Oncology hospitalist: Why it’s important for minority leaders to be both visible and vocal

I’m originally from Ghana, a small country in West Africa. I didn’t come to the United States until I was an adult. So, my first real experience with health inequities related to race didn’t happen until my residency in Chicago.

I was exploring possible hypertension treatment options for a patient with an attending physician. And he said that some of the medications we were discussing were not as effective in Black populations as they were in white people.

That claim didn’t make any sense to me. Because why would a drug that’s been proven to work in clinical trials not be beneficial to Black patients? Was it just because of their skin color? When I asked that doctor for clarification, he cited a study that he felt supported his statement.

At the time, I was not well-versed enough yet in either analyzing studies or understanding how they were conducted to contradict him. But the experience made me very determined to learn. After finishing my residency, I applied for and won a National Research Service Award from the National Institutes of Health. I used it to earn a master’s degree in clinical epidemiology.

Now, when people make similar statements, I can understand the shortcomings of the studies they are citing, and the importance of focusing on genetics and the biology of disease, rather than race.

The importance of being seen

Advocacy is just one reason there’s a real need for more Black representation in the field of medicine. Another is that our numbers in medicine across the board don’t accurately reflect our true percentage of the general population.

As the adage goes, “You can’t be what you can’t see.” And by acting as consistent, visible role models in the community, we can expand the pipeline for minorities in the sciences and medicine. When subsequent generations of talented minority students see us, they will realize that medicine can be a part of their future, too.

But it’s not just about recruiting, training and retaining the best and brightest minority students in high schools and colleges. We also need to be vocal with our colleagues and visible at our workplaces, to create “ally-ship” in support of improving diversity, equity and inclusion.

Helping to heal America’s wounds by rebuilding trust

Having greater numbers of minority doctors is important not only for increasing diversity in the workplace and correcting misinformation in the medical community. It’s also about helping to right some historic wrongs. Events like the Tuskegee syphilis experiment have made the experiences of Black patients here in the U.S. a little different from those in other countries.

I also recall one story in particular, which was related to me by a colleague during my residency in Chicago. She said that she and many other female relatives had always been told by their forebearers never to let anyone operate on them, because an ancestor had been operated on without anesthesia long ago, as part of an experiment to see how well Black people tolerated pain.

There’s a lot of understandable mistrust there, as a result of these experiences, as evidenced by the current skepticism about the COVID-19 vaccines. So, just having more minorities in medicine today could go a long way toward rebuilding some of that population’s lost trust.

The importance of being heard

To effect change at the highest levels, I think more Black faculty members need to pursue positions of leadership, too. As physicians, we can only make decisions about individual patients. But in leadership roles, we can have a say in policy changes that affect much larger groups of people. This, in turn, will have a greater impact in terms of improving health outcomes and closing the inequity gap.

Early on in my career, I had a patient request a physician change based solely on the color of my skin. But I believe that with more minority physicians becoming visible in health care, incidents like that will become fewer and farther in between.

We all have to put our shoulders to ending the root causes of health inequities. Because if you see injustice and you don’t address it directly, someday, it will come back to haunt you. And in the meantime, it tugs indirectly at all of our hearts.

That’s why I want to make sure going forward, everyone sees less of it. So, it’s important to make myself visible in the community and let my voice be heard. Because it is through this, hopefully, that we can reduce contemporary inequities in health.

Josiah Halm, M.D., is the ad-interim chair of Hospital Medicine at MD Anderson.

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