Black Male Doctors Needed Stat: A Medical Emergency in Health Equity and Outcomes

In 2020, for the first time ever, the U.S. saw a decline in the percentage of people who identify as white. And, by 2065, it will not have any single ethnic or racial majority.?

This trend has massive implications for the workforce, particularly in the world of medicine where growing evidence suggests that a greater diversity of healthcare providers leads to better outcomes. And, today, as we continue to see racial and ethnic minority groups disproportionately affected by COVID-19, we can envision the difference this trend has the potential to make.?

Yet, as the racial and ethnic makeup of our country shifts, and the recognition that diverse and inclusive organizations are more productive, creative and innovative becomes more widely accepted, progress for one major demographic group—a group that is particularly important in Temple University’s home of Philadelphia—has long been stalled according to one extremely significant measure.?

The number of black males enrolling in medical schools has only just started to rise after more than 40 years. While the rise is welcome, much more work still needs to be done. According to a 2015 report from the Association of American Medical Colleges (AAMC), Altering the Course: Black Males in Medicine, there were 542 black male matriculants in medical school in 1978. According to the latest AAMC data, the number started to increase over the last few years, with the most recent data showing 813 Black male matriculants in 2021. Still, black men only account for 3.6% of all matriculants, and approximately 3% of applicants and enrolled students.?

And among the physician population, only 5% of physicians are Black—including both men and women. This is in spite of the fact that Black people make up approximately 13% of the U.S. population.?

This raises some serious questions.?

First: Why??

Second: What can we do to ensure there’s continued movement toward equity for this group at a time when their talents are needed more than ever??

The financial burden?

The sticker price for a medical degree is certainly high—and rising—but the cost of tuition may be especially prohibitive for Black students.?

A 2013 study out of the Mailman School of Public Health at Columbia found that Black students—to a greater degree than members of other groups—enter the medical school application process expecting to graduate with more than $150,000 in debt. That amount would be even higher today.?

The alarming racial disparities in wealth in the U.S . mean that Black students are more likely to come from families who cannot help financially. The Mailman School study noted that anticipated debt may help explain why becoming a doctor is considered a high-risk goal even for high-achieving Black students.?

But the fear of anticipated debt is actually only one piece of the puzzle. Add to it that limited financial aid is available for all students in the medical and health professions and that many Black men lack a network to help them identify existing scholarships, and you get a more complete picture of the financial burden Black men face when considering medical school.?

Lack of networking and role models?

The scarcity of Black male doctors translates into a vicious and self-perpetuating cycle. Fewer and fewer role models for young Black men and fewer networking opportunities available for those who do decide to pursue a medical degree mean that Black youth often lack a robust network to help them navigate the road to medical school or even just identify others who have been through it all to provide moral support.?

And, once in medical school, Black men may feel isolated. When they look around, they see so few who look like them, who are joining them on their journey, or who can mentor from a place of shared experience as they traverse the ups and downs of their professional careers.?

Steuart Wright, a second-year student at the Lewis Katz School of Medicine, is familiar with this feeling.?

“I’m proud to be here at Temple, where the number of Black men in medical school has increased significantly over the last three years. But at times, I still wonder if I belong here when I see very few Black men working as professors, physicians and/or administration. So, while our number has grown, it is not the time to stop advocating for change and inspiring younger Black men to pursue medicine.”?

Public perception and social expectations?

Black men also face bias and negative stereotyping. In fact, those interviewed for the 2015 AAMC report noted explicitly that public perceptions and images of Black men have an adverse impact on their educational progress and career outcomes.?

They specifically referred to the claim—actually a debunked myth —that is nevertheless frequently cited in the media: “there are more black males in prison than in college.” The interviewees explained that being bombarded by negative media portrayals and lower expectations fuels a self-fulfilling prophecy.?

Cedric Bright, interim vice dean and professor of internal medicine at the Brody School of Medicine, described the influence of negative expectations on career ambitions. “From the perspective of Black boys, when they first come into school, [they] have very similar aptitudes and aspirations as all other students,” said Dr. Bright, “but somewhere between … third grade and the fifth grade, there is something that occurs to them [and] they become consciously aware of how they’re being treated or how they’re not being treated, which then starts to change some of their expectations and even their aspirations for what they feel that they can achieve.”?

What can we do?

First, universities have a decision to make.?

At Temple University’s Lewis Katz School of Medicine , located in the heart of a predominantly Black and African American community, we recognize our responsibility as an urban medical center to provide our neighbors with the best possible clinical care.?

That’s precisely why we are strategically focused on increasing the number of Black men in our medical school pipeline.?

Increasingly, the idea that health is determined by social factors, such as one’s neighborhood or built environment, access to nutritious food, education, economic stability—and even personal and cultural values, beliefs and behaviors—is becoming widely accepted among the healthcare community.?

And it’s also now commonly recognized that the ability of providers and organizations to understand and integrate these factors into the delivery of healthcare is necessary to address racial and ethnic health disparities.?

A 2004 report from Georgetown University’s Health Policy Institute noted that a culturally competent healthcare system is critical to improving health outcomes and addressing health inequities among a diverse population of patients. The report stated that under the current system, African Americans and other ethnic minorities describe lower levels of partnership with physicians, less participation in medical decisions, and lower feelings of satisfaction with their care. Members of these groups likewise believe they would receive better care if their physician were of a different race or ethnicity.?

And many other studies support this finding. One from 2018 found that patients are more likely to follow their doctors’ orders if they feel they share similarities with them , and that race concordance is a primary predictor of perceived similarity. These patients report higher levels of trust and satisfaction with same-culture physicians, and the medical visits even last longer—by 2.2 minutes, on average.?

And higher levels of patient satisfaction may be leading to better results. A study by the National Bureau of Economic Research found that when Black men were treated by Black doctors, they experienced greater trust in their care and correspondingly agreed to more preventive procedures than those seen by non-Black doctors.?

Here’s the payoff: the researchers forecast that a workforce consisting of more Black doctors could significantly improve health outcomes for Black men and lead to?

• a 19% decrease in the Black-white male gap in cardiovascular mortality.?
• an 8% decline in the Black-white male life expectancy gap.?

All of this means that if we are going to start making a dent in the troubling health disparities we see in our region and our country, we need to increase the diversity among our medical students, professors and providers … across the board.?

If we do that, everyone benefits: In fact, studies also show that all students trained at schools with a diverse faculty and student body are more comfortable treating patients from a wide range of ethnic backgrounds.?

A call to action?

As the nation diversifies, universities need to recognize that lack of diversity in healthcare creates far-reaching consequences and leads to negative health outcomes for Black Americans, in particular. Medical schools and universities with healthcare systems have a critical role to play. They must invest in programs that target Black male students, and they have to start now.?

Since 2019, the number of Black male students enrolled at Temple’s medical school has increased significantly. We are witnessing this historic shift and moving the needle in the right direction by focusing our efforts.?

For example, at the recent “An Evening for Black Men in Medicine” event at Temple’s Katz School, dozens of Black male college students were connected with Temple-affiliated Black male physicians and medical students. We hope to continue our upward trend by providing this kind of space for conversation and networking opportunities.?

In addition to creating networks that attract and support these young men, we must better direct applicants to sources of financial assistance that are not currently apparent or easy to find.?

As well, training the wider workforce on diversity, equity, inclusion, and belonging concepts that celebrate the unique expertise that these young men can bring to their practices is also part of reversing the broader trend.?

“Black males are one of the most underrepresented and untapped resources in the field of medicine. Medical schools need to ensure our students feel supported throughout their academic careers and beyond,” said Albiona Berkeley, interim senior associate dean of diversity, equity, and inclusion at the Katz School of Medicine. “Now more than ever, it is essential for us to develop the necessary programming to sustain and grow the number of Black men in medicine.”?

That’s what we are working toward here at Temple, across all underrepresented groups.?

“Diversity within the Lewis Katz School of Medicine is a strength. We know and understand the significant impact that the social determinants of health play in illness and disease,” said Amy Goldberg, interim dean at the Katz School of Medicine. “This experience lays the foundation for our commitment to developing cultural competency in our students to grow into inclusive and equity-minded physicians and scientists.”?

We must produce physicians from all segments of our society. This in turn will improve our ability to positively impact the provision of healthcare and outcomes for our increasingly diverse population.?