More Black Doctors could close the disparity of care gap of COVID-19

Disparity of care is thought to be one of the leading causes of why Black people have worse outcomes not only with COVID-19, but with all other health conditions in comparison to whites when it comes to medical care. 

What if there were more Black doctors?

While watching the James Baldwin vs. William Buckley Jr. debate at Oxford in 1965, Buckley brought up the Black doctor and how presently in the 1960s, the number of Black doctors had dropped in comparison to the turn of the 20th century. Buckley used this point to attack the Black Community suggesting an individual and collective failure. 

I have often wondered about this subject.

 In early 20th century African-American literature, the Black doctor was prominently featured.

The doctor shows up in Charles Chesnutt’s “The Marrow of Tradition” in 1901 and in “Of One Blood” by Pauline Hopkins in 1902 as the 20th century continues this character becomes less of a central theme in African-American literature making one of its last significant appearances in Toni Morrison’s 1977 “Song of Solomon.” 

So what happened to the Black doctor? What happened to the Black doctor that for those of us who were born after the Civil Rights Movement and into the petite bourgeoisie, African American community often heard about, but rarely saw.

My grandmother would always say, “We had Black doctors.”

In “Look Who Is Coming to Dinner,” Sidney Poitier’s character was an ambitious Black prodigy doctor. He was the pinnacle yet ubiquitous symbol of Black achievement.

Moving from my hometown of LA to NY, I could not find a Black doctor. My doctor in LA wasn’t even Black. So what happened to the Black doctor? 

We have to go into hidden history to find him.

In the early 20th century, there was a professionalization of the medical field. Professionalization is the labor equivalent of urban renewal, and both tend to have similar results. James Baldwin nicknamed Urban Renewal, “Negro Removal.”

The lead “reformer” of medical schooling was Abraham Flexner, a man with a degree in the classics, but who never completed an advanced diploma. Weird how all these reformers of education past and present, i.e., Betty DeVos, never seem to have much of an education themselves, but they are white, so I guess that is all that matters.

Before embarking on the reforming medical school, he started with the reforming of secondary education. He was against grades, tests, and for small-group, personalized learning. His wealthy students went to some of the best schools in the country. Highly tutored rich kids getting into top schools, who would have thought that would happen? So with that as his credentials to work magic, he was given the task of reforming medical schools. 

Flexner in 1910 wrote a landmark report, the Carnegie Foundation Bulletin Number Four, that would come to be known as the Flexner Report. 

Flexner’s report had severe consequences to African American higher learning institutions and to the number of students that could receive a medical education. At least 14 Black medical schools existed between 1865 and 1910. After his report, five out of seven remaining Black medical schools were closed. The white medical schools that admitted Black students were also closed. The avenues for the African American medical student became narrow toll roads.

The report stated, “The Negro needs good schools rather than many schools —an essentially untrained negro wearing a MD degree is dangerous.”

Keep in mind this is a report written by a person with a BA in classics, no advanced degree, and no medical training. 

The two Black medical schools he spared from his hatchet pen were Meharry in Nashville, Tennessee and Howard in Washington DC. 

Flexner felt Meharry Medical School was worth saving, because essentially it was started by a “nice” white guy with a lot of social capital. The President of Meharry Medical School was Dr. George W. Hubbart, alumni of Vanderbilt Medical School. He was on a mission of “mercy” to help the “poor” negro. 

Howard Medical School he felt was necessary, because it was connected to Freedman Hospital and the Feds, and it was a place that was created to look after formerly enslaved and impoverished Black people.

Flexner probably would have recommended closing all hospitals open for Black students, but he couldn’t. His rationalization was an unsupported hypothesis outside of his area of expertise as a Bachelor in Arts, Classics: 

“Negroes could contaminate whites with their tuberculosis and hookworms.” 

White doctors might have to touch Black people if Black people had no Black doctors. The white doctors would then become infected, return home and spread “black” diseases to their white families and white communities.  

Thus Flexner’s rationalization to leave a separate-and-unequal, segregated, dual medical community. 

The Flexner Report gave even more power to Jim Crow and killed foundational funding for all medical schools that educated Black students except Meharry and Howard. 

The US Census Bureau states that in 1890 there were 909 Black doctors, in 1900 there were 1,734 Black doctors, in 1910 there were 3,409 Black doctors, in 1920, there were 3,885 Black doctors, and in 1930, there were 3,770 Black doctors. 

The Flexner Report written by a racist with a BA degree in Classics effectively laid the ground-work to not only kill the Black doctor, but also in tarnishing the Black doctor’s reputation among their colleagues and the community as a whole. 

According to the May 2019 JSTOR Daily article “The 1910 Report That Disadvantaged Minority Doctors” by Jessie Wright-Mendoza —currently, less than 4% of doctors are Black and 80% of those Black doctors graduated from Meharry and Howard Medical Schools. 

If the rates had continued as they had been in the early part of the 20th century by 2010, a conservative estimate would be that 6.5% of doctors would be Black, or we would have a total of 57,000 Black doctors or about 23,000 more Black doctors.

Black people were denied entry into white hospitals, denied treatment by most white doctors. Then our Black schools that created our Black doctors were shut down. The hospitals that Black medical residents were admitted to practice were few, and then pundits like Buckley tried to present the lack of Black doctors as an individual failing of Black people instead of what it was –an active throttling of education access and opportunity for young Black medical students and consequently leading to a lack of Black doctors to service Black patients respectfully. 

So what happened to the Black doctor between 1910 and the present? White nationalism lynched their educational opportunities and then blamed the community for being lazy.

In the era of COVID-19 one of many solutions for the continued disparity in care of the Black community is to rebuild the Black medical schools and the Black medical community that was systematically dismantled by institutional racism.

Lark Sontag
Children’s Book Author, Early Childhood Education Specialist, Curriculum Developer, and Social Justice Advocate for Children

 


I calculated that if the number of Black doctors continued to increase as a function of the Black population, we would have 57,000 black doctors or about 23,000 more doctors. Using our useful function, y=mx+b, I first calculated the slope of the increase in the percentage of Black Doctors in the Black Population from 1890 to 1910 (1.12048 * 10-5). Then I determined what they would be 120 years later in 2016 if the growth rate remained constant (y= (1.12048 * 10-5 * 120) + .00012135) = .00146592. So we went from 1 Black doctor in 10,000 in 1890 to 1.5 Black Doctors in 1,000 in 2010. And since there are roughly 38,901,937.79 African Americans, there should be 57,000 Black doctors. And that’s still only 6.5% of all doctors using 2010 census data of 850,085. The ideal free distribution suggests that 12.6% of the doctors should be Black or a total of 109,620, but racism and stuff…

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