J Natl Med Assoc
-
Minority physicians have been persistently underrepresented in medicine (URiM) when compared with their representation in the general U.S. ⋯ This review summarizes and updates the literature on programs to improve the diversity of faculty at AMCs. It includes specific recommendations for components that can provide a foundation for programs to improve faculty diversity. Future research should use high quality methods to compare different interventions to improve the diversity of faculty in AMCs.
-
Patients with chronic kidney disease (CKD) are susceptible to infectious organisms in part due to the many facets of uremia-associated immune deficiency. Vaccination plays a crucial role in curbing vaccine preventable infection in patients with CKD and Kidney transplant recipients. Vaccination should be done early in the course of CKD or prior to kidney transplantation when possible. It is incumbent upon all healthcare providers to not only stay abreast of the rapidly evolving evidence and recommendations regarding this area but to also continue to update clinical practice regarding vaccines for long-recognized infectious threats, such as pneumococcal disease and chronic hepatitis B infection, to mitigate the burden of infectious diseases on this particularly vulnerable patient population.
-
Review
"Can i donate a kidney?" Common questions and simplified answers to the prospective kidney donor.
For individuals with end stage kidney disease (ESKD), kidney transplantation is associated with reduced morbidity, mortality, and decreased health care costs. African Americans have higher rates of end stage kidney disease (ESKD) and reduced access to transplantation compared to their White counterparts. One way to improve access to transplantation is by increasing the number of living donors. ⋯ Often individuals with ESKD are hesitant to inform loved ones about living donation out of concerns that their donors may feel pressured or may be harmed by donation. Even when patients discuss donation with loved ones, these potential donors may not seek information from their physicians. As an important first step, we provide general information about living donation to primary care physicians for their African Americans patients with ESKD and potential African American donors.
-
Recent recognitions of longstanding societal effects of structural and overt acts of racism have led to calls for the elimination of race, a social construct, from medical algorithms. This accelerated a growing concern with the use of race in kidney function estimating equations. ⋯ We herein review the journey of kidney function estimating equations, race in GFR estimating equations, new race-free equations and the path forward in caring for chronic kidney disease. We urge upon all primary care providers to employ concerted focus on early detection and identification of kidney dysfunction as well as risk factors including social determinants of health to prevent progression.
-
A need exists to examine racial disparities in the healthcare arena and the impact on patients with cancer. Despite ongoing efforts to increase equity in primary healthcare access, racial and socioeconomic disparities persist, thus contributing to disproportionate treatment outcomes and survivorship among minority and low-income patients. Such disparities have been revealed in treatment cohorts of patients with multiple forms of cancer, including breast, cervical, ovarian, endometrial, prostate, lung, colorectal, gastrointestinal, and hepatocellular, and have been attributed to a range of co-occurring behavioral, social determinants of health, underlying genetic factors, as well as access to educational opportunities that limit the quality of informed healthcare. ⋯ This requires developing a system of justice and trust based on specific, solution-oriented grassroots community efforts working in tandem with medical and pharmaceutical leaders. By fully exploring and pinpointing the underlying causes of healthcare disparities, it should be possible to define strategies and interventions most likely to transform cancer care. The ultimate goal is understanding individual, cultural, and biological vulnerabilities, including environmental and epigenetic liabilities, to optimize cancer prevention, diagnosis, and treatment.