Imagine that the principles of diversity, equity, and inclusion (DEI) do not exist, and so we remove any DEI initiative of training in health care, can healthcare truly thrive without it, or would patient care suffer the consequences? Without DEI, would future doctors, nurses and healthcare providers in general be prepared for real-world patient diversity?
This is neither a political article nor one that aligns with government practice or ideology. No matter your political stance, this is simply a parallel thought experiment: what if?
President Trump started his second term as US President this month in his inevitable style. Of course, absolutely nothing controversial or remotely discussion-worthy happened to catch the attention of commentators, everything he does is naturally absorbed as completely inoffensive. He’s slipped through the White House front doors like a parent returning home late at night, trying not to disturb a newborn child. (I hope you can see how I am seeking to avoid politics here).
However, one of the executive orders he signed presented a unique parallel thought worth exploring. Mr Trump declared Diversity, Equity, and Inclusion (DEI) programmes “illegal” and subsequently ended all DEI initiatives within federal government organisations, promptly placing all staff connected to these programmes on garden leave.
This got me thinking: what would this mean for healthcare and healthcare education if such a ban were extended to these fields? What would it mean for educators, students, providers, and, most importantly, patients?
DEI in Healthcare: Does Eliminating It Solve Anything?
Another question arises: by simply eliminating DEI initiatives, would we naturally treat everyone equally, regardless of their differences and needs? By avoiding the discussion and the attention, would things resolve themselves? Just as some believe that if we stop talking about racism, racism might magically disappear.
DEI must have emerged for a reason, right? Before DEI initiatives, were people from historically underrepresented groups truly included and free from discrimination or marginalisation? Was unconscious bias at play? If we can so easily afford to do without DEI, does that mean everything is now better, or was there never a problem to begin with? Or is this about the survival of the fittest and Darwin’s theory of natural selection, applied to the workplace, to healthcare, and to patient care?
Key Elements of DEI in Healthcare
Irrespective of what DEI means in government, what does it mean in healthcare?
In training and delivery, as they relate to patients and staff, DEI encompasses the following:
- Culturally competent care
Providing care that is respectful of patients’ cultural values and backgrounds. Let’s be clear: this does not mean receptiveness to only minority cultures but to all cultures, including the one that dominates your country or the space you currently inhabit. - Training
Delivering training to help staff recognise unconscious bias and challenge assumptions, not just for minorities but also for the majority. DEI works in all directions. - Accessibility
The practical side of DEI. This includes ramps, accessible parking, accessible toilets, and other measures for individuals with physical disabilities. Even as able-bodied people, what would we do without accessible toilets? The landscape would feel slightly strange. Would you stop and help someone in a wheelchair use a standard cubicle? - Support
Providing additional support for patients who need it, such as those with learning disabilities or mobility issues. DEI initiatives offer specialist assistance tailored to individuals, ensuring that our family members, friends, co-workers, and fellow patients receive the right support. This results in a more flexible, personalised service—less robotic, more human-centred. - Communication
Ensuring that those with communication barriers—whether due to language differences, social difficulties, or health conditions—are understood, whether they are patients, colleagues in distress, or students. How could better communication methods introduced through DEI initiatives be considered unnecessary? - Policies
- All of these elements can be formalised into policies, ensuring that DEI principles are upheld regardless of whether an institution—such as, say, the leaders of the free world—deems them necessary. (Just so they also know how to avoid DEI).
The Impact on Medical Simulation: A Training Perspective
Medical simulation plays a crucial role in training healthcare professionals, bridging the gap between theory and real-world patient interactions. But what if DEI were removed from this equation?
- Standardised Patient Representation: Without DEI, would medical simulations account for diverse patient backgrounds? Standardised patients (SPs) play a key role in exposing students to real-world patient diversity. Eliminating DEI might reduce exposure to different ethnic, linguistic, and socio-economic backgrounds, impairing a future doctor’s ability to treat patients effectively.
- Bias in AI-Driven Simulations: Many modern simulations use AI-based models for diagnosis and patient interaction. However, if these systems are trained on data that lacks representation, the risk of biased outcomes increases. DEI ensures that training data is broad and that simulations reflect real-world patient demographics.
- Inclusive Scenario Development: Simulation-based training creates realistic case studies for medical professionals to practice decision-making. Without DEI, there’s a risk that scenarios default to a limited patient population, overlooking the complexities of treating patients from varied backgrounds, including LGBTQ+ individuals, non-native speakers, and those with disabilities.
- Communication Training: One of the key elements of medical simulation is fostering effective patient-doctor communication. Without DEI, would simulations teach medical students how to handle language barriers, cultural sensitivities, or patients who distrust medical institutions due to historical inequities?
- Ethical Decision-Making: Many simulations incorporate ethical dilemmas where healthcare providers must navigate complex decisions. Without DEI, there’s a risk that these dilemmas would be framed within a narrow perspective, ignoring issues like systemic bias in treatment plans and access to care.
If DEI were banned, medical simulation would lose a vital component of realism, creating a gap between training and actual patient encounters. Healthcare education would regress to a one-size-fits-all model, diminishing the quality of patient care.
Final Thoughts
The reality is, regardless of one’s personal stance on DEI, those who uphold its principles and implement its policies are not only improving life for individuals represented under the DEI banner—whether as employees, service users, patients, or extended families—but also making life easier for those who oppose DEI.
DEI ensures that systems are less overwhelmed by matching specialised needs with specialised professionals. Instead of creating inefficiencies, DEI mitigates potential problems before they arise.
But then again, maybe all this DEI stuff is just a hoax.
READ ALSO
