The unspoken racism in the medical system goes beyond my experiences alone.
This is Race and Medicine, a series dedicated to unearthing the uncomfortable and sometimes life threatening truth about racism in healthcare. By highlighting the experiences of Black people and honoring their health journeys, we look to a future where medical racism is a thing of the past.
As a Black mother of two, it often feels like my relationship to the American medical system was determined centuries before I was born.
This was never more clear to me than during the month of pain I experienced after giving birth to my son.
At each checkpoint with my doctor, the reality of what I was experiencing was ignored because my symptoms didn’t “fit” into the postpartum narrative my doctor was accustomed to.
Instead of compassionate and affirming care, I was met with denial and disbelief.
It turned out that I had a retained placenta, a life threatening experience that was treated as trivial. It opened my eyes to the unspoken racism in the medical system. It’s bigger than my birth experience alone.
It’s the “all lives matter” environment that made me uncomfortable at the physical therapist’s office, on top of the staff continually denying the severity of my pain.
It’s the sudden shifts in tone that happen when front desk staff at a doctor’s office speak with me versus my white counterparts.
And it’s undoubtedly the difference in treatment I receive when wearing my wedding ring to an appointment, especially if my children are present.
Rachel M. Bond, MD, FACC, a women’s heart and prevention specialist who is the system director of the Women’s Heart Health Program at Dignity Health in Arizona, says trust between patients and their physicians is an essential aspect of preventing illness and improving health outcomes.
“Disparities in healthcare are not solely based on race as a risk factor, but most prominently racism as a risk factor. Racism is a public health crisis that we need to eliminate to provide equal and quality care,” Bond tells Healthline.
She notes there’s a history of mistreatment in medicine. One of the most infamous examples is the
This history has long shaped the relationship between people of color and the medical industry.
In the near-century since that infamous study, few medical professionals have done the personal development or anti-racist education required to treat Black, Indigenous, and People of Color (BIPOC) with respect and dignity. Those who have share powerful
A 2009 review on cultural competency in medical schools noted that only 2 of the 34 curricula involved discussions of racism.
Efforts to shift toward racial inclusion are often well meaning, but they usually focus on admissions numbers without giving much thought to what’s needed to actually support a more diverse student body.
We continue to witness headlines of Black Americans dying following lack of access to care.
These heartbreaking tales have taught me that having a “nice” doctor isn’t sufficient. People of color across the country, especially
What we need are medical professionals who have made an active effort to educate themselves on the legacy of dehumanization that people of color have experienced in their interactions with the medical system.
Now that I’m also responsible for managing my children’s medical care involving chronic health concerns, seeing a doctor brings me more anxiety than ever.
Each appointment on my calendar reminds me that I’m preparing for the latest battle in a long war that Black Americans have been fighting for centuries.
It’s not an overstatement to suggest that your doctor is one of the most important relationships in your life. It can quickly turn into a matter of life and death.
At the same time, the history between the medical community and people of color can make that relationship taxing, intimidating, and even feel impossible.
Chatting with your loved ones of color about their firsthand experiences is a great way to hear how different professionals treat their patients.
Bond suggests that seeking medical professionals who are in community with physicians of color could be an overlooked way to connect with racially competent medical professionals.
“We know that although the most comfort is felt when the clinician is of the same background as the patient, if you have a series of clinicians who work with a robust group of clinicians of color, this can make them more empathetic and understanding of the disparities they face and more culturally sensitive to their needs,” Bond says.
For many folks, like myself, it’s not always possible to have access to a provider who looks like you.
However, many professional organizations are having conversations on the pervasive presence of racism in medicine.
When seeking a new provider or checking out your current ones, try to find out their interests as well as any memberships with affinity groups they have.
Implicit bias in healthcare is pervasive, and Bond notes that medical professionals and administrators aren’t always aware of how to identify it. She believes that acknowledging this bias is instrumental in eliminating it.
“If you are a patient of color and notice your clinician is unwilling to address your concerns, such as basic questions to better assess your health literacy, is unwilling to use a translator if English is not your native language, or is unwilling to provide you the same care as your friends or family of a different racial background may have received, then you may want to seek the opinion of another clinician,” Bond says.
While medical professionals of color are trying to change the culture from the inside, there’s a really awesome effort with mostly Black medical professionals using the hashtag #EndTheDisparity to bring attention to the ways that the medical system is failing patients of color.
It’s also crucial that patients advocate for themselves.
Remember that you’re the expert on your own experience. Deep down, you know if someone is mistreating you. Trust your gut.
It’s taken me 5 years to admit that I should have filed a complaint after having so many doctors tell me that the pain I experienced postpartum was nothing.
At the time, I was too timid and fearful that I would be ignored again. I thought moving on would make the trauma of that experience subside faster. I was wrong.
These days, women reach out to me seeking community with someone who understands the horrific experience of having a retained placenta. I tell them to speak up.
Reporting mistreatment is central to the healing process of overcoming traumatic medical experiences. Plus, it’s worth noting that by speaking up, you’re not only freeing yourself. You might be saving others from suffering a similar fate too.
Open and honest communication should be practiced long before you find yourself having an emergency procedure.
If you don’t feel comfortable telling your provider that the care they’re providing isn’t meeting your needs, or you feel like your voice is being silenced, you don’t have to stay.
File a complaint and leave.
Resources like the Irth app allow you to leave reviews on your experiences with bias in healthcare. Use them. No one should feel unsafe while seeking care.
You can also ask your doctor to input your request on your medical record to ensure that everything is documented. This may even encourage a doctor reluctant to provide a particular treatment to rethink their position.
After 6 years of living in the Mountain West, I’ve unfortunately gotten used to receiving subpar care from medical professionals who are underprepared or even unwilling to address how racism shapes the way I interact with the healthcare system.
My anxiety toward these interactions typically begins to build from the waiting room forward. If I had more options, I’d be intentional about seeking support from someone of color.
I’ve come to accept that individuals of color who seek nonwhite medical professionals aren’t the problem. The medical professionals who refuse to be bothered to provide quality care to BIPOC are the real problem.
You don’t need to feel guilty about intentionally seeking out doctors of color.
“Studies have shown that when there is a concordance in the race of the patient and clinician, there is an improved level of trust that leads to better compliance, follow-through, and overall health outcomes,” Bond says.
Preliminary research has documented that specific populations, like Black men, report better health outcomes when they have access to Black providers. This truth is a powerful reminder that representation matters.
Medical trauma changes the way you interact with the healthcare system. I have a long way to go before I feel that I’m healed from the negative experiences I’ve had over the last 5 years.
At the same time, I’m now empowered enough to know that I have a level of choice in what I’m willing to accept from a medical professional.
And I refuse to suffer in silence ever again.
A. Rochaun Meadows-Fernandez is an award-winning writer, speaker, and activist working to amplify Black women’s voices in the mainstream dialogue, especially within conversations on health and parenting. She’s also the founder of the #FreeBlackMotherhood movement.