“CME has an incredibly large role to play in whether healthcare is successful,” Russell J. Ledet, MD, PhD, MBA, declared during his keynote delivery at the Alliance 2023 Annual Conference. He reminded the hundreds of continuing medical education professionals in the room, including me, of the direct and influential line between our work and clinical patient care.
Dr. Ledet highlighted some of the many disparities that face patients in America, such as that Black women in the United States face childbirth-related mortality at a rate almost three times higher than white women. Pulse oximeters, a standard tool in healthcare delivery, inaccurately gauge oxygen saturation in Black, Asian and Hispanic individuals, leading to substantial discrepancies in care.
Furthermore, a mere 0.01% of skin cancer cases occur in Black individuals, compared to 0.03% in white people. Yet, the survival rate is shockingly 30% lower. Medical education overwhelmingly features white or light skin, effectively hampering doctors' understanding of how skin color impacts care.
This does not read like success. But it does present a tremendous opportunity. "CME possesses an immense potential to reshape the healthcare landscape," he said, during an emboldened, blunt delivery that dare not fall on deaf ears.
Dr. Ledet impressed that the urgency of the situation doesn't afford us the luxury of time to wait for systemic changes. As the Black population has waited long enough, it's now time to accelerate the pace of progress.
“We’ve been walking too long. It’s time to start running,” Ledet, the president and co-founder of the 15 White Coats, said. 15 White Coats is a nonprofit Black physician-led organization, whose mission is to “promote cultural imagery in learning spaces, provide economic support to minorities aspiring to be physicians, and to promote culturally appropriate literature access in learning spaces.”
When medical education is riddled with knowledge gaps as significant as skin color, stark truths must be faced and acknowledged. Lives are lost, outcomes suffer, patient trust diminishes and, under these circumstances, healthcare delivery is untenable.
That’s why Dr. Ledet urged every attendee to take up this call to action and disseminate his message, to become catalysts of change in their respective organizations and spheres of influence. The fight for change must become our collective endeavor.
He reminded the crowd that, within this industry, resources aren’t scarce. It’s the initiative that’s lacking and falls short.
One of the first things I noticed when entering the CME space a few years ago was the overrepresentation of white patients and white and male physicians. In stock photos. In faculty lineups. In patient testimonies. I issued a rally cry for change. This is what Dr. Ledet asked — no, demanded — from every one of us irrespective of role or position, but on an even more broad scale. To challenge these norms consciously, consistently and unabashedly. Consider who is being represented every time you hire faculty, select patients or choose imagery. Each of these choices matters, with far-reaching ramifications for delivery and quality of care and, ultimately, quality of life.
“We need white people to do the work. But you’re not going to get credit for it. So don’t look for it. There are no awards,” Dr. Ledet informed the room of mostly white professionals.
Each day, I am deeply aware of the ultimate impact of my work on patient care. My background lies in journalism and marketing where, not unlike healthcare delivery, the art of listening is key. Really hearing what’s needed from an individual or entire population yields actionable insights that we, the CME community, can use to improve care.
A doctor understanding the nuances of psoriasis presentation in Black skin can provide better, more personalized care. A Black child meeting with a Black psychiatrist, like Dr. Ledet is training to be, may feel more seen and understood. When patients feel seen and heard, their trust in medical systems strengthens. They're more likely to seek help and stick to treatment protocols, improving outcomes and saving lives.
As CME professionals, we must prioritize marginalized voices, amplifying experiences that are often underrepresented. Medical textbooks and continued education should reflect the diversity of patients that healthcare professionals will treat. By diversifying the sources of this knowledge, we facilitate better, more comprehensive learning.
I practice Maya Angelou’s proclamation that “when you know better, you do better.” As a white woman and CME industry professional, I take seriously the responsibility I have to do everything I can to improve representation and inclusion for people who don’t look like me, and whose lived experience differs from mine.
In his 90-minute discussion, Dr. Ledet provided unfiltered exposure to uncomfortable truths. The air in the room was thick with tension, the kind that challenges ingrained biases and incites growth. We all need to feel that particular muscle tear, and let it rip.
My team and I will not let Dr. Ledet’s time, energy or lived experience be shared in vain. We have a responsibility, as does everyone who heard his call that day, to drive this work forward with meaningful action.
Dr. Ledet and Brandi Koskie at the Alliance 2023 Annual Conference.
If you don’t know where to start, Dr. Ledet made it very simple. Educate yourself.
- Read his recommended book, “Medical Apartheid.” (He distributed 50 copies during the keynote and noted that while it is available at major booksellers, try to support Black-owned bookstores.)
- Take Harvard’s IAT test to understand and confront your own biases.
- Watch his recommended films, “The 1619 Project” and “When They See Us.”
- Ask the questions that make patients feel seen and heard.
- Champion diversity and inclusion within your organization.
- Don’t burden Black patients with the responsibility to educate you.
As he said, the time for patience has expired. Stop walking. Start running.
Lives depend on our collective effort here. What will you do to help?
Brandi Koskie is the senior director of operations and brand strategy for CME Institute and The Journal of Clinical Psychiatry, using nearly 20 years’ experience in digital brand development, marketing, user experience and content strategy for the healthcare industry to drive meaningful innovation and change.