Restless Leg Syndrome01:00 AM Thu April 27, 2023
With Black History Month underway, we will hear stories highlighting Black Excellence in all forms; whether that be excellence in service to others, career fields, or in any other aspect of life, Black individuals are rightly recognized for their success despite adversity, inspiring others who resonate with their identity and experience. While it is incredibly important to recognize the perseverance and success of Black individuals, it is equally important to acknowledge the structural barriers that are rooted in our society that make it hard to not only reach these accomplishments but also to maintain them. The field of medicine is historically notoriously known for its lack of diversity and barriers to accessibility. With the extensive training needed to become a doctor, that often requires pre-existing knowledge of the field oftentimes from networks with physicians, as well as the hefty costs associated with it, many minority individuals have found themselves having to work twice as hard to keep up, not due to a lack of ability but a lack of resources and support.
One of the fundamental obstacles for minority individuals trying to practice medicine is entering a space that was not designed to welcome them. In a nation where 13% of individuals are Black, only 5% of physicians are Black in the US, highlighting a serious issue with our system. Dr. Ayana Langston reflects on her experience of having to balance two identities: a Black woman in the US and a physician in the US. As she reflects on how her identities don’t seem to be able to fully coexist, she states, “How does one honor and protect the sanctity of one’s own Blackness while also giving so much of oneself to a health care system that in many ways continues to dismiss, ignore, and mistreat Black people?” Dr. Danielle Hairston reflects the same sentiments, describing “a sense that medical and mental health care is not of — or for — the Black community.” This shared feeling of being part of a field that is not designed for them highlights exactly why we need Black and other minority physicians.
“When providers don’t match the population, care suffers.” This statement by Owoicho Adogwa, assistant professor of clinical neurosurgery, succinctly explains the necessity of having underrepresented minority (URM) physicians. Within the Black community specifically, there is a lengthy history of medical mistrust that stems from exploitative experiences in which the medical field used Black individuals for testing and research in inhumane ways. Perhaps the most famous example of this is the exploitative use of HeLa cells – cells taken from Henrietta Lacks, a black woman with aggressive cervical cancer, without her consent. This medical mistrust is not limited to historical cases, unfortunately; recent studies find that Black patients are less likely than white patients to receive proper pain medication and treatment in response to complaints of pain and discomfort. When you consider all of these factors and the many more, including how pulse oximeters fail to accurately report oxygen levels on darker skin, it is no surprise that 55% of Black Americans polled stated they did not trust the health care system. Being able to seek help from a physician that not only looks like you but also shares cultural values immediately changes the dynamic in the doctor’s office and can lead to more open, candid conversations that can ultimately improve the care for the patient; not to mention, a physician with a shared identity is likely to use their platform to advocate for better treatment of patients from that identity. By encouraging and supporting URMs to pursue careers in medicine, we can help shift the dynamics of healthcare to truly serve all.
However, it is not enough to encourage URMs to pursue medicine but also to ensure they are supported throughout the journey and stay in the field. Investigations have shown that, “Black residents either leave or are terminated from training programs at far higher rates than white residents.” These rates increase as one looks at the more selective/lucrative specialties of medicine, further emphasizing the ways in which Black physicians are blocked from certain levels of success even once they have been able to enter the medical field. A closer look at why this is happening points to the effects of institutional racism and a lack of mentors with shared identities. Fixing this issue will require organizational changes from medical schools and hospitals in order to create spaces that welcome and continuously support their students and physicians from underrepresented backgrounds to ensure that they feel heard and valued throughout every step of their career. In looking to create a better healthcare system, it is absolutely imperative that the field is created by and for people of all backgrounds.