Medicine Needs YOU!

[Notice: Today’s post is not so much about how to be a successful applicant and more of a reminder of why the field of medicine and your future Black patients need you. Increasing the number of Black providers to provide care for Black patients is kinda my soapbox. Sorry, not sorry. The next post will definitely be beneficial to your application, but I think this one will be beneficial to your career!]

As you’ve probably already noticed from social media and/or your minority pre-health meetings, Black physicians (like myself) are all about hyping up pre-med students and medical students! Why? Because we want, and need, you to join us! And, more importantly, your future patients need you! Those who look like you (read: your future Black patients) especially need you, as well as those who don’t look like you! 

As a future Black physician, not only will you be helping to reduce the shortage of Black physicians in this country but you’d also be a welcoming face for your Black patients and future Black physicians to look to. And, in your own way, you’d be increasing access to health equity for all!

Shortage of black physicians

The percentage of physicians in the U.S. who identify as Black or African-American is 5%. That’s concerning when you consider that Black people account for roughly 13.2% of the population. The percentage of Black physicians should (at least!) be this or higher. There is so much historical context related to Black physicians’ plight in the field of medicine and we still have a very long way to go to reach more equitable representation. And getting there starts with increasing the number of Black students applying to and being accepted into medical school. According to the most recent figures from AAMC, of those applying to medical school in 2019, only 8.4% of them were Black/African-American. Of those accepted into medical school, 7.1% are Black/African-American. Meaning unless you go to a few select medical schools (like Meharry, Morehouse, Drew, Howard), I can assure you that you will be of the minority in your medical school class. Those statistics have to change and that starts with you! That’s a lot of the purpose behind Melanin Mentor, MD…to help Black students be the strongest medical school applicants they can be to get accepted and get these white coats! The shortage of Black physicians is real, but don’t let it discourage you from thinking you can become a physician. Know that you BELONG in medicine! If being a physician is your goal, come on, let’s do everything in your power to make it happen. 

Healthcare disparities

So much recent attention is put on the disparities Black people in this country are facing related to COVID-19. But these disparities aren’t new! Black people have been suffering from chronic and preventable diseases at an alarming rate for decades. According to the Office of Minority Health, compared to their White counterparts, African-Americans are generally at higher risk for heart disease, hypertension, stroke, cancer, asthma, influenza, pneumonia, diabetes and HIV/AIDS. There are higher rates of perinatal deaths among Black women and babies.  And this is not, I repeat NOT, because we are genetically different, but it’s because there are systemic and social barriers in place that put most Black people at a significant disadvantage to living their healthiest lives. To add to this already increased higher risk, Black patients are less likely to have received the appropriate cancer screening and proper healthcare maintenance. I focus so much on prevention of disease, especially cancer prevention, in my practice as a family physician. My patients know I mean it and put up very little fuss (most of the time) when I look them in eyes (hands on my hips usually, cause I’m my momma’s child) and tell them that they ARE getting a colonoscopy because Black people are dying from colon cancer at incredible rates. Or a pap smear, mammogram, or prostate screening. I’m in front of them as a Black physician trying to keep them from dying from diseases that are disproportionately affecting and killing Black people! Most of them feel that in their spirit and it hits a little bit different coming from someone who looks like their daughter or their niece. And I totally milk it for everything it’s worth to get their screening done!

Inequitable treatment

 Racial disparities are well-documented in healthcare. Studies in emergency departments show that Black patients, compared to their White counterparts are less likely to receive timely and appropriate pain control; those presenting to the ER with chest pain are less likely to have a full, appropriate, cardiac work-up. Black patients are also found to have longer wait times to see providers and shorter visit times with providers when they are seen. There is much discussion, especially lately, about racial bias in medicine. Whether it’s implicit or explicit, it certainly exists. Patients realize these biases in medicine and this can affect their decision to seek care or to trust their health care providers and the healthcare industry. Black patients report that they feel “talked down to” during visits with non-Black providers and don’t feel that their concerns are always fully addressed or that they play a role in the decision-making process. Lately, and for good reason, there is a lot of to-do about teaching cultural competence and, particularly these days, teaching non-Black trainees and physicians how to interact with Black patients. You know who doesn’t need to be taught this? (point to yourself). Likely your momma and grandmother taught you this very early in life and may even have reinforced it with their house shoes when you got it wrong. 

Patient-physician concordance

Physicians who can provide culturally appropriate healthcare is so important. There is much data that re-enforces the idea that minority patients “do better” with minority physicians. Studies show that patient satisfaction and health outcomes are improved when health providers and their patients have concordance in their racial, ethnic, and language backgrounds. We know that Black physicians disproportionately provide care for Black patients. That’s why more Black doctors in white coats is game-changing. We also see from research that Black patients with Black physicians are more likely to adhere to medication plans, are more likely to feel as if they are a part of the decision-making process, and have a better perception of the care given to them by their physician. All of these lead to better health outcomes and reduction of the disparities in chronic diseases mentioned above.

Despite the apparent preference among Black patients to have a Black physician and research that supports Black patients’ responsiveness to Black physicians, most Black patients in America have a White physician, largely due to the fact that there is a significantly higher proportion of White to Black physicians in the country. Now this isn’t to say that we need to go back to racial segregation in medicine, we’ve been there and done that and it was wrong and didn’t work out well the first time. But it is to say that we should be better able to provide patients with options so they can choose physicians with whom they would be most comfortable and feel that they receive the best care from.

The joy of treating Black patients as a Black physician

I love interacting with my patients. I would say roughly 85-90% of my patients are Black and there is not a single day that goes by in clinic that at least one of them doesn’t remind me why I’m so blessed to work with this population. Whether it’s a mom who says they drive an hour to see me even after moving to another town because she wants her child to grow up with a Black doctor (that happened yesterday and I cried real tears when I left the room), or a little kid who says “a doctor like you,” when I ask them what they want to be when they grow up during their well child exam, or a young adult who says they appreciate being able to talk to someone they can relate to, or middle-aged adults who remind me of my mom, dad, and aunts, or older patients who pray with me and tell me they’re so proud of me at every single visit…It literally is the best. I have patients who won’t even start talking about their own health issues in their visit before they ask how my mom and dad are doing, make sure I’ve gotten my oil changed and my tires rotated, ask if I went to church last Sunday, and question whether I’ve found a man to marry yet. I don’t practice in the town I grew up, these folks literally met me as their physician, not as a kid, but they have taken ownership of me as “theirs” and I’ve taken ownership of them as “mine.” And that relationship, which I think is magnified by the fact that I look like them, goes a long way when it comes time to talk about their health or the health of their kids. I love the connection I have with my patients. My nurses and students and residents who come to clinic are always really amazed by the rapport I have with them. I care about them as more than just patients, but as people. My people! I make a point to meet my patients where they are; I talk with them as I would my own family members, and I believe they understand that I care for them just as I would my own family members. And that makes the conversations, respect, and care genuine. 

This type of relationship is what you have to look forward to in a career in medicine. You should strive to get there with all of your patients, but I just know that you will have a major and life-changing impact on the ones who look like you. 

The medical field needs you! We need your enthusiasm, your smarts, and your skills. I know that sometimes as a pre-med student, the road gets tough and you may lose sight of why you even started on this journey. I hope this post was a reminder to you of why you started and the impact that you can make on your future patients and future students who will want to follow in your footsteps. You have everything it takes to make the much-needed difference in the healthcare field.