Care Ring is pleased to have Jewel Greywoode, MD as the guest author of this blog post. Dr. Greywoode is an otolaryngologist who specializes in cosmetic and functional facial plastic surgery. He practices with Charlotte Eye Ear Nose & Throat Associates, PA. and is part of Care Ring's Physicians Reach Out network of volunteer providers who donate free care to our patients.
Two of the most common questions I get asked from patients are “Where are you from?” and “How did you decide to become a doctor?” The answer to the first question is a little complex: as a third-culture kid, I am from Sierra Leone, born in Nigeria, and grew up in the United States. The second answer requires even more depth because now as the adult son of African immigrants, I am able to look back at my journey into medicine as something remarkable.
As a high school student, I was given the opportunity to do a summer internship with several physicians at a local hospital, and I fell in love with the field of medicine. In college and medical school, I was exposed to influential mentors who supported my dreams.
It was during my third year of medical school when I decided on a career in otolaryngology, simply because I enjoyed the patient population and admired the character of the physicians who took care of them. I discovered my passion – facial plastic surgery – during my residency, and now I find myself practicing the specialty I love. As a Black male otolaryngologist and facial plastic surgeon, I am a minority.
According to American Association of Medical Colleges (Mighty, 2022), Black physicians make up just 5% of the US healthcare workforce, a figure that has hardly changed since the 1970s. In 2021-2022, there were only 9.8% Black or African American applicants and only 6.5% Hispanic Latino or Spanish origin applicants to US MD-granting medical schools. This is compared with 41% of White students. Regarding matriculants to U.S. MD-granting medical schools in the same time period, 9.3% were Black and 6.9% were Hispanic compared to 42% of White students. In the field of otolaryngology, 5.9% of applicants were Black and 3.6% of applicants identified as Hispanic compared to 55.8% of White applicants (“Eras statistics,” 2022). These statistics have held pretty steady over the years, so the chance of a Black or Hispanic patient meeting a physician that looks like them is low.
Most of us are aware of social determinants of health, or SDOH. As defined by the Center for Disease Control and Prevention (2021), these are factors that affect health risk and outcomes depending on where you live, learn, work and play. These factors play a huge role in health care disparities that we see today. The COVID 19 pandemic highlighted these disparities as communities of color suffered more infections, hospitalizations, and deaths due to COVID 19 (Mighty, 2022). The impact of SDOH on health care disparities is a reality and it is important to not only recognize that they exist, but work toward change.
One important often overlooked aspect that is known to affect outcomes is the disparity in providers from underrepresented populations. Black and Hispanic physicians are significantly underrepresented in otolaryngology (“Out of Committee,” 2022). While this fact is unfortunate, there is evidence for improved patient-provider interactions when racial/ethnic minority patients are seen by physicians of similar racial/ethnic or gender backgrounds. Patient outcomes improve as patients are more likely to follow recommended therapy (Cooper-Patrick, 1999).
Over the past 10 years, I have had countless patient encounters where patients volunteer that the reason they are seeing me is because I look like them. This is a humbling position to be in and carries with it a certain level of responsibility. I am excited about my position and find it a privilege as a Black physician to impact the system and change the narrative.
Throughout my journey from high school to now, I can recount instances where I have found it important to be involved with effecting that change. As a medical student, I spent a summer mentoring students who were considering science, medicine, math, computer science, or engineering careers through the Student Science Training Program. While at the University of Maryland, I was involved with the UMB CURE Scholars program, an NCI program, which serves as a pipeline for middle school students from West Baltimore to steer them toward a STEM career. My involvement came on the heels of the death of Freddie Gray and the ensuing riots that occurred in West Baltimore. This was a poignant moment in my career where I found myself at the crossroads of succumbing to cynicism about change that would never happen for the underrepresented or being a part of that change. I am glad I chose the latter.
Since moving to Charlotte in 2019 and joining Charlotte Eye Ear Nose and Throat Associates, I have continued this journey of discovering my impact as a Black physician. I have opportunities every day to improve the outcome for patients seeking ear nose and throat care, and through Care Ring I find myself once again with the privilege of being a part of change. I am just one individual, and I hope to be a light and beacon of change in this ever-changing landscape. Maybe one day one of these patients might become a physician, and when asked about why they entered medicine, they can answer, "Care Ring changed my life!"
Centers for Disease Control and Prevention. (2021, September 30). Social determinants of health. Centers for Disease Control and Prevention. Retrieved April 1, 2022, from https://www.cdc.gov/socialdeterminants
Cooper-Patrick, L. (1999). Race, gender, and partnership in the patient-physician relationship. JAMA, 282(6), 583. https://doi.org/10.1001/jama.282.6.583
Eras statistics. AAMC. (n.d.). Retrieved April 1, 2022, from https://www.aamc.org/data-reports/interactive-data/eras-statistics-data
Mighty, H. (2022, March 24). Eliminating bias from medical school admissions. AAMC. Retrieved April 1, 2022, from https://www.aamc.org/news-insights/eliminating-bias-medical-school-admissions
Out of committee: Outcomes research and evidence-based medicine: Growing the evidence base for healthcare disparities and Social Determinants of Health Research in otolaryngology–head and Neck Surgery. AAO-HNSF Bulletin. (2021, May 3). Retrieved April 1, 2022, from https://bulletin.entnet.org/aao-hnsf-2021/article/21403373/out-of-committee-outcomesresearch-and-evidencebased-medicine-growing-the-evidence-base-for-healthcare-disparitiesand-social-determinants-of-health-research-in-otolaryngologyhead-and-neck-surgery