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White III '57 P'98 reveals racial bias in medicine and care

Augustus White III '57 P'98 is no stranger to breaking down racial barriers.

In 1961, White was one of only four black graduate students at Stanford University. He went on to become Stanford's first black medical school graduate, as well as Yale's first black resident surgeon and the first black department head at Harvard's medical teaching school.  

Born and raised in Memphis, Tenn. during the Jim Crow era, White witnessed dramatic changes in the nation's attitudes concerning race over the course of his life.

He recently published a book titled "Seeing Patients: Unconscious Bias in Health Care." The book highlights inequalities in the field of medicine that result from conscious and unconscious bias, he said. Part memoir, part research, it is told through both White's personal story and the lens of medicine, he added.

"One of the lessons I've learned from medicine," White said, "is how common humanity is."

Yet innumerable articles, reports and personal stories reflect discrimination in today's medical education, patient treatment and workforce.

Certain minority populations are 50 percent less likely than non-minorities to receive pain medication after arm and leg fractures, according to White.

"There is no sign that said, ‘Don't give any black people any medication if they come in with a broken bone,' " White said, but "there are still examples of residual bias."

For White, much of his perspective relates to "how people react to me as an African-American male in certain settings." Yet even he was surprised by the "extent and prevalence of the disparities which affect so many people."

"Doctors who really thought they were not prejudiced … were shocked to find out that they had treated black people in a disparate manner," White said, referencing the results of an implicit association test.

Several other studies confirm these disparities and reveal that patient treatment is not the only area still mired in racial biases.

U.S. physician demographics do not reflect the country's racial composition, according to a 2010 Association of American Medical Colleges report. For example, blacks make up 12.4 percent of the country, but only 6.3 percent of all physicians, according to the report. For Latinos, the imbalance is even greater — 15.8 percent versus 5.5 percent.

Why the disparity?

One reason may be the long history of systematic racial discrimination in the medical field.

By the end of the 19th century, two medical organizations had emerged, reflecting the country's blatant racism: the exclusively white American Medical Association and the predominantly black National Medical Association.

In 1910, a report commissioned by the AMA recommended closing seven of nine black medical schools, leaving even fewer options for black medical students, according to a 2008 Journal of the American Medical Association article.

As late as 1961, during the black freedom movement, the AMA refused to defend eight black physicians who had been arrested for requesting service in the whites-only section of an Atlanta hotel during a medical society luncheon, according to the Journal article. It was not until 1964 that higher education was forced to desegregate, and not until 1965 that segregated hospitals were banned by law.

Although racial segregation is no longer sanctioned by organization or law, disparities continue to exist.

Only 7.5 percent of medical school faculty are minorities, according to a 2009 AAMC investigation.

Faculty positions for people of color are "very, very rare," White said.

White highlighted the importance of mentorship in his own success.

After serving as an army surgeon in Vietnam, White met William Montague Cobb, a physician at Howard University, who was also head of the NMA for over 10 years and chair of the board of trustees of the National Association for the Advancement of Colored People.

"Cobb thought it was important to help others, to give opportunity to more African-Americans if you were in a position to do that," White said.

In 1986, White was in such a position at his own alma mater, Brown, where he once studied psychology.

White served on the Blue Ribbon Committee, an external review of minority education and student life at Brown. The committee was formed after students occupied the John Carter Brown Library, protesting the University's failure to meet previous demands for increased student and academic diversity.

This committee published a report titled "The American University and the Pluralist Ideal," in which several recommendations were made to address minority student concerns. These recommendations resulted in the hiring of the first full-time Latino dean and an increased effort to recruit minority faculty in each academic department, according to a 1986 article in The Herald.

The University followed all but one of the committee's recommendations: that students be required to take at least one course that relates to a minority issue, according to White.

White said the University's response was, "sounds like a good idea, but remember — we have no required courses."




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