Being a black female physician
Black women physicians are often the primary breadwinners in their families, but they also carry a heavy load of family responsibilities. Because of cultural expectations and norms, black women are more likely to take on the personal caretaking responsibilities of sick and/or elderly parents and grandparents rather than utilizing nursing facilities and other resources. In addition, as a result of several hundred years of stolen labor and prohibition of land and home ownership, there is an overall lack of passed down funds and assets through generations of African American families. This means black women often have less financial flexibility that their peers, which affects their professional choices and actions.
Black female physicians also experience many of the same limitations facing other black female professionals, who face daily macro and micro-aggressions within and outside the work environment. These can range from being called a racial obscenity in public by a stranger to being the only physician to be called by their first name in a line of introductions. These cultural differences and experiences are not always easily explained or understood by mentors and colleagues who do not share these same experiences.
There are other striking differences in the day-to-day experience of being a black American. Black women and men often worry about their sons, daughters, brothers, uncles, and cousins being killed by the police and have to actively train their loved ones how to behave around police officers. The added pressures to assimilate your hairstyles, style of dress, language, and overall demeanor forces those from excluded racial/ethnic groups in medicine to have to balance a duality of personalities and lived experiences that others who are not a part of these groups are unfamiliar with.
These experiences and duality of efforts and mental gymnastics can be physically exhausting and mentally overbearing. But we are still fierce, gifted, and bold because we tell ourselves and each other that we are so. These affirmations are sometimes the difference between persevering and surrendering.
“When I asked the grandmother of one my patients to recount the recommendations of the referring subspecialist, she responded: ‘He didn’t really say much of anything, Dr. Jones……you know we are just black people.’”
Toward true equity in health care
Black women physician leaders are essential to achieving equity within medical professional environments. These leaders provide effective, innovative, empathetic, patient-centered care to all children and families. Black women leaders are needed to not only identify, mentor, and promote other black physicians and medical professionals, but also to shape the medical environment through their personal insights, knowledge, and unique perspectives that provide true equity in health care.
When I asked the grandmother of one my patients to recount the recommendations of the referring subspecialist, she responded: “He didn’t really say much of anything, Dr. Jones……you know we are just black people.”
These words course through my head often. I personally ached over the fact that she had been made to feel this way. There may be many reasons why she made the remark. This could have been due to experiences that she’d had outside of our hospital or it could have something to do with the fact that when she walks through our halls there are very few who look like her and her grandson and wear the “DOCTOR” tag on their badge. This may send an unintentional message that black people are less valued or less important in this environment. Having diverse leadership can send intentional messages to patients and staff underscoring their inclusion and importance in the medical environment.
Leadership and activism
Leadership is activism, and activism is leadership. Black women in America have always been activists and effective leaders. From Harriet Tubman who rescued the enslaved, to the black women who led alongside white women for the right to vote, to today’s leader activists like Tarana Burke, who started the “Me Too” movement in 2006.
In medicine, black female leaders include Dr. Edith Irby Jones, who was the first African American to integrate medical schools in the south; Dr. Renee Jenkins, who was elected the first African American president of the American Academy of Pediatrics (AAP) in 2007; and today’s current and rising black female medical leaders who are calling out inequity daily, whether asked or not.
Within pediatrics, there is a pressing need to seek out and utilize the unique voices, input, and skills of diverse women instead of continuing to rely solely on subjective checklist criteria of “qualifications” that are often applied more loosely to less diverse groups. Diverse leadership can model possibilities for others who share similar cultures and backgrounds, supplying mentors and sponsors who understand and can most effectively help navigate and address unique barriers. It provides a link to communities and perspectives currently lacking in medicine, and highlights currently unrecognized or unaddressed deficiencies in how we provide health care.
Medical leaders define the vision and priorities of institutions, hospitals, and medical organizations, and significantly impact communities. Lack of diversity, and specifically the lack of perspective of black women among medical leaders, yields a narrow view that does a disservice to patients, families, and the medical profession.
“I tell my students, 'When you get these jobs that you have been so brilliantly trained for, just remember that your real job is that if you are free, you need to free somebody else. If you have some power, then your job is to empower somebody else. This is not just a grab-bag candy game.”
* The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.
Bridgette L. Jones, MD, MS, FAAP, is an AAP cohort member of the Women's Wellness through Equity and Leadership project and serves as Chair of the academy’s Committee on Drugs. She is a clinician scientist who also holds a faculty appointment as Associate Professor of Pediatrics at the University of Missouri-Kansas City in the divisions of Pediatric Clinical Pharmacology, Toxicology and Therapeutic Innovation and Allergy/Asthma/Immunology at Children’s Mercy. She is also the Assistant Academic Dean of Student Affairs at the school, as well as the inaugural chair of the Faculty and Trainee Diversity Equity and Inclusion Committee and the Medical Director of the Office of Equity and Diversity at Children’s Mercy. In addition, she serves as a member of the Food and Drug Administration Pediatric Advisory Committee and was appointed by the United States Secretary of Health to serve on the National Institutes of Health Task Force on Research Specific to Pregnant Women and Lactating Women.