and reputation is important (Grumbach & Mendoza, 2008). Healthcare has the additional layer of being important from a moral perspective, again strengthening the need to investigate and increase diversity within the healthcare workforce. The purpose of this paper is to examine the healthcare workforce diversity in American hospitals, and then establish the patterns and problems within this area. From a human resources perspective, it will then examine different ways of managing this diversity to try and establish a positive workforce diversity program which aims to provide good, consistent service to the population. The different layers of the healthcare workforce will be examined to try and provide a full picture of the workforce in the United States. Also, the examination will illustrate that how this is affecting the healthcare system within this country, and try to come to some resolution with regards to improving, managing and maintaining the system. Current Healthcare Workforce Diversity in American Hospitals: To examine the management of healthcare diversity in American hospitals, it is worth looking at current issues within the workforce diversity of American hospitals within current academic researches. It has been noted that providing diversity in healthcare is vitally important for 'culturally competent healthcare' (Taylor & Lurie, 2004, p4) and it is instrumental in providing a good and worthwhile service to the population. The real question is, however, how much diversity is there currently in healthcare in the United States? It has been shown that there are serious sociocultural boundaries between different groups when it comes to careers in healthcare, with only 2% of healthcare workers identifying as Hispanic or Latino (Betancourt et al, 2003), despite the fact that 12.5% of the general population identify as this race (Grumbach & Mendoza, 2008). This is not the only example of a mismatch in diversity within the workforce. Gamble (1997) has shown that African Americans are also severely underrepresented in healthcare within the United States. With such an emphasis being placed on providing good healthcare that is both culturally relevant and culturally sensitive, it is obvious that these disparities are a significant problem in American healthcare. Interestingly, it has also been found that areas with high diversity with respect to African Americans and Latino residents are just as likely as predominantly white areas to have a shortage in physicians (Komaromy et al, 1996). This study also shows that black physicians were five times more likely to practice in an area with a high proportion of African Americans. This suggests that there may be issues with recruiting these equally skilled workers in predominantly white areas, something that should be further investigated to outline the underlying reasons for this disparity. A physician identifying as white is only slightly less likely to work in a predominantly white area (Komaromy et al, 1996), something which can be explained by the fact that there is a much larger number of practising white physicians than those from other racial groups. Komaromy et al (1996) also found that black physicians were more likely to care for black patients and Hispanic physicians were more likely to care for Hispanic patients. This does not necessarily represent a problem in the healthcare recruitment technique, but as there are far less Hispanic or black healthcare workers, particularly physicians, this preference for same sociocultural group care does mean that recruitment needs to represent this preference. It could well be that this disparity represents the need for culturally competent healthcare, reinforcing the idea that the management of healthcare diversity is an important issue within Human Resource Management, particularly in the healthcare industry. Comparative Healthcare Workforce Diversity: It is interesting to compare the state of healthcare workforce diversity in the United States to that within other countries. There has been far less research on the topic concerning other countries, perhaps because the United States has an interesting relationship with race and diversity which is not evident in many other areas. Diversity is also at one of the highest levels in the United States comparatively to other countries. Despite this, it can still be useful to look at the state of affairs within other countries and see how they manage their healthcare diversity. Davies et al (2000) has shown that there are similar levels of the disparity between the percentage of the black population and the percentage of black physicians in the United Kingdom, for example. These issues are being tackled directly by the National Health Service (NHS), who has implemented a positive discrimination method of employment, which is there to attempt to provide this culturally sensitive healthcare. Australia is another interesting example of this, because of the large Aboriginal population who may reject some treatment methods by requiring that they are treated with traditional medicine (Omeri, 2003). Whilst the percentage of Aboriginal physicians is relatively low, there has been an increase in the number of Aboriginal nursing staff to help deal with this problem, with the proportions being roughly equal (Omeri, 2003). Discrimination in American Hospitals: It has been shown that people from ethnic minorities experience “disproportionate difficulty in obtaining hospital posts” (Esmail & Everington, 1993, p1), suggesting that there has been a tradition of discriminating against those from ethnic minorities in the healthcare workforce. This is despite the evidence discussed above showing that ethnic minorities are often a positive force within the healthcare system, providing culturally sensitive healthcare and allowing patients to feel more at east during their treatment. Nunez-Smith et al (2008) performed a qualitative study examining the role of the African American physician in hospitals. It found that race-related issues amongst these physicians were usually discussed outside of the workplace with eternal institutions attempting to find the problems. This is something that could be addressed, as hospitals should provide services for their staff to make them feel comfortable in the workplace and provide the opportunity to discuss discrimination amongst healthcare workers. The study also found that these African American physicians perceived potentially offensive race-related incidents in the workplace differently to their non-ethnic minority counterparts. This suggests that there may be room for providing education on race-related issues within the healthcare industry to try and minimise potential issues amongst the hospital staff. It is not just ethnic minorities that experience discrimination in the workplace, with obese candidates being significantly less likely to get hired for a hospital position than those within the healthy weight range (Kaminsky & Gadaleta, 2002). This is another form of diversity that is often under addressed within the Human Resource community but still exists as an element that needs to be considered for true healthcare workplace diversity. There are added elements to this discrimination, such as the need for increased costs of providing health insurance and perhaps that these staff members may be seen as hypocritical and setting bad examples for patients. However, with one third of the American population being obese, it is necessary to consider this sub-group as an important part of maintaining workforce diversity. Also interesting is the discussion of gender within this context. Many female patients in particular feel more comfortable discussing their problems with a female doctor (Butler & Mason, 2010) suggesting that there may need to be a higher proportion of female physicians than would be proportional to the rate of the population. It was found that many female physicians have experienced sexual harassment in the workplace, and many still feel the effect of traditional gender roles throughout their training and work life (Butler & Mason, 2010). This is something that needs to be addressed when it comes to managing diversity within the workplace of American hospitals. Positive Discrimination in the American Workplace: Positive discrimination is something occurs fairly frequently in the American workplace, most frequently in the context of race and gender. This is in an attempt to reduce the fact that women and minority races often experience discrimination across all workplaces (Grumbach & Mendoza, 2008). Positive discrimination is essentially when an equally qualified candidate is given a job in preference because of other factors to try and equalize the ratios of gender and race throughout the workforce. Hospitals are not immune from this, with 34% of human resource managers in healthcare admitting to using positive discrimination techniques during the hiring process (Williams et al, 2008). Although this is a significant number, taking into account the factors above (that women generally prefer female doctors and Latino and African American patients prefer culturally sensitive doctors from their own race), it could be suggested that positive discrimination should occur more within the hospital environment. It also suggests that there is a desperate need for people from all sociocultural backgrounds and of all genders to be part of the healthcare workforce because these are the people who are desired. Healthcare is a service, and like any consumer service needs to aim to offer satisfaction to the customer, and satisfaction in this case may come from providing healthcare workers of all diversities. Something which is often not discussed is that nurses are in a huge majority female within the United States (Grumbach & Mendoza, 2008). Positive discrimination has occurred trying to equalize the amount of male nurses available for patients (Grumbach & Mendoza, 2008) and this is something that looks likely to increase in the future. The problem with this is that there are many more trained female nurses than male, and this could lead to a compromise in the quality of the healthcare provided as equalizing the ratio may lead to hiring nurses who are not as competent simply based on their gender. This is something that worries many people with respect to positive discrimination, but the issue of the male nurses is more prevalent of others simply because of the huge discrepancy in numbers. Increasing Healthcare Diversity in American Hospitals: It has been noted that the American healthcare workforce is likely to change dramatically in the next decade. In the case of nurses, the huge swell in numbers of registered nurses in the past is likely to take its toll as these nurses will age and retirements increase (Buerhaus, 2004). This gives an incredible opportunity to encourage more young people of different sociocultural groups to enter the healthcare workforce and increase the diversity to a level which is appropriate for the United States. However, one of the best methods aimed at increasing the diversity in the healthcare workforce is trying to illustrate the benefits of a healthcare career to young people who many not otherwise have considered it. This will increase the pool of suitable candidates from different backgrounds, hopefully eliminating the need for positive discrimination. This is particularly important in the case of African American and Latino teenagers, as well as illustrating that nursing is not an exclusively female occupation to males who may feel pressures of gender stereotyping. After doing this, these people will be more likely to qualify and will thus require jobs in their chosen field, meaning that they will have to enter the healthcare workforce and will play a vital role in increasing the diversity of the American healthcare workforce. This is probably the most important way of achieving this goal. Another method of increasing diversity in the healthcare system is to tackle the culture of the college system. It has been proposed that increasing the diversity at these institutions is imperative in increasing the diversity of the American healthcare workforce (Grumback & Mendoza, 2008). This works by providing human resource managers with more qualified options amongst ethnic minorities. It has been shown that there has been an increase in African American students enrolling in medical school (Grumback & Mendoza, 2008) and this is because of the positive discrimination techniques employed by these universities. This is something that can be referred to as 'grassroots activism' (Grumback & Mendoza, 2008, p6) because this tackles the problem at the root without causing any problems to the healthcare industry itself with respect to having underqualified staff of ethnic minorities. After the qualification of these minorities, jobs will need to be filled by the minorities and thus there will be an increase of diversity in the American healthcare workforce, something that is greatly desired by all. Maintaining and Managing Healthcare Diversity: Having outlined some of the techniques employed by human resource managers to try and increase diversity in healthcare staffing both generally and specifically, it is necessary to understand the role of the human resource manager in this context. The purpose of the human resource manager is to deal with any issues that might arise in the hiring and firing of employees, and as such they play a crucial role in maintaining and managing healthcare diversity, something that is important for the reasons outlined above. In this case, there are several techniques that can be used. The healthcare manager can ask all applicants to provide information on their sociocultural background and employ this in positive discrimination techniques to try and raise the amount of minorities in the healthcare workforce. By doing this, it is important that all those hired are of a suitable standard, but this has been shown to work in many cases (Grumbach & Mendoza, 2008). Another element of this is using the techniques available to human resource managers to try and implement the diversity programs in schools and colleges that have been mentioned above. This could involve sending qualified doctors and nurses of minority groups to these institutions and showing the young people involved that race or gender is not a handicap in holding down one of these professions. Ensuring that these healthcare workers are of various diversities would mean that other people would identify with these people and increase diversity within the health world. This could raise awareness of the issues of diversity found in the healthcare workforce. Another interesting proposed solution is for the healthcare manager to try and educate existing staff members on the issues facing ethnic minority or other staff to try and remove any problems with discrimination in the workplace. This could include lectures and seminars on diversity, workshops with teamwork exercises involving different diversities, or presentations given by various members of the healthcare workforce. This will make American healthcare institutions more positive places to work for these individuals and perhaps lead to more understanding and sympathy in the workplace. This could lead to these individuals encouraging others to become doctors, nurses or other healthcare professionals because of their own positive experiences. Conclusion In conclusion, it is clear that diversity in the American healthcare workforce is an important issue that needs to be addressed for several reasons identified above. One of the major reasons is the link between happy patients and the healthcare workforce; people are happier with care from someone they identify with, whether this is someone of their gender or someone of their own social cultural background. This means ensuring that there is an appropriate ratio of female, Latino, African American and other workers in healthcare is really important to maintaining a good standard of care. Something else that has been highlighted throughout this paper is that there is a huge discrepancy in the number of ethnic minorities training to become workers in healthcare, something that is particularly evident amongst physicians. This is something that needs to be addressed because without the appropriate training it is impossible to equalize the ratios of these groups entering the workforce. There are many complicated issues in maintaining and managing healthcare workforce diversity in American institutions, which have been outlined above. Research has shown, however, that there are many solutions to these problems that can be addressed by human resource managers. In any case, the human resource manager has a central role to play in the creation of this increased diversity and it will be interesting to see the progression of diversity in the American healthcare workforce in the future. References Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-Firempong, O. (2003). 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