2020 CIBH current events pregnancy Pregnancy #4

Medical Professionals Chosen By Race: Racism or Self-Preservation?

It started out as a simple post.  A friend of mine posted on social media that she had made a conscious decision to have medical professionals that looked like her because she believed they were stronger advocates for her and her family than those who did not.  Immediately, replies of affirmation  hit the page, along with stories of people who hadn’t made the decision initially and the medical battles they fought because of what they felt were preconceived notions about African-American patients. 

As expected, there were also posts of opposite opinion that stated that by having her consciously admit that she was choosing doctors based on race, she was essentially being racist.  Her response was “Self-preservation is not racism.  It is survival”.  I couldn’t disagree.

“Self-preservation is not racism.  It is survival”

You guys know.  I posted about it before. Statistically, black women have a 234% higher chance of death in childbirth than any other ethnic group. In Virginia, where I reside, “black women die in or near childbirth more than three times as often as women from any other race. They died at a rate of 36.6 per 100,000 births since 2016, according to the Centers for Disease Control and Prevention. The rate was 11 for white women.” (Hafner, 2018). Shortly after the statistics of black maternal death were released, another article was published regarding the death of black babies under the care of any one other than black physicians.  Some of the stories shared in the comments of moms across the social media spectrum made my heartache.  Thinking about it now, as a pregnant woman, I was more than a little concerned about what could happen.  And suddenly, my friend’s post made a lot of sense.

sleeping baby in baby swing

I attend a practice owned by a black obstetrician/gynecologist. She is phenomenal. She delivered my son (14 years ago) and has provided gynecological services for me for just about 20 years. She has cared for me in the latter part of my pregnancy for my youngest children as well. I respect her and trust her judgments. I also love that she advocates for me. Her practice has changed over the years and now you are seen by her at the latter part of your pregnancy (36 weeks on) unless there are complications or additional needs. She is a very competent PA who is a Latina woman and I equally enjoy seeing her as well. I feel “safe” at this office and if something is off or bothering me, they take it serious and evaluate it immediately.

She was chosen by recommendation of a family member after a particularly distasteful appointment with a Caucasian Ob/Gyn who acted as I was just wasting him time simply being there.  He loved my insurance though.  His bedside demeanor and side comments left me very uncomfortable.  So, yep,  I left him quick.

                                     

I also attend a practice where my dentist is black.  I didn’t do this on purpose.  I went in the practice based on the recommendations because I have a severe dental phobia and I wanted someone who would be able to assist with that.  She has and is phenomenal.  She sees the entire family and I love that.  She also eases my fears and takes minimal drugs to treat me.  The dentist I saw previous actually would give me five needles thirty minutes before an appointment because I never numbed.  This dentist has never had to stick me beyond twice and I am never druggy feeling after. 

My pediatrician is a white woman who has also been with me since my oldest son’s birth.  I like her a lot.  She listens to my concerns.  She is professional.  But I admit we have had to build that relationship.  In the very beginning there were a couple of issues with her front desk staff that almost had me seeking another practice, but the doctor was so highly recommended that I didn’t want to raise a stink about it until I had too.  It turned out that there were quite a few preconceived notions from the front desk.  I didn’t match what they thought I did at all.  And the fact that I corrected them made them nervous.  Those people are no longer there.

I saw all of this to say that I didn’t purposely seek out medical professionals of color, but I more than understand why it is done.  I have been asked about my WIC (Women, Infant, Children) and TANF status more times than I can count.  These are federal welfare programs.  I am not on welfare and have never been as an adult. I’ve been told by new professionals who hear my name that they are not taking patients on Medicaid or Medicare and when I respond that I have neither but a very good PPO with excellent care, suddenly they are stumbling over themselves to get me through doors.  SMH.

I am very thankful that the doctors in my circle and that of my family’s are all professional–regardless of color.  They are more than capable, but I have had more than my fair share of doctors who I know have treated me discourteously because of what they thought I might be.  This was especially an issue when I was a student in college.  I had a couple of times where I needed to head to ER including a time when I had a severe kidney infection that was exacerbated by the medicine that was given to me.  Apparently my telling someone I had a possible allergy to sulfates was treated as my not having a clue and sulfates were given.  I was telling the doctor that I felt ill and was in a lot of pain.  They didn’t believe me until my BP crashed and I started vomiting….oops.

In contrast, as an adult carrying my youngest son, I called the doctor when the back pain I was having was so severe that I could barely walk.  When I told my doctor, she tried to give me an exam immediately.  She realized that I needed to be monitored and had me go straight to Labor and Delivery.  It was discovered that I had severe uterine irritability.  My uterus was NOT happy at all and was contracting to let the world know.  I was placed on pelvic rest and told to rest the rest of the next day.  I didn’t have to convince anyone that something was wrong with me or that it was beyond regular pain.  I was so thankful that she believed me and thankful that something was done.

This same doctor knows that people in my community have a tendency to have low vitamin D.  She has been watching that faithfully knowing it could cause some issues for me.  When it spiked instead, she made sure to contact me so we could make adjustments.  I am not saying another doctor would not do this.  I know better than that.  The doctor who delivered J was phenomenal and wasn’t my African-American obstetrician.  Still, I trusted this doctor in part because of the recommendation of my doctor who specifically asked that this doctor be on call for her.

The post of my friend reminded me that there are a host of reasons to find medical professionals who are advocates instead of judges.  History has taught eugenics and forced sterilizations and all sorts of medical atrocities according to race, religion, and creed exist.  I can certainly understand why there is a conscious desire to have someone in your corner to be trusted.

What are your thoughts?  Regardless of race, do you include a physician’s ethnicity in your considerations as a potential provider?  Let me know.

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