By Sarah Prosser
Introduction
The Civil Rights Act of 1964 prohibits discrimination on the basis of race, color, religion, sex, or national origin (U.S. Department of Labor). However, the year is now 2021, and persons of color continue to experience discrimination every day in the United States.
Completing medical school requires intelligence, dedication, and perseverance. Most people in the United States, even non-medical professionals, would agree with this statement. In the 2019-2020 academic year, only about forty-one percent of applicants to U.S. medical schools matriculated (U.S. News, 2020).
Although society regards physicians as exceptionally brilliant, skin color seems to largely affect this perception in the United States. This systemic racism can be traced throughout American history, and namely rooted in the nation’s notorious “Jim Crow laws,” which legalized racial segregation.
This systemic racism can be traced throughout healthcare history in the United States, beginning primarily in the Post-Civil War Era up to the present. Thomas Watson, an emergency room employee in the UNC Hospital recounts the discrimination he faced as a black man in the mid-twentieth century. Dr. Damon Tweedy, in his memoir, Black Man in a White Coat, informs readers of his own experiences in the healthcare industry where he encountered racial discrimination from patients and colleagues in the late-twentieth century; Dr. Seema Yasmin shares similar experiences in her present-day poem, “When the Patient Asked for a White Doctor” (Dr. Tweedy, 2013; Dr. Yasmin). Alternatively, Dr. Max J. Romano, a family medicine doctor in Baltimore, Maryland, assesses his privilege as a white physician in comparison to his black counterparts in a 2018 essay, and how this has shaped his career (Dr. Romano, 2018).
Racial Disparities in Health Care: Post-Civil Rights Movement
Black persons withstood the marginalization dictated by the Jim Crow laws in the United States for roughly one-hundred years after the American Civil War. After the revision of the Civil Rights Act in 1968, it was unlawful to discriminate on the basis of race, color, religion, sex, or national origin, in every aspect. Nevertheless, many persons of color remained alienated in employment, housing, healthcare, and social situations, and they remain suppressed by these injustices today.
Although sanctioned desegregation occurred throughout the United States, many black persons remained subjected to the ‘separate but equal’ doctrine held by whites, specifically, in the southern United States. Racial discrimination remained, although unlawfully, prominent in several industries. As Thomas Watson recounts in his interview for the Southern Oral History Program at the University of North Carolina at Chapel Hill”
“[University of North Carolina at Chapel Hill Hospital] was a very prejudiced institution… When I started working here [in 1969], you could still see ‘black bathroom, white bathroom’… They had scraped it off… And then the semi-private rooms they were all black, all white. And you didn’t mix them” (Watson, 7, 9).
While action was taken in the UNC Hospital towards integration, the prejudices that were lingering over black persons continued to generate racial strife; strife which affected black healthcare workers, and ultimately, no matter their race, patients of the UNC Hospital.
As Watson continued to work in the emergency department of the UNC Hospital, he witnessed the prolonged discrimination of black physicians due to prejudice. In 1975, Watson believed the first black physician joined the UNC Hospital.
Black physicians, as Watson described in his interview, were held to the prejudices of the past, as “patients would walk up to [Watson] and say, ‘I want to see a doctor, but not a black doctor’” (Watson, 9). When refusing care from black physicians, white patients run the risk of receiving substandard care from a less qualified, white, physician. Black physicians also suffer from this behavior, as the legacy of racial distress can, and will likely, affect their mental stability in prolific ways. The legacy of racial discrimination continued into the late twentieth century, as the black persons in the healthcare system became increasingly prevalent. While Thomas Watson observed the maltreatment of physicians based on race, thirty years later, Dr. Damon Tweedy, a black psychiatrist at Durham Veteran Affairs Health Care System, experienced prejudice firsthand during medical school, residency, and even as a practicing psychiatrist.
Racial Disparities in Health Care: Late Twentieth Century
As a resident at Duke University Hospital, Dr. Tweedy encountered Chester, a white patient who “did not want any ‘[black] doctors’ taking care of him,” (Dr. Tweedy 95). Some patients that accepted Dr. Tweedy as their assigned physician, “took one look at [Dr. Tweedy] and inquired about [his] basketball skills,” (Dr. Tweedy, 98). While Dr. Tweedy “worried less about [patients’] perception that [he] must be a good basketball player than [he] did a question specific to his future: Would they doubt [his] ability to be a competent doctor?” (Dr. Tweedy, 100). Dr. Tweedy attended medical school beaming with aspirations of becoming an exceptional physician, but a plethora of these ambitious thoughts were depleted by racist patients to which he was present to alleviate their pain. Dr. Tweedy goes on to describe a similar situation where black doctors were previously overlooked for their white patient’s treatment plan. “As one medical subspecialist phrased it: ‘we have just met and they want someone else. I don’t think that most patients want to discriminate against me… But patients sometimes expect us not to do a good job or as well as somebody else would do,” (Dr. Tweedy, 101). The preconceived ideas regarding black persons prior to the Civil Rights Act of 1968 were either retained by older patients, or passed down to their children, subjecting almost all black physicians to this treatment. For Dr. Tweedy, the discrimination he experienced strained his relationship with medicine and his mental health. Rather than focusing on the patients he was assigned for the day, Dr. Tweedy could not cease his anxiety regarding Chester. “How would Chester cope with this situation? Would he request another doctor? If not, would he continue to refuse to speak with me? Would he allow me to draw blood or do other procedures on him? Would I have to deal with a family full of people who shared his prejudices?” (Dr. Tweedy, 102).
As the United States has reached its fifty-third year since the Civil Rights Act was authorized, many black physicians continue to experience oppression in the field of healthcare. For some white Americans, a sense of detachment regarding racial equity exists and multiplies in the course of time. For those who do not experience racism firsthand, this issue may appear as a complication of the past. This notion is displayed in a 2019 study, conducted by the Pew Research Center, where seventy-one percent of black Americans believe that race relations in the United States are bad, compared to fifty-six percent of white Americans who believe they are bad (Race in America, 2019).
Racial Disparities in Health Care: Present Day
Time cannot heal all wounds. Black physicians still are discriminated against today, and every day. These black physicians are physicians that diligently worked to attain the career of their dreams; a career in healing someone’s mother, son, or friend. These physicians, who have earned medical degrees from Harvard, Stanford, and Duke, are surely overqualified for their jobs. Yet, black physicians face the fear of discrimination prior to attending work every day. Thomas Watson saw this in the 1970’s, Dr. Tweedy in the 90’s, and Dr. Seema Yasmin in the 2010’s. In Dr. Yasmin’s poem, When the Patient Asked for a White Doctor, Dr. Yasmin explores the stereotypes to which she believes her patient, who asked for a new, white doctor, believes Dr. Yasmin accurately fits. As Dr. Yasmin is assumed to have cooperated, she informs readers that she “danced away her ruin beneath a black girl’s melody,” and likely moved on to the next patient (Dr. Yasmin, lines 19-20).
Why, though, is the United States frozen in a stalemate where black persons simply must accept unrelentless racism? As Dr. Max J. Romano tells readers in his article, “White Privilege in a White Coat: How Racism Shaped my Medical Education,” “white physicians seldom ask how their own racial privilege reinforces a white supremacist culture,” (Dr. Romano, 2018). White Americans associate the degree of racial reconstruction with increasing time, while black physicians and persons are still hindered by structures of inequality today, structures that have not been socially deconstructed due to the prolonged views of black persons in the Civil War and post-Civil War era.
Resolution
As black physician experiences are juxtaposed in the post-Civil Rights Era, the late-twentieth century, and the present 2000’s, readers and listeners repeatedly observe identical accounts from healthcare employees. Although over half a century separate Thomas Watson’s account and Dr. Yasmin’s account, the same story is told white supremacy remains in control of the United States’ healthcare system. The United States has failed to heed ongoing racial inequality after the Civil Rights Act of 1968. As Dr. Romano informs readers, “failure to confront racism within the medical profession has implications for the patients… infants of color continue to die at higher rates, children of color get less needed care, and adults of color receive poorer quality care than their white counterparts, and the trends are not improving,” (Romano, 2018).
Policies must be changed to accommodate the lack of reconstruction following the post-Civil Rights Era. Black persons have been subjected to inadequate resources, including housing, education, and employment, since Jim Crow laws were enacted following the abolition of slavery. The stereotypes that have been created as a product of segregation do not allow space for black persons in the medical field, which leads to mass discrimination. What principle do Americans stand by if black physicians continue to be oppressed by their own patients? We must not neglect this matter any longer. Public schools must become more diverse to include black students. Black students must be immersed in science, technology, engineering, and math programs. Black students must be granted equal access to honors and Advanced Placement courses and exposed to college-like settings in high school. Black physicians must be seen for more than their skin color; they have brilliant minds that earned the right to practice medicine. They possess empathy and compassion, and they yearn to heal patients.
References
Civil rights act of 1968. (n.d.). Retrieved May 03, 2021, from https://www.thestoryoftexas.com/discover/artifacts/civil-rights-act-1968-spotlight-102414
Civil war. (2018, August 21). Retrieved May 03, 2021, from https://www.history.com/topics/american-civil-war
Figure 18. percentage of all ACTIVE physicians by race/ethnicity, 2018. (n.d.). Retrieved May 03, 2021, from https://www.aamc.org/data-reports/workforce/interactive-data/figure-18-percentage-all-active-physicians-race/ethnicity-2018
History.com Editors. (2018, February 28). Jim Crow laws. Retrieved May 03, 2021, from https://www.history.com/topics/early-20th-century-us/jim-crow-laws
History.com. (2018, November 28). Segregation in the United States. Retrieved May 03, 2021, from https://www.history.com/topics/black-history/segregation-united-states
Horowitz, J., Brown, A., & Cox, K. (2021, March 16). Views on race in America 2019. Retrieved May 03, 2021, from https://www.pewresearch.org/social-trends/2019/04/09/race-in-america-2019/
Legal highlight: The civil Rights act of 1964. (n.d.). Retrieved May 03, 2021, from https://www.dol.gov/agencies/oasam/civil-rights-center/statutes/civil-rights-act-of-1964
Romano, M. (2018, May 01). White privilege in a WHITE COAT: How Racism shaped my medical education. Retrieved May 03, 2021, from https://www.annfammed.org/content/16/3/261
Watson, T., Necochea, R. (2012, October 09). L-0361. Retrieved May 03, 2021, from https://dc.lib.unc.edu/cdm/compoundobject/collection/sohp/id/17109/rec/1
Yasmin, S., M.D. (n.d.). When the patient asked for a white doctor BY Seema Yasmin – Poems | Academy of American poets. Retrieved May 03, 2021, from https://poets.org/poem/when-patient-asked-white-doctor