How Black Doctors Can Improve Healthcare for Black Patients
The concept of health equity means that every person has the right to get the best and most appropriate care possible with respect to his or her individual needs. It means that each of us deserves to become as healthy as we can possibly be.
In order to accomplish true health equity, though, we as a nation need to address the numerous barriers standing in the way: income gaps, discrimination along racial and ethnic lines, lack of access to high-quality medical information, housing inequalities that place some groups farther away from resources than others, and more.
Black doctors for Black patients
The many health inequities prevalent in the United States today are thrown into stark relief by one simple statistic: Black patients often die earlier or faster than white patients diagnosed with the same condition.
Recent research has shown one particularly effective way of providing health equity, and a higher quality of patient outcomes, to people of color: Have Black physicians treat Black patients.
This isn’t, of course, to say that Black patients do not thrive under the care of white physicians. There are numerous examples that demonstrate the dedication and success of doctors from all backgrounds in treating patients across ethnic and cultural lines. Here’s what we have learned, though:
One 2019 study looked at the short-term patient outcomes of adult Black males who received care from Black doctors or other healthcare workers, versus those of Black men who got their care from non-Black healthcare teams. The patients treated by Black providers ended up receiving a measurably more in-depth range of preventive services and other care.
The central importance of communication
Another key issue has to do with ease of communication. A 2018 study showed that adult Black male patients demonstrated greater confidence and comfort in talking about their medical concerns honestly with Black healthcare workers. In addition, the Black healthcare providers produced a greater volume of notes about their Black patients and their conditions than did the non-Black providers.
The overall picture obtained from this study clearly shows that Black patients were able to spend more time with their Black healthcare providers, in large part due to the fact that these providers were able to convince them to take more potentially life-saving tests and screenings while under their care.
Other research builds on the data from this one to show that Black patients treated by Black physicians tend to receive crucial treatments sooner than those treated by non-Black physicians. Researchers have extrapolated from these data that the uptake of a greater number of life-saving tests and other care on the part of Black patients with Black physicians could reduce the mortality gap in cardiovascular disease between Black and white males by close to 20 percent.
A provider who can’t communicate effectively with patients can’t inspire trust, and therefore can’t address a patient’s healthcare concerns to the fullest extent possible. A strong doctor-patient relationship, anchored in empathetic communication, is essential in the practice of modern medicine, which views the patient as a whole person with agency, rather than simply a collection of body parts or diseases. When physicians can’t, for whatever social or cultural reason, establish a full relationship of trust and open, honest communication, it’s pretty much a given that treatment will be less effective.
A 2020 study shed more light on the importance of a strong doctor-patient relationship. What it found was that, even when the words and way of communicating are very similar, Black patients tend to be more likely to accept guidance about surgery from a Black doctor than from a non-Black doctor. Previous other research has also shown that Black patients cared for by Black doctors demonstrated greater medication compliance, were more likely to understand their personal risk for specific diseases, and were better able to avoid negative outcomes.
Boosting comfort and trust
Studies also show that even the most routine conversations between white physicians and Black patients can be clouded by unconscious bias. To take one now-familiar example: Black patients are often less likely to receive adequate treatment for pain.
Black patients have expressed a number of reasons for their greater comfort with Black providers: They feel less likely to be dismissed or shortchanged, less tense about engaging in honest conversations, and less anxiety in terms of their awareness of the historic racism in medicine. In light of the deep memory of the 40-year Tuskegee Syphilis Study in the 20th century, and other examples of white institutions’ ill-treatment of Black patients who were not allowed to give informed consent, this kind of anxiety is not unfounded.
Black doctors help Black infants thrive
A news item on this subject gained particularly wide attention in 2021: After studying close to 2 million hospital birth records compiled from 1992 through 2015, researchers discovered that when Black physicians were the doctors of record for Black newborns after birth, mortality rates among those infants were cut in half. (Statistically, Black newborns have a mortality rate roughly twice as high as that of white newborns.)
While the researchers noted that they have so far only identified an association, rather than a direct causal linkage, between care by Black providers and mortality rates, the results are exciting in terms of their potential to substantially lower the mortality rate among Black infants.
Only about 5 percent of physicians in active practice in the U.S. as of mid-2019 were African American, not enough to provide equitable healthcare services when about 13 percent of the country’s people are Black. To make the dream of health equity a reality, we definitely need more Black doctors and other healthcare workers.