But Black women doctors said they have seen how Black patients rely on their presence to get the best care. Monique Smith, a physician in Oakland, Calif., was working in the emergency room one night when a young Black man came in with injuries from a car accident. She was confused when some of her colleagues called him a “troublemaker,” so she visited the patient’s bed and asked him about his experience being admitted. He told her that he had begun to lash out when he felt he was being stereotyped by staff members because of his skin color and the neighborhood he came from.
“I was able to go into the room and say, ‘Hey dude, Black person to Black person, what’s up?’” Dr. Smith said. “Then I advocated for him and made sure he got streamlined care.”
The conversation made Dr. Smith more attuned to the degrading comments that Black patients experience at hospitals, and she now tries to intervene and identify her colleagues’ biases. She believes, for example, that physicians are sometimes quicker to order drug testing for Black patients, even if their symptoms are most likely unrelated to substance abuse.
But many Black physicians find it challenging to be advocates for themselves and their patients, particularly within the rigid hierarchies of the medical system. “You’re faced with situations where you’re going to be perceived as the angry Black woman even though you’re just being your own advocate,” said Dr. Katrina Gipson, an emergency medicine physician. “You’re constantly walking the line of how to be a consummate professional.”
Dr. Landry, an author of the recent paper and an emergency medicine physician at Brigham and Women’s Hospital, said that hospital and residency directors who are looking to address the deep-rooted problem should begin with hearing and validating the personal experiences of Black doctors. Continuing to diversify emergency medicine departments is also critical, she added, so that Black physicians are not working in isolation to implement cultural changes and arrange mentorship from more senior Black colleagues.
“I’m the only African-American female physician faculty member in my department, and that creates this feeling of not having a support system to speak up when something happens to you,” Dr. Landry said. “Having this paper is a validating tool for people to say, ‘See, I’m not the only one this is happening to.’”
Dr. Molina, an emergency medicine resident at Brigham and Women’s Hospital and one of the paper’s authors, said that spotlighting diversity in medicine was particularly important amid a pandemic that disproportionately impacts Black patients. “The Covid pandemic has served to emphasize health disparities and how they impact Black populations,” she said. “As emergency physicians, we have to present a united front recognizing racism is a public health issue.”