Dr. Rhonda McIntyre of Ross University School of Medicine On 5 Things We Must Do To Improve Patient Outcomes for Underrepresented Populations
To improve patient outcomes in underrepresented populations, a number of elements are necessary for improved health outcomes. These include patient education and training interventions, healthcare provider training in culturally competence and supporting culturally appropriate services, a strong community engagement agenda and inclusion of these populations in clinical trials and research and leveraging digital technology. These strategies can be effective in removing barriers to health access and improving the quality of care provided to underrepresented populations.
Healthcare disparities continue to affect underrepresented populations, leading to unequal patient outcomes. Social, economic, and cultural barriers often hinder access to care, appropriate treatments, and equitable health services. How can we bridge these gaps and ensure that all patients, regardless of background, receive the highest standard of care? In this interview series, we are talking to healthcare providers, policy makers, community leaders, researchers, and anyone who is an authority about “How We Can Improve Patient Outcomes for Underrepresented Populations”. As a part of this series, I had the pleasure of interviewing Dr. Rhonda McIntyre, MBBS, FAAP, FRCP(C)
Senior Associate Dean of External Affairs Dr. Rhonda McIntyre has been with Ross University School of Medicine (RUSM), an Adtalem Global Education institution, for more than 20 years building partnerships that improve healthcare accessibility and eliminate disparities in communities that need it most.
Dedicated to creating a more impactful medical education to support the next generation of physicians, she is passionate about exposing medical students to diverse communities. She believes students and medical professionals should address access to healthcare for vulnerable populations to shift outcomes and dismantle unjust health inequities.
Prior to joining RUSM, Dr. McIntyre spent many years in clinical practice and was head of pediatrics at Princess Margaret Hospital in Dominica. Her over 20-year career as an academic and clinical leader and pediatrician informed her broad view of the challenges facing maternal-child healthcare and marginalized populations.
She is a fellow of the Royal College of Physicians and Surgeons of Canada, a fellow of the American Academy of Pediatrics (AAP) and a member of the AAP Section on Global Health. She is a graduate of the University of the West Indies with residency training at the British Columbia Children’s Hospital, University of British Columbia in Canada and holds a Certificate in Healthcare and Change Leadership.
Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a story about what brought you to this specific career path?
It was more an introspective awareness over the years rather than a story. I have always had a genuine interest in others and would often find myself readily sharing words of wisdom or advice. This came from a place of curiosity about other people’s lives and circumstances and from a keen interest in their welfare. These characteristics combined with a desire to be an advocate for the vulnerable drew me to a career in medicine. Mentoring young professionals and witnessing their development brought fulfillment and satisfaction and this has served me well in academic medicine.
Can you please give us your favorite “Life Lesson Quote?” Can you share how that was relevant to you in your life?
“Doing well by doing good.” I believe that true success should be interconnected with contributing to society. Being authentic in relationships and acting with a positive intent, combined with a sound work ethic grounded in reaching for excellence leads to outcomes that speak for themselves. Combined with a community mindset and a strong sense of social responsibility, this approach can bring fulfillment personally and professionally.
Much of my professional interests have led me to engagement in developing programs that prioritize enhancing healthcare in vulnerable populations. This is true for both my clinical and academic pursuits, such as non-profit work or leading the development of community academic programs or training for healthcare workers. This has highlighted the value of the co-existence of social accountability and success in creating a sense of purpose in my life.
How would you define an “excellent healthcare provider”?
An excellent healthcare provider has at their inner core an appreciation for and respect for humanity. One who is a lifelong learner, patient-centric, humanistic and a patient advocate, and who practices evidence-based medicine without favor, towards achieving equitable healthcare delivery.
What are your favorite books, podcasts, or resources that inspire you to be a better academic leader? Can you explain why you like them?
A few of my favorite books are, “The 7 Habits of Highly Effective People” by Stephen. R. Covey and Patrick Lencioni’s, “The Five Dysfunctions of a Team”. I have found them to offer practical and realistic guidance towards effective leadership. The “7 Habits” provides advice to help promote personal and professional growth, leading to enhanced productivity. I often refer to Patrick Lencioni’s pyramid and find it a valuable resource in team building activities. Another of my favorites is, “Get Real” by Anna Crowe. As a believer in the value of embracing authenticity throughout one’s professional journey, this book resonates with me. I also stay informed on topics of interest and current trends in medical education through resources such as academic and other journals.
Are you working on any exciting new projects now? How do you think that will help people?
RUSM through the Office of External Affairs launched an exciting program through an agreement between RUSM and The Pan American Health Organization, Regional office of the World Health Organization (PAHO/WHO). The intention of this relationship is to assist in strengthening health systems in Barbados and the Caribbean region. The agreement, which was signed on June 11, 2024, focuses on capacity strengthening, advocacy, service and research. This relationship places RUSM on a pathway to becoming a PAHO/WHO collaborating center. The initiative provides a pathway for RUSM to give back to communities in collaboration with PAHO, ensuring that the work we do is relevant to the countries’ needs and adds value to the healthcare system.
A work plan has been developed and implementation of activities have begun. One of the high-level activities is around enhancement of emergency response systems through training of healthcare providers. This initiative is a key step in strengthening our community partnerships in Barbados and the region and in working on healthcare challenges facing our communities. We expect the societal impact of this initiative between PAHO /WHO and RUSM to be far-reaching to the health sector.
Ok, thank you for that. Let’s now jump to the main focus of our interview. What are the primary barriers that underrepresented populations face when seeking healthcare?
Limited resources and access to basic health education are significant barriers underrepresented populations are facing. Many people in underrepresented communities do not have the resources they need to travel to a doctor’s office or hospital, and some who do might not have the ability to take time off from their jobs. When these populations live in healthcare deserts, not only do they lack access to basic healthcare, but it would require even more time and effort to get the care they need. The cost of treatment can also be a major barrier for people with a limited disposable income. Another challenge I think they face is access to education that provides fundamental knowledge about preventative health and how to navigate the healthcare system. Many people don’t even know if, when or why they should seek help, or the impact everyday activities like diet and exercise have on life-threatening illnesses such as diabetes and heart disease.
How can healthcare providers build trust with patients from diverse backgrounds, especially in communities that have historically experienced medical neglect or discrimination?
Our healthcare providers need to reflect the diverse communities they serve and that starts with diversifying the pipeline of future physicians. We need to attract multilingual and culturally diverse students to the healthcare field, which is why RUSM and Adtalem Global Education, including its four other institutions rooted in healthcare, are committed to providing educational access to those who may not have otherwise had an opportunity. By removing barriers and taking a more holistic approach to the admissions process compared to traditional medical schools, we are forging the pathway for aspiring physicians to pursue a career in healthcare. Then, once these students graduate, they will go on to work in the communities they know and represent.
What role does cultural competence play in improving patient outcomes, and how can medical professionals be better trained to meet the needs of underrepresented groups?
Cultural competence is a key component for providing high-quality care and improving patient outcomes. When physicians are culturally competent, they eliminate their own biases and approach care with empathy and compassion to better understand a patient. Whether it’s in the hospital, clinic, or a humanitarian outreach setting, medical professionals need to create an inclusive and open environment that applies to all races, genders, ages and cultures. But they can only do this if our higher education institutions include cultural competency training as a requirement in the curriculum and in the clinical settings, and require training in diversity, equity, and inclusion at all levels to ensure everyone has the skills to provide the same standard of care to all patients. RUSM has made that a priority.
Can you share any successful strategies or programs that have been implemented to reduce health disparities and improve outcomes for underserved communities?
RUSM recognizes that social determinants of medical education are barriers to access and inclusion in medicine and uses academic and non-academic criteria to select students who are not admitted to traditional medical schools. We provide both academic and non-academic student support as part of our programming to ensure successful outcomes. Diversifying the medical profession contributes to health equity resulting in better patient outcomes and ensures representation in the physician workforce.
RUSM is part of Adtalem’s Medical Education Readiness Program, a 15-week science-based course that introduces content that is taught in greater depth in the early semesters of medical school. MERP helps close the preparation gap and expands access to students who might not have been ready for direct admission to medical school. Between 2020 and 2024, 804 MERP advancers from RUSM and our sister school American University of the Caribbean School of Medicine, including 210 from underrepresented groups, have graduated from medical school and entered residency positions in the U.S. RUSM has also developed a unique model that integrates early clinical and community experiences through our network in Barbados, which has expanded to five U.S. communities.
How can technology and telemedicine be leveraged to reach underrepresented populations who may face geographic or financial barriers to traditional healthcare services?
Two critical barriers underrepresented communities face are limited access to technology and lack of transportation to healthcare services. Digital technology solutions can mitigate barriers such as transportation through telehealth services. Expanding the reach to underserved populations can be further enhanced by offering services in languages other than English.
While the use of technology in delivery of healthcare has increased in recent years and access to technology has improved healthcare delivery, the lack of technology in some areas can contribute to health disparities because of unequal access to digital technology. Policymakers have recognized the need for a digital strategy in healthcare delivery to address such issues, an example of which is The World Health Organization, Global Strategy on Digital Health. Our healthcare system and digital technology have advanced throughout the years, creating possibilities for improved healthcare access through digital healthcare services.
As a “healthcare insider”, if you had the power to make a change, can you share 5 changes that need to be made to improve patient outcomes for underrepresented populations? Please share a story or example for each.
Healthcare disparities often impact underrepresented populations from marginalized racial and ethnic groups, lead to poor health outcomes due to inadequate quality and limit access to healthcare. Improving patient outcomes in these populations by limiting health disparities is critical in advancing health equity. Having the agency to effectively change this narrative through the following interventions is not far-fetched, if all stakeholders are able to universally adopt the strategies presented.
1. Patient-centered and culturally competent services
- Cultural competency is essential in achieving a level of patient care that addresses patients’ varied backgrounds, cultures, belief systems, behaviors, and languages.
- Culturally appropriate communication and interactions are important in ensuring a true patient-healthcare provider partnership and in delivering culturally sensitive care. Training of healthcare providers in cultural competency and humility is an essential measure to build patient trust and ensure patient adherence to treatment, resulting in improved health outcomes. This is particularly important in the management of chronic diseases, which is associated with a high degree of morbidity. Such training should be mandatory in the healthcare workforce and should be included in medical school curricula and that of other future healthcare providers.
- Accommodations to provide culturally competent services and eliminating stigma, is another related intervention to help engender trust, resulting in improved patient outcomes in underrepresented minorities.
- At RUSM we have included a Community Medicine thread in our curriculum that includes training in cultural competency and humility. Our medical students begin patient interactions from their first semester of medical school and learn to apply cultural competence skills to effectively communicate and address the needs of patients from diverse backgrounds. This training includes an in-depth exploration of social determinants of health and reflections on the varied exposures in community clinical encounters. This engenders empathy and a deeper appreciation of the need for patient-centric care.
2. Community Engagement and Collaborative interventions.
- Community stakeholders are essential in developing strategies and development of interventions and should be involved in decision making. Ensuring the inclusion of communities and patients in healthcare programming, such as education, training and research will increase the level of engagement and participation and help improve outcomes.
- Multisectoral networks such as governmental agencies, non-governmental agencies, civil society, and non-profit organizations are valuable partners in ensuring successful programming, leading to improved health for underrepresented populations.
- At RUSM we have established a wide range of community partnerships through which we have provided opportunities for our students to engage with patients from underrepresented populations in diverse and in some cases marginalized communities. This provides a rich exposure to patients from varied backgrounds, many of which are impacted by social determinants of health.
3. Educational Interventions
- Culturally appropriate educational interventions including multimedia approaches have been shown to have a positive influence on patient engagement and health outcomes in underrepresented groups. The development of educational interventions that are culturally and language appropriate are key to effecting positive change in various aspects of healthcare planning across the spectrum of acute and chronic care in ethnic and racial minority groups.
- At RUSM, we engage in regular health screening fairs and other engagement activities in the community. Through these activities, RUSM Faculty and students engage in health promotion and education through various presentations to community partners. RUSM provides basic life support provider certification to community members and nursing students with about 80 to 90 provider certifications annually. We also provide the Heart Saver training to staff and parents of the childcare board in Barbados. Our faculty contributes at local conferences and has recent contributions on Breast Cancer awareness for the UN staff in Barbados (Oct 24) and Innovations in digital screening in non-communicable diseases for non-governmental agencies and civil society organizations (Sept 24). We hosted an Obesity Symposium for healthcare workers on the island of Barbados on February 25, with elevated level international and national speakers.
4. Digital and Mobile Health Technology strategies
- There is a need for leveraging the increasing availability of digital technology and the rapidly evolving landscape of mobile health apps, wearable devices, telemedicine, and other digital interventions, to scale up access to healthcare to underrepresented populations.
- Digital health tools and other Innovations can be effective in screening, leading to better health outcomes in underrepresented minorities with chronic diseases, such as diabetes, cardiovascular and respiratory diseases as well as enhanced management of these diseases.
- The COVID-19 pandemic through necessity has left us with innovative interventions in health monitoring and healthcare delivery. Public health interventions, like the digital proximity tracing apps using Bluetooth capabilities that were used for tracing and notification of potential risk of coronavirus exposure, is one such example.
- At RUSM we introduced a telemedicine offering into the curriculum where students interact with patients remotely. A supervised patient evaluation allows our students to experience taking a medical history from patients who are in their home setting. The benefits derived from access to digital tools have created opportunities for scaling up disease detection and management, and the concomitant rapid increase in the number of mobile phone users has made digital technology in healthcare more accessible. There are a number of benefits associated with the use of digital technology in healthcare, one of which allow patients to be proactive in self-management. Other benefits include an enhanced patient experience, lower delivery costs, better communication between the patient and the provider, earlier treatment interventions, improved outcomes, and timesaving. Overcoming challenges such as health literacy and privacy issues will help prepare for scaling up the use of digital interventions, using telemedicine, mobile apps, M-Health, and E-Heath technology.
5 . Research and Community academic partnerships.
- Healthcare delivery within the context of community academic partnerships can be advantageous to underrepresented populations. A collaborative relationship where additional resources are made available for programming can be of mutual advantage and provide benefit to these communities. Research gaps can be addressed in these settings which are of value to both the academic institution and underrepresented populations. Additional human resources and medical supplies can contribute to better outcomes. At RUSM, through the establishment of community partners, we are leveraging the respect and trust built to begin to engage with patients and community leaders in community-based research.
- To improve patient outcomes in underrepresented populations, a number of elements are necessary for improved health outcomes. These include patient education and training interventions, healthcare provider training in culturally competence and supporting culturally appropriate services, a strong community engagement agenda and inclusion of these populations in clinical trials and research and leveraging digital technology. These strategies can be effective in removing barriers to health access and improving the quality of care provided to underrepresented populations.
What specific steps can be taken to ensure that medical research and clinical trials are more inclusive of underrepresented groups, and why is this important for improving overall patient outcomes?
Increasing representation of underrepresented groups in clinical trials can contribute to improvement in patient outcomes, through the application of research findings to similar populations. Selection of sites where underrepresented minorities seek care and broadening selection criteria can be of value. Additionally, the establishment of community academic partnerships where there is mutual respect, and trust can be invaluable in furthering the research agenda of underrepresented populations. To be successful research involving such populations need to be inclusive of community stakeholders, and stakeholders must be part of the decision-making process with academic institutions. The academic institution needs to nurture the relationship with community partners in a culturally sensitive manner and ensure that there is a true collaboration and clear communication to help build trust. Once these measures are in place, these community academic partnerships can be an effective platform for furthering research inclusive of underrepresented populations.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
I’ve always believed that to do well as a society, we must do good. This principle has to be adopted on our journey towards a sustainable future. RUSM’s innovative and experimental medical education programs are helping me live out my movement by providing critical aid and humanitarian assistance to underrepresented populations. Extending this movement to those impacted by extreme climate and natural disasters and other humanitarian crises, I am preparing my students — our future doctors — to answer the call and deliver high-quality care to those in these communities that do not have the resources to protect themselves and their neighbors. By implementing RUSM’s ethical, compassionate, patient-centric and culturally competent approach to everyday medicine, we can advance local and global healthcare.
How can our readers further follow your work online?
www.linkedin.com/in/rhonda-mcintyre-0b01843b
Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.
Dr. Rhonda McIntyre of Ross University School of Medicine On 5 Things We Must Do To Improve Patient… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.