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Breaking the cycle of racism in health care: a call for anti-racist action

Tomi Mitchell, MD
Policy
May 10, 2023
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May 25th marks the anniversary of the brutal murder of George Floyd. I remember feeling numb when I first heard the news. Then, some days later, the tears filled my eyes, then came my anger. It is frustrating that we still live in a world filled with so much ignorance and the complicit attitudes of individuals who gain from their white privilege. However, the experience of George Floyd, and the countless other black individuals murdered due to hate crimes, compelled me to take action and be more vocal.

Let me explain what it means for those still bristle at white privilege. White privilege refers to the structural and societal advantages that white people have simply because of their skin color. White privilege is invisible to those who possess it, but its effects are pervasive and far-reaching. It manifests in ways such as access to better health care and education, more job opportunities and higher wages, and freedom from racial profiling and discriminatory treatment. These advantages are often taken for granted by white individuals, but for black patients, lack of access to quality health care can have serious consequences. Understanding how white privilege impacts health care is critical for those who seek to minimize the barriers that black patients face when seeking care. By acknowledging and addressing white privilege in health care, providers can create a more equitable and just system for all patients.

As a black woman who has faced numerous challenges and unjust treatment, I would like to share some personal reflections on my experiences.

Her lips aren’t blue.

I’ve heard these words, and they will forever be etched in my mind. Years ago, I had to rush my newborn baby to the hospital. She had stopped breathing at home, and I had to do CPR on her to revive her. As a mother, this is one of the scariest things to experience. At the hospital, despite telling the nurses that my baby had many moments when she stopped breathing, and her oxygen levels dropped to as low as 51 percent, they didn’t believe me. The nurse commented, “But her lips are not blue.” They didn’t think my observations or that my baby’s 02 stats dropped at least six times, to as low as 51 percent 02. Ironically, these nurses knew I was the child’s mother and a physician trained in that hospital, but they disregarded my concerns.

The color of a baby’s lips can be a helpful indication of hypoxia or a lack of oxygen in the body. However, it’s important to note that this isn’t always true for all babies. In particular, black babies may not experience blue lips as a side effect of hypoxia due to their skin pigmentations. This can be concerning for doctors and parents alike, as hypoxia can be a serious medical condition that requires prompt treatment. Health care professionals should be aware of this potential discrepancy and consider other signs and symptoms when assessing a baby’s health for potential hypoxia. This approach can ensure that all babies receive the best possible care and treatment when needed.

Stand up for your colleagues.

For me, residency and clinical practice was often lonely place. I often felt isolated and undervalued. I experienced double standards in comparison to my white colleagues, which was both startling and all too common. Microaggressions in the workplace can be frustrating and exhausting for black employees. These subtle, often unintentional actions can harm an individual’s mental and emotional well-being and sense of belonging. To address this, non-black colleagues must proactively recognize and address microaggressions. By being an ally, non-black colleagues can help create a more supportive and equitable work environment where everyone feels valued and respected. This can lead to a more engaged and productive team, benefiting the organization.

There are reasons we are guarded and might not trust you.

As a woman who has repeatedly been a statistic of the staggering rate of maternal mortality and morbidity of black women, I am thankful to be alive today. Telling ourselves that we are not racist is not enough; one must be “anti-racist.” Too many times, Black women’s concerns are ignored.

The history of the relationship between Black people and the health care industry in the United States is complex, which can help explain the mistrust many feel toward providers today. From the Tu Tuskegee Syphilis Study to countless other instances of medical experimentation and neglect, there have been many instances in which the health care system has mistreated Black people. Even outside of explicitly unethical practices, Black people have faced discrimination and bias from doctors and nurses. This history cannot Be easily washed away, and the scars it has left behind continue to impact how Black people interact with health care providers. As we try to move forward and create a more equitable health care system, it’s important to acknowledge and address this history to build trust between Black communities and the providers who are meant to serve them.

We feel pain too.

I remember the joy of giving birth to my first child and the tears that spilled down my face. I also remember the extreme pain I also felt during my C-sections. Those moments of pain, coupled with my shouting for the female gynecologists to stop, they initially dismissed me before I was finally relieved of my pain.

Over the years, a false narrative has taken root within the medical community that black patients do not experience pain at the same level as other groups. This deeply ingrained bias has led to under-treatment of pain, particularly for black women, who face an intersection of racism and sexism in the health care system. A study published by the National Institutes of Health found that black individuals are less likely to receive pain medication for fractures, back pain, and abdominal pain when compared to white patients. This discrimination Is rooted in a history of racism in medicine. Health care providers must address it to ensure that all patients receive adequate care regardless of race.

In today’s society, where systemic racism persists in various sectors, including health care, being anti-racist is an essential ethical and moral obligation and a vital professional one. Health care providers must understand the potential harm that can stem from racist beliefs, attitudes, and practices, challenge their own conscious and unconscious biases, and strive to provide equitable, unbiased care to all patients, irrespective of their race. By being anti-racist in health care, providers can create a safe and inclusive environment for all patients and improve patient outcomes, promote trust and credibility, and contribute to addressing the systemic inequalities perpetuated for them for far too long. Therefore, adopting an anti-racist stance in health care is a matter of personal choice and a professional obligation that health care providers must embrace to ensure better health outcomes and a more just and equitable society.

Tomi Mitchell, a family physician and founder of Dr. Tomi Mitchell Holistic Wellness Strategies, is not only a distinguished international keynote speaker but also a passionate advocate for mental health and physician’s well-being, hosting her podcast, The Mental Health & Wellness Show. With over a decade of experience in presenting, public speaking, and training, she excels in creating meaningful connections with her audience. Connect with her on Facebook, Instagram, and LinkedIn and book a discovery call.

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Breaking the cycle of racism in health care: a call for anti-racist action
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