Black History Month Q&A: Diversity, mentorship and representation in medicine

David Mitchell — It took more than 50 years for the AAFP to have its first Black president, Warren Jones, MD, FAAFP, and three additional years passed after his 2001 inauguration before Mary Frank, MD, FAAFP, was the first woman to hold that office. But momentum has built in recent years.

Davis: I grew up, and still live in, Montgomery County, Maryland. My ancestors were enslaved here, just two miles from where I live. I can walk to the place where they lived. They later built a church and one of the first schoolhouses for Black children in this area. My grandmother lived less than a mile away. She was in her 90s before she had a Black physician.

When you talk about seeing what’s possible, I was really lucky to have that many Black women physician leaders in my program. We were a very diverse program. We had men, women, white folks and Indian folks. But I think that was a cherished bond that we had so many Black women in our program, and many of them have stayed active in the Maryland Academy. Somebody tapped on my shoulder to lead, and now I’m going to tap on others’ shoulders. We have diversity in Maryland that you don’t always see in other places, and I really cherish that.

Diversity strengthens organizations

Mears-Clarke: You reminded me of something interesting I learned while doing my Master of Business Administration. There’s a wealth of data that shows that if you compare a corporation that’s led by women versus one led by men, the corporations led by women are much more likely to be profitable. The same thing goes for having a diverse board. The more diverse a board is, the more profitable it is. Diverse boards are more effective at building their brand and accomplishing their mission.

Diversity is so important for the success of any organization. It is the key to empowering each other, and rising together. It’s beautiful to hear that you had those “shoulder tap” experiences in residency and now continue to pull up others as a physician leader. Our career trajectories are so often influenced by the people who encouraged us to do things out of our comfort zone, to venture into spaces we didn’t see ourselves ever being in.

Has it ever been difficult for you, as a Black woman, being in those spaces of influence?

Overcoming bias

Davis: People put a lot of projections on you when you’re in a leadership role, regardless of who or what you are. As a Black woman in leadership, people may look at me and assume different things, but I don’t have to take their assumptions.

When I walk into the room, I walk in knowing why I’m there and who I’m advocating for. Their perceptions or biases about me are their business, not mine. I try to leave that at the door, come in as myself, who I am and what I represent. There will be times when I think folks are going to underestimate me, and they don’t. And there are other times when folks do underestimate me. I can’t let what I think other people’s perceptions of me may be rule the day.

I prepare to the best of my ability every time, and I try not to let my biases about who is in the room get in the way. I have presented to folks in rural areas about DEI and the importance of diversity and health equity. I could have had biases and perceptions about what they think of that topic. But every time I have found people who have embraced it. I have been in places where you might think people would be more interested in social justice issues, but they weren’t. So, it does not benefit them or me to come in with my biases about them or to place expectations on what I think their biases are. I can only be who I am, and I can only bring what I know. When you let that stuff go, you open yourself up to let people see who you are, and you also open yourself up to see who they are.

Mears-Clarke: Unfortunately, people often make snap decisions and assumptions based on pattern recognition. If we see a puppy, we’re excited. If a car zooms past as we’re trying to cross the street, we step back. We drift toward what is familiar and are inherently wary of things we haven’t encountered before. Underrepresented individuals in our society are battling against those patterns and biases every day.

Every time we, as Black leaders, show up to a meeting prepared, focused and ready to speak up, we have an opportunity to shift those biases and change those patterns. We’re able to positively affect our communities’ structures, schemas and emotions. Each moment we share with another is one where we can all grow together.

Leading with authenticity

Davis: How do you see yourself showing up in these spaces as a Black male, especially as you move into bigger leadership roles, given there are not a lot of Black men in medicine?

Mears-Clarke: When I walk into a room, I look around to get my bearings, especially if it’s a new place, or a new role. I look around, and I’m like, “Oh, I’m the only one.”

My heart initially starts to beat a little faster when I start to feel alone. I have to breathe and remind myself that my perspective as a Black man is unique and my place at this meeting is special. And the truth is, I’m not actually alone. I think about all the love that my parents and aunties poured into me. I think about the mentorship that I’ve had throughout my career. I think about my partner and the words of affirmation that she has given me. I bring all those people with me when I come to a meeting. I am not alone. As a Black immigrant from an underrepresented community—or whatever your identity may be—being outside the majority gives you a perspective that is meaningful and has the power to effectively shift conversations.

Do you have those same heart flutter moments? How do you remain focused and grounded when you come to the table?

Davis: My nature is to be soft-spoken, mild-mannered. I’m not going to come in and fight. What helps me in meetings is to remember who I am there for and make sure that I am representing the voice of whoever I am there to represent, whatever cause it is, whatever issue it is, whatever point needs to be expressed. That gives me a little bit more oomph in whatever space I’m in, regardless of who else is sitting around the table, to make sure I am representing the folks who entrusted me to be the person in the room.

Mears-Clarke: If you’re being authentic and you’re being true to the missions and values of your organization or your own personal values, then people cannot help but feel connected to that. That’s true leadership.

Mentorship, sponsorship and the power of a ‘shoulder tap’

Davis: Who was an important mentor for you, and who are you mentoring now?

Mears-Clarke: There’s a subtle difference between mentors and sponsors, and it’s important to have both when you’re thinking about leadership. Mentors provide you with advice and guidance, and they may connect you with individuals who can help you succeed. Sponsors are people who are able to talk about you in a positive light when you’re not in the room. They’ll say, “Hi, Dr. Davis, have you heard about Toussaint Mears-Clarke? He’s interested in talking about leadership with you.”

The person who did that for me, who was both a mentor and a sponsor, is Dr. Erika Roshanravan, who was the president of my local chapter in Sacramento. She reinvigorated our chapter and tapped my shoulder to work on the board and be part of a lot of the decision-making over the past five or six years. Erika was the person who told me, “You need to talk more in meetings. Why are you so quiet? You’re a very verbose human being. Say your piece.” She taught me that my voice does matter, and that my ideas are important.

I’m in graduate medical education, and it’s one of the best jobs in the world because I get to serve as a professional mentor. My whole role is to empower others. I was texting this morning with one of my residents who’s having issues getting notes done on time. I said, “Let’s have a conversation later this week about efficient note writing tips.”

There have been a ton of opportunities through the California Academy of Family Physicians for mentorship as well. Physicians going to the NCCL (National Conference of Constituency Leaders) ask, “How do you get elected as a constituency co-convener?” I said, “Let’s talk specifics on how you get elected. I’ll review your speech. I’ll give you encouragement. I’ll connect you with other family physician leaders. I’ll text pictures of you at the microphone and let everyone know how awesome you are.” Without support, a lot of people would probably sit back and let others take the position. My job as a leader is to make sure that everyone who has an idea that leadership is in their future takes that risk and takes that next step to apply and advocate for the things they believe in.

Did you have any pivotal people who influenced your journey?

Davis: There’s so many, too many to name them all, but I will name a couple. I’d have to name my residency director, Dr. Yvette Rooks. She was the one who tapped me on the shoulder and said, “Go to NCCL,” and has been an encourager for me all along the way.

Inspiring family and community pride

Davis: I know when I walk into certain spaces it means something different for people that I am the one walking in the room. When I see my pediatric patients, I tell every one of them they can be a doctor because I may be the only one who tells them that. One of them is going to grow up and say, “I became a doctor because my doctor told me I could.” They won’t know that I told all of them that, but it’s true. They can do it, and they need to hear it. It’s my job as their doctor to help that spark in them.

My parents have two children who are family doctors and one who is a lawyer. They brag about us a little. We’re the first doctors in the family. It means something different for them and for our community to know that their Black daughters are physicians.

It is special to be a doctor, whatever community you come from, whatever background you come from. At my church, they introduce me as “Doctor” all the time. I say, “You don’t have to introduce me as doctor. I’m Kisha.” But it’s not about me. It’s about them and their pride in having a doctor in their community.

I’d love to hear what it means to your family and your community to be able to introduce you and your wife as doctors.

I feel that same sense of community pride when it comes to being an immigrant, a Black, and Jamaican physician here in the United States, especially given the long history of discrimination against Black people. For people like you and me, to get to the position of being a physician in the United States shows that there can be progress. There is change.