Racial bias

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A few months ago, my daughter met another doctor who helped a patient on a plane. Dr. Fatima Stanford works at Massachusetts General Hospital and is an assistant professor of Medicine and Pediatrics at Harvard Medical School. In 2018, she attended to a distressed airline passenger but was repeatedly interrupted E\DLUOLQHVWDƵDVNLQJWRVHHKHUPHGLFDO credentials. As part of a Communications assignment, my daughter attended a lecture by Dr. Stanford at Boston University’s School of Public Health and met her afterwards. Here’s the article she wrote:

+DUYDUG3URIHVVRU6D\V5DFLDO%LDV LQ0HGLFLQH0XVW6WRS by Chiara M. Marshall Allowing minorities to have a voice is essential to eliminating racial bias in the health profession, an assistant Harvard University professor said during a talk at BU’s School of Public Health last Wednesday.

Recognising that this issue not only DƵHFWVPLQRULWLHVEXWHYHU\RQHLVWKHƶUVW step to making changes said Dr. Fatima Stanford, who made national news in 2018 IRUDOOHJHGO\EHLQJUDFLDOO\SURƶOHGRQD 'HOWDƷLJKW)OLJKWDWWHQGDQWVUHSHDWHGO\ asked for her credentials while she administered care and asked if her medical license was hers.

“Our degrees don’t protect us,” said Stanford, who specialises in obesity medicine as a Massachusetts General Hospital physician. “Despite the fact that I have four [of them], did two residences, did two fellowships, and actually had P\PHGLFDOOLFHQVHRQPHWKHƷLJKW attendant had the audacity to ask me if [the license] was mine.”

Addressing several hundred Boston University undergraduates, graduates

Racial bias in medicine

Award-winning cardiologist Dr. Shane Marshall asks if racial bias in medicine is bad for your health?

and medical students, Stanford said that acknowledging that the current system is creating barriers for non-white professionals is paramount to stopping discrimination.

This comes at a time where the total medical school enrollment for non-white students is at a historic high, according to a 2019 report by the Association of American Medical Colleges.

Diminishing the potential discrimination IDFHGZRXOGFUHDWHDEXWWHUƷ\HƵHFW improving healthcare employment for the next generation, said Stanford. She also said one of the main problems is non-white students not seeing representation within WKHLUƶHOG

The event’s organiser, an associate professor at Boston University’s School of Public Health, said that witnessing this representation should start in schools, but that this is not currently a reality. ţ,DPRIWHQWKHƶUVW>SURIHVVRU@RIFRORU that many [Boston University] students have ever had,” said Dr. Yvette Cozier, who specialises in epidemiology. “And I teach graduate school.”

Cozier believes that representation within the health profession can reduce the stereotypical image of doctors being white men, but this process may take time.

Measures to promote diversity are now gaining traction. From 1986 to 2016, there was a 51% increase in the number

of non-white university faculty, and the upward trend has continued in recent years, according to a 2019 report by the American Council on education.

Natalia Kanj, a freshman in the College of Arts and Sciences on the pre-med track, said that these developments are creating an atmosphere of inclusivity.

“I think [classes are] well-representative [of every ethnicity],” said Kanj. “[The students] are all treated the same way. They’re all equal.

During her talk, Stanford said that increased diversity in medicine could EHQHƶWSDWLHQWVDVZHOOŞSDUWLFXODUO\ ethnicities with higher genetic health risks. Having doctors of the same ethnicity has EHHQVKRZQWROHDGWRPRUHHƵHFWLYH medical care, according to a 2018 report from the National Bureau of Economic Research.

When talking to non-white students who are considering practicing medicine, Stanford said that no one should be discouraged from a profession because of potential bias.

“If it’s something that you’ve been driven to do [and] is your passion,” she said, “why allow that to stop you?”

Though older professionals such as Stanford and Cozier have had to deal with outdated perceptions, the younger generation seems more optimistic about their future in medicine.

“I think the profession’s open to everyone,” said Kanj, “I can imagine anyone being a doctor if they have the drive for it.”

Although I love pre-med Natalia’s optimism, I suspected most black doctors would read this and think “No surprise.” So, last Sunday when I spotted Dr. Fiona Ross in the MarketPlace parking lot, I asked her opinion.

Dr. Ross, of Lifecare Family Practice, was carrying two grocery bags, her hair ZDVƷ\LQJDOORYHUWKHSODFHDQGVKHKDG just spent the morning updating her CPR credentials. “No surprise,” she said. Dr. Ross had a few other interesting things to say about the experience of black doctors. As a medical student she remembered VSHFLƶFDOO\EHLQJFDOOHGRQWRDQVZHU questions, then her professor expressing surprise that she knew the answers. Even now, she sensed that in general white doctors were perceived as more competent. She often reminds young people and medical students of color that LWLVQRWDQHYHQSOD\LQJƶHOGŞWREHWDNHQ seriously they need to be better than their white classmates.

Sadly, there’s a huge literature documenting racial disparities in medical care, including heart health. The reasons for this are complex – there’s racism, but there’s also access issues, lack of insurance, and cultural mistrust. But I hadn’t given much thought to the challenges faced by black doctors once they’d earned their degree.

Dr. Stanford’s airline experience helped start the #whatadoctorlookslike movement on Twitter. Check it out. As you’ll see, not all doctors are middle-aged white men.

Finally, for my white friends, if you think UDFLDOSURƶOLQJRQO\KDVFRQVHTXHQFHVIRU black doctors, I invite you to reconsider. +RZZRXOG\RXUHDFWWRDLUOLQHVWDƵ if your relative had a cardiac arrest on an airplane, a black doctor was doing CPR, and the stewardesses kept interrupting her to ask for medical credentials? Just a reminder that racial bias isn’t just a black person’s problem. It’s everybody’s problem.

For more news on the latest developments in cardiology, visit www.ShaneMarshallMD.com, subscribe to the free newsletter The Annals of Cardiology, and follow Dr. Marshall on Twitter @ShaneMarshallMD.