Takeaway
We must each take personal responsibility for educating ourselves about racism. Increasing our understanding will allow us to improve health outcomes for all of our patients.
Lifelong Learning in Clinical Excellence | June 24, 2020 | 1 min read
By Christle Nwora, MD, Johns Hopkins Medicine
I stood at the bedside and her grief rested on my spirit. In minutes she had gone from frustrated to devastated, eventually settling into sorrow. I had entered her room expecting to get a history of her migraine, but left the room hearing her story of being a pregnant Black woman who felt abandoned by her medical team.
“If Serena Williams was at risk of dying, what chance do I have?” she asked.
I resisted the urge to reassure her and left the question unanswered. I couldn’t confidently reassure her of anything. I knew that Black women are more likely to die from pregnancy-related complications than white women. In the U.S., Black women feel that their concerns are often dismissed. I was searching my brain for something I could offer her, but came up blank. The implicit bias training I received in my pre-clinical education as a med student didn’t meet this moment. I knew about the grave injustices of the world and felt powerless to help my patient.
In an effort to educate healthcare professionals about health disparities, many medical educational programs defer to implicit bias trainings. The hope is that recognition of internal bias will reduce the disparities in care and outcomes. Unfortunately, implicit bias trainings become the sole tool, instead of one of many, to tackle the underlying problem—racism.
Talking bluntly about racism in medicine is often met with resistance. Phrases like “implicit bias” and “social determinants of health” point at racism without explicitly naming it. Yet racism is an ever-present reality that is foundational to how our society works. As clinicians working to help heal all patients, we must commit to the following:
1. Use implicit bias trainings as a starting point for conversations about racism.
We must go beyond implicit bias trainings by using them as a starting point for conversations about racism and oppression. Discuss how racial bias in medicine causes harm to Black communities and must be eliminated.
2. Adopt an anti-racism lens.
Seek to better understand why health inequities exist and ask yourself what you can do to improve outcomes. Take personal responsibility to make sure your actions oppose racism.
3. Understand how the medical field is complicit in upholding white supremacy.
Medicine has a long-standing history of harming Black communities, and we must right that wrong.