September 2000 • Volume 6 • Number 9
Calling all FPs
Join the push to increase minority organ donations
BY SHERI PORTER
The very concept of organ transplantation still inspires a sense of awe in many Americans. But for some minority groups, that second chance at life is elusive.
Statistics tell the story. Every day, 14 Americans die while waiting for an organ or tissue transplant. Half of those are minorities.
Margo Ferguson, M.D., works up a sweat in the MOTTEP of Detroit 5K walk Aug. 12 to draw attention to the critical need for minority organ donors.In 1998, 50 percent of the 53,000 people listed on the national transplant waiting list were minorities. But minorities represented just 25 percent of the donor pool. That's not good news, considering that compatible matches are most often found within the same racial or ethnic group.
Blacks are particularly hard hit, because diabetes and hypertension, leading causes of dialysis and organ failure, affect this group disproportionately.
"We recognize that the need for donors must be indelibly etched into the hearts and souls of the minority population because we are in much greater need than the majority population," says Clive Callender, M.D., a transplant surgeon at Howard University Hospital in Washington, D.C.
Callender, founder of the national Minority Organ Tissue Transplant Education Program, knows the numbers and understands the reasons behind them. Minority groups, particularly blacks, don't donate for five reasons: lack of awareness, religious misperceptions, fear, mistrust of the medical community and racism.
MOTTEP, funded by the National Institutes of Health, has grown since its inception in 1993 into a network spanning 15 American cities. MOTTEP targets five minority groups, including Latinos, Native Americans, Arabic Americans and Pacific Islanders. But the biggest push -- and the biggest need -- is in black communities.
What can you do to help?
- Make organ donation information available in your office.
- Display it prominently, or, better yet, hand it directly to patients.
- Utilize routine office visits -- don't wait for an emergency.
- Talk statistics with your minority patients.
- Emphasize family communication.
Check out these resources:
- Minority Organ Tissue Transplant Education Program: http://www.lifegift.org/mottep.htm
- Institute for Minority Health Research: http://www.sph.emory.edu/bshe/imhr/organdonation.html
- Archives of Family Medicine, July 2000, "Family Physicians' Role in Recruitment of Organ Donors," by AAFP members Susan Bidigare, M.D., Detroit, and Aaron Ellis, M.D., St. Clair Shores, Mich.
- The AAFP Board of Directors approved a policy statement on organ donation at its March 14-18, 2000, meeting. Call (800) 274-2237, Ext. 4130, to request a copy of the statement.
Remonia Chapman, program director of MOTTEP of Detroit, says the organization's grass-roots strategy works by tapping messengers such as religious leaders, donor families, organ recipients and wait-listed patients.
But there's another type of leader that both Callender and Chapman would like to see in the trenches with them: the family physician.
"Here's a person that is really involved in the total health care of entire families -- and here's an issue that can be the focus of family discussions. I cannot think of a better person to serve as a catalyst for that particular discussion," says Chapman.
Family physician Margo Ferguson, M.D., of Detroit says broaching the subject of organ donation can be difficult, especially in her inner-city clinic. "I have to deal with a lot of stereotypes and myths about organ donation -- it's a cultural thing," she says. Still, she takes advantages of opportunities when they arise. When a 10-year old patient recently went on the heart transplant waiting list, Ferguson gently approached the child's mother about becoming involved with MOTTEP.
Similarly, when a patient is diagnosed with hypertension or diabetes, Ferguson snatches the opportunity to teach other family members -- first about their own health and preventive measures such as losing weight and lowering blood pressure, and secondly, more discreetly, about the need to sign an organ donor card.
FP Linda Davenport, M.D., of Ann Arbor, Mich., also works closely with MOTTEP. She knows that the ER is not the best place to begin a family discussion about organ donation. "It's a time of high stress, and that's really a bad time to initially present the subject," she says. Instead, Davenport uses the window of opportunity at the end of a health maintenance exam. After she's reviewed smoking cessation or STD prevention, after she's talked about high blood pressure, she might just turn the conversation in a different direction.
"It's just another opportunity to present the topic, and then if they're faced with the issue, it's nothing new ... 'This is something I've heard over and over -- my family doc talks about it, has information on it.' It's old hat by the time the procurement specialist approaches them in the ER. It's okay, it's expected," Davenport says.
She also tells all patients, adults and teens, to discuss their wishes about organ donation with their families. "If your next of kin are there and they say no, then it's no. The thrust now is to be a donor and tell your family."
FP Report is published by the AAFP News Department.
Copyright © 2000 by American Academy of Family Physicians.
FP Report | Headlines |AAFP Home | Search
