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    Better Health for All

    As the first female Black president of the American Medical Association (AMA), Dr. Patrice A. Harris led the country’s influential doctors’ organization through the critical first months of the COVID-19 epidemic.

    According to an NBC News report, she ended her year-long term having given the 250,000-member group “a historic and inspirational legacy of governance during an unparalleled time in modern history.”


    Harris became the AMA’s 174th president after serving in several other roles with the organization, which champions better health policies and practices. They included membership on the governing council of the AMA Women Physicians Congress and chairing its Opioid Task Force.


    Earning her bachelor’s, master’s and M.D. at West Virginia University, Harris became a board-certified psychiatrist, with her own practice. Since finishing her AMA presidency, she has co-founded eMed (www.emed.com), an in-home test kit service aiming to improve access to health care, where she serves as CEO.


    Harris is also a visiting professor at the department of psychiatry at Columbia University’s Vagelos College of Physicians and Surgeons, an adjunct professor of psychiatry and behavioral sciences at Emory University School of Medicine in Atlanta and an adjunct clinical assistant professor in psychiatry and behavioral sciences at Morehouse School of Medicine in Atlanta.


    Her conversation with WayMaker Journal was edited for clarity and length.


    WJ: What inspired you to go into medicine?
    PH:
    When I was a wee little girl, I saw this TV doctor (Marcus Welby, M.D.)—a white, middle-aged family medicine doctor. What I liked about him was he not only took care of patients inside the exam room, I also saw him caring about families and communities. And I saw that, as a physician, he had a platform and that people listened to him. Even at that young age, I must have believed early on that I had something to say, or at least would have something to say in the future, and I wanted to make a difference… though never did I ever dream that I’d have the platform of being the president of the American Medical Association.


    WJ: How did you rise to that position?
    PH:
    I am the first African American woman to be president of the AMA, but I do want to give homage to the first African American president, Dr. Lonnie Bristow [1995-96]; I always like to make sure we give honor to those who have come before us. [My appointment] was 30 years of hard work. I’ve always been interested in politics and appreciated and understood politics and policy, and at the end of my residency I went down to the Capital where I really just had my “aha” moment about how policy and politics shapes my ability to take the best care of my patients—or, unfortunately, sometimes interferes with my ability to take the best care of my patients. I overheard another person speaking to his legislator, but quite candidly the information was not based in science and not based in evidence and so I knew that it was critical for physicians to be there, to be engaged in policy.


    WJ: There has been and continues to be a lot of mistrust in the Black community in regard to medicine and the medical profession. What can we do about that?
    PH:
    Well, the first thing we have to appreciate is that trust is earned, right? No one just bestows it upon you. Now fortunately, in the broader perspective, health care professionals—physicians and nurses—are among the most trusted professions in the world. But, as you note, we have not done the work that we need to do to earn that trust, particularly in the Black community. We saw that highlighted with COVID.


    So, the first thing you have to do is show up. You have to be present. You have to go to communities, and you have to ask. I’ve been guilty of this in my career, with the best intentions: sometimes we go in as experts and leaders and we want to help but we don’t take the time to sit with the community and ask what we must do to earn their trust. And once they tell us what we must do, we must do that. We must act, we must be willing to course-correct. When we make mistakes, we must be willing to be honest and tell the truth about the past and the present. Reconciliation comes after truth-telling.


    Today, where we are going into communities and perhaps asking them to participate in our clinical trials, we then have to go back and say, “This is what you helped us learn.” It’s a process… continuously being present in the community, not just going in when we need them, but staying present and having the community as partner. And then there is making sure that the community gets accurate information. We know we are in a context of a lot of misinformation and disinformation. That was one of my proudest moments as president of the AMA, I think, that people saw an African American woman as a leader, and I told the truth. We must say what we don’t know. I’m a doctor; we have a hard time saying what we don’t know, but sometimes we have to say, “Look, we do not know the answers to this, but here’s what we know based on our best available evidence.”

    The inequities that existed pre-pandemic, that we saw exacerbated by the pandemic, continue today.



    WJ: COVID remains a problem, especially for the Black community, doesn’t it?
    PH:
    The fact is thousands of people are still dying from COVID and that disproportionate impact that we saw at the very beginning is still the same. We have more Black people who are hospitalized with COVID. We have more Black people who are dying with COVID. We have fewer Black people who are getting access to the treatment… unfortunately, the inequities that existed pre-pandemic, that we saw exacerbated by the pandemic, continue today.


    WJ: People have had mixed experiences with testing. How should we view testing these days?
    PH:
    There’s no one test that’s 100% accurate on a lot of issues and different tests that are on the market work better in certain situations. But we have to realize that this virus has been evolving. This virus is very smart… I understand the confusion sometimes in the public, because we may say something now that may be a little bit different [than previously].


    My grandmother said, “When you know better, you do better.” So, it’s about continuing to follow the best evidence in science and then communicating that as best we can. And, by the way, I think we could have done a much better job in communicating these messages, and that’s one of the many lessons that I’m going to take away.


    WJ: With testing in mind, tell us about eMed.
    PH:
    As I was thinking about my next phase of impact after being the president of the AMA, I wanted to make sure that technology and health care and the intersection of those two things worked for people. During the height of COVID, so many of us were frustrated at the lack of testing in the very communities who needed it the most. And so I got together with a couple of folks and co-founded this company and said, “Let’s go solve some problems.”


    WJ: Is the aim to democratize health testing in our communities?
    PH:
    Absolutely that is our goal. Listen, there’s no one panacea. Sometimes people look for the magic wand answer in health care, but you do what you can. [During the pandemic] so many people had transportation barriers. They couldn’t take time off from work. And so at eMed we said let’s develop a platform where people could test at home with integrity. We have as our North Star affordability, accessibility and integrity. We will continue to do that beyond COVID. There are so many instances [where] people can be empowered to know the results of their tests, be more empowered regarding their own health care, and then in partnership with physicians, decisions about how to stay healthy.


    WJ: What is the state of diversity in health care?
    PH:
    It is not good and particularly not good when it comes to Black men. The night of my inauguration, June 2019 (pre-COVID), I said I wanted to highlight… important issues during my presidency in addition to the strategic priorities of the AMA. Number one was the importance of mental health and overall health. Number two was the importance of increasing diversity of the physician workforce—this goes across the health care spectrum, but not in the service of a checkbox.


    Some people get so caught up in, “We have to have x many women and x many this,” it’s really in the service of equity. If we look back over time, at the Flexner Report [in 1910], as a result of that there was some increase in quality of medical training, but also they closed several medical schools that were training Black physicians. We have to appreciate that we have not always made the path easy for communities of color… we should be on high alert, red alert, and doing all that we can to increase the diversity of the physician workforce.


    This does not mean that only Black physicians can take care of Black patients. But we do know that when there is a diverse team, the whole organization performs better. It lifts up the entire physician workforce; you have others around the table who can appreciate issues around these health inequities and the social and structural determinants of health and some of these other issues. We have a long way to go… some medical schools are working on this issue, but this is a 10-alarm fire, and we should be doing all that we can to increase diversity.


    And, by the way, as a child psychiatrist, it’s important that we start early. You can’t decide on Tuesday that you’re going to apply to medical school on Wednesday, right? You have to take all the prerequisite courses, and that means that you have to have that prep. We need to make sure we’re preparing our students early on, particularly for medical school. The journey is hard and long; it’s very competitive to get into medical school, and so we really have to start early.


    WJ: What advice do you have for young people who may be considering a career in health care?
    PH:
    You can google potential opportunities in health care and there are so many, from being a physician to respiratory therapists, who are very important, to nurses. I think we do need to do a better job of making sure we are reaching back into the schools… It’s a bit ad hoc.

    Many folks knew about these health inequities pre-COVID and with George Floyd and [the pandemic] a lot of people and corporations made statements. So, when I talk to CEOs, I say, “Look at your community. Get active in your community. Be a good community partner.”

    I say this out of experience; even though the AMA is a national organization, with physicians all over this country, we decided that we were going to make a commitment to the West Side of Chicago [the AMA’s headquarters are in the city]; we were going to be a good community partner right there.

    I’m hoping that other large organizations with resources take our lead and look in their communities and not only address health inequities for their employees (and a lot of folks are doing that) but how can they be good community partners? And this is one way to do it, to make sure that they’re working in the elementary schools and all through K through 12, to make sure that they are lifting up the communities and showing them what career opportunities are out there.

    DR. PATRICE HARRIS: MY WAYMAKERS

    There are so many to name, but I must start with my family. When I told my mother and father I wanted to be a doctor, it was just, “OK. Not a big deal; whatever you want to do, do.” And they just supported me through that journey.

    None of my grandparents had formal education, but my maternal grandmother made sure that all of her daughters went on to some education beyond high school. What a role model for me that was. My mother was an educator, her sister (my aunt) a nurse. My other grandmother just made sure that I had a strong sense of who I was and that certainly held me in good stead in all the years and the challenges.

    At one point in my career I said, “Well, maybe I’m not smart enough to go to medical school.” I did get discouraged and then I decided I was going to go back, and someone said to me, “You’re going to be old when you graduate from medical school.” I told my aunt that story and she said, “Well, you’re going to be old anyway, hopefully, so you might as well be old and a doctor!”

    Dr. Rosalind Barnes Griffin was the first psychiatrist that I ever met in the flesh, a Black woman, a physician. Through her presence, I said, “I can see it. I can be it.” And then there are just so many mentors I’ve had along the way… even people that I’ve not known that I wish I had. Rebecca Lee Crumpler was the first African American woman physician [in 1864]. There are so many people that I can name: I realize the value of people who came before me, that made my path possible.

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