Black women on the nightmare of seeking healthcare in the US: ‘I have to be my own doctor’ | US healthcare

For many Black women in the United States, navigating the healthcare system isn’t simply about receiving medical attention—it’s a strategic act of self-advocacy. From being dismissed by doctors to facing implicit bias, numerous accounts reveal a pattern of challenges that demand vigilance and, often, a proactive approach to one’s own health.

A History of Dismissal

Christina Brown, a 30-year-old content creator in New York City, first encountered this dynamic at age 18. Having been taught by family members how to perform self-exams for breast cancer, she promptly sought medical attention upon discovering a lump in September 2014. Despite repeatedly explaining her concern and pointing to the same location, she was initially told by multiple doctors that they couldn’t feel anything and that she was mistaken. It took four appointments before a biopsy was scheduled, months after her initial discovery.

Brown’s experience led her to prioritize self-knowledge and, when possible, seek care from Black physicians, hoping for a more receptive and understanding environment. This isn’t an isolated case. Many Black women describe similar experiences across various medical specialties, including gynecology, primary care, and reproductive health.

High-Profile Cases and Systemic Issues

The challenges faced by Black women in healthcare have gained wider attention through the experiences of public figures. In 2018, Serena Williams revealed her near-fatal experience after giving birth via emergency C-section, where her concerns were initially dismissed despite a known history of blood clots. More recently, the death of Dr. Janell Green Smith, a Black certified nurse-midwife, on January 1st from complications after a ruptured incision, has brought renewed focus to maternal health disparities.

These cases highlight a broader pattern of systemic issues. Christine Thomas, a 33-year-old strategy consultant in Washington DC, recounted a traumatic experience during a routine pap smear in 2018, where a gynecologist made inappropriate comments and used a speculum without lubricant, causing pain and bleeding.

The Burden of Advocacy

Dr. Kristamarie Collman, a primary care physician in Houston, emphasizes that when patients feel listened to, visits are more efficient and outcomes improve. Dr. Chiamaka Ilonzo-Ukwu, an obstetrician-gynecologist in Tampa, notes that a lack of trust and communication can lead to poorer outcomes, including missed diagnoses and dismissed concerns.

Research suggests that racial concordance—when patients and providers share the same racial background—may contribute to improved health outcomes, including lower emergency department use and reduced mortality rates for Black infants. However, Brown cautions that racial concordance isn’t a panacea, acknowledging that bias can exist regardless of shared identity.

Brown described feeling as though she must present a “case” for her health when seeing non-Black doctors. In a recent emergency room visit, after six months of worsening respiratory symptoms, she had to repeatedly advocate for a specific scan she had researched, only to have her concerns dismissed until she was seen by a Black doctor who acknowledged the relevance of race to her condition.

Medical education has historically centered white patients, potentially leading to gaps in understanding how conditions present in Black patients, particularly concerning autoimmune diseases. Black physicians, through their lived experiences, may be more attuned to these patterns.

While race-concordant care can be beneficial, Dr. Ilonzo-Ukwu emphasizes that the responsibility for addressing bias shouldn’t fall solely on Black women. Instead, healthcare systems, medical training, and individual providers must prioritize listening to patients and taking their concerns seriously.

Frequently Asked Questions

What prompted Christina Brown to seek out Black doctors?

Christina Brown sought out Black doctors because she believed they would be more likely to believe her concerns the first time around, based on her previous experiences with dismissal from other healthcare providers.

What happened to Serena Williams after giving birth?

Serena Williams nearly died after giving birth via emergency C-section when doctors initially ignored her insistence that something was wrong, despite her known history of blood clots. She had to repeatedly push for proper imaging and treatment.

What role does implicit bias play in these experiences?

Implicit bias and the chronic dismissal of pain have been widely documented issues in healthcare for Black patients, contributing to a breakdown in trust and communication between patients and providers.

How can we create a more equitable healthcare system for Black women?