Poor medical care and mistrust fuel black patients’ desire for black doctors: beatings

Dr. Michelle Wilson has just graduated from Charles E. Schmidt College of Medicine at Florida Atlantic University. She will continue her training through a family medicine residency at Phoebe Putney Memorial Hospital in Albany, Georgia.

Verónica Zaragovia / WLRN

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Verónica Zaragovia / WLRN

Dr. Michelle Wilson has just graduated from Charles E. Schmidt College of Medicine at Florida Atlantic University. She will continue her training through a family medicine residency at Phoebe Putney Memorial Hospital in Albany, Georgia.

Verónica Zaragovia / WLRN

In South Florida, when people want to find a doctor who is black, they often end up contacting Adrienne Hibbert through her online website, South Florida Black Doctors.

“There are a lot of black networks that are behind the scenes,” says Hibbert, who runs his own marketing business. “I don’t want them to be backstage, so I bring them to the fore.”

Hibbert says she came up with the idea for the website after giving birth to her son 15 years ago. Her obstetrician at the time was white, and the Miami suburban hospital didn’t feel welcoming as a black woman pregnant with her first child.

“They didn’t have unique photos of a black woman and her black child,” Hibbert says. “I want someone who understands my background. I want someone who understands the foods I eat. I want someone who understands my upbringing and the things my grandmother used to tell me.”

In addition to a shared culture and values, a black doctor can provide black patients with a sense of security, validation, and trust. Research has shown that racism, discrimination, and unconscious bias continue to harm America’s healthcare system and can cause unequal treatment for racial and ethnic minorities.

Black patients saw their complaints and symptoms ruled out, their pain subcontracted, and are referred less frequently for specialized care. Older black Americans can still remember when parts of the country had separate hospitals and clinics, not to mention deeply unethical medical failures and abuse, such as the 40-year-old. Tuskegee Syphilis Study.

But even today, black patients say too many clinicians can still be dismissive, condescending, or impatient – which does little to restore confidence. Some black patients say they would prefer to work with black doctors for their care, if they could find one.

Hibbert is working to transform its website into a more comprehensive and searchable directory. She says the most sought-after specialist is the obstetrician-gynecologist: “Oh my God, the No. 1 the call I get is [for] a black OB-GYN. “

For black women, the impact of systemic racism can be evident during childbirth. They are thrice more likely to die after giving birth than white women in the United States.

Nelson adams is a black obstetrician-gynecologist who works at Jackson North Medical Center in North Miami Beach, Florida. He says he understands the desire that many women have for a black OB-GYN but says that cannot be the only answer: “If every black woman wanted to have a black doctor, it would be next to impossible,” he says. “The numbers are not there.”

And it’s not just about recruiting more young black students into medicine and nursing, he says, although that can help. He wants systemic change, which means medical schools must teach all students – regardless of race, culture or background – to treat patients with respect and dignity. In other words, how they themselves want to be treated.

“The golden rule is to do to others what you would like them to do to you, so that a doctor’s heart needs to be that kind of heart where you take care of people like you would like to be treated. or want your family to be treated, ”he says.

George Floyd’s death in Minneapolis in May 2020, and the wave of protests and activism that followed, prompted US businesses, universities, nonprofits and other institutions to reassess their own history and their race policies. Medical schools were no exception. In September, the Miller School of Medicine at the University of Miami revamped its entire four-year medical curriculum to to integrate anti-racist training.

New training has also been incorporated into the curriculum at Charles E. Schmidt College of Medicine at Florida Atlantic University in Boca Raton. Medical students are taught to ask patients about their history and experiences in addition to their bodily health. New questions could include: “Have you ever felt discriminated against?” or “Do you feel safe to communicate your needs?”

“Different things, these were questions that we may never have asked in the past, but that we need to start asking ourselves,” says Dr Sarah Wood, Senior Associate Dean for Medical Education at Florida Atlantic University.

Medical students begin to learn about racism in healthcare in their first year, and as they go, they also learn to communicate with patients from a variety of cultures and backgrounds, Wood added.

These changes come after decades of racist teachings at US medical schools. Adams, the OB-GYN, completed his residency in Atlanta in the early 1980s. He recalls being taught that if a black woman comes to the doctor or hospital with pelvic pain, “It was assumed that it was probably a sexually transmitted disease, what we call PID, pelvic inflammatory disease. Typical causes are gonorrhea and / or chlamydia.”

This initial assumption was consistent with a racist view of the sexual activity of black women – a presumption that white women were spared. “If the same symptoms were presented by a Caucasian, a young white woman, the hypothesis would be do not an STD, but endometriosis, ”Adams says. Endometriosis is not sexually transmitted, and is therefore less stigmatizing, less linked to the behavior of the patient.

This diagnostic rule of thumb is no longer taught, but physicians can still bring unconscious racial bias to their encounters with patients, Adams says.

While reorganizing their programs, medical schools are also trying to increase diversity within their ranks. The Schmidt College of Medicine at Florida Atlantic established in 2012 a partnership with Florida A&M University, the historically black state university. Undergraduates who wish to become physicians are mentored as they complete their pre-medical education, and those who meet certain criteria are admitted to Schmidt after graduation.

Dr. Michelle Wilson followed this path and graduated from Schmidt College of Medicine this spring. She is heading to the Phoebe Putney Memorial Hospital in Albany, Georgia for a family medicine residency. Wilson was drawn to this specialty because it can do primary care but also give birth. She wants to build a practice focused on the needs of black families.

“We are changing the code. Being able to be so comfortable with your patient, I think that’s important in building a long-term relationship with them, ”Wilson says.

“Being able to relax and talk to my patient like family – I think being able to do that really builds on the relationship, in particular, makes a patient want to come back another time and like, ‘I really like this doctor. ‘”

She says she also hopes her work could inspire the next generation of black doctors as well.

“I didn’t have a black doctor growing up,” Wilson says. “I am preparing the ground for other little black girls who look like me, who want to become a doctor. I can let them know it’s possible.

This story is from NPR’s health reporting partnership with WLRN and Kaiser Health News (KHN).

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