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Black and Hispanic dermatologists represent only 3% and 4.2%, respectively, of the dermatologist workforce in America, study data show. These percentages are a mere fraction of the respective 13.4% and 18.5% of the U.S. population that identifies as Black or Hispanic.

While efforts are underway from the and others to increase diversity in dermatology, the U.S. Supreme Court's recent decisions effectively banning affirmative action may drive down these numbers even further. As such, medical schools and dermatology residency programs need to redouble their efforts to recruit students from underrepresented minority groups.

That's the primary message of a commentary published in the .

Jane Grant-Kels, MD, co-author of the commentary, is professor of dermatology, pathology, and pediatrics and vice chair of dermatology at UConn Health. She is also the assistant director of the health system's melanoma residency program. Her exchange with the Reading Room has been edited for length and clarity.

In the wake of the Supreme Court's decision-making regarding affirmative action, what motivated you to want to write this piece in the first place? Why was this an important set of messages to disseminate?

Grant-Kels: My concern is that we need, for the sake of patients, more diversity in medicine. I went to medical school in the 1970s, when there were tremendous restrictions for minorities, both racially and ethnically, and even religiously. I happen to be Caucasian, but I am Jewish, so I was aware of the restrictions.

The American Academy of Dermatology is making a tremendous effort to attract various ethnic groups and minorities to our specialty so that our workforce is equal in percentages to that of the general population. Right now, we're far below that goal. If colleges don't seriously consider candidates and take ethnicity into consideration, then those people won't get to medical school, much less a dermatology residency.

So I was concerned about the domino effect that the Supreme Court decisions might create, and I felt it was important for people to be aware of it.

Could you say more about that domino effect? How exactly do you see it playing out?

Grant-Kels: I'm not an affirmative action expert, but I do sit on the committee in our department that reviews and interviews applicants. I can tell you that the quality of applicants from various minority groups is outstanding, that many of them would get in on their merit alone. But the number of minorities who apply to dermatology residency programs has historically been very low.

I think there is a misunderstanding by the public that some people are favored just because they're Black or Hispanic, even when their applications are of lower quality. That's just not true.

What do you think the dermatology and/or academic medical communities should do to improve these numbers?

Grant-Kels: The way to do it is to stimulate high school kids.

So, you take a Black kid in high school who doesn't think they're going to go to college, and you stimulate them and you get them turned on and then you don't minimize their chance of getting into college.

By the time they apply to dermatology, they're as good if not better than any other strong applicant.

There was a simple but telling sentence in your commentary: "the importance of a diverse dermatology workforce cannot be understated." Could you talk about the importance of a diverse dermatology workforce to the patient populations being served?

Grant-Kels: I'll give you an example. If you have a Black woman who's having hair loss, she might really prefer and feel more comfortable talking to someone who looks like her. It's not that a white woman or man isn't going to be trained on how to deal with hair loss in African-American women, but that patient might feel much more comfortable speaking to an African-American woman dermatologist who can perhaps better understand her fear. There are going to be patients who are going to feel more comfortable going to a doctor more like themselves. That's just the reality.

In fact, there have been very good studies to show that when patients seek out care from someone of their own kind, visits are longer and patients feel that their questions are answered better. They're more satisfied with the kind of care they got.

The second piece is that it's fairly common for trained physicians to go back to their hometowns to set up a practice. This goes for all sorts of communities, including rural America. If we want practices to be set up in areas that predominantly include minorities, we need to train people from those communities. Obviously once trained, these physicians have total independence, and can go anywhere and do whatever they want. But there is evidence that many return home and take care of their own neighborhoods and their own communities. I think that's important.

To spin all of this forward, what suggestions might you have for someone who's reading this? What can people at medical schools and academic health systems do to be more responsive?

Grant-Kels: I think we owe it to our specialty to reach out and go to high schools, colleges, and med schools, and talk to students. A lot of people don't even know about the specialty of dermatology and what it entails and how people of different ethnic groups could add an important quality to our profession. And particularly once the kids are in med school, we need to reach out to the entire student body, no matter what their race or religion or ethnicity, and try to get them interested in dermatology.

It needs to be a fair process for everyone, and when kids apply to college, they want to get a fair chance. That's why we need to reach out in high school and get those kids stimulated early so that they're all qualified. I just think it's our responsibility to make sure our specialty gets more diversified and remains diversified for the kind of research we do, as well as for the quality of patient care we deliver to the American population.