Expanding your life lens to enhance patient care

Kimberly Manning, MD, FACP, has used both her own life lens as a black woman in America to aid in treating her patients, but she has expanded that lens through interaction with her diverse colleagues.

Manning, professor of medicine at Emory University School of Medicine, spoke about her experiences as part of a plenary during the American College of Physicians Internal Medicine Meeting 2021.

She began her discussion by describing how her own background as a descendant of U.S. chattel slavery affected her own journey to becoming a physician. She described how the Abraham Flexner report of 1910, which retooled medical education in the country, actually closed five of the seven historically black medical schools which produced between 80 and 100 new physicians a year. This lack of opportunity has led to the loss of a potential 50,000 Black physicians over the past 110 years.

“So, when asked how do we reach a point where we have 38,975 full professors in U.S. medical schools, of which 307 are black woman, there's no shock,” Manning said. “The numbers play out because of the system and the system does exactly what it was designed to do.”

She said that proximity to those who are under-represented is to humanize them by broadening one’s life and looking beyond their own lens of experience.

Manning told a story of early in her career when she saw a Black patient who had been diagnosed with colon cancer but was adamantly opposed to even discussing surgery. Her colleagues were mystified by it, but she thought back to the medical myths she had heard amongst her own family members about cancer spreading when exposed to the air.

“Much of that has to do with health disparities, this lack of access to care that by the time people got into care, cancers had already metastasized and had no opportunity to be caught early,” she said.

When she spoke to the patient, Manning said she found his mannerisms reminded her of her father so she spoke to him directly without code-switching, or adopting an affectation to blend in, like she normally did in professional situations. After the two talked and shared some laughs, the man asked her directly if he believed he should get the surgery and she told him it would save his life. The man ultimately left the hospital fully recovered.

Manning also told stories about how her interaction with a diverse group of physicians helped expand her lens by informing her on other cultural attitudes. Whether it was being more respectful to the patient’s religious beliefs or helping celebrate a patient’s birthday with a song in their native language, expanding a life lens has benefitted patients.

“Our stories are life lenses, the humanity of each individual and value of each patient, each colleague, each interprofessional team member is what will help get us there,” Manning said. “It is the thing that will ignite us to move toward rebuilding those structures and opportunities.”