Diversity in radiology lags, but discussion in JACR clarifies path to progress

Over the past year, a dialogue has developed in the pages of the Journal of the American College of Radiology that sheds light on the complexities and differing perspectives related to diversity in the fields of radiology and radiation oncology (RRO).

First, in July and August 2014, the ACR Commission for Women and General Diversity published two articles detailing the history of diversity in the American workplace, the challenges faced today by minority groups in their professional careers, and ways to possibly bring more diversity to RRO.

“Training, recruitment, retention, promotion, and leadership development of radiologists from underrepresented groups are important to the well-being of our profession and the health of our patients,” wrote Johnson B. Lightfoote, MD, member of the ACR Commission for Women and General Diversity, and colleagues.

The authors looked at the shifting U.S. population—by 2050, white Americans will no longer  be the majority—and noted that the current RRO workforce do not reflect these changing demographics.

For example, 6.5% of all diagnostic radiologists and 7.2% of all radiation oncologists are black, Hispanic, American Indian, Alaskan native, native Hawaiian or Pacific Islander. Meanwhile, those same groups account for 15.3% of all medical school graduates and 30% of the total U.S. population.

The number of women working in RRO, the authors found, also leaves much to be desired, though there are some areas—academic radiology, for instance—in which women are well represented. Data about the representation of lesbian, gay, bisexual and transgender individuals in healthcare is incomplete at this time.

In its analysis, the commission made several recommendations about how to improve diversity, representation and inclusion in RRO for both women and underrepresented minorities. A few of those recommendations include:

  • Increase visibility of accomplishments by women and underrepresented minorities
  • Focus on developing leaders that consistently value diversity
  • Require diverse search committees for new hires
  • Implement regular, transparent salary reviews to verify there is equal pay for equal work

“By leveraging diverse backgrounds, experiences, and skills of radiologists and radiation oncologists, we will create new, effective ways to not only educate our trainees, medical colleagues, and patients but also improve delivery of health care and our service to society,” the authors wrote.

The point & counterpoint

Last week, less than one year after those articles, two editorials were published in JACR that served as a point-counterpoint to the commission’s findings.

David Hayes, MD, of Windsong Radiology Group in Amherst, N.Y., wrote that the committee made many recommendations, but failed to explain how any of those changes would help “improve the daily existence of a struggling imaging practice.”

“Human resources issues, 24/7 service demands, professional competencies, and governance are the typical challenges for a medical imaging group, and the authors failed to demonstrate how a diversity initiative would improve those chronic problems,” Hayes wrote. “A diversity project devoid of an obviously practical benefit is a heavy lift that many radiologists will find unnecessary, unworkable, and ultimately undesirable.”

Hayes also wrote that the commission’s philosophy revolves around “special treatments” and “reparation.” Referencing the work of business writer Peter Drucker, Hayes countered that hiring employees objectively, measuring job performance and holding everyone accountable is the way to achieve diversity.

Lightfoote and his co-authors from the commission then provided a response to Hayes’ editorial with one of their own. In it, the authors wrote that they did not recommend “special treatments” as a possible solution at any point in their analysis, and that their recommendations were more in-depth than Hayes suggested.   

Overall, the commission stood by its message, pointing out that the actions it recommended have been successfully implemented by businesses in a wide variety of industries over the years. The authors concluded by stating they don’t have all of the solutions, but something must change for there to be true progress.

“Doing business as usual will not take us forward to a future in which all members of the radiologic professions are included, welcomed, and valued as contributors,” Lightfoote et al wrote. “Advancing diversity and inclusion presents critically important opportunities to ensure a modern, progressive, and bright future for our profession.”