About Diversity in Medicine

opinions

You Should Care About Diversity in Medicine

Akansha Das

managing Editor

My mom is an Asian-American immigrant with a full-time job, two children and a husband with cancer. She’s already carrying a heck of a lot on her shoulders and her upbringing in a low-income family in a developing country meant that preventative medicine was not always prioritized — especially breast, vaginal and vulvar health. She checks the boxes of an immigrant, a racial minority, a woman at average risk of breast cancer and a woman brought up in a generation that was taught that “the epitome of womanhood was losing oneself” (Glennon Doyle). Convincing her to get a mammogram this year was not easy for these intersectional reasons. So I told her “If Dad’s cancer was inevitable, would you rather have found out at stage one or the stage we ended up finding it?” Relating her care to the care of her cancer-afflicted husband she cares so deeply about was the only way I could convince her to do something her doctors had not been able to.

Along with the running theme of self-care for cancer caregivers in this anecdote, I tell this story because I think it highlights a fundamental reason why diversity among healthcare practitioners is so important: relation and connection. Marginalized individuals especially can often feel judged by individual healthcare providers (possibly due to increased dependence on adverse health behaviors or power imbalances and white coat syndrome in medical offices) or hold distrust of healthcare institutions on the whole (possibly due to past medical-based incidents such as gynecological experiments on enslaved women by Dr. James Sims, the Henrietta Lacks case or cultural perceptions about the importance of preventative screenings and the role of healthcare). For a patient, seeing the representation of someone who looks like them acknowledge a patient’s unique concerns and cater patient counseling and discussion to these concerns can make a huge difference in a patient’s understanding and motivation to pursue healthy lifestyle behaviors. We have data to back this up too. Studies report that white vs. Black patients in racially concordant patient-provider relationships report higher quality of interaction with their providers (cited in Dr. Barr’s Health Disparities in the United States 3rd Edition).

In this text, Dr. Barr also details a study where a group of Black medical students from the University of Pennsylvania visted barber shops who served a large proportion of individuals identifying as Black. Medical students would engage in conversation with customers in line, screen them for hypertension and refer them to local pharmacists they could visit for treatment and management. The effort caused many Black customers to visit the pharmacist and begin to control their blood pressure.

This study is notable first in the fact that it was spearheaded by Black medical students who used their own cultural competency and understanding to recognize that barbershops were a cultural staple for many Black males in their community. By meeting patients where they were at (both physically in a barbershop rather than a potentially stressful medical office and psychologically through casual individual conversation rather than a formal power dynamic-infused discourse), there was increased uptake of medical services. To me, it’s a beautiful and powerful example of why diversity among our healthcare workers is imperative and how it can begin eliminating blind spots the healthcare system may have.

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