As part of Black History Month, MedPage Today spoke with several African-American healthcare leaders in order to recall some of the triumphs that have been accomplished by black physicians in medicine, but also to highlight the inequalities and disparities that still exist in the field.
U.S. Surgeon General Jerome Adams, MD, MPH, is the second African-American male to hold the position. Since taking office in September 2017, he has led initiatives addressing public health issues such as the opioid overdose epidemic and urged the American Medical Association (AMA) to diversify its membership. In this interview, he discusses his own path in medicine, improving workforce diversity training, and the importance of mentorship.
You suffered from severe asthma as a child and frequented the hospital to get treatment, but it wasn’t until you reached college that you met a physician who was black. How did this experience influence your career?
Adams: At the time, I thought it was normal there were no black doctors out there and looking back, it’s important because that profession didn’t really occur to me as an option. Despite being sick, I was a straight A student in gifted and talented classes and did really well, but it just never occurred to me that I could be a physician because I had never met another black physician.
That’s why it’s really important to me to try to get in front of as many young people as possible and to try to help people understand the importance of having role models. We think of role models as people who have a close relationship with you, but you can be a role model just by being visible, just by folks [seeing] there is a black male who is a doctor, much less a black male who is the surgeon general.
African-Americans are disproportionately affected by certain health issues like hypertension, obesity, and diabetes. How can we improve our means of training physicians so they may better serve the nation’s African-American population?
Adams: Two things immediately come to mind. One is workforce diversity training and the other is diverse workforce training. I juxtapose the two on purpose because we often talk about workforce diversity training and in that regard some places are doing a great job while some still have a long ways to go. We want folks to learn about the class standard or the culturally and linguistically appropriate service standards because they are an evidence-based way to help individuals who are already out there practicing, who may not come from a disadvantaged background, to be able to provide culturally and linguistically appropriate care. That’s workforce diversity training and cultural competency.
But what we also need to do is focus on diverse workforce training. That’s looking at the pipeline and trying to figure out how to get more young African-American men and African-American women, in addition to other young people of color, interested in and pursuing careers in the healthcare industry, and also [providing] the tools and resources they need to be successful.
Evidence shows that when you’re cared for by people who look like you, who talk like you, who think like you, who come from your background, you have a greater faith in the system and you also have better outcomes. It’s not just about having workforce diversity training and making sure everyone knows how to talk to a black person. It’s about making sure there are more black people in the care setting and having a diverse workforce so that you have that trust that develops from the first time you step into the hospital and see there are people there who look like you and who you can relate to.
Who were some of your role models that you looked up to when you were younger and why?
Adams: When I was growing up, [Ben Carson, MD] was the most famous black doctor out there and when I got a chance to meet him when I was in college, that really changed my trajectory because I met him and finally thought, “I can do this.”
Unfortunately, today only 6% of physicians are black and the number of males going into medical school right now is actually less than the number of males going into medical school in the 1970s and 1980s, so we’re actually going in the wrong direction, particularly in terms of black males. That’s why its even more important that we lift up people like Dr. Carson.
Another black physician who has been a role model to me later in my career has been Dr. David Satcher. Dr. Satcher was actually the only person to ever serve as CDC Director, U.S. Surgeon General, and Assistant Secretary for Health. He is just a giant both in the field of public health and medicine and has committed himself throughout his career to addressing health and equity, and exemplifying what a black male physician should be.
I think it is also important to recognize your mentors don’t always have to be of the same color or the same background as you. I’ve had many white males and females reach out to me over the years and be both mentors and sponsors and really lift me up, give me opportunities, and open doors for me. That’s important because I want folks who aren’t black to recognize they can still be mentors to black males and females and help them along the way, give them advice, and push them in the right direction. I also want young black people to realize they may grow up in an environment where they don’t have folks around them who look like them but there are still plenty of people out there who can care for them and help them along.
What advice would you give the next generation of physicians who wish to pursue a medical career today?
Adams: Remember that you’re going to be the first, the only, or one of the few to do a lot of things in your path. You have to acknowledge that, find a way to gather a support system around you, and do so very consciously, because unfortunately, it might not organically happen for you. But don’t let being the first or the only deter you. In many ways, that’s allowed me to blaze the trail and create my own path without having to fit into someone else’s expectations of what I should or shouldn’t be. Recognize it, embrace it for the benefits it provides, but also recognize you may have to reach out a little bit more to establish your network and establish that support system when you go out there.
One other thing I would say is never be afraid to ask for help, never be afraid to ask someone to advocate for you or give you an opportunity, and never be afraid to be politely persistent.
What does Black History Month mean to you in the context of healthcare?
Adams: One of the things I love about Black History Month is visiting or revisiting many of the great advancements that have been made by African-Americans in the healthcare industry. Our whole blood banking system wouldn’t be here if it weren’t for African-American researchers.
I’d like to think we lift up heroes and show those opportunities every day but the reality is we don’t. Black History Month is an opportunity for us to really focus on lifting up those opportunities and those role models so that hopefully young black people and young people of color, native Americans, Hispanics, Latinos, can see that they too can achieve some of these great heights.