We still have a long way to go before Black people receive the medical care they need.
This is Race and Medicine, a series dedicated to unearthing the uncomfortable and sometimes life-threatening truth about racism in healthcare. By highlighting the experiences of Black people and honoring their health journeys, we look to a future where medical racism is a thing of the past.
As a dark-skinned and sometimes sensitive little Black girl, I could never shake the feeling from my bones that my pain might be viewed as inconsequential to the very people who were supposed to provide medical care to me. It’s still something I have trouble reconciling.
With the legacy of medical racism dating back to antebellum America, it’s no surprise that Black patients seeking treatment today are still mistrustful, cautious, and protective.
As a child, I remember watching movies about how the U.S. Department of Public Health experimented on Black war veterans by
Later, I learned about white doctors testing the first gynecological instruments on enslaved Black women without anesthesia and using Black cells for groundbreaking HeLa cancer research without consent.
I sat down to talk to Black patients of all ages about their racist experiences in healthcare. Some of them wish to remain anonymous due to the stigma of openly discussing mental health, while others work in the healthcare industry and fear professional backlash.
Here are their stories.
“Maya,” 38, works as a doctor and has experienced racism among her colleagues and as a patient. Due to the professional risk of speaking out, she asked that her name be changed.
Maya’s experiences with racism in healthcare began as she looked for a job after her residency ended. Maya asked for a recommendation from the lead doctor she had worked with for 3 years and got a yes.
Once Maya got the job, which was a per diem temporary position, the woman who hired her let her know that her reference might not be ideal.
The lead doctor had said, “Well, Maya is not a go-getter.”
The woman hiring asked, “What do you mean? Is she smart? Does she know what she’s doing? Does she work hard?”
The lead doctor said yes, and Maya was hired.
The second doctor in the residency, a Black male, applied for a per diem job at the same clinic where the residency took place. The lead doctor wanted him to interview, even though she worked side by side with him for 3 years.
While she reluctantly recommended Maya and required the other Black doctor to interview, the same doctor went out of her way to create a job for the third resident, a white male medical student.
Per diem jobs are temporary, have no guaranteed hours, and benefits are rarely provided. It’s difficult to secure stable income, and many providers have to work multiple jobs just to make ends meet.
Like Maya, Black residents and doctors already exist at the margins of their field.
In fact, in 2018 only 5 percent of medical doctors were Black, with Black women representing just 2 percent of all medical doctors. Currently, just 7 percent of medical school students are Black.
This lack of racial representation is coupled with long-standing beliefs about who deserves to occupy space as medical authorities. In turn, this causes doctors (of all races) to distrust that future (or current) Black doctors deserve professional opportunities, even if they are smart and hardworking like Maya.
For many Black medical professionals, there is an uncertainty in knowing whether your colleagues and superiors will support you or sabotage you because of your race.
Maya’s navigation of medical racism only continued with the birth of her second child.
She shares what it was like having her labor pains doubted by doctors, an experience that contributes to the death of Black mothers at
“When I was 38 weeks pregnant with my second kid, I started to get contractions. I went to the labor and delivery department,” Maya says. “The nurse basically said I wasn’t dilated enough, so I should just take some Tylenol or morphine, and I could just go back home.”
It’s not uncommon for Black women’s pain to be dismissed or minimized. Maya pushed back, but the male OB-GYN insisted she still wasn’t dilated enough.
“I just stayed there and fought through the pain. I eventually got the morphine,” Maya says.
When a midwife performed a check, it turned out Maya was actually more dilated than the doctors had thought.
She ended up having her baby 10 hours later.
Maya shared that her reluctance to go home wasn’t purely from pain. She had known another Black woman who was 38 weeks pregnant who was sent home by labor and delivery, even though she told them that something didn’t feel right.
“They told her to go home, and her baby died,” Maya says.
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For many expecting Black mothers, it’s infuriating and terrifying to think you might lose your baby because a doctor questions your humanity or your experience.
This is on top of the demoralization caused by lack of access to the social determinants of health, like quality foods, healthcare, and insurance.
Fortunately, many Black mothers are taking zero chances with doctors who may be racist. Instead, they’re turning to Black doula collectives or Black gynecologists to keep themselves and their babies safe.
And it’s working.
A 2020 study found that when Black babies are treated by Black doctors, their chances of surviving are nearly doubled.
André, 27, received different care from his white counterparts for the same condition.
“One of my [college] hallmates started feeling sick. [Then] we all started feeling sick,” says André. “I was a voice performance major… and I remember having difficulty even singing… so I went to the student health center.”
At first, André was tested for strep. His test came back positive, but he didn’t receive treatment.
A few days later, several of his peers tested positive for mono. Concerned that he may have been exposed, André went back to the student health center. He wasn’t administered a test.
“I didn’t get treatment or anything for strep throat. I couldn’t stay awake for more than 8 hours a day,” he says. “So I went to the emergency room, got tested, and I got my results: I had mono.”
For André, seeking medical treatment for his mono symptoms didn’t register as medically racist — at least not at first.
He saw the discrepancy when he compared his experience of having to return to the student clinic and then visit the emergency room on his own to that of his white classmates.
“My [white] friends got the mono test right away,” André says.
André was one of the few Black students on campus, so it’s highly unlikely that the health center staff interacted with many Black patients, let alone treated them on a regular basis.
While no medical staff was outwardly hostile to André, implicitly racist behaviors, like stereotypes, patronizing language, and dominating conversations versus asking humanizing questions all contribute to lower quality care and overall health for Black patients.
Morgan, 27, shares her experience of an anti-Black microaggression from a doctor.
When Morgan, 27, moved from Massachusetts to California, she noticed some surprising and unwanted side effects in the form of rosacea flare-ups, dry skin, and breakouts.
When she went to her primary care doctor for relief, her PCP didn’t seem to care at all about the skin issues Morgan was experiencing.
Instead, the doctor recommended that Morgan try skin lightening cream, saying, “You really need it.”
Morgan was stunned.
“I didn’t even know what to say back to her,” Morgan says. “I had never experienced that in healthcare. I had also moved to California under the pretense that Californians are really open, liberal, and progressive, and here I was being told that I’m too dark!”
Her story highlights an important point: This kind of anti-Black attitude is pervasive. No matter how “progressive” the region, no matter the politics.
And the consequences are serious: The incident left Morgan untreated — and certain she’d never return to that doctor.
Erika, 56, recalls an experience early in her adulthood when she saw a doctor for a routine breast exam.
“When I was 23, I went to the doctor for a breast exam with a white male OB-GYN. He said I would probably have breast cancer because my breasts were very large, and they had fatty tissue. At that time, I weighed 120 pounds, and my breasts were a 34D, so that was strange to hear to me,” says Erika.
“My question to him was, ‘Do I have cancer now?’ and he said no, so I said, ‘Well, I’ll worry about it when I get cancer.’”
When her doctor made that explicit and extreme comment, Erika’s sense of trust in him as a provider vanished immediately. She felt even more marginalized as a young Black woman seeking care in a majority white field. It was over two years before she would visit the gynecologist again.
In this case, Erika’s doctor’s racist behavior created a barrier for her to receive reliable healthcare.
She’s not alone. Research confirms that microaggressions regularly undermine Black patients’ health.
“Iyana,” 61, is a public figure living with bipolar disorder. She was prescribed medication at 35 and immediately didn’t feel right.
“Within a week, I started having side effects and noticing changes in my body,” Iyana says.
When she brought this up to her doctor, he said it wasn’t possible.
Even though she felt in her gut the doctor was wrong, Iyana listened.
Still, she adjusted her medication on her own, taking less than what he told her to take. Due to a lack of trust, Iyana felt the need to adjust her medication in secret. This can be dangerous.
While Iyana’s doctor made no outwardly racist or demeaning comments to her, invalidating her side effects was another example of how doctors covertly fail to effectively treat Black patients.
A 2020 study on racial microaggressions in racially charged patient-provider interactions indicates implicit bias against Black patients.
Iyana’s psychiatrist was likely displaying this bias.
His dismissal of her concerns about what she was feeling in her own body caused Iyana to distrust her doctor’s treatment plan and instead treat herself, a common outcome for Black patients.
She never returned for another visit with him.
Everyone interviewed shared that having Black doctors was a more empowering and humanizing experience than being treated by non-Black doctors.
Research confirms that Black patients experience fewer microaggressions, discrimination, and anxiety from Black doctors than from non-Black doctors. They’re also more likely to have their pain believed and effectively treated.
“It was so easy with her.”
“The only time I had a Black healthcare provider was when I was in Philadelphia. Bless her!” André says of his experience. “Even now, I don’t want to see anyone in this [rural and white] area because of how it was seeing [her] and how easy it was with her.”
His reluctance to see other doctors speaks to how validated André felt in receiving quality care.
“She initiated every conversation, and if I forgot anything, she would probe me…it was amazing,” André says. “She was like, ‘You got a Black dentist now? I got you. You got a Black therapist?’ She was giving me all the hookups.”
This is a far cry from the disregard André experienced on his college campus.
“It was perfect.”
Erika had a similar encounter with a Black doctor.
“It was perfect — couldn’t have been better! [He] was the one who suggested that I have my fibroids taken out in case I wanted to have children,” she says.
“He talked about children, family planning, my marriage, parenting, family background, versus [a white doctor] saying something negative about my body with no preamble.”
With a Black doctor, Erika was treated as a person with hopes, dreams, and a future.
“I was just so desperate.”
Morgan shares her experience switching to a Black doctor.
“I was just so desperate. I was like, ‘I need somebody who looks like me who can provide guidance,’” she says.
Not only was she provided with guidance, but attention and care.
“She took things more seriously. She was more attentive to me as a human than any other doctor I’ve had because she [was] aware of the experiences Black women have in healthcare. Ultimately, that’s why I think I ended up trusting her so much,” says Morgan.
Still, this quality care came at a cost.
“[She] ended up being my primary care doctor, but this was a wildly expensive alternative that was not covered by insurance,” Morgan says.
The weight of anti-Black medical racism can seem insurmountable for doctors and Black patients alike. There are achievable actions that can ensure that Black lives matter and are medically treated that way.
See Black patients as human
Maya suggests doctors take extra time to consider the life circumstances of their Black patients.
“If you need to, spend an extra minute or two on [the patient’s] history. Take the whole person into consideration. How far away are they from a grocery store? Is there fresh produce available? What is their living situation? Get a detailed history. Help these people,” she says.
Black experiences are real
“Don’t automatically discount what a patient is telling you they are experiencing in their bodies,” says Iyana.
Look at your biases
Morgan emphasizes the importance of looking within to understand your own biases.
“Racism definitely can’t be solved in one day or [with] one training, but it’s necessary that [doctors] do a lot of self-identity work to understand their own biases… look at the way they were trained and challenge that,” she says.
Advocate
Lastly, Maya urges Black patients to advocate for their health, no matter what.
“If you feel like somebody is not listening to what you’re saying, find another provider, because there’s a lot of them out there,” she says. “Don’t feel guilty about it! A lot of times Black patients want to give [doctors] a lot of chances — no! If you’re not having a positive experience, find somebody else.”
She adds that if you have a hunch you need a particular test, you have a right to demand it and call in support.
“If you want a test done and [the doctors] don’t want to do it — and you don’t feel you can fight for it — bring somebody who can,” Maya suggests.
While strides are being made, we still have a long way to go before Black people receive the medical care they need.
Black people deserve to have their experiences validated, their feelings respected, and their bodies treated with real care.