My Black Skin Makes My White Coat Vanish - Newsweek Columnists - MSNBC.com

Mana Lumumba-Kasongo is a Medical Doctor working in New York City, but for some reason, the general public, regardless of gender or race, seems to have a hard time accepting that she, a black woman, is a physician. To quote from her article:

"Over the years, the inability of patients and others to believe that I am a doctor has left me utterly demoralized. Their incredulity persists even now that I am a senior resident, working in one of the world's busiest hospital emergency rooms. How can it be that with all the years of experience I have, all the procedures I've performed and all the people I've interacted with in emergency situations, I still get what I call "the look"? It's too predictable. I walk in the room and introduce myself, then wait for the patient—whether he or she is black, white or Asian—to steal glances at the ID card that is attached to my scrubs or white coat. (I've thought of having it changed to read something like: It's true. I'm a real doctor. Perhaps you've seen a black one on TV?)"

While this is surely frustrating, for me, one of the most hearkbreaking situations was the following:

"Unfortunately, black children may be even more adversely affected by this than white ones. That point was driven home to me months ago, when a 6-year-old black girl refused to let me treat her when her mother brought her to the emergency room and left us alone. She insisted on being seen by a white doctor, leaving me feeling both embarrassed and humiliated."

This breaks my heart. Dr. Lumumba-Kasongo should be a role model for little girls everywhere, regardless of their race. However, our society has dictated that all doctors are white, and most doctors are men. When this theory transcends all genders and sexes, it will filter down to our youngest citizens - the future physicians. Will this concept discourage children from becoming a physician because their skin is a different color, or perhaps because they are a girl?

My personal experiences with physicians has always been fairly positive. I was brought into this world by a female physician who came to this country from England. She was my primary physician when I was a kid, and later as an adult, and I stayed with her until she retired. It was her compassion and competency that made me want to be a doctor when I was a kid. Later, when I lived in Denver, my primary care physician was male, but he was also African-American. He was one of the most wonderful doctors I have ever had the pleasure of visiting, and much of what I observed in his interviewing and examination skills I have carried with me to use in every clinical situation I have been in. I always felt like he was listening to everything I said, he never rushed off (I always got enough time with him), and his personality made me loyal to his practice even after my workplace changed insurance companies (I paid out of pocket to keep him as my physician.) However, I must admit, I don't think I have ever known an African-American female physician.

I do, however, know three strong, intelligent, beautiful African-American medical students, one of which is one of my best friends. M (I'm going to stick with that, as I don't know if she wants me to toss her name about) is one of the kindest, most hard-working, smart, beautiful women I have ever met. She's a gunner with a heart - any time I have needed help reviewing something, she's one of the first to offer to help me learn. I know that when she graduates, she will be highly competent, compassionate, and capable. Heck, I'd go see her, and would refer someone to her in a heartbeat. However, my heart breaks knowing there are those who will not judge her by the same criteria that they use among white male doctors, but based solely on the color of her skin.

Regarding the actual make-up of ethnicity in medicine, I can only speak from my experience. My class at school has the following breakdown (and I might not be totally accurate with numbers, so please forgive me in advance): 55% is Caucasian (including those of Middle Eastern descent), and 42% is Asian (I'm including the entire continent of Asia here, so this includes everything from Korea to India to the South Pacific.)The other 3%? We have a scant handful of kids who are of Hispanic and African descent - around 6, yes 6, students (that I know of off the top of my head - there may be a couple more Hispanic kids that I'm not familiar with.) This disparity is staggering.

According to the US Census information of Los Angeles County for 2004, 10% of the population describes themselves as being African-American, and 44% self-describes as Hispanic. However, our class has three African-American kids and three Hispanic kids... out of a class of 220. The proportion should be much higher, and reflective of the actual population of the county. However, that is not the world we live in.

So, my question is two-fold. First, how can we, as healthcare workers, and as the general public, overcome the reaction to stereotype a physician based on their genes? Does it matter if the doctor you see is male or female? Does it matter if they are white or brown? How does the public, and the health care field in general, view an Asian female doctor when compared to an African-American female doctor? One idea is to go out into every community to give not just one face to medicine, but to show that physicians are as diverse as the general population. Second, and this might seem silly but I think it holds some weight, how do we portray physicians on television shows and in movies? Watch "E.R." some night and notice that most of the actors playing doctors are good-looking, young, and white. There are only a couple of African-American doctors on TV ("Scrubs", "House, MD") and they are all men. Pop culture has a strong effect on kids (let's face it, most spend hours planted in front of the screen each day.) Can this be utilized to send a positive message to young viewers that not every doctor out there is a white male?

 Secondly, why do we continue to have uneven numbers of minority students in post-graduate studies? Is it a cost issue? Personally, I don't know of any medical students at my school who have their parents footing the bill - we are all digging ourselves into debt for the ideal cause of helping those in need. But of someone cannot get any Federal financial aid because their parents are not US citizens, or they cannot even afford to go to college, the chances of them taking up this path would be slim. Is it something that carries over from K-12? Is it our school system? Is it cultural? Do we need more outreach programs to inspire young minds - to kindle a love of science and an interest in medicine? I would love to hear from my teacher blog buddies (Mocha and T) as to what could be done to inspire more minority kids to pursue post-graduate education.