#WhatADoctorLooksLike – How Racism And Implicit Bias Affect Health Care

Photo by Getty Images/JGI/Tom Grill
Yet another example of how racism robs us of our dignity and humanity. 

Last week, Dr. Tamika Cross, a young Black OBGYN practicing in Texas, was barred from helping a sick passenger aboard a Delta flight because members of the crew refused to acknowledge her as a medical professional. The incident sparked the #WhatADoctorLooksLike hashtag on social media as a rallying cry for young female physicians of color responding to yet another example of how racism robs entire swaths of the population of their dignity and humanity.

At the end of an exhausting year marked by police brutality, mass shootings, global epidemics, and devastating hurricanes, it’s easy to write off Dr. Cross’s experience as simply unfortunate or inconvenient. The truth, however, is far more sinister.

The same unconscious bias that allows a police officer to suspect a Black man of criminality and immediately respond with force also prevented the aircraft crew from acknowledging that a Black woman could be a physician. Luckily, the passenger’s life was saved, but the trending conversation illustrates the commonality of how racism and implicit bias affect the health care system—both for those who work within the system and those who are seeking its care.

While anyone has the potential to be a doctor, the reality is that America’s medical field is not representative of the people it serves. Decades of segregation and accompanying divestment from educational systems serving Black and Latino children leave children of color inadequately prepared for careers based in science, technology, engineering and math.

According to the American Association of Medical Colleges, in 2013, over 91 percent of all physicians were White. Despite Black women comprising the most educated segment of the American population, Black women and men comprised only 4 percent of the physician workforce.

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We cannot adequately respond to the needs of people of color—often the sickest patients— if we have little connection to the contexts of their lives.

And for Black women specifically, that represents real life consequences.

In comparison to White women, Black women are more likely to get sick or die from a whole host of conditions including heart disease, breast cancer, colon cancer, HIV/AIDS, and even pregnancy.

While medical advances contribute to longer, healthier lives, many health inequities have only gotten worse with time—a cruel irony as many of these advances have historically exploited people of color. Dr. James Marion Sims, known as the “father of modern gynecology,” perfected his technique to repair vesiovaginal fistulas by experimenting on enslaved African women in the 1800s. Sims purchased some of these women solely for the purpose of his experiments, which he performed without anesthesia, though it was available at the time. And who could forget the generations of devastation and mistrust caused by the Tuskegee syphilis experiment?

These examples aren’t just relics of a troubled past. Over ten years ago, research concluded that physicians are less likely to give Black patients medically-indicated treatment for heart disease; more recent studies established that Black children and adults are less likely to receive appropriate pain management in the emergency room.

As the only Black woman in my entire graduating medical school class, I understand the impact of the erasure of women of color. Now in my role as New York City’s Health Commissioner, I’m proud to be one of only a few Black women helming strategies for American cities’ health.

I’m sounding the alarm on how the history of racism and oppression has conspired to create unhealthy communities. As a determined member of the less than 9 percent of non-white doctors, I call on my colleagues throughout the medical and public health community to join me in broadening the landscape of #WhatADoctorLooksLike so we can better exercise the most important tool to fight disease—empathy.

 

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