Effects of Racism Shaped Experiences, Patient Care

AAFP News: What types of difficulties did you experience with regard to racism, and how did you get through those experiences?

Ada Stewart, M.D.: I attended a pharmacy school in Ada, Ohio, at a small Methodist university. There were very few minorities, but I never thought about the differences between white and Black students.

It was not until medical school that I truly experienced racism. I was asked questions such as, “How did you get into medical school?”, “My brother couldn’t get in. How did you get in — who did you know?”, or “Were you part of affirmative action?” As many African American students have experienced, my work had to be exemplary; I had to go above and beyond my non-Black colleagues to show that I did belong there.

In residency, I experienced things that were more shocking to me more from a patient standpoint. Sometimes I would hear the patient say, “I want the white doctor.” When I would go into the room of an African American patient, on the other hand, and say, “I’m Dr. Stewart,” I would be greeted with statements like “Oh my goodness” or “Yes! I’m so proud of you!”

And then, as a woman, we always have a tough go regardless of race or ethnicity, with patients asking if we’re the nurse or the cleaning person. It’s tough, but it’s even tougher when you feel like you’re being treated differently by your colleagues.

This is really emotional for me as I think about what just happened with Dr. Susan Moore. This is something we’re still encountering today, but you still have individuals who will say we don’t have racism in our country, when we can see it. It’s right there before us, in front of our faces.

There was a study where the researchers had common Black names and common white names on resumes, and the persons who had the more common white names were called back more often for interviews. That was almost 20 years ago, but we have to recognize, sadly, that these things still exist and are still a challenge.

The Academy is recognizing the issues that have been barriers to getting to where we need to be with health care — addressing health disparities and getting more minorities and greater diversity within our profession. We’re recognizing those things that had an impact on the past, and we’re making changes so that our future looks different. We know there is more to do, but we’re making progress.

AAFP News: Why do you think it is important for everyone to recognize the contributions of Black Americans now and all year long?

AS: I remember a time when we weren’t able to recognize the contributions that African Americans had made in this country. In school we learned about the impact that non-Black individuals had on our country, but we didn’t really talk a lot about the impact of African Americans and the importance they had on our history.

When we first celebrated Black History Month, we’d recognized the accomplishments of people like W.E.B. Du Bois, Martin Luther King Jr., Frederick Douglass and Harriet Tubman. Now, as a physician, I think of the contributions of African Americans who came before me to impact medicine. I think of Dr. Rebecca Lee Crumpler, the first African American woman to earn a medical degree. Had it not been for her, I probably would not be here today.

Currently, I use this time to learn more about Black history. We get so engrossed in our daily lives, especially as physicians in doing what we do best, but this gives us an opportunity to go back and celebrate the accomplishments. I saw former Surgeon General Dr. David Satcher on television the other day and it reminded me of all the accomplishments he had in public health. I also think about the accomplishments of former Surgeon General Dr. Joycelyn Elders, and Dr. Charles Drew — these people of color have positively impacted what we do today in medicine. It’s a time for celebration and reflection about where we need to go next as far as our future is concerned, especially now with the COVID-19 pandemic.

While we celebrate Black History Month, we need to also recognize that we still have health disparities and inequities where Black and brown people are suffering more during the pandemic. We need to make sure we address these disparities and work to achieve health equity to improve the health of our entire nation.

AAFP News: Historical injustices have led to vaccine hesitancy and overall distrust of the health care system in the Black community. What role has institutional racism played in these hesitancies, and how can it be overcome?

AS: It’s a journey. People of color trust other individuals of color, especially when it comes to health care, because of the longstanding distrust that they’ve experienced over the years. A few examples that have created this mistrust are the Tuskegee Study, or the issue now that some people believe African Americans are more tolerant to pain.

One way to help overcome these trust issues is to ensure that we have a diverse workforce. Studies have shown better outcomes when people are cared for by individuals who look like them. It embodies trust that for so long has been an issue, not only by having a family physician in the community but a physician who looks like them.

Even now when I talk about the COVID vaccines, patients will ask me, “Well, Dr. Stewart, did you get it? What do you think about it? Is it safe?” And I’ll tell them “Yes, I did,” and show them a picture of me getting the vaccine. I say, “I did my research.” I talk about some of the individuals who were on the teams who developed the vaccines. I tell them, “People of color are out there trying to save people of color just like I’m trying to save you.” I tell them that they’re my family. It’s all about gaining their trust.

In addition, I tell my patients that more of us are dying of COVID. The vaccine is the only thing we have other than mask wearing and social distancing to stop this — and we need to stop this. We need to save our families, our loved ones and our communities.