Barrier-Breaking Doctor Says COVID-19 Exposed The Need For More Black Physicians In Healthcare

The year 2020 will forever be marked for the way it changed American life forever. With the spread of COVID-19 at the start of the year, shown to disproportionately affect black and lower-income communities, and the protests and outpouring of solidarity for the African-American community in light of the brutal murder of George Floyd by the hands of Minneapolis police, we are witnessing an important tipping point.

Now more than ever we believe it is important to amplify the voices and stories of women who are beating the odds to rise up to levels of leadership where they are changing their communities for the better. One of those women is Dr. Ashley Denmark, a barrier-breaking physician from Missouri who is using her experience to make way for other young black physicians who are sorely lacking in the US healthcare system.

Dr. Denmark was born and raised near Ferguson, Missouri. Her journey into healthcare began as a senior in high school with her first job at BJC Hospital as a dishwasher. Dr. Denmark went on to earn a Biology Degree from Spelman College, a Masters of Neuroscience from Tulane University. In 2015, she became one of the first African American females to graduate from The Edward Via College of Osteopathic Medicine in South Carolina. In 2018, Dr. Denmark returned to St. Louis and joined the BJC Medical Group and became the first African American Female Family Medicine Physician at Missouri Baptist Medical Center, since it’s opening in 1884. Dr. Denmark is passionate about increasing minority doctors in the medical field and launched Project Diversify Medicine in 2015. This platform has grown to a community of over 30,000 aspiring black and brown doctors who receive daily education and inspiration from Dr. Denmark on how to become a  doctor. Dr. Denmark is also a children’s author who wrote Olivia’s Doctor Adventures which teaches children about various types of doctors.

We spoke with Dr. Denmark to talk about the need for more minority doctors, the impact of COVID-19, and why more young black girls and boys need to be encouraged to aspire to become medical professionals.

Can you tell us how your regular work schedule has been impacted by COVID-19 and how you deal with patients? 

As a family medicine doctor, we normally see an average of 18-20 per day in person. But now with COVID, we’ve had to alter our schedule in how we interact with patients and do so virtually through telemedicine. Telemedicine has been around a while, but that’s the norm for how we do things in family medicine. But for now, I’d say the majority of my visits are done through telemedicine. However, we do still have to come into the office, and it’s a much different scenario. I have to use a respirator mask, face shield, gowns and gloves all of the time, which isn’t our typical routine. We’re having to wear PPE and make those changes and take serious precaution. It’s a strain, but we’re learning to adjust. 

As a barrier-breaking physician, you are adamant about seeing more doctors from the African American community, and black women in particular. Why is this important?

I think the pandemic itself is a reflection of not having enough minority doctors. One of the factors on why the pandemic is impacting the black community so much is because we haven’t had minority doctors go back into the community to work. We see the research studies that show us minorities are willing to go back and work in underserved communities that need care, and not run to suburbs or already densely populated areas that have more enough hospitals and clinics. But they’re actually willing to put in the work and go back to these communities. So, when we have communities, like the community I grew up in in North St. Louis, that doesn’t have easy access to a primary care provider, you see chronic conditions have a perfect place to set up and run uncontrolled. So, when pandemics like this happen, they’re more vulnerable. I advocate so much that we need to have more black and brown doctors because we know that we can provide the care that our community needs, we can save our community, literally. 

But that also goes back to the importance of making sure all of our doctors across the board are culturally competent. If they haven’t experienced what it means to be black or Latino in America, they may not be able to understand why that patient wasn’t able to come into the clinic that day or chose to get their rent instead of their medication because of financial hardships imposed upon them because of the racism that’s been placed in our society. As a black doctor, I find myself often times having to educate my white physicians about what a patient is experiencing. Not because they’re “non-compliant” because they don’t care. Understand what’s happening on the back end: the medication you prescribed is costing too much. They can’t afford a $400 medication that maybe someone in an affluent white community can. You have to look at that whole person. Overall, we need more minority doctors in leadership to make sure our communities can be prioritized and be at the table to teach everyone how to provide adequate care to our communities.

We are seeing a disproportionate amount of black and brown people across America being affected by COVID-19 and there are a number of reasons being touted, from poverty, to racial health disparities, food deserts, education and more. Can you shed some light on what is real and what is not?

I think those are very much so the social determinants that are driving why we’re seeing Covid-19 impact black communities more. Marginalized black and brown communities just don’t have the same access to the resources that we need to have the actualization of what most white Americans have.

I feel that’s the social structure in place now in our society, and the policies that have hindered us from upward mobilization. We’re told to “boot strap” our way up. I used to work as a dishwasher, in the same hospital system I work in now as physician. And when I mention that to someone from an affluent or white community, they’ll tell me oh I was a dishwasher too. But what they don’t understand is, my boot strapping is a little bit different from their boot strapping, because they may start off there, but they’ll still get to an opportunity quicker than I will.

I lived in the food deserts. I lived in those areas without access to healthcare. I wasn’t told you can go to Harvard and here’s how you can do it. There’s an end date to their bootstrapping, our bootstrapping seems like it lasts a lifetime. It’s so unfortunate that our community is constantly overlooked in terms of resources, but then they frown their nose down and say, well you should be here despite your obstacles. They see one black person who made it, and think you can make it, too. I think it’s that tokenism attitude that one black person making it means everyone will make it, that limits people from really seeing the wide picture that the racism and oppression that exists in our communities and society is holding us back.

So, when you have a community that is deprived of simple necessities, like food, water, healthcare, educational systems, of course they’re falling into a category of maybe not being able to land gainful employment and a high paying job to get the benefits I need to take care of my health. And then we see they fall further down into essential workforce where they’re forced to work long hours for less pay, then when things like COVID-19 happen, they can’t go get the healthcare that the need or stay home from work, because again they were never given the resources or the tools to be able to obtain the same success.

This all plays a role in why COVID-19 is affecting our communities so much. We started off with so little, we were not given the resource to be successful or have the actualization of the American dream. And now we’re asking why black and brown are so affected by COVID-19? We need to start asking what are the solutions in place that we can fix and address this because we are the essential workers, staffing the Targets, the Whole Foods, and our society allowed for that disease to fester in African American communities, but it’s going to spread right to affluent communities next. We have to understand this is going to bring us all full circle and force us to understand that we are one and we need to come together in order to bring ourselves up. 

As a doctor, how does it make you feel seeing some Governors and legislators advocating for focusing on the economy at the expense of people’s lives, without more emphasis on the need to address the systemic problems first (as well as working to find a vaccine for the virus)?

Two parts. For me, seeing these leaders, who tend to be white male and have benefited from a society that’s run by capitalism, they’re looking at how it’s impacting them. And so, for me it’s frustrating to see that people are saying they prioritize an economy over human life. Or when I hear [Former New Jersey] Governor Christie say we’re going to have to lose some lives to open an economy. For him to actually say I value money over human life is so concerning.

People are not willing to hear the experts, the people who went to school for years and years on this subject, like Dr. Fauci. And to sit there and say “I prioritize the economy over you, I’m not going to listen to your expertise, because my bottom line affected right now”, instead of looking at the big picture that this will directly impact the economy, it’s mind blowing to me. I feel that people need to listen to the doctors, the experts, the scientists, who understand that once we reopen, we’re going to have a surge again. This disease is very contagious. We don’t have vaccines. We don’t even have enough masks and gowns and goggles for our own clinics. No one even asked us, “before we open should we make sure that our doctors have enough PPE?”. No one cared about that.

We can’t have an economy if we don’t have healthy people to drive the economy. And then this will happen again, and we’ll be right back to square one. My thought process as a physician is like let’s do this thing right once, let’s not keep having resurges if we can prevent it. We can’t give this false sense of hope or security that we’re safe to go out business as usual, when we know how this disease spreads. I urge every single leader to talk with the experts and see that this is the same incident that happened with the Spanish flu when they lifted the ban too early, unfortunately. 

It’s not just healthcare workers, but delivery workers, grocery store staff and more who are helping to keep up sustained right now, and many of them are African American. What do you think COVID-19 is teaching us about poverty and race in America right now? 

I think it’s teaching us that these communities are historically overlooked. When they were asking for $15 an hour, it was no we can’t do that, but now we’re asking them to sustain us during a pandemic and risk their lives and bring it back to their family and community, risking their lives too. But pre- pandemic, they were saying we don’t want to give you a raise. But I think it shows how we’ve always been the backbone of America keeping this country together, and I think it’s time that we finally get the equal footing and the same opportunities as other communities.

We have to start waking up and understanding that there is a problem with racism in this country. There is a problem with how we’re handling the lower economic tier in this country. We can’t keep saying it doesn’t affect me. You’re going for a walk in your park, enjoying work from home, but others are living completely different lives, and you disconnect. But my family and a lot of my patients are from North St. Louis so I can’t disconnect. You can’t stay in that bubble; you have to wake up. Poverty is playing a big role in this, and exposing how it’s been such an ignored issue, and we cannot ignore it anymore.  

How can we as individuals stay healthy and positive during such an uncertain time like this? 

One thing we can shine a light on is that 80 percent of people who get coronavirus get better. When we look at the news or the numbers, we see death tolls and that makes us think if we get it, it’s an automatic death sentence. It’s not, even though especially in the black community it can cause more harm, but there are plenty of people who do survive coronavirus.

Second, is making sure we’re in tune with our health. Growing up I didn’t even know what a primary care doctor was. I always said I wanted to be a pediatrician because that was the only doctor I ever saw. So, of course when I got into the real world, I realized there were other types of doctors. One thing we have to do is start teaching our family, our children, about connecting with our doctors and prioritizing their health. And even though things might feel fine today, you still need to check in every year, even if you don’t have a known history of anything. And if you do have a known history of something, please make sure you’re following up with your doctor regularly, especially during these times.

As a primary care physician, I sometimes change my regimen to accommodate all patients. Don’t ever feel like you can’t share with someone your struggles or what’s going on, because it’s our job to make sure that you’re staying healthy. Anybody with high blood pressure, diabetes, chronic lung condition or obesity, please touch base and get with a doctor if you haven’t already. Also, keep social distancing. It’s very difficult, but we have to understand that this is the best way to keep each other safe. 

Lastly, make sure you’re doing self-care and establish a new routine. A lot of us are having to do different things now that kids are home etc. Make sure you’re taking time for yourself, even if it’s 30 minutes at night listening to music. Make time to do something every day that you enjoy, so that you can keep that stress from causing more health problems. 

How do you hope our healthcare system will potentially change (for the better) as a result of COVID-19?

I’m hopeful that this will change to a more physician-centric healthcare system. Right now, I think it’s exposing the leaders in the healthcare system, those running the big insurance companies, hospital admins still getting quite a lot of money, but we need to start including everyday physicians in these conversations. They need to reflect what our society looks like. We need more diversity. This pandemic is exposing that we need to diversify this white administration role in healthcare We need more women, minorities at these tables discussing our healthcare, so that they can make sure that everyone is included.

Tell about how you are mentoring up-and-coming black doctors through your advocacy and social media? 

I started Project Diversify Medicine back in 2015, when I was still in my residency program training to become a family medicine doctor. There was not one doctor that looked like me when I walked down the hallway. And I realized the value of community and getting more of us here into these spaces, so that’s when I started the Instagram account, Project Diversify Medicine. It started off with just a few people and now it’s over 34,000 aspiring black and brown doctors who are all eager to learn about how to become doctors and are wanting to get into healthcare. The one thing that we learned about why a lot of us are kept out, is because many are not getting resources on how to become doctors. A lot of us are told we can’t do it just because of the color of our skin. I remember being told that I couldn’t get into med school even though I had a high GPA. It’s the fact that when we are trying to pursue these white coats, we are told no by people are willing to say yes to someone who has white skin, and that’s not fair. We must advocate for more of us at the table. It has been proven that minority patients are more comfortable with minority doctors, but they can’t find minority doctors, and that’s a problem. And the fact that only 2% of doctors that look like me is a huge problem. Because if it was the reverse problem, where only 2% were white male doctors, I promise there would be an uproar.

We’re just saying we want equality. I’m asking that at the end of this pandemic, we see that we need to start from the ground up. Making sure that our children know that they can become doctors, and that’s what my book “Olivia’s Doctor Adventures” which teaches children about various types of doctors, is about. Start teaching them what it means to be neurosurgeon at 4 years old. Just like they do in affluent communities, let’s bring it into our communities. Let’s stop telling them it’s too soon to talk about that, or they have to wait until they get to college. Let’s start when they’re in elementary school. Had I listened to all the people that told me “no”, I wouldn’t be here.

Finally, what makes you a powerful woman?

I think being able to wear so many hats and being a mom through it all. When I started this journey, I wanted to be a doctor, but I wanted to be a mom too, and I never imagined blending them together for some reason. They were always separate in my mind. And in my case, I ended up going to med school pregnant, so I was kind of forced to blend the two together! But I think it’s powerful to see that my actions not only influenced the outside world but influenced my children. They have so much confidence, more confidence than I had growing up myself. I was a very shy, very timid, very scared to even say what my dreams were out loud. Seeing my children manifest, saying “I want to do this, I want to be this”, is encouraging. My daughter started her own literacy campaign because she saw me doing stuff. And it just blows my mind because when I was growing up, that was not my life. My life was filled with vacant homes, seeing drug deals, cops etc. And to see the power that a black woman like me could have by dreaming out loud, it has now enabled another generation of my family to go higher than I ever imagined and it’s really powerful to see.

 

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