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Tuesday Mar 15, 2016

Fake Teen Doc Reflects Need for Real Minority Physicians

In mid-February, a black teen accused of posing as a doctor made national headlines. The story of "Dr. Love-Robinson"(www.sun-sentinel.com) was mesmerizing. The teen reportedly had secured not only a white coat, but also an office, a website and, most incredibly, patients.  

It made me wonder, are people so hungry to have a doctor -- especially a doctor who looks like them -- that they are willing to overlook some major anomalies? I was struck by the teen's tenacity and wondered what encounter with the profession could have inspired such eagerness to pursue his dream (albeit unlawfully). It also made me reflect on my own experience with medicine as a child and my current habit of asking my young patients about their career goals during annual well child and adolescent visits.

Although blacks represent 13 percent of the U.S. population, black doctors account for only 4 percent of the physician workforce.

As a child, I loved being asked, "What do you want to do when you grow up?" It gave me the feeling that I was expected to aspire to be something. It gave me purpose and direction.

Therefore, when I was 7 and my mom was pregnant with my younger brother I went to all her prenatal appointments. As I listened to the baby's heartbeat and started the process of being an older sibling, I became enamored with my mom's OB/Gyn. Dr. Brooks was personable, caring, smart and --- most important to me -- he was black. He was the only black doctor I had exposure to as a kid, and the impression he made gave me confidence that becoming a doctor was something I could achieve. I remember him asking me what I wanted to be when I grew up, and I also recall the pride in his eyes when I responded sincerely that I wanted to be like him.

I have been surprised that when I ask this basic question of my own young patients it seems like it is the first time that they have even considered it. I have also found that that there are some common replies, which many of my peds-loving peers and I lament because these popular answers often are given without much thought or reflection of the child's true skills and abilities.  

If a child doesn't want to be a professional athlete, he or she often wants to be a coach or manager. Other popular choices are a singer or rapper for the younger children, and forensic science or correctional officers for the older children. These kids, no doubt, are influenced by the media and awareness that minority athletes and entertainers often have incomes of seven figures or more. Career choices can also be influenced by the systems children and families have more familiarity with, even if it is the prison system.  

I recently asked an older teen what she aspired to be when she grew up, and she responded, "A stripper!"  

After my initial surprise about her choice and the enthusiasm with which she stated it, I realized the best way to respond was to not be judgmental but to engage her further. I asked about her decision, and she mentioned that people she knew who had this job always had a lot of money. It also allowed her to do another thing she enjoyed, which was dance. I asked her what other things she thought she was good at. After some reflection -- and an initial response that she wasn't good at anything else -- she mentioned cosmetology.

After more probing, she revealed she no longer attended school. The smell of marijuana on her clothes, the frequent STD testing noted in her chart, and the mention of an older boyfriend who had just been released from jail (prompting her current visit to the doctor) shed some light on some of her more recent activities. I left her with some encouragement as well as a handful of condoms.   

I also desired to leave her with hope for a better life -- even if it was just my presence as a female doctor of color and someone who cared enough to ask.

Although blacks, Latinos, and Native Americans make up 13 percent, 17 percent, and 1 percent of the U.S. population respectively, these groups make up a mere 4 percent, 4 percent, and 0.4 percent respectively of the U.S. physician workforce(aamcdiversityfactsandfigures.org). Increasing the diversity of the physician workforce depends greatly on developing the pipeline -- where children and young adults are exposed to, academically prepared for, and encouraged to join our profession. In the age of struggling public school systems and fewer students going into STEM fields, we need more role modeling, mentoring and academic success programs so that there are more minorities applying to our medical schools. And of course, once they reach the doors of our universities, we need to be willing to admit dedicated and capable students.

Sadly, we are losing ground. Despite an increase in the number of black males graduating from U.S. colleges, the number of black male applicants to medicals school dropped from 1,410 in 1978 to 1,337 in 2014(bit.ly). During the same time span, the number of black males enrolling in med schools fell from 542 in 1978 to 515 in 2014.

One day, hopefully, there won't be such an unmet demand for a doctor of color that people could be willing to put their health in the hands of a teen playing dress up.

Venis Wilder, M.D., is a board-certified family physician who practices at a federally qualified health center in Harlem, New York. She also considers herself a community health practitioner working at the intersection of primary care and public health.

Posted at 07:00AM Mar 15, 2016 by Venis Wilder, M.D.

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