Equality v. Equity

“I give the same equal care to all my patients,” is a phrase we often hear, and, inside, I cringe.

Working towards giving equitable care, not equal care, should be our focus for our patients, especially if we’re aiming to shrink the health disparities gap.

We must reaffirm that our profession is one that champions individualized care and medical strategies that are in accordance with the patient’s capabilities (economically, geographically) and beliefs (cultural, spiritual and religious).

Our practice with patients must be equitable in order to best serve them. For instance, equal care strategies ensure patients receive the same resources; however, an equitable strategy considers which resources most effectively support the unique patient.

Why does this distinction matter?

Equality doesn’t assure the optimization of health care and its outcomes. Giving the same resources to all of our patients doesn’t shrink disparities in healthcare, in the same way that giving a two-wheeled bike to two different adults (one confined to a wheel chair, while the other is able to walk) doesn’t mean they both have an equal riding experience.

If we acknowledge the need for fair opportunities in health and healthcare for all patient populations, then multi-disciplinary strategies will be key to achieving health equity. In line with the bicycle analogy, giving a two-wheeled bike to a patient confined to a wheelchair won’t result in riding. Indeed, this situation warrants additional services (engineers, physical therapists) to help create an equitable bike for that patient to achieve the same health outcome as an individual who can ride a two-wheeled bicycle.

How does this influence daily patient care?

Know your patient with the disease—this reaffirms that knowing your patient will help to better manage the disease. It’s hard to think that providing “equal” care takes into account knowing the patient. What if they come from a low-income, high poverty neighborhood and speak English as a second language? Equal resources won’t help this patient. Health communication equity, therefore, must be utilized to know your patient and implement fair health strategies.

Now more than ever, we must know our patients to deliver the promise of medicine—health equity. Allowing our patient and the populations we serve fair opportunities to health will move us all “closler” to such a promise.