ARI SHAPIRO, HOST:
African Americans make up more than 13% of the U.S. population. Yet only 5% of American physicians are Black. That lack of representation is not only a problem within medicine. It also perpetuates a sense that medical and mental health care is not of or for the Black community. NPR's Yuki Noguchi reports on the experience of young African American physicians about where they see challenges for those in training now.
YUKI NOGUCHI, BYLINE: Growing up near Washington, D.C., Danielle Hairston had models for what she calls Black excellence.
DANIELLE HAIRSTON: I had the example of a Black woman pediatrician, and so it never occurred to me, like, I couldn't become a doctor.
NOGUCHI: Hairston is now the director of psychiatry residency at Howard University, educating young Black doctors herself. But she's routinely questioned about her rightful place there, like one white woman who saw her badge.
HAIRSTON: And she's yelling, like, you're a doctor? Oh, my God - you? You?
NOGUCHI: Hairston says this type of reception is routine among Black colleagues. They're questioned entering the physician's lounge, in elevators. One of Hairston's white colleagues ignored her at a patient's bedside.
HAIRSTON: He's like, oh, well, the psychiatrist will be here to speak to you soon. And I was like, I'm right here. And he's like, oh, my gosh. Like, I thought you were the sitter. And he's like, oh, my God; I don't know why I said that. And I was like, oh, it's because I'm Black. And I don't even necessarily think that he's racist. It's just that that's the bias.
NOGUCHI: Institutions everywhere are confronting the impacts of racism and inequity that persist in their system. Medicine is no different. Lack of access isn't just a problem for Black patients, who continue to face economic and social barriers to care. The gaps are evident in the profession itself. Black physicians remain in a disproportionately small minority, and many say that's because medical training itself alienates them, perpetuating those gaps. And those gaps, says Hairston, have real impact on the care patients receive.
HAIRSTON: If you're ignoring this part of their experience, if you're not understanding the impact of being Black on them in this country and on their mental health, you're doing a disservice to them. And I don't know how you can treat them effectively.
NOGUCHI: Altha Stewart agrees. She became the first Black president of the American Psychiatric Association two years ago. She trained in the late 1970s in Philadelphia. She considered herself lucky. She had Black mentors who helped shepherd her and teach her about the needs of the African American community.
ALTHA STEWART: I know residents who don't even have that, even today in 2020.
NOGUCHI: So it was for Anthony Chin-Quee, who is Black. He finished his training as an ear, nose and throat surgeon four years ago.
ANTHONY CHIN-QUEE: The number of Black men in medicine is very, very small. The number of Black men in surgery is orders of magnitude smaller. And the number of Black men in specialized surgeries like ENT is tiny-tiny.
NOGUCHI: Chin-Quee says mistreatment came shrouded in subtlety. For years, he didn't even suspect racism.
CHIN-QUEE: They wouldn't say that Tony's lazy to my face. They would say that Tony's not efficient.
NOGUCHI: That's in spite of the fact Chin-Quee's work and hours matched his white counterparts. Already sleep-deprived, he worked harder, yet criticisms persisted. And Chin-Quee questioned his sanity. He fell into a major depression.
CHIN-QUEE: That's the danger of this whole profession and being Black in this profession - is that because it's so silent and because it's so invisible, you just think you're going crazy for thinking it because you can't prove it.
NOGUCHI: His struggles became an open secret. The only other Black physician turned a blind eye.
CHIN-QUEE: You know, it helped to bolster this idea that what was happening to me had nothing to do with race because I was thinking to myself, if it did, this Black doctor would reach out and let me know. But he didn't.
NOGUCHI: Chin-Quee gritted it out.
CHIN-QUEE: And it was only last year, actually, that I sat down with my colleague who went through residency alongside me and brought up to me - and you can tell this has kind of been weighing on him for a long time - like, yeah, you know, they used to say a lot of stuff about you.
NOGUCHI: That colleague was Matt Smith (ph).
MATT SMITH: I'm a pediatric ear, nose and throat surgeon in Cincinnati, Ohio.
NOGUCHI: After training, Smith grew closer to Chin-Quee.
SMITH: He is one of the smartest people that I have ever met and one of the most talented. That's including outside of medicine as well.
NOGUCHI: Smith is white. He says he believes comments he heard from some supervisors about Chin-Quee were racist.
SMITH: While nothing was overtly said as an inflammatory comment, I would say that there are those biting remarks that lead to microaggressions and build up over time.
NOGUCHI: Initially, Smith said nothing to Chin-Quee.
SMITH: At that time, what I thought - if he didn't know those things were being said, then it wouldn't affect him necessarily directly. And as I went along, things continued to go the way they did. I realized that that was not the right approach to take.
NOGUCHI: Smith is now outspoken about social justice with his medical students. He's starting a program to mentor minority schoolchildren to expose them to medicine.
SMITH: Until there are changes made in the pipeline, all you're going to get is what you put into the system.
NOGUCHI: Therein lies the problem and the opportunity. Chin-Quee agrees but also says it isn't just about seeing more people like him in the job.
CHIN-QUEE: The goal can't just be getting more Black doctors into medicine. Getting them there is vital because having someone who cares for your health who understands and has lived through the struggles personally and culturally that you've experienced is super, super, super important.
NOGUCHI: That's one systemic change medicine needs, in other words, to overcome some of the barriers to care.
Yuki Noguchi, NPR News.
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