Disparity of care is worse health outcomes based on institutional and systematic issues, meaning everything being equal, a person owing to their race or gender will typically have the worse income. Black doctors and Black babies
The disparity of care is thought to be one of the leading causes of Black people having worse outcomes with COVID-19 and all other health challenges than whites. A study published by Proceedings of the National Academy of Sciences in September 2020 stated that Black babies were more likely to thrive when they have a Black doctor.
What happened to Black doctors? Black doctors and Black babies
We used to have 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 compared to the turn of the 20th century. Buckley used this point to attack the Black Community, suggesting an individual and collective failure.
And it is a subject I have often wondered. Black doctors and Black babies
The Black doctor was prominently featured in early 20th century African-American literature.
Black doctors in literature and film
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 for those of us who were born after the Civil Rights Movement and into the petite bourgeoisie of African America often heard about, but rarely saw.
My grandmother often said, “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?
“Professionalizations” of fields is the negro removal of labor
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 renamed 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. Black doctors and Black babies
Flexner Report, school reform for medical school
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 serious consequences to African American higher learning institutions and the number of students who could receive a medical education. At least 14 Black medical schools existed between 1865 and 1910. After the 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 an MD degree is dangerous.”
Keep in mind this 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.”
If there were no Black hospitals that Black people could be admitted to, then white doctors might have to touch Black people. They would then become infected, return home, and spread “black” diseases to their white families and white communities. Thus his rationalization to leave a separate-and-unequal, segregated, dual medical community.
Jim Crow and institutional racism
The Flexner Report gave Jim Crow even more power 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 was written by a racist with a BA degree in Classics effectively laid the groundwork to kill the Black doctor and tarnish the Black doctor’s reputation among their colleagues and the community as a whole.
The present day Black doctor
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 schools to create our doctors were shut down, the hospitals that they were admitted to practice were few. 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, a lack of Black Doctors to service Black patients.
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, the solution to 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.