Earlier in April, the Centers for Disease Control and Prevention declared that racism is a serious threat to a person’s health. It shows up in doctors’ offices and hospitals — and for Black women, that experience can be especially dangerous in pregnancy and childbirth.
In Florida, Black women are more than twice as likely to die during childbirth as white women, part of what motivated Adrienne Hibbert to launch the online directory Black Doctors of South Florida in 2018.
"Oh, my gosh — the No. 1 call that I get is a Black OB-GYN," said Hibbert, who owns and runs the marketing firm ThCreativhous and lives with her two sons in Pembroke Pines.
"There are a lot of Black networks that are behind the scenes," Hibbert said. "I don't want them to be behind the scenes, so I'm bringing it to the forefront."
Doctors pay to advertise on her website, and she refers them patients. Hibbert says she, too, wanted a Black OB-GYN 15 years ago, when she gave birth to her first son at Memorial Hospital West in Pembroke Pines.
"They had no singular photos of a Black woman and her Black child," Hibbert said. "I want someone who understands my background. I want someone who understands the foods that I eat. I want someone who understands my upbringing and things that my grandma used to tell me."
Dr. Nelson Adams, chief of staff at Jackson North Medical Center in North Miami Beach and a Black OB-GYN for 42 years, knows finding a physician who meets that profile isn't easy.
"If every Black woman wanted to have a Black physician, it would be virtually impossible," Adams said. "The numbers are not there."
When Adams did his residency at Emory University in Atlanta from 1978 to 1982, residents were trained that if a Black woman came in with pain in her pelvis, "the assumption was that it was likely to be a sexually transmitted disease, something we refer to as PID — pelvic inflammatory disease. The typical causes there, gonorrhea and/or chlamydia. If the same symptoms were presented by a white young woman, the assumption would be not an STD, but endometriosis."
Endometriosis is a painful disorder that can cause swelling in the reproductive organs.
"That training transcended the race, the culture, the ethnicity of the provider, so Black docs as well as others would have that same implicit bias," Adams added.
Recently, some medical schools have started teaching future doctors not to think that way.
"Our goal is to have our students be really always recognizing the role that race and racism plays in health care and that by recognizing it and drawing attention to it, that's how we're going to make significant changes," said Dr. Sarah Wood, senior associate dean for medical education at the Charles E. Schmidt College of Medicine at Florida Atlantic University in Boca Raton.
Wood said physicians must ask Black patients far more than "Where do you live?" and "What work do you do?"
"Have you ever felt discriminated against? Do you feel safe communicating your needs? You know, different questions that we maybe never historically asked, but we need to start asking," Wood explained.
At the University of Miami, Dr. Roderick King is part of a similar effort that gained momentum after the murder of George Floyd on May 25, 2020. He's the senior associate dean of diversity, inclusion and community engagement and director of the MD/MPH Program, and associate professor at UM's Miller School of Medicine.
They're now integrating the "understanding around racial bias, implicit bias, issues around social justice, working with diverse populations, and the idea that it would not be just a one course that you do," King said.
"We integrate all of these different ideas all throughout what we call vertically, so all four years of medical school. Within each year there will be elements of this that will be integrated, whether they're doing basic sciences, whether they're learning how to take care of patients and do a physical exam, or whether you're doing subspecialty training."
"It's now time that we not put all the onus on behavior change on our patients, in this case Black mothers," King continued. "What kind of behavior change may need to occur at the level of providers and at the level of hospitals?"
Adams, Jackson North's chief of staff, also reminds physicians and future providers that "you need to have the heart of a physician, and that means you need to be compassionate," he said.
"You really need to look at these folks as being someone in your family. The golden rule says 'Do unto others as you would have them do unto you.' So that heart of a doctor needs to be that kind of heart where you are taking care of folks the way you would want to be treated or want your family treated."
Another important part of that change is training more Black doctors.
Michelle Wilson is about to graduate from medical school at FAU and start her family medicine residency at the Phoebe Putney Memorial Hospital in Albany, Georgia. As a Black provider, she said the way she’ll talk to patients also matters.
"We code switch. Being able to be that comfortable with your patient, I think it's important when building a long-term relationship with them," Wilson said. "Being able to relax and talk to my patient as if they are family — I think being able to do that really builds on the relationship, especially makes a patient want to come back another time and be like, 'You know, I really like that doctor.'"
Wilson took part in the Florida A&M-Florida Atlantic Medical Scholars Program. She says growing up in a Nigerian-American family, her relatives expected her to pursue one of a few careers — and that included medicine. But this program, aside from the encouragement of her family, helped her go from undergrad at FAMU straight through to medical school at the Charles E. Schmidt College of Medicine at FAU.
"Going through the program, I realized it makes sense that this is where I belong. I enjoy helping people, especially in health care, and then you realize there's such a disparity, at least for me. I didn't have a Black doctor growing up," she said. "I'm kind of paving the way for other little Black girls that look like me that want to be a doctor — I can let them know like it's possible. Even though I'm this 'unicorn' in medicine, it's possible to be successful, it's possible to get into medical school. It's possible to be someone's doctor."
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