This Viral Twitter Thread Shows the Importance of Having Diverse Doctors

A viral Twitter thread is opening up a conversation about the importance of having doctors with a variety of perspectives and backgrounds, who can connect with their patients on a more personal level.

During a medical appointment, the way a doctor or nurse explains their patient’s diagnosis and treatment and the quality of the conversation between them can have a huge impact on how supported and educated the patient feels. That’s why it’s important for healthcare providers to be able to approach their patients in an accessible, approachable way.

Healthcare provider and Twitter user @Oga_DoctorBlue shared a thread on Thursday about an experience he had with a patient who had just been discovered to have multiple sclerosis. Members of his team thought the patient, a black man in his 30s, appeared to “not care” about the news, but as @Oga_DoctorBlue explained in the thread, it was clear to him, as a fellow black man, that the patient just needed someone to connect with him.

Read the thread below:

Why we need more black men in medicine. I had a patient this week who came in with left leg weakness over the last week. Younger black guy in his 30s. Brain MRI clearly indicates multiple sclerosis. So we all go in during morning rounds to give my man his diagnosis.

— The Medical M.A.B. (@Oga_DoctorBlue) August 23, 2018

He has a bit of blank stare as he listens to my attending try to explain what he has. He was told earlier he mightve had a stroke, and now we’re telling him he doesnt have a stroke. But he’s clearly processing what he does have and just says “nah” to having any questions.

— SI6HTS (@Oga_DoctorBlue) August 23, 2018

So we’re running the patient list after rounding, and as we get to him my attending says somn like “idk if apathy is the word, seems like he doesnt care”. Laughs and so does the rest of the team. I’m sitting there like, this aint it. And yes, I was the only one.

— SI6HTS (@Oga_DoctorBlue) August 23, 2018

So after running the list, I don’t even stick around with the team. I go straight back to dude’s room and the code switch was automatic. “Look mane, I know all that was a lot. Did you really get what the doc was sayin?” Mans looked at me with a face of relief.

— SI6HTS (@Oga_DoctorBlue) August 23, 2018

Now I’m goin into detail on MS, how it’s different from a stroke, and what it means for him long term. The real validation came when he interrupted me early on and said “OH so it’s a BRAIN thing I got?” “Yes my man it’s a brain thing.”

— SI6HTS (@Oga_DoctorBlue) August 23, 2018

And now my dude understands what he has, why we need the tests we need, and what the rest of his life might look like. All because I could recognize what everyone else seemed to miss, from a cultural perspective. He’s not apathetic. Folk just weren’t connecting with him.

— SI6HTS (@Oga_DoctorBlue) August 23, 2018

I’m in the right field fam.

— SI6HTS (@Oga_DoctorBlue) August 23, 2018

Thanks for all the in depth conversation and support! Happened with a few thousand more people than expected ????. I do wanna say…my attending wasnt and isnt ignorant or a bigot. He’s very kindhearted. Just misread the patient response. I do it too, hence the need 4 diversity.

— SI6HTS (@Oga_DoctorBlue) August 24, 2018

Case in point, the next day we rounded on the pt and he was much more interactive with the entire team, asking great questions and getting great responses. The diagnosis is tough but his story will end well

— SI6HTS (@Oga_DoctorBlue) August 24, 2018

@Oga_DoctorBlue, who wished to remain anonymous, told The Mighty he brought up black men in medicine in particular because, as a study by the Association of American Medical Colleges showed, there are less black men enrolled in American medical schools now than there were in 1978 — 542 vs. 515 in 2014. But he said the real spirit of his message was that we need differing backgrounds represented on a healthcare team so they can teach the other members about what may be a “deficit in cultural perception.”

He said in some cases he himself has misread a patient’s response, and the same attending physician mentioned in his thread helped him understand what it actually meant in terms of the patient’s disease.

“In this particular case [in the thread], I could use vernacular in which my teammates were not fluent, and it allowed the patient to be an active participant in his own care,” he said. “I think we need more doctors capable of ‘code-switching,’ or at least communicating in a way to make it easier for patients of different backgrounds from their own to understand their diagnosis and treatment plan.”

Research agrees that doctors of diverse backgrounds translates into better outcomes for patients. A new study by the National Bureau of Economic Research found that black men seen by black doctors agreed to more preventative services than those seen by nonblack doctors. Researchers thought this was due to better communication and trust, and if this finding translated to the general population, a workforce with more black doctors could result in a 8 percent decline in the black-white male life expectancy gap (black men live on average 4.5 fewer years than white men).

A recently-published study of 580,000 heart patients admitted over 20 years to Florida emergency rooms found that mortality rates for men and women were lower when the treating physician was female.

The effect of a lack of diversity among doctors is also seen in mental health: Black children are more likely to die by suicide than their white counterparts, possibly in part due to a lack of black therapists (only 5.3 percent of practicing psychologists are black). Actress Taraji P. Henson recently launched the Boris Lawrence Henson Foundation to raise awareness of mental health issues in the black community and provide scholarships to high school and college students pursuing a career in psychology.

To patients who have felt unheard or like their doctor isn’t communicating in a way that works for them, @Oga_DoctorBlue explained that “medical speak” is a different language — one doctors are trained to speak fluently to each other. So when speaking to the patient they have two options: translate it to layman’s terms and break it down or keep it in “medical speak” and try to teach a language, while also hoping the patient trusts that the doctor has their best interests at heart.

“In either case, things can get lost in translation,” he said.

If the medical speak is overwhelming and you find yourself trying to use context clues more than you’d like, @Oga_DoctorBlue recommended being straightforward and asking the doctor to explain in a different way. It’s OK to ask him or her to slow down.

On the other hand, if you have questions that are not in line with what the doctor is trying to tell you at that moment, he recommended waiting until the end of the doctor’s train of thought before bringing it up.

“From the doc’s perspective: there’s generally a point docs want to make to their patients, so if the doc’s train of thought is consistently interrupted with questions not on track with that point, it will end up frustrating for both parties,” he said.

At the end of the day, he said both parties should show some empathy: 

Patients are at their most vulnerable when receiving a diagnosis or results. New docs are trained to give news in the most empathic way possible. At the same time, patients please recognize that docs bear the emotional burden of many patients, and unfortunately that may come out in the wrong time/place. Mutual understanding leads to the best possible outcome in physician-patient relationships.

It’s not uncommon for patients and doctors to have difficulty communicating with each other, so we asked our Mighty community to share a time they felt like a doctor was not addressing them in the most helpful way and what would have made the situation better. Here’s what a few had to say:

1. “I was actually the one trying to explain what I was there for when the endocrinologist I saw suddenly interjected, ‘oh, now that makes sense,’ as if I hadn’t been trying (my absolute hardest) to be clear the entire time… His immediate expression of doubt, that I was intentionally being obtuse was disrespectful (and nonsensical, as I had no motive for it), and, naturally, didn’t encourage me to keep talking to him. He didn’t have to agree with my other doctors — he only had to treat me respectfully, as they had to get somewhere with me.” — Kyra J.
2. “I had a new provider Google my diagnosis in the room with me because they didn’t read my chart. Because they didn’t read it before they could not help me and asked me to come back for a ‘follow up.’ It’s extremely important for specialists to read our charts before they see anyone with an illness.” — Tiffany T.
3. “When I was diagnosed with fibromyalgia my headache specialist just walked over and pushed on trigger points. When I pulled away and swore at her for doing it she nodded and said ‘yup, fibro’ and that was it. She diagnosed me with just one word and didn’t actually tell me what it meant. I love my headache specialist and am thankful she got me diagnosed after years of suffering but it would have been nice if she sat down and explained it all.” — Shayla F.
4. “When I was first diagnosed with gastroparesis, I hadn’t even seen the doctor first… I was handed a packet with the diet on it and given a prescription for erythromycin (which did nothing). I had to learn over time, and am still learning… but I have a fantastic team now.” — Celaena W.