American health care will improve with diversity, equity, inclusion

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Growing up in Newark, New Jersey, Sampson Davis and two high school friends promised each other they would become doctors.

They fulfilled their pact. Now he is Sampson Davis, MD, a practicing emergency physician, bestselling author, educational speaker and philanthropist. He has appeared on numerous television and radio programs and has contributed commentary to a variety of print publications. Media giant Oprah Winfrey named him “One of the Premiere Role Models of the World.” Davis emphasizes his 3 Ds – Dedication, Determination and Discipline – as vital for success.

Sampson Davis, MD

Davis and the friends of his youth, Dr. Rameck Hunt and Dr. George Jenkins, also established The Three Doctors Foundation, a nonprofit dedicated to giving back to their community.

Davis spoke with Medical Economics about the current state of diversity in the American health care system and why it is crucial to the health of patients and the nation going forward.

This transcript has been edited for length and clarity.

Medical Economics: How would you assess the state of diversity in medicine, particularly for black physicians?

Sampson Davis, MD: This conversation is a much-needed conversation about what we do. African American physicians make up about 5% of physicians across the board, but yet African Americans make up about 15% of the population, so it's underserved. And so, what we need here is a push for racial concordance, we need to have diversity across the field not only for African Americans, for Latino Americans, for Asian Americans, it has to be a balanced deal. One thing that studies have shown is that we learn more from each other than not, so having a diverse field where there's doctors and nurses and health care professionals that resemble the patient population helps to decrease implicit bias, helps in decreasing microaggressions, any code switching, any gaslighting, those types of terms that people feel often. And studies have shown that in particularly with African Americans that the ability to stay compliant with medications, adhere to the treatment regimen, is stronger when receiving it from someone that they find similarities. So having a black physician and a black patient match up with each other shows a more promising outcome for that patient as well.

Medical Economics: What strategies or methods can be used to bring more African Americans into the medical field?

Sampson Davis, MD: I think we have to move with intent and purpose. We have to have a stepwise process in place. Recently has been a target against affirmative action. Programs that historically brought in more physicians of color have been eradicated. You look at HBCUs, which are historically black colleges and universities, which is a pipeline to black medical schools or medical schools in general, like those programs with affirmative action being targeted, are no longer able to recruit physicians of color or potential doctors or dentists, nurses who may be interested in going into the health care field because difference of action programs have been taken away. Now, there's always been some issues and discussions around affirmative action because it feels like it gives a sort of unfair opportunity to people of color of get into schools and take places of other students. But the real issue here is whether we call it or affirmative action, something else, we have to have some sort of pipeline that creates more opportunity for physicians of color or health care professionals of color to have an opportunity to get into the health care grounds. We have to do more marketing strategies like within communities that are challenged to make sure that minorities know that this is an opportunity for me. If I'm a young black man or a young black female sitting in Chicago, Illinois, I have an opportunity to go into the health care field because there are pipeline programs in high school, there are pipeline programs and colleges, in medical school, in hospitals that would allow me an opportunity to explore this. And why is that the case? The reason being is that because there's a lack of exposure, so you can't aim for what you can't see. I can't expect to become a superhero. If I don't see the Hulk or Superman or Wonder Woman in the streets. I can't expect to become that. So, it's modeling yourself at the images that we see.

Medical Economics: Let's talk about the patient side of it. Beyond having physicians that look more like their patients, what other steps can health care organizations do to make sure that their all of their patients are being treated effectively and appropriately?

Sampson Davis, MD: Again, I feel that it's racial concordance, it's making sure that we're moving on with it with intent and purpose. But further along again, it's following the breadcrumbs. In other words, at patients of color are more likely to take their medications, adhere to a treatment regimen, trust the system, be more compliant, schedule their preventive cares when they're talking or interacting with someone that they have similarities with. But I don't want to send the message, that doesn't mean that if you're not from the same background, that you can’t take care of that patient, that's not it. What you learn with diversity, interesting enough, that we develop cultural sensitivity. So, when I'm working around the person as Asian American, Latino American, Caucasian, whatever the gender, if they're LGBTQ, whatever the gender equity situation may be like, I'm more likely to like, OK, I learned from that and that helps me to treat a patient that may be similar to any of those individuals. As my mother would tell me, you don't want to be the smartest person in the room, right? So having other people with different voices you can learn from is important. I think for patients, more importantly, we will start to see longevity is a direct correlation. And being African American myself, obviously, I can speak from the platform, but a lot of the studies have shown just a direct correlation that African American patients treated by a similar person from their walk has a longer lifespan. So, you mean to tell me, my life can be shortened based upon my physician that’s treating me? And that's an issue, that is a big issue. I'm a bit biased, I guess, in a way because I think healthcare professionals want to do the best by their patient. But I think sometimes we don't know what we have when it comes to unconscious biases. We don't realize that we may have unconscious bias, we may not understand the big term social determinants of health and what does that mean? Social determinants of health basically mean, where you live, where you play, where you shop, where you eat, where you drive. So all those circumstances may be an issue for you when it comes to your health care.

Medical Economics: In terms of specialties, are there specific medical specialties where it seems like those might be the areas that can have the largest benefits? Obviously, you want diversity and inclusion across all specialties. What are your thoughts on where we should really focus our efforts?

Sampson Davis, MD: If you compare primary care and obstetrics and gynecology, they are the most areas that's diverse, which is kind of interesting. It is the pipeline, primary care is kind of the bread and butter of medicine. But when we look at specialties, radiology, orthopedics especially, cardiology, there's an underserved number of physicians, of diverse positions in those arenas, especially. Again, I look at it as a big broad number, if 5% of physicians are physicians of color and represent 15% of the population, we have to at least make up 10% before we have a discussion of where the need is. I think the need is overall and global. I receive calls often from family members or friends in particular looking for a physician of color and I really don't have the Rolodex to share. I do have a few, and like, to speak to them, a few friends that are physicians of color, and they’re like, I'm overwhelmed, I don't have any openings at all. I think the other aspect is mental health. Mental health is a huge, huge component that is so important, that we have cultural sensitivity around. Super huge only because, you know, a person from a culture that’s say from arranged marriages, if you're a culture of arranged marriages and you have some challenges with your significant other in your relationship, I’m a physician of color, and I don't understand that, because I'm not from a culture of an arranged marriage. So, having someone to talk to that’s of similar backgrounds can help you in this amount of time versus that amount of time. They can shorten the process and the gap relatability. And so I think mental health is a huge area of psychiatry, talking about psychologists, you know, having similar backgrounds of people that can really relate to some of the challenges and struggles that we've been through.

Medical Economics: When you're talking to young African American boys and girls, young men, young women, what is your message to them about the options that are out there when it comes to health care? If you go back in time and see yourself when you were a kid, what advice would you give yourself about the options that are out there?

Sampson Davis, MD: I enjoy, I love speaking to young men and women regardless of their racial background. I travel the country, I speak, that’s what I do, as part of something that I'm excited about, simply because people did it for me. Going through college, going to medical school, it was so many times I wanted to give up, there were so many times I wanted to quit, there was so many times I just didn't believe it was possible, there was so many times I didn't feel welcome. And again, like I never felt this like, get out, you don't belong. But it was just the underbelly that microaggression.

As weird as it may seem, when I was a child, it was something of an anomaly. I didn't think it was possible. But now I think it’s important that we champion the cause of not only of diverse voices, but also letting the kids of color of all walks know that it is possible that they can go into this industry. We have to have hospitals, management groups that we have to push for diversity in the workplace because it really helps to create growth, stability, financial success. And it helps to give back to the community because we have these individuals going back to their respective homes, telling other talented individuals like hey, jump on board here. How much talent we lose if we don't develop it? It's important that we do so. I enjoy traveling the country, I enjoy speaking to youth at colleges and universities and hospitals and organizations and entities and companies about the importance of diversity, equity, inclusion. I think having this balance of creating a diverse workforce would eventually eradicate health care disparities, health inequities, health inequalities, and it's important that we champion it, regardless of what your race may be. I think it's important that we all jump on board and be a part of that because the truth of the matter is we all can learn from each other.