Eric Emilcar

Professor Olga and Professor Geoghan

FIQWS Narrative Medicine

12/13/19

 

The Shortage of Black Physicians

Black people are not supposed to be physicians. They can be anything, but a physician from sports players to rappers. Statistically speaking, the chances of becoming a sports professional or musician is less likely to occur than becoming a physician yet a medical future is the one seen as an unfeasible goal. In society, black physicians are rarely mentioned or talked about because they are seen as abnormal in the sense that they do not conform to society’s perception of an ideal physician. The model physician is a white male with the famous ‘genuine white smile.’ This translates to black physicians failing to meet that status quo all because of the color of their skin. Their counterparts are constantly glorified in the mainstream media through avenues such as TV series even though they perform the exact same tasks. Simply enter the term doctor on google, and the results speak for itself. The search yields mostly white grinning doctors with the occasional black doctor beside a white doctor. This prompts me to ask, why is it so unrealistic to believe a physician could be black? Why is it that a claim to being a black physician is unequivocally questioned? Why is that we allow this prejudiced notion to continuously threaten the health of black communities?

Figure 1 (Castillo-Page 17)

 

The narrative that black people are not supposed to be physicians is exemplified in the lower percentages of black physicians and medical students in the United States. According to the chart above, in the United States black people make up approximately 4% of the total amount of physicians in the medical field in 2010. Black medical students make up only 7.7% of the total medical student population. In comparison, 75% of physicians and 58.9% of medical students are predominantly white. The large discrepancies provided by Figure 1 in combination with the Davis text, “Constructing Normalcy,” have only exacerbated why the social norm of a physician is considered to be a white male. Davis essentially coins the term, normalcy, as a social construct that is dependent upon the commonality amongst the majority. Those that drift from the standard of normalcy are to be considered as “deviant”. The term, deviant, creates a negative stigma that confines the deviants to the outcasts of society. Within the medical field, black physicians are the deviants confined to the outcasts of society. The white male is the normal standard for the model physician because they make up the greatest percentage of all physicians in the United States therefore they are the “commonality amongst the majority.” The prevalence of white physicians and inversely the lack thereof in black physicians provide reasoning as to why it is unrealistic to believe why a physician could be black. Similarly so, this prejudiced notion plays into the questioning of the validity of black physicians’ doctorate. A story in which this scenario actually occurred back in 2016, where a black female physician, Tamika Cross, en route from Detroit to Minneapolis was denied from helping a passenger emergency. As Tamika got up to assist, a flight attendant told her, “Oh no, sweetie, put [your] hand down…We are looking for actual physicians or nurses or some type of medical personnel, we don’t have time to talk to you” (Hawkins). It was due to Tamika’s color of skin that barred her from helping a man in critical need. The prejudiced narrative that black people are not supposed to be doctors in this instance prevented a passenger from receiving urgent care. 

Although Tamika’s experience may seem minor because it was only one instance, imagine the repercussions this prejudiced notion has across the board. The significance of the discrepancies exemplified in the provided statistics is that the lack of a black presence in the medical field has created a domino effect that can be attributed to the negative health outcomes of black communities. The first domino to fall as a result of this is that the black community has been subjected to perceived discrimination in accordance with the lack of black physicians. In fact, “8-42% of African Americans perceive that they have personally experienced racial discrimination while seeking healthcare” (Hausmann). The black communities are left the majority of times with physicians they can neither fully trust nor relate with due to the prevalence of white physicians. 

It can be seen in Figure 2 that 15% African American population feel as though they would receive better care if they were of a different race. This alludes to the notion that they would receive better care if they were white because the vast majority of physicians are white. Further compounding the long term effects by dissuading black communities from seeking health care. Figure 3 exemplifies the disengagement from healthcare by demonstrating how black people wait longer in comparison to white people in pursuing healthcare opportunities. The disengagement from healthcare will only jeopardize the health of black communities as simple illnesses that could be treated with ease manifest itself into larger and more complicated problems. 

Essentially the lack of cultural competency has paved the way for discriminatory practices to continue amongst the medical field which severely compromises the health of black communities throughout the United States. Cultural competency in the medical field serves to provide high-quality healthcare to every patient regardless of race or ethnicity. The lack of diversity within the medical field has failed the objective of cultural competency because it fails to provide high-quality healthcare to minorities, specifically black people. Due to the increased prevalence of discrimination black people face within the medical field, the perception of quality healthcare has diminished. Based on Figure 4, “those reporting DMS were more than twice as likely to rate their quality of care as fair or poor compared to those with no DMS” (Benjamins) while “those reporting DMS were also significantly more likely to be less involved in decisions than they wanted and have less time with the doctor than they wanted compared to those reporting no DMS”(Benjamins).

Figure 4 (Benjamins)

The lack of cultural competency compounds the issue of disengagement from healthcare within black communities. Black communities will feel dissuaded in pursuing healthcare opportunities due to the poor quality of care in combination with the clear lack of patient-physician interaction exemplified in the little time spent with the doctor and lack of autonomy in decision making. Overall the lack of cultural competency is another domino to have fallen due to the racially toned narrative that black people are not meant to be doctors. 

Figure 5 (African American Health)

 

As previously mentioned, the shortage of black physicians has contributed to negative health outcomes in black communities. It is well known that the largest demographic of physicians, white people, fail to adequately practice in black communities. On the other hand, new black physicians continue to practice in these communities yet these communities continue to suffer great disadvantages health-wise. This is further supported in the article, “The Coming Shortage of Black Medical Students,” because “black doctors practice in communities in which blacks make up 32% of the population while white doctors on the other hand practice in communities where the population consisted of 5% blacks” (JBHE). Therefore black communities are often times neglected because they are more likely to suffer from a shortage of all races of doctors. Even though there is a clear need for more willing physicians to practice in these neglected communities, the medical field continues to fail its cultural competency objective by not increasing the percentage of black physicians. The aforementioned suffering is exemplified in the increased risk of “illnesses such as cardiovascular disease, cancer, diabetes,  asthma, and complications of childbirth” (JBHE). In addition to these illnesses, across the board, as mentioned in Figure 5, “African Americans are more likely to die at early ages from all causes” (African American Health) in comparison to white people. 

Rappers, sports professionals, mechanics, construction workers, and janitors are just some of the types of professions that are seen as attainable for black people in society. Look up the image of a doctor, and you are overwhelmed with countless white faces containing that famed white smile. Society’s perception of a model physician has exacerbated negative health outcomes for minorities especially true for black communities. African Americans should not be more prone to die from the same illnesses than other ethnicities, yet here in the modern-day we are faced with a problem that has failed to have been addressed. It is common knowledge that there’s been a deficit of black physicians since the 1950s yet the percentage of black physicians in the medical field has not significantly changed while the overall health of black communities has continued to be jeopardized. In the introduction of my paper, I asked why is it so unrealistic to believe a physician could be black? Looking at the question holistically, the vision of a black doctor is one that is seen as unfathomable because society has viewed physicians through the normalcy lens explained by Davis. The great majority of physicians are white, so society determines that as the norm which casts any other race as abnormal or deviant. This lens also explains why the credit of a black physician is doubted especially at first impression. The prejudiced notion that black people are not supposed to be physicians in modern-day society, has created a domino effect that has failed to have been rectified. This narrative perpetuates an endless cycle of structural violence in which the health of black communities is continuously compromised. In order to combat this cyclical problem, there needs to be an increase in pipeline programs into medical school. This will not only increase minority enrollment, but also increase the chances of the respective students matriculating into residency programs. This would change the perception of the limits of black people becoming a physician as there would be an increase in the number of black physicians in the medical field. If we were to address this narrative, the health of black people would no longer be jeopardized at the expense of a lack of cultural competency. 

 

Works Cited

“African American Health.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2 May 2017, www.cdc.gov/vitalsigns/aahealth/infographic.html.

Benjamins, Maureen R., and Megan Middleton. “Perceived Discrimination in Medical Settings and Perceived Quality of Care: A Population-Based Study in Chicago.” Plos One, vol. 14, no. 4, 2019, doi:10.1371/journal.pone.0215976.

 

Castillo-Page, Laura. Diversity in the Physician Workforce. Association of American Medical Colleges, 2008, pp. 7–39, Diversity in the Physician Workforce.

“Constructing Normalcy.” Enforcing Normalcy: Disability, Deafness, and the Body, by Lennard J. Davis, Nota, 2016, pp. 9–26.

 

Hausmann, Leslie R. M., et al. “Impact of Perceived Discrimination in Healthcare on Patient-Provider Communication.” Medical Care, vol. 49, no. 7, 2011, pp. 626–633. JSTOR, www.jstor.org/stable/23053690. 

 

Hawkins, Derek. “Flight Attendant to Black Female Doctor: ‘We’re Looking for Actual Physicians’.” The Washington Post, WP Company, 29 Apr. 2019, www.washingtonpost.com/news/morning-mix/wp/2016/10/14/blatant-discrimination-black-female-doctor-says-flight-crew-questioned-her-credentials-during-medical-emergency/.

 

“The Coming Shortage of Black Medical School Graduates.” The Journal of Blacks in Higher Education, no. 28, 2000, pp. 44–46. JSTOR, www.jstor.org/stable/2678687.