Charlottesville Reminds Us: We Must End Racial Bias in Medicine and Society

Earlier this year ACOG issued a Statement of Policy, originated in our Committee for Underserved Women, which acknowledges the many ways that racial bias affects our patients and colleagues. In the document, ACOG calls on all physicians to work together to create an equitable health care system that serves all women.

Reflecting on the recent events in Charlottesville has been a chilling experience for many of us, and brought to mind the, fortunately, very few experiences in my career where I was faced with racial and gender bias. In the mid-1970s, when I was a third-year medical student on General Surgery, I was assigned the task of a physical examination on a patient admitted for radical surgery for breast cancer. The patient promptly announced that she would not be examined by me because of my race. While not totally surprised to be confronted with this encounter at a southern medical school, I was surprised that someone with a potentially fatal condition was more concerned about my race than her disease and the radical surgery she was about to face.

The chief of General Surgery, when informed, entered the patient’s room on rounds and explained that he would have to cancel her surgery because she declined to have a member of his team perform her pre-operative physical examination. He could have assigned her to another team member but chose not to and gave this patient a choice. She agreed and I was assigned as the primary point of contact throughout her postoperative care until discharge. How the chief handled this event reflected his moral and core values and had a profound effect on my professional development because it taught me how to handle racial and gender bias, which I, in turn, taught to my trainees over the past 35 years.

The hate and bigotry on display in Charlottesville reminds us that we still have a lot of work to do in medicine and in society when it comes to ending racial discrimination and gender bias. We must continue to challenge them wherever they exist and encourage diversity at all levels of our profession from medical school to residency to practice to leadership positions for the benefit of our patients and society. Additionally, how can we ever achieve gender equity without ensuring women’s right to control their own reproduction in the United States and globally? The two issues are intricately tied. There is no place for legislative interference in the ob-gyn-patient relationship.

Recently, I had the occasion to attend a 50th anniversary commemoration for the Sri Lanka College of Obstetricians & Gynaecologists, along with past presidents Thomas Gellhaus, M.D., and Jeanne Conry, M.D. The highlight of the meeting was an address by Lesley Regan, M.D., D.Sc., president of the Royal College of Obstetricians and Gynaecologists, on the impact of the global gag rule on women’s health care worldwide. ACOG has opposed this rule for many years. Regan quoted in her presentation from the book by Nicholas Kristof and Sheryl WuDunn, “Women hold up half the sky.” She reminded us that in the 19th century we were confronted with abolition of slavery, in the 20th century racial discrimination, and in the 21st we must challenge gender inequity throughout the world.

I believe we, as obstetricians and gynecologists, must stand up against acts and policies that disadvantage women and show our patients that we will not tolerate any discrimination based on race, gender, color, national origin, disability, age, religion, marital status, sexual orientation, or any other basis. There is no neutral ground, and staying silent only supports their continuation and growth.

This entry was posted in Women's Health and tagged , , , , by Haywood L. Brown, MD. Bookmark the permalink.

About Haywood L. Brown, MD

Dr. Haywood L. Brown is Professor in the Department of Obstetrics and Gynecology at Duke University Medical Center in Durham, NC. He received his undergraduate degree from North Carolina Agricultural and Technical State University in Greensboro, NC and his Medical Degree from Wake Forest University School of Medicine in Winston-Salem, NC. He completed his residency training in Obstetrics and Gynecology at the University of Tennessee Center for Health Sciences in Knoxville, TN, followed by subspecialty fellowship training in Maternal and Fetal Medicine at Emory University School of Medicine/Grady Memorial Hospital in Atlanta, GA. Dr. Brown has participated in ACOG activities in District IV, V and VII over his 30-year career in Obstetrics and Gynecology. This includes being the Scientific Program Chair and General Chair (2001-2002) for the Annual Clinical Meeting. He chaired the steering committee for the District of Columbia National Institutes of Health Initiative on Infant Mortality Reduction, the Perinatal and Patient Safety Health Disparities Collaborative for HRSA and serves as the Chief Evaluator for Indianapolis Healthy Start. Dr. Brown is especially committed to the care of women at high risk for adverse pregnancy outcome, particularly those disadvantaged. Dr. Brown has served as Chair of CREOG and has been on the Board of Directors for the Society for Maternal Fetal Medicine and is past President of the Society. He is past President of the American Gynecological Obstetrical Society (AGOS) and Chair of the Ob-Gyn Section of the National Medical Association. He also served as a Director of the American Board of Obstetrics and Gynecology. Dr. Brown is past president of the North Carolina Obstetrical and Gynecological Society and is immediate Past District IV Chair of ACOG.

18 thoughts on “Charlottesville Reminds Us: We Must End Racial Bias in Medicine and Society

  1. Great blog and completely on point! We all have a responsibility whether it directly effects us or we witness biases directed toward others to address it in the present.
    Thanks for your insight and leadership!

  2. Dr. Brown,
    I respect and acknowledge your voice and statement. I will endeavor to uphold the values of racial and gender equity espoused in your statement. As an OB/GYN white male, I promise to endeavor to practice and live by your example.

    Dr. David Linton, DO FACOG

  3. Racial Bias exists in every day functioning of health care. I have personally experienced it for the last several years. My horrifying discriminatory and harassing experience at Sharp Mary Birch Hospital for Women and Newborns in San Diego ended my career. It is very easy to say to end Racial bias. In reality, it is not easy to create personal change and accept diversity. The existence of racial bias among physicians is a stain on our noble profession.

  4. Thank you Dr. Brown.
    Enough already!
    This nonsensical, sick belief in the superiority of one race over all other races would be funny if it wasn’t lethal as well as impossible to get rid of.
    The normal, sound thinking, none racist Americans would start shouting their objections to racism at the top of their lungs if they knew how much distain and ridicule the rest of the world have for America’s racist culture.
    I am angry, sad, sick and tired of it.
    Oh, btw, where are all the “I’m in agreement and outraged solidarity” responses/comments to this restrained, eloquently but on point dissertation on racism in America?
    The silence is deafening unless I just don’t know how to access them .

  5. Excellent blog. Thank you for reminding us all to continuously check ourselves and make the difficult moral choices needed to make a difference vs. the easy path of conformity. Character is truly a reflection of our many decisions including the one to remain silence and do nothing. Thank you so very much for your leadership in such a time as this.

  6. I would like to hear Dr Brown’s response on how his ethics, and in particular regarding gender equality, translate into a response to the same example of a woman with breast cancer who only desires a female examiner, or if a religious belief dictates to her conscience who should examine her and, ultimately, who places themselves as the judge of knowing her heart. In his example, if race was the issue, his mentor did the right thing. Using Charlottesville however as a springboard to uncategorically label our society as gender biased is both uneducated and harmful. Just as bigotry and racism suppress equality and rights, so too does engaging in blanket aspersions of our society. If there is substantive inequality of any kind, call it out by fine detail and back it up with data that can be refuted or challenged, for without which such can only remain opinion.

  7. Excellent commentary. As an African American semi-retired obgyn(currently Medical Director at Meherrin River Regional Jail in Alberta,VA) the diaspora of being black in white coats has not eluded me either. I suspect Dr.Brown had the lady given you a chance to have a dialog regarding her medical challenges she would have changed her mind.Even my hardest clients(skin heads in the correctional system) open up when knowledge is confronting ignorance 🙂
    Dr.Michael D.Brooks FACOG

  8. So moved to see Dr Brown in his position. Remember well being a second year resident in the 1980s at Charity Hospital and our new MFM attending showing up in community “Labor Room 5” at 3am and my shock “What are your doing here?!” because you yet didn’t see attendings at that hour :). A great leader.

  9. Dr. Brown very well written and inspiring to know that you’ve made an awareness in the Medical Arena as well. Too many times lack of knowledge toys with mindless people and often destroys the reality that a person is a person that one day could save a life. I’m sorry that you had to endure that ignorance at medical school but glad that you learned from it.

    We could use you to be an inspirational speaker at one of our conferences!

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