Kimberly Wilson has often struggled to find doctors who understand her physical, cultural and mental health needs. Although she took advantage of booking platforms such as ZocDoc, she had visited multiple doctors to find a good match.
In 2017, that search became urgent when she landed in the emergency room due to complications from uterine fibroids. Fibroids, noncancerous growths in the uterus, are common among black women, who are three times more likely than white women to develop them during their lifetime, according to the Centers for Disease Control and Prevention.
But Wilson’s situation was unusual because of the size and amount of fibroids — she had more than 30 — and in 2018, she was in and out of the hospital with complications. She visited numerous doctors in New York City, the majority of whom were white men, who advised that her only treatment option was a hysterectomy, which would mean she would not be able to have children.
She ultimately received a referral from a friend to a black obstetrician/gynecologist at Johns Hopkins University in Baltimore, Dr. Khara Michelle Simpson. She recommended an alternative procedure, an abdominal myomectomy. Wilson underwent the procedure in December 2018, and it preserved her uterus and removed the majority of her fibroids. Although she was grateful for the outcome, Wilson wondered why it took so long to connect with a black doctor — and why no other doctors recommended this option.
“I was frustrated by my experience and having to travel so far just to find a culturally competent physician,” Wilson said. She also acknowledged that she believes her experience with Simpson was better because she is also a black woman.
Research shows that health outcomes for black patients are better when they are treated by black doctors. That research is critical given that African Americans in the United States generally experience poorer health outcomes across a variety of diseases and conditions. Currently, black men have the lowest life expectancy of any major demographic group in the United States and live on average 4.4 years fewer that non-Hispanic white men. There is also a documented maternal mortality crisis among African American women in the United States: Black women are three to four times more likely to die as a result of complications from pregnancy, labor and childbirth than white women.
A research team led by Dr. Marcella Alsan from Stanford University’s School of Medicine published the results of a study in September 2018 that tracked the impact of diversity in the physician workforce on medical decisions and outcomes among black men.
In Alsan’s study, researchers set up a pop-up clinic in Oakland, California, and recruited over 1,300 black men from local barber shops and flea markets. The clinic was set up to provide preventive services and was staffed with 14 male doctors. Participants were surveyed about their preference for preventive services (such as cardiovascular screening) before meeting their assigned physician and then surveyed again after speaking with their physician. Patients who met with black physicians asked to receive more preventive services than patients who met with nonblack physicians.
Researchers attributed the findings to improved communication between black patients and black physicians. Patients were 29 percent more likely to talk with black male doctors about other health problems they were experiencing, and black physicians were 35 percent more likely to write notes about black patients than nonblack physicians.
“A medical consultation can be intrusive or stressful,” Alsan said in an interview with NBCBLK. “Our results suggest that black doctors are more likely to provide a comfortable setting to black patients, perhaps because of shared experiences or backgrounds.”
The study concluded that increasing the amount of black physicians could lead to a 19 percent reduction in the black-white male cardiovascular mortality gap and an 8 percent decline in the black-white male life expectancy gap.
Wilson’s experience with a black doctor inspired her to launch HUED Co., an app that connects patients with health and medical professionals of color. HUED’s goal is to decrease health disparities and improve health outcomes for people of color, according to its website.
“My inspiration came from a place of frustration,” Wilson said. “Frustration with the lack of access and opportunities for black and brown people — specifically when it comes down to something as simple as taking care of our health. Nobody is going to take care of us, but us.”
HUED also has an online platform that provides health information tailored to audiences of color. The company is planning to host in-person events on health topics of interest to patients of color. In April, the organization partnered with Trellis Health, a New York City-based fertility clinic, to host a conversation on fertility and egg freezing for black women.
In addition to apps such as HUED, organizations such as the Tour for Diversity in Medicine are working to increase the amount of students of color in the pipeline for medical, dental and pharmacy school. The organization connects high school and undergraduate students with physicians, dentists, pharmacists and medical students of color and conducts biannual tours to colleges and universities around the country.
In 2004, the National Academy for Medicine published a report, In the Nation’s Compelling Interest: Ensuring Diversity in the Health Professions, that called for a diverse health care workforce as a way to reduce racial health disparities. Although African Americans comprise 13 percent of the U.S. population, they account for only about 6 percent of physicians and less than 6 percent of recent medical school graduates, according to data from the Kaiser Family Foundation.
Dr. Kameron Leigh Matthews, one of the co-directors for the tour and the deputy undersecretary for health for community care at the Veterans Health Administration, was inspired to start the organization while working as a student leader with the Student National Medical Association.
“We noticed a need to reach students in a different manner — on their home turf, on campuses where perhaps their advising resources or exposure was not as strong or in towns that did not have immediate access to medical schools,” Matthews said in an interview with NBCBLK. “We also wanted to reach students who otherwise may not have been exposed to the mentoring and support that is available at the typical colleges that send students to medicine and dentistry.”
Since launching in 2012, the Tour for Diversity in Medicare has visited more than 40 campuses and mentored 3,500 students.
“Many students in our audiences lack role models or mentors that look like themselves or come from communities like their own — they feel often marginalized from other students interested in these fields,” Matthews said. “We hear regularly of negative experiences with faculty and advisers when they seek out help or advice. The tour seeks to motivate these students, give them insights based on real life experiences, and educate them on how to be a strong candidate for a future in health care.”