The racial disparities in COVID-19 cases and fatalities are devastating, but not surprising. The explanations put forward include the usual suspects, such as poor access to care, lack of quality healthcare, poor housing conditions, poverty. Even worse, leaders often point to the higher rates of hypertension and diabetes among Africans Americans, cleverly pointing the blame back to the people who have been the beneficiary of inequitable treatment for decades.
The less popular explanations for African-American health disparities include physicians who are culturally unequipped in effective and contextually relevant communication with African-American patients and the unconscious biases of clinicians who disproportionately marginalize African Americans.
I am an African-American male physician, with two advanced degrees. Accepting this reality, I oscillate between heartbreak and outrage. What can I do?
I frequently listen to my favorite speech, the last speech given by Reverend Dr. Martin Luther King Jr. I’m often soothed to simply hear his opening words: “I’m delighted to see each of you here tonight, in spite of a storm warning.” I often feel like I am in a storm, but his words and his voice comfort and encourage me.
The last time I listened to this speech, I heard something as if for the first time. He said, “We've got to strengthen black institutions. I call upon you to take your money out of the banks downtown and deposit your money in Tri-State Bank. We want a ‘bank-in’ movement in Memphis … Put your money there. You have six or seven black insurance companies here in the city of Memphis. Take out your insurance there. We want to have an ‘insurance-in.’"
In that moment, I knew not only what I could do, but what I must do.
I have the luxury of standing on the shoulders of giants, the African American physicians that came before me. America’s first black physician, James McCune Smith, had to leave America to obtain his medical degree in 1836. At that time the American Medical Association (AMA), founded in 1847, did not accept black physicians. It would be nearly another 60 years in 1895 when a group of African-American physicians would co-found the National Medical Association.
I recognize that, despite the challenges that I face as an African-American physician, I am a doctor because of those that came before me. Yet, here I am, in the middle of a pandemic, and I am completely disconnected from the organizations that supported and advocated for black doctors in America – the organizations that continue to fortify and fight for equity not just for black medical doctors but for all black people.
The large national organizations supporting African Americans – like the NAACP, the Rainbow Push Coalition, and the National Medical Association – have been at the forefront of health equity and social justice for black people since their inception. Without them, there would be no us.
These organizations brought attention to disparities in maternal and infant mortality in African-American communities, the HIV/AIDS epidemic, and the gross underrepresentation of African Americans in medical school. These organizations galvanize the collective power of black people to secure funding for our communities, enact legislation to promote equity, and implement policies that address disparities. These organizations force change.
I found my answer to what can I do. I was exhausted, working at the hospital during the COVID-19 pandemic and bearing witness to the preventable death of so many people, so many African-American people, my people. I heeded Dr. King’s call to invest in our institutions and our organizations, and I joined the National Medical Association and the Rainbow PUSH Coalition. A week later, I joined the NAACP. Without them, there is no me.
Dr. Adam J Milam is a fourth-year Anesthesiology Resident at Cedars-Sinai Medical Center in Los Angeles. He has part-time faculty appointments at Johns Hopkins Bloomberg School of Public Health and Michigan State University College of Human Medicine. Following residency, he will be pursuing a fellowship in Adult Cardiothoracic Anesthesiology at Cleveland Clinic. Twitter @ajmilammdphd.