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This year our theme for Black History Month (BHM) is Reclaiming the Narrative - an opportunity for every member of the Black community to take part in shaping how our stories are told and ensuring that the complexity of our experiences is fully represented. In this blog, we aim to understand the root of the current narratives surrounding Black medical professionals and patients, and advocate for a new, empowering narrative that truly reflects our contributions and challenges in the NHS and wider healthcare organisations.
It's essential to recognise that the experiences of Black patients and doctors are not monolithic; individual narratives vary widely based on factors like socio-economic status, geography, and personal circumstances. By incorporating diverse stories and testimonials, we can paint a more accurate and nuanced picture of the challenges and triumphs within our community.
Reclaiming my Health: The Narrative on Black Patients
Black patients have historically been subjected to systemic biases that have distorted their healthcare experiences and compromised the quality of care they receive. These deep-rooted issues have created barriers to equitable treatment, highlighting the urgent need to reclaim and reshape narratives around Black health and well-being. As someone invested in this field, it's painful to witness how these deep-rooted issues continue to create barriers to equitable treatment.
Historically, black patients have had to endure a challenging healthcare experience due to silence, mistreatment and unmet needs. Biassed diagnostics, disparities in treatment, dismissed concerns and minimised pain has shattered the patient-provider trust leading to hesitance in seeking care. There must be a shift in narrative, a focus on movements that empower black patients to advocate for their health and mental well-being. We applaud the initiatives that are aimed at increasing awareness of conditions that are rampant within black communities. These initiatives, such as Black Minds Matter UK, give all black patients the ability to tell their stories, to illuminate the disparities in their perception of pain and health outcomes - to truly be heard in a system that systematically ignores their needs. If this silence within healthcare is not addressed, it leads to unwanted outcomes, greater risk of misdiagnosis or inappropriate treatments.
The challenges Black individuals face in accessing mental health services are rooted deeply in systemic barriers and cultural stigmas, as shown in a qualitative study from Southeast England. This study detailed two major themes that influenced access to mental health services. The first was the inability to recognise and accept mental health problems, and the negative perception and social stigma against mental health. Moreover, the inadequate response to mental health needs as well as the lack of understanding and sensitivity to cultural differences towards black services users and the lack of awareness of the different services was highlighted. There is a dire need for improving information about services and access pathways, with healthcare providers being provided relevant training and support in developing effective communication strategies. This can be done by developing resources in multiple languages and training being provided specifically on cultural sensitivity. The information on access pathways should be given in a format that explains the process simply and step-by-step. Moreover, regular opportunities to give feedback should be introduced so that patients have the opportunity to have their opinions heard and acted on by providers refining their communication approaches accordingly.
This study highlighted to me the need to reshape the narratives around mental health, to encourage open discussions about the topic in black homes, communities and in the hospital to destigmatize seeking help. Moreover, I find it essential to promote culturally relevant mental health resources to ensure Black communities are aware of where to seek support, allowing them to navigate the healthcare system more effectively. By reclaiming narratives around mental health, we can create a more inclusive dialogue that de-stigmatises seeking help and addresses the specific needs of Black individuals. I believe that us as black medics have a crucial role to play in this by leading these conversations, advocating for mental health awareness, and being visible examples of the importance of seeking support. This shift is critical for encouraging greater engagement with mental health services and empowering communities to take control of their mental well-being.
Overall, I believe there is a need to reclaim the negative narratives that form the experience of black patients in healthcare. The empowerment of black patients and an increase in education and awareness of their rights and services available is essential to address their needs and how they are viewed. Moreover, culturally relevant training for healthcare providers is crucial for improving communication and trust between patients and their doctors. To address the disparities in healthcare outcomes, all black patients should be encouraged to share our stories and challenge existing biases, in this way we can advocate for our own health which can lead to systemic improvement in healthcare practices and policies.
As we explore the barriers that Black patients encounter in the healthcare system, it's crucial to recognise that these challenges extend to Black medical professionals as well.
Reclaiming My Profession: The Narrative on Black Doctors
We will also take a deep dive into the narratives that have been placed on black doctors in the professional environment. We will look at challenging the negative historical perceptions to promote equity within the medical field.
As a Black medic, I've seen firsthand how deeply ingrained stereotypes can affect not just my career but my daily interactions with colleagues and patients. Throughout time, black doctors have been perceived as less competent or qualified than their white counterparts. These harmful stereotypes persist within medical institutions such as the NHS, undermining the confidence and credibility of black professionals. Moreover, as a black medical professionals, we often experience mistrust and scepticism from our patients solely based on the colour of their skin. This can lead to a breakdown in the patient-doctor relationship further complicating our ability to, as black doctors and medical students, provide effective care. From microaggressions to overt racism, these experiences of racial discrimination faced by black doctors can create a hostile work environment leading to stress and burnout which can ultimately impact career progression.
It was reported that black surgeons were 27% less likely to be promoted than their white colleagues between 2016 to 2020, with black women being 42% less likely. As someone navigating this field, these numbers hit close to home. It’s disheartening to know that even with hard work and dedication, many Black doctors may likely face significant barriers to career advancement. For me, and for many of my peers, the lack of Black representation in senior roles is more than simply a statistic but impacts the way we see ourselves and our future in medicine. Initiatives such as the Melanin Medics SurgIn: The Lewin Programme have been pivotal in supporting black medics reach these career milestones. A lack of black representation in higher roles within medicine can cause a suffering in treatment of patients, when those in charge don’t reflect the diversity of the population, important perspectives are often left out of the conversation.
In this case, it is thus crucial that we, as black healthcare professionals and students, share our personal narratives to highlight the experiences of racism and discrimination within this system but also flip the script and showcase the stories of black doctors who have successfully navigated their careers despite barriers, serving as role models for future generations. It is also crucial that representation of black doctors in leadership positions is increased, with increased efforts to create a more inclusive environment where diverse voices are heard and valued.
While it's crucial to address systemic issues and challenges faced by Black patients and doctors, highlighting success stories is equally important to inspire hope and resilience. In my own journey, seeing Black professionals make strides in medicine and witnessing the impact of community-driven health initiatives has been a constant source of motivation.
Celebrating achievements within the community, such as advancements in health initiatives or notable contributions by Black professionals, can motivate others to engage and advocate for positive change.
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