A diverse workforce is vital to ensuring patient populations in all communities receive an optimal and effective healthcare experience, but much still needs to be done to ensure proper racial representation in the care setting. 

Dr. Dale Okorodudu, author of the book Diverse Medicine: Building a Stronger and Healthier Nation, a pulmonary and critical care physician at Dallas VA Medical Center, and founder of Black Men in White Coats, an organization seeking to increase the number of black men in the field of medicine, sat down with MobiHealthNews to discuss how a lack of diversity affects all healthcare stakeholders, his experience as a physician and how digital health can improve healthcare equity.

MobiHealthNews: How does a lack of diversity in healthcare affect providers and patients?

Dr. Dale Okorodudu: Well, let's start with patients. So historically, people would just kind of say, "Oh, we need diversity. We need diversity." But there was no real data to back it up. The great thing about academic medicine is academic medicine provides data.  

For patients who are underrepresented patients, there's tons of data to suggest that if you have a clinician who looks like you, there are some healthcare benefits. And a lot of those things are based around things like you're more likely to have a base on a foundation of trust and also a foundation that your provider might be able to relate to you better and better understand your healthcare needs.

And what we've seen is, when that's the case, we call it racial concordance, when you have racial concordance between doctors and patients. A study came out some years ago for black men. Specifically, if your doctor was black, you're more likely to do preventative healthcare types of things.

MHN: So, just from the racial background of the doctor, patients are more likely to adhere to their health?

Okorodudu: That's not an uncommon thing for me. So, I could be in the hospital, and I have a patient who's refusing to do something. And then I come around, and I talk to them. And I don't know if it's because of my race. I don't know what it is. But there have been certain situations where the patient will clearly feel bonded to me and tell me they trust me, and things of that sort. And they'll then move forward with the recommendation that they had been, you know, they've been kind of fighting against for some time.

MHN: What has your experience been like as you've come up in healthcare, both with patients and providers, and why did you feel it necessary to write the book?

Okorodudu: I will say, as a provider, there are certainly times when you might feel as though a patient might not want you to be their provider. So there's two sides to it, right? There's a good side and a bad side. Let's start with the bad side. 

For example, when I was in medical school, just trying to learn how to be a doctor, having a patient essentially, because of my name, my name is foreign. Okorodudu is a Nigerian name. Having a patient start essentially challenging my medical knowledge because I'm Nigerian, and even though I'm there in med school at the University of Missouri, they're saying, "Are there hospitals in Nigeria? Do they know how to do this? Are you sure you feel comfortable?"

And I have to reassure them. I don't live in Nigeria. I'm in America. I grew up in America. So you have those situations, even now as a triple board certified physician, where I walk into the room, and, you know, I had a case probably a couple of months ago, where a patient was like, you know, came and talked to him, he's like, "Where's my doctor?"

I'm like, "I am a doctor." He was like, "Oh, great." Then kind of rolls his eyes, not even knowing who I am. I just walked into the room and said, "I'm the doctor," and he was already disappointed right off the bat. I had times where patients were saying, "Can I see the head doctor?" "Hey, that's me. I am the head doctor." Patients have thought I'm transportation services, you know, anything but the doctor.  

So, you have all those situations where the patient, it's hard for the patient to acknowledge you as being capable of taking care of them. Those are the negative sides of it, and those are the times that make me think, but at the same time, I'm okay with it because I know I'm competent in what I do.  

On the good side, I have some patients who are just struggling to kind of get through to have these breakthrough moments in healthcare, and they see me, and it clicks, and it relates to them. And because of that, it moves them one step further towards, you know, better healthcare. So you know, for every bad, there's a good. There might be actually more good than bad even when I have these moments with these patients. So, you know, that's how my race has impacted me as a clinician.   

One thing that I want to mention is that your race has nothing to do with how good of a doctor you can be. So, just because I'm a black man doesn't mean I can take better care of black patients. That has nothing to do with it.  

I'm always careful to say that the reason race matters in health care is because the patients feel more comfortable. That's one of the primary reasons.  

The second reason is because there is bias. All of us have inherent biases in ourselves that we can't control and we don't know about. So because that bias exists, we need representation to try to combat some of that inherent bias, unconscious bias, that we're subconsciously living day in and day out.

MHN: How can digital health help improve health equity?

Okorodudu: One of the things that's a huge issue when you talk about healthcare disparities, of course, is access to care. So with access to care, what you tend to find when physicians, for example, you graduate from medical school, you go through residency, fellowship, et cetera.

A lot of physicians, initially, want to go work in the underserved areas. They want to take care of these people who don't have great access to care. But then you come out and practice, and these big, you get attention for all these big, you know, shiny hospitals. A lot of people end up going towards those hospitals, which there's nothing wrong with it. 

But what you end up seeing is the fact that we don't have great healthcare delivery and great access to care in these underserved areas. So you know, when you talk about digital care, you know, telehealth things of that sort, what that does is, obviously, it is improving access to care.

What you tend to see is a lot of minorities will go work in these underserved areas, but this will allow people who are not minorities who might, who may or may not be from those environments. So some people say I want to go back to my environment. But this will allow people who may or may not be from those environments to get into those environments and start working with patients.   

Ultimately, the more patients see people that don't look like them, whether it's virtual or in-person, the more comfortable they'll be, the more willing they'll be to adhere to the recommendations, take their advice, and trust in what these providers are telling them.

So the digital world, the telehealth world, what that's really doing is doing two things: It's giving them direct healthcare benefits that way and such by providing care, but I think it's also helping break down that racial divide, or it has the potential to help break down that racial divide by letting people who are now in those communities virtually get into those communities.