DIVERSITY & INCLUSION
WHO AM I TO LECTURE ? AUTHOR Mike Imburgia , MD
Who am I to lecture about racism in health care ? After all , I am an older male physician with lifelong white privilege .
Well , there was that one time … when I was a kid growing up in rural North Carolina in the mid-1960s . We relocated there from a rural community south of Chicago . The move to that part of the country was eye-opening . I volunteered to be the high school track manager , and I remember the best athletes were Black . They brought recognition to the school yet there was a separate “ colored ” water fountain . I could tell you that my dad opened a factory in that rural community and got into all kinds of trouble for hiring Black workers .
Those experiences don ’ t make me an expert on race relations . I haven ’ t felt the pain of being a person of color . However , for the past 13 years I have been the Medical Director of Have A Heart Clinic in Louisville . I have spent a great deal of time communicating to our community about all kinds of disparities in health care , from patients with multiple medical conditions to disparities based on wealth , on insurance status and most definitely those based on race . None stands out more than the health care disparity based on race .
Statistically , a poor Black man will live a shorter life than a poor white man ; and a wealthy Black man will live a shorter life than a wealthy white man . Because of the disparity in deaths that are announced daily during the current pandemic , showing that people of color are dying disproportionately , the general public , including youth , now sees more clearly the marked disparities related to morbidity , health care and racial background . I have become more inspired to take advantage of the public outcry on this crisis , to come up with a way in our community to address it .
This is implicit bias in American health care . It has been around for years , yet I am shocked that many of my colleagues continue to say , without proof , that it does not exist in their practices . I don ’ t believe this is outright racism with malicious intent , but it is systemic racism and implicit bias . Many current health care professionals , practices and facilities are serving minorities at disadvantages . There are many things that we have grown up with that allowed racial bias in our decision-making .
I believe providers mostly want to do better by those with illness and they respond well to data . But recently , everywhere we researched to get racial data we were told they didn ’ t have race data and didn ’ t know if they could get that data . But isn ’ t that part of what new age advantages like electronic health records offer ? Isn ’ t that part of the data capture that is shared with insurers ? Maybe it ’ s not that they don ’ t have the data , they just don ’ t want to look at the data . But the data is key . How can we move forward if we don ’ t know for sure where we are ? More importantly , how can we change if we don ’ t believe there is a problem .
In my position at the Have A Heart Clinic , I make sure we have our own separate database and I am not afraid to share our results .
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