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Coppin State University: Pre-Med Day
Oct. 14, 2015
Coppin State University
Good afternoon. I’m so happy to be with you today.
Dr. Thompson, I’m delighted we’ve had the chance to talk and get to know one another since you’ve come to Coppin. I welcome you again to our city and to our family of exceptional colleges and universities, and I thank you for your leadership and vision.
When I received the invitation to meet with all of you, I was thrilled. And I mean that sincerely. There are few things I’d rather do than get to know Maryland’s pre-med students and encourage them into medical school.
But when the pre-med students are from historically black institutions like Coppin, it’s an invitation that’s nearly impossible for me to turn down. And there’s a simple reason why: The medical profession needs you. Your neighbors need you. Baltimore needs you. Desperately.
Why Black Doctors Matter
Without putting too much pressure on you, I absolutely believe it’s going to be our physicians of color who will be most instrumental in shrinking the yawning gap between the health of our white neighbors and the health of our black neighbors.
I want to preface my remarks with a couple of caveats.
First, I’m well aware that we need to recruit more students of all races and ethnicities and backgrounds into medicine, especially with the serious physician shortage we’re experiencing right now.
My second caveat is this: Once you’re a doctor, you’ll choose where you practice. You’ll choose which patients you see. And there are all sorts of valid considerations that will influence those decisions.
But here’s the thing: Studies show that physicians of color are more likely to treat minority and other medically underserved patients.
Studies show that patients and physicians who share a race, ethnicity, or language enjoy better relationships with one another and better communication. And these relationships increase the likelihood that patients will accept and receive high-quality care.
There was a study done about a decade ago looking at communication between doctors and patients in Baltimore, DC, and Northern Virginia. The investigators wanted to figure out why African-American patients tended to receive lower quality care than white patients—even when everyone had equal access to care. Same income, same insurance, etc.
The study found that physicians talked 43 percent more than their black patients—but only about 24 percent more than their white patients. And the emotional tenor of the conversations—on the part of the doctors and the patients both—was more likely to be positive when the patients were white.
Generally speaking, the more verbally dominant the doctor, the less satisfied the patient.
So do we need to teach physicians how to communicate better with African-American patients? Absolutely yes. Do we need to teach African-American patients how to communicate better with their doctors? Yes.
But you know what else we need to do? We need to get more black students into the medical school pipeline. We need to put patients in a position where they’re sitting across from a doctor who looks like them, who understands them, who shares a background similar to theirs, and can relate to their experiences.
When I was first back in Baltimore about five years ago as the new president of UMB—after having been the medical school dean at the University of Kentucky—I was making the neighborhood rounds, meeting with community and faith leaders. I talked about my goals for the University and for the city; they talked about their longstanding work to strengthen Baltimore. We found a lot of common ground.
At the end of one of these meetings, a prominent leader, an African American, asked privately if I could refer him to a doctor. Without hesitation, I said, “of course.” Then he leaned in closer and said, “Jay, could you recommend a black doctor?”
This is human nature. It’s natural to want to be comfortable, to share an easy rapport, to feel understood by the person to whom you’re entrusting your health.
The Black Doctor Pipeline
And this is where the problem lies. We simply don’t have enough black doctors to give many patients this opportunity.
You might’ve seen a pretty startling statistic recently: More black men applied to medical school in 1978 than did just last year. And that drop has occurred even as overall college enrollment among black men has climbed.
In the entire U.S., just 515 African-American men enrolled in medical school last year. Just 6 percent of the 85,000 students in U.S. medical schools today identify as African American or black. Meanwhile, if you live in Baltimore, you’re living in a city that’s nearly two-thirds African American.
This disconnect is huge—and it’s damaging.
You probably already know how damaging it is. You’re probably familiar with a lot of the facts around race-based health disparities. But let me give just a few examples from Maryland.
In Maryland, black men are 2½ times more likely to die from prostate cancer than white men; and black women, more than twice as likely to die of cervical cancer. African-Americans are 51 percent more likely to be obese, and 84 percent more likely to be diabetic.
Asthma, stroke, heart disease, breast cancer, HIV/AIDS—all significantly higher among African Americans than whites. Maternal mortality among black women is 2½ times the rate for white women. And the infant mortality rate? About 2½ times higher for African American babies.
And while the state’s black residents are much more likely to be diagnosed with chronic diseases and die from them, they’re less likely to be able to afford a potentially life-saving visit to the doctor.
Just last weekend, I was talking to a group of middle school students about these very disparities. (I’ll tell you why in just a minute.) And I told the children that these differences in health outcomes aren’t right. They aren’t fair. And they’re not inevitable.
Whenever you’re looking a population health, you’re looking at a complex interplay of biology, behavior, and environment.
To the last point—environment—we know that daily inequities and routine injustices perpetuate grave differences in health outcomes. We know that growing up in a house with lead paint peeling off the walls disadvantages children right from the start. That living in a house with no electricity or in a neighborhood miles from the nearest grocery store has as much to do with our health as our habits and our genetics.
And we know that many Baltimore residents are denied those things we consider critical to basic well-being: economic stability; personal and public safety; quality education; reliable housing and transportation; access to nutritious foods, social supports, and adequate health care.
A CURE for the Pipeline
I don’t have all the answers to these problems. But I think I have one answer.
At the University of Maryland, Baltimore, we’ve decided to cultivate students like you who are smart, and talented, and hard-working, and driven.
But not you at 20, 21, 22 years old. Instead, we find you when you’re 10 or 11, when you’re on fire with scientific interest and sure you can do whatever you set your mind to, when all you need to excel is some extra attention and encouragement, and before any potential difficulty in science or math has a chance to derail a promising medical career.
So that’s what we’re doing. This past Saturday, we inducted our very first class of UMB CURE Scholars—43 sixth-graders from three middle schools not too far from here: Franklin Square Elementary/Middle, Southwest Baltimore Charter School, and Greene Street Academy.
We’re giving the students access to our campus and our people—some of the world’s greatest physicians and researchers. They’ll do hands-on science in our labs under the guidance of University mentors—five mentors for every scholar. They’ll attend science camps, and career lectures, and tutoring sessions.
And we don’t plan on letting them go. We’ve made a promise that we’re in their corner for the long haul—through middle and high school, through college, med school, and beyond.
For those of you who didn’t have mentors when you were in middle school—and I presume that’s most of you—imagine how it would’ve felt to have this blanket of support wrapped around you, so that when you struggled or faltered or grew insecure about your abilities, there was always someone rooting for you and showing you the way.
That’s how you build a pipeline.
And, more than that, it’s how you sustain a pipeline.
Last month, there was an article in the New York Times Magazine, titled “A Prescription for More Black Doctors.” If you haven’t read it, I hope you will.
It’s an in-depth look at how Xavier University in New Orleans—with fewer than 4,500 students—gets so many African Americans into medical school. More than the Ivies, more than huge state schools, more than much bigger HBCUs.
The entire article is terrific, but there were a couple of lines that especially caught my eye. In describing how one Xavier student—now a doctor in Chicago—became interested in medicine, the author wrote, “Something captured his attention, something he had never seen before. His mom’s obstetrician was a black man.”
All of you here today—you’re going to be that obstetrician, or cardiologist, or oncologist, or pediatrician, or internist. You’re going to be that spark for a child.
Whether you know it or not, you’ll be an inspiration, you’ll be a role model, you’ll represent a future that children here in West Baltimore and across the country might not even know they could want.
Black children need black doctors to emulate. It’s the only way we’re going to expand and strengthen our pipeline of African-American medical talent. And so, by taking this path, you’re not only fulfilling your own dreams; you’re making those same dreams possible for countless others. You’re doing a brave and generous thing—and I thank you for it.