How Should Academic Health Centers Desegregate Health Professions Education?

Abstract

One expression of structural injustice in the United States is delivery of health care according to patients' race and insurance status. This de facto segregation in academic health centers limits community organizations' and leaders' capacity to dismantle racism and undermines health equity. This commentary on a case considers this problem, argues why academic health centers are ethically obliged to respond, and offers strategies to do so.Case PR is a community organizer who lives in a historically Black neighborhood in a large city near a prominent academic health center (AHC). Despite PR's community's proximity to this AHC, PR and other community members do not seek care there if they can avoid doing so, since they do not generally feel it is "meant for us." PR and others in the community know that world-class clinicians practice at this AHC and that wealthy people from all over the world come to see them. Neither PR nor PR's neighbors have ever seen a physician in this AHC, but they have received care at the AHC's clinics that are staffed by trainees and students who are "volunteering" and doing "service learning."