Background: During the past two years, societal events and the COVID-19 pandemic have significantly increased awareness of the importance of diversity, equity, inclusion (DEI) efforts in the healthcare community. Hospitalists have a role in DEI efforts, especially as frontline providers during the pandemic, where racial disparities in hospitalizations (1) and deaths due to COVID-19 highlighted broader disparities in healthcare. Limited data and analysis of DEI efforts exist within hospital medicine divisions, particularly with regard to funded roles and programs. We aimed to explore the evolving landscape surrounding DEI efforts in hospital medicine divisions across the United States.
Methods: We created two parallel web-based surveys, one targeting Division of Hospital Medicine (DHM) leaders, and a separate one targeting hospitalists. Both surveys, emailed between February and May 2021, asked respondents to evaluate perspectives surrounding DEI efforts in the division and institution. We used descriptive statistics to summarize quantitative survey responses from both groups, and Spearman correlation to compare hospitalists’ responses to DHM leaders’ responses from their site for specific questions.
Results: From the DHM leader surveys, > 75% of institutions, departments, and divisions have DEI efforts focused on faculty development (93%), learner education (93%), and increasing recruitment and retention of individuals who identify as underrepresented in medicine (87%). Thirty percent of surveyed divisions have a position dedicated to DEI, and of those, 56% are funded roles. The biggest barriers to advancing DEI efforts include lack of data (77%), time (70%), and resources (70%). Opportunities for programmatic growth based on DHM leader surveys include DEI efforts focused on: advocacy (67%), disparities data (70%), and social determinants of health (70%).When asked about DEI perceptions in their divisions, 47% of the DHM leaders responded that DEI issues were prioritized as essential, compared to 15% of hospitalists. Eighty three percent of DHM leaders report preparation for and action toward DEI, compared to 56% of hospitalists. There was a weak but statistically significant positive correlation between hospitalists’ and leaders’ answers to the question ‘DEI efforts are a priority for our division’ (r=0.104, p=0.04), and to ratings of divisional readiness (r=0.114, p=0.028).Ninety percent of DHM leaders and 77% of hospitalists felt their divisions were moderately or extremely inclusive; however, 7% of hospitalists felt little to no inclusivity or belonging. Correlation between hospitalists’ and leaders’ ratings of divisional inclusivity were not statistically significant.
Conclusions: Although DEI efforts are in place in a majority of institutions represented in this survey, few divisions have positions focused on DEI efforts and these are not always funded. DHM leaders and hospitalists perceived prioritization of DEI efforts similarly, but perceptions of inclusivity remains an area of needed improvement in order to ensure Hospital Medicine is able to recruit and retain diverse physicians.
