(bright, upbeat music) - [Jessica Guh] The distance that people are willing to travel to come see me, just to find a provider that understands their culture or understands their language is shocking to me.

I have a patient who lives on Vashon Island.

Her daughter, specifically, brings her mother all the way from the island.

There's no way to get from that island to our clinic without having to use a ferry each time.

Certainly there are other medical clinics on Vashon Island, none that are specifically focused on the Asian-American population.

- [Announcer] All passengers must disembark the vessel upon arrival.

- Jessica Guh] As her mother's health has continued to decline, they're actually considering even just moving entirely from Vashon.

It's just really sad that someone has to literally move their whole household just to get healthcare that they feel like is adequate.

That's how important this sort of like cultural piece is, in terms of being able to access a doctor that she feels like her mother can relate to.

- [Narrator] Jessica Guh's patient isn't alone in wanting a provider she feels comfortable with.

Many patients prefer to see someone who shares their background, understands their culture, or speaks their language.

All these things contribute to a trusting relationship and research shows that patients fare better when they trust their provider.

- Are there other concerns that you wanted to talk about?

- (speaking Asian language) - [Leo Morales] And that trust comes in many forms, and on a basic level the trust comes when someone understands the history of a community.

- Okay, well, the good news is that I didn't see any sign of infection or any other cause for this problem.

- [Edwin Lindo] Patient racial concordance is when your racial identity is the same, or is one that you are comfortable with, in relation to the identity of your provider.

And so, if you identify as a Black person and the provider identifies as a Black person, that is racial concordance, and the data shows that there's benefit from that.

I'm not suggesting that every person now go and say, "Ooh I want X person because of their race."

No, because there isn't data that shows that if a white person seeks a white provider that they'll get better care.

That data doesn't exist, we haven't found that.

But what we have found, is that for marginalized communities the trust and relationship between a patient-provider racial concordance means that there's a likelihood that there will be better outcomes.

(microphone giving feedback) - Mic check.

- [Narrator] Nait Misgina has lived in Washington their whole life, and says they often feel the need to change the way they behave at the doctor's office to feel heard by white providers.

- [Nait] Code switch.

Meaning that when I speak to my friends, I do not speak the same way when I go into a doctor's office.

And that's like a self-defense mechanism, so that I am taken seriously in that office.

- With liberty and justice for all.

- [Nait] In the Black community and in even African community, you don't really go to the doctor unless you're like basically on your death bed.

And why is that?

I think that has a lot to do with culture and the lack of representation.

When you do go to a doctor's office, I have never had a Black doctor.

All of them have been white.

I haven't even had any BIPOC doctors at all.

There's a lack of representation.

And I think that affects a lot of people's subconscious, when it comes to trusting the system that they need to go to, to have healthy, regular checkups.

It doesn't feel like a safe space.

- [Narrator] Having a good patient-provider relationship is especially important for communities of color.

Due to various structural inequities, they tend to have worse health outcomes, such as: lower life expectancy, higher diabetes rates, and higher rates of cancer.

But because doctors are mostly white, mostly from higher income backgrounds ... - There's a huge discrepancy between who's in the profession and who is in our communities that we serve.

That's the gap that I would address.

- [Narrator] And it's not just about trust.

Black, Latino and Native American physicians are also more likely to work in underserved communities.

And they're more likely to care for patients on Medicaid, who are low-income and disproportionately people of color.

That means they help reduce disparities by making healthcare more accessible.

- [Leo Morales]] But, the truth of the matter is, is that we don't have enough Black, Brown, Indigenous physicians.

(map smacking against table) - [Narrator] Let's take a closer look.

Here's Washington's demographics, according to the latest census data.

And let's compare that to the best estimate we have of our state's physician population.

In Washington, the Latino physician shortage is especially concerning.

- [Leo Morales] Latino physicians in the state of Washington, they're about 3.4% of the physician workforce.

Latinos are about 13% of the population.

- [Narrator] Our estimate says we'd need over 1900 Hispanic and Latino doctors to reflect the general population.

For reference, we currently have less than 500.

(map rolling up) - [Leo Morales] Non-white populations in the country as a whole, and in the state of Washington, are growing.

Probably, the point that's most important to notice: The rate of change among the physicians is much slower than the rate of change in the population in general.

What that means is there's no point of convergence in the future if we stay with the way things are now.

We're diverging, in terms of becoming less representative over time.

Even though we see greater numbers of minority physicians going to medical school and becoming physicians.

It's just not happening fast enough to keep up with our population.

- [Narrator] It's also not just doctors we should be worrying about.

- [Leo Morales]] It's the health professions, and almost every profession: medicine, dentistry, nursing, physical therapy, occupational therapy, public health, social work, and pharmacy.

Healthcare is a team type of a system, and so it's important to have members of the entire team that are diverse.

- [Jessica Guh] We know that diverse teams function better.

Even in business studies, you know, McKinsey, Bain, some of those large consulting firms that talk about productivity profitability, have done studies.

And over and over again they show that teams with diverse representation outperform those that are more homogenous, because diverse viewpoints mean that you have different perspectives.

You have new ideas that come to the table.

And so, really making sure that we have providers that reflect our patient populations is really important.

(traffic whooshing by) What has struck me the most is how far people are willing to travel for that.

But I think it also speaks to how difficult it is for people to find clinics that are appropriate to them.

And wouldn't it be great if we had diverse physicians, so that she didn't have to come from Vashon Island one day?

She could just see a physician on Vashon.

- [Narrator] This series is made possible in part by the generous support of Premera Blue Cross.