In a recent essay, a Massachusetts General Hospital physician, Fatima Cody Stanford, MD, MPH, points out the myriad of hurdles and inequities that contribute to the underrepresentation in medicine that Black women still face. Dr. Stanford gives voice to the many frustrations that Black women physicians like her are still forced to deal with.
The deplorable history of Black women being disregarded in this country continues in the experiences of many Black women in medicine today. They are rooted in the three-fifths compromise with slave holding states in the U.S. Constitution that discounted Black women as only a portion of a human being who were counted merely for congressional representation and taxation purposes.
Janice Brown, a 3rd-year medical student at the University of Pennsylvania, and former Rhodes Scholar, tells us that, despite the obstacles from the Civil War to the 21st Century, Black women have always fought to become physicians. She recounts the story of the hindrances Black women pursuing a career in medicine have faced throughout history. She writes, “It is important to understand the barriers Black women physicians faced. As more professionals are working to correct some of the wrongs and increase diversity in medicine and research, we need the historical perspective to understand what these barriers are rooted in.”
Moreover, despite Black women’s long historic activism in prominent social justice movements, Black women continued to experience crippling racism and elitism into the 19th and early 20th centuries. The woman’s suffrage movement for voting rights made access to the voting booth for white women the focus rather than for all women, a fact that is often ignored or forgotten.
It has been Black women, long active in the long struggle for justice and equality, whose courageous, steadfast contributions have been largely unrecognized and underappreciated.
We see this low regard manifest in the demanding expectations that help perpetuate the daunting constrictions we see for Black women physicians.
Recent data show that almost half of medical school students are now white women (among Black matriculants, 60% are women) nevertheless only a third of practitioners are women.
Further, Black women physicians’ experiences with bias in medical education, training and in the workforce are extensions of overlapping systems of oppression and privilege one sees in stark relief in some of the unfiltered expressions of prejudice they experience from their medical colleagues as well as some of their patients.
Yet it is a widely accepted that Black patients have better health results when they are treated by Black healthcare workers and that there is a direct correlation between health and personal success. Improved representation in health care leads to better health and reduced medical costs.
Nonetheless, all of the Black men and women physicians in the U.S. constitute only a meager 5% of practicing physicians and 53% of that small number are female. This compares with white and Asian women physicians who make up 34.4% and 43% of their respective group’s physicians.
White women physicians do indeed face well-documented gender-based discrimination from white male physicians who continue to dominate in the field of medicine. In their early careers, 76% of white women physicians reported gender-based discrimination, 56.3% during mid-career and 35.8% in late career, but they are spared the additional emotional disruption that racial bigotry inflicts.
The American Medical Association, the country’s largest and most-influential physicians’ group’s President Dr. Gerald Harmon admits that “a shortage of Black physicians contributes to poorer health outcomes for Black patients.” Also, the Association of American Medical Colleges and the National Medical Association (NMA), the most influential Black physicians’ group, have announced a joint initiative to address the dire need for more Black physicians by working with Black colleges and universities to secure more scholarships. It remains to be seen whether these well-intentioned efforts can be sustained and make a substantial difference over time.
The NMA writes in unequivocal language – “Academic medicine has a professional and ethical responsibility to educate its trainees and health professionals on the history of medicine –including its ugly side – and to critically examine how historical and contemporary political and social factors have created racial/ethnic health disparities. Until such reckoning, across the field of medicine’s ability to achieve health equity for all will continue to be futile.”
We would add that the remarkable history of so many strong, incredible Black women physicians who followed a calling and broke down entrenched racial and gender-based barriers and paved the way for future generations should serve as a powerful reminder and great inspiration for all of us, those in the medical field and beyond. These esteemed women are powerful exemplars for our community of the power of belief, courage, dedication, hard work and a passion to serve others. We need to let them know that we are grateful and they are deeply appreciated.
