Empowered Healing: The Fight for Health Equity and Advocacy

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[00:01:00] This is a show where we talk about how complicated health care can be in every single one of our guests. Essentially brings their piece of this like 30,000 or 300,000-piece puzzle that is health care.

[00:01:11] And so I would love to take a minute to give you a moment to introduce yourself. Tell us where you fit into the big picture. Well first, thank you for just having me. So I'm a physician, I'm a mom, and I'm a health equity advocate.

[00:01:22] So I'm a black female physician who's really trying to move the needle when it comes to advocating for those who have been historically excluded, which are often the underserved communities of color that often do not have the ability to really advocate

[00:01:39] for themselves as well as there's so many different race-based medicine practices. So my goal is to provide solutions, awareness and help the community I serve as a practicing physician and it's been an honor. Well it sounds like you have a lot on your plate.

[00:01:54] Can you tell us all of the things that you do and the ways in which you bring solutions to patients? Yes, so I'm a practicing physician. I always like to start with that so I get to see patients from all ages and really help

[00:02:07] them in a time of need or sometimes celebratory as well and really help them get or achieve the best health outcome that they would like. I also am a medical contributor to several national networks. I'm a two-time TEDx speaker. My second TEDx just went live three months ago.

[00:02:25] It's titled Do No Harm. And it highlights how black women are dying at the highest rate during pregnancy or shortly after and through that I share the statistics but I also share as a black female physician

[00:02:38] how I almost died giving birth in hopes that I can raise awareness and provide those solutions that we talked about. And last but not least, I have a series called Beyond Clinical Walls that provides health information in a digestible engaging in an informative way.

[00:02:53] Through all of those mediums, I not only raise awareness but what do I do as far as solutions? I give you information that you can take whether you're at the bedside, a family member,

[00:03:03] of what you can do with whatever ailment you are facing and be able to also have dialogue and conversational pieces to talk to your doctor when you feel like you're not being heard. And then I take it a step deeper.

[00:03:17] When we talk about often access to care or social economic that that is the problem that is facing those who have been historically excluded, I highlight it's beyond that. It's also unconscious bias that is often not talked about in the healthcare arena.

[00:03:34] And that's where I kind of infuse myself how I almost passed away and I had the most access and knowledge but still you could not see me because of bias and that almost cost me my life.

[00:03:46] Can you share with me and our audience what that is actually like because I feel like we've had so many conversations around the maternal mortality crisis but it's different from somebody who's actually experienced it.

[00:03:59] Can you share what it was like and if you felt the unconscious bias when did that happen? Like was it multiple touch points along your experience? So it was multiple, you know, I hear I was having my second delivery it was the

[00:04:14] C-section and I came out of the OR and I knew I did not feel right. Something was off and I shared that with my nurse and I said something I just don't feel like myself but not able to speak or concentrate and she said bio

[00:04:27] everything's fine, your vital signs look fine, you're fine. And so I let it wait. I waited a couple more minutes maybe 20, 30 minutes and I still I was starting to feel worse. And so I asked I said please call my doctor and she said nope you're fine.

[00:04:42] This is just normal. So I asked my husband to call my physician, which I had his number in my phone and he called and said something's wrong with bio. He came and he saw that I was not my baseline and those who know me know I am

[00:04:58] quite energetic even through multiple things. And so it was taken back to the OR and I was found that I was bleeding internally and so I was transfused a couple of units of blood and as a health equity advocate I've always heard of these statistics and stories and

[00:05:14] trying to amplify but being there and knowing that I was so close to being one of the statistics that are affecting lives every single day. It really highlighted that it's beyond access, it's beyond social economic. It is a layer of bias as well.

[00:05:33] And there was multiple touch points when I said something isn't right. I don't feel well. The image of what she felt was considered not well. I didn't fit that picture. And so that was a huge touch point where I was dismissed and ignored.

[00:05:50] And so when you think about that, when those things are happening in healthcare every day, we have to highlight that. And so that's my goal, my mission, just to help as many women or birthing people as I possibly can just to advocate for the best care.

[00:06:09] And it's not a solution that's going to come through technology. It's not a solution that's going to come through even a payer plan. Like how do we solve it? I think it takes a lot of self-awareness and people to be have

[00:06:21] the ability to consider that they have an unconscious bias. Is it unconscious bias training, the solution? I can't be the only solution, but I'm sure it's part of it. It's part of it. And so when we talk about unconscious bias, it's important to unpack that

[00:06:35] because often people gloss over and they're like, that is such a strong and a big word. So when you break it down and you realize that unconscious bias is something that we all have. It's how we look, talk, behave and react to people.

[00:06:48] And so when you acknowledge it that it exists, you're able to kind of unravel it and then have introspection and think about this is what I have. How can I check it? And how can I hopefully prevent it from hurting someone?

[00:07:02] And so the training that's in play, I'm sure it's wonderful. But what are we doing to kind of make sure it is racially, ethnically, culturally competent and respect to not really kind of going on those historical thoughts and making sure it is really for those

[00:07:20] for to help people. So that's part of it. The other thing is a patient center team. You know, we hear a lot about doulas and and midwife midwifery, which I think is a huge part and everybody plays a role.

[00:07:33] And it's not going to be one piece that's going to fix this because I often share, you know, when I've had other health care professionals say, what about doulas and so forth helping? I said, absolutely. But if that clinician isn't listening to that patient,

[00:07:49] what makes you think they're going to listen to the midwife and doula? If that unconscious bias is playing a role? So those are the things, the conversations we have to talk about. And then one more thing I'm going to add.

[00:08:00] There's a score called a VBAC score that often people don't know about. What is it? What is it? What does it stand for? It's vaginal birth after C-section. And so the tool came about because at one point when you had a C-section,

[00:08:13] it was thought you should have another one. So what we decided to do, the government said, OK, let's have a tool to help doctors really advocate for women to have a natural birth, which has less complications and so forth. And so with that tool, they asked for questions.

[00:08:27] And the questions were age because older women might have more complications, height because the bone structure of more petite women might not allow a bigger baby to come through. And then they also asked weight. And then the last question that is asked is the patient African American,

[00:08:42] black or Hispanic? And so when we hear about social determinants of health and we talk about how that does interplay, why was that part of an algorithm that we know if you have a C-section, that increases your risk of poor complications?

[00:08:58] So the color of my skin increases my risk of going to a surgery that has more complications. And I'm going to break it down one more piece. Often, the part that's not talked about race is a social construct. So it's not biological.

[00:09:16] So my kidneys are the same as you. My heart is the same as you. So why are we allowing the color of my skin to be a part of the care that I receive? And why is that part of an algorithm that pushes me into a higher risk

[00:09:31] surgery? So there's all of those elements that I like to talk about that are often not presented. I have never heard that piece and that makes so much sense. When we talk about structured racism, that feels like something that is built into a system that could be easily,

[00:09:49] hopefully untangled, taken out. When you said that, you know, it's something that can be done. But what's happening is when they do remove it, we're forgetting another piece. So there's multiple studies, one including from the National Institute

[00:10:03] of Health that said it takes 17 years for new evidence to translate into standard clinical practice. So this scoring system was officially removed a couple like a year ago. But it's been in place since 2007. So it is still impacting the care that it's given.

[00:10:21] Because when you have that at the top of mind, unconscious bias, all of those things, how do you unravel that? And that's where I get to the point where I was talking about, let's go back and look at those systems or those trainings and how they play

[00:10:35] a role in policies and delivery of care today. I love that you are bringing this conversation up. So when we talk about trainings, you're supporting trainings that are patient facing as it also provider facing. What other types of trainings do you create and offer?

[00:10:54] I'm also a big fan of community engagement. Now, we hear about great organizations going to communities that are underserved and providing health care services. Well, I'd like everybody to think about it from a different perspective

[00:11:07] when you talk about training and going out to communities before you go there, ask them what they would like. And I'm going to go deeper, introduce yourself before you even go there, utilize the amazing people in the communities to help understand the information

[00:11:24] and give you feedback and then you shape your delivery. And so that's also something that I do as far as building trust, because we forget there is a historical mistrust in so many different communities. And until you acknowledge that, you're not going to move that needle.

[00:11:42] Can we talk about the how of that? If somebody were to introduce themselves to a community, where should they start? Like, I want to go work in a particular community. Where do they go to facilitate that in a way that is respectful and responsive?

[00:11:54] The way that you're describing the first part is really thinking about your intention of why you want to go into that community. Because when you identify that, it's easier to be able to connect. And so always knowing that why like you and I talked about.

[00:12:09] And then if you do partner with an organization or if you want to do it alone, find those trusted leaders, find those advocates and introduce yourself and say, this is why I want to be here. Not this is why I'm here. Oh, I love this.

[00:12:25] Well, yeah, you can't really just insert yourself and just say, OK, I'm here now and then expect everybody to want to have your answer by your solution. And that's what's happening right now. And so that's what I invite people to think about this differently.

[00:12:40] Instead of continuing to do the same path, think about it and then revert and fix it. So you have been doing quite a bit of building trust in with your community. And I'm saying that as in like broad community, social engagement.

[00:12:56] Can you share with our listeners what it is that you do to provide education and build trust? I mean, you know, in their bodies and in medical, what do they need to know? The first thing I love to do and the first thing that I do is,

[00:13:08] you know, I've been so privileged to have this health information and it is my honor to give it forward in any way that I can. And so I utilize social media through my series Beyond Clinical Walls. And I write all of my content.

[00:13:23] We have a studio in our house and my husband does all the editing. And that is not his full time job, but he helps me put together this information that's engaging, digestible and informative in hopes that I can

[00:13:35] help people across the world have answers, whether it's diabetes, hypertension, menopause, any of those pieces and help you feel informed so you can have those questions about that disease process or, you know, with your your

[00:13:51] clinician and then feel like you've got something to really hold on to to advocate for the best health. And so I do a wide variety of topics. I take comments and messages. And if there's something that you'd like me to highlight, I am all in.

[00:14:06] And so I do that and then also through, you know, TEDx talks as well. If it's something that I can help people, I do it. And last but not least, I shared with you, I always like to talk about my why of what I do, what I do.

[00:14:20] And it stems from my father who recently passed away. But he was a 99 year old man who gave back in so many different ways. And as a child, I grew up going to rallies in different places, advocating for things that I had no idea what I was doing.

[00:14:37] But I knew it was something important to help people. And so I give all credit to him as my through line of trying to help as many people as I can as a physician. And I feel so blessed to have such an amazing opportunity to help people.

[00:14:56] I feel blessed to have an opportunity to talk with you right now. Well, I thank you. Thanks for just allowing me to have this time to discuss and amplify. One of the things that I face often is the conversation about education, patient education and engagement.

[00:15:13] And it sounds like so many people and organizations struggle with that. How do you reach people where they are in a way that matters, that is, you know, digestible and that they are actually asking questions. And it feels like you have tapped into something

[00:15:26] in a way that people are actually reaching out to you and looking for answers and asking questions that are relevant to their own health or their families. And I mean, kudos because that's a huge, huge accomplishment. I am just grateful.

[00:15:41] My heart is filled with gratitude that people reach out, that I can help people. And again, you know, it's just been a wonderful thing to do. And, you know, I think of from the lens of representation as a black female physician, I represent less than 3 percent of doctors,

[00:15:59] although the black population is greater than 14 percent. And so not only do I get to provide health literacy, I get to also highlight as a black doctor, you can do this. And whoever may be watching somebody of color, gender, whoever may be identifying something with what I have.

[00:16:19] I hope I'm planting that seed, getting to water it in hopes that you know you can do this. And it's just been fantastic. You mentioned something outside of this room where you were talking about skin cancer or skin disease and on black skin.

[00:16:35] Can we just before we close out, I'd like you to touch on that just because I think it might help our audience. Can you kind of go over what people might need to know about darker skin?

[00:16:45] Yes. So there's a misnomer that we cannot get sunburned because we have melanoma. Now, yes, our excuse me, not melanoma. Melanin, excuse me because we have melanin. And so that is true. It's a protective source. However, it does not protect you from all UV rays.

[00:17:03] And so often people feel like they don't have to put sunblock on or anything of that sort and that they can't get skin cancer. Well, when you look at the data for skin cancer for black individuals, it's quite low. And you know, you wonder why?

[00:17:17] So I always lean into curiosity. And it's often because it's not socialized that we can get it. So how many black individuals are dying from skin cancer? Because they didn't know because there was a late diagnosis.

[00:17:31] And so I often like to highlight Bob Marley, who actually had a skin cancer and it was in between his toes. And so skin cancer can present in all different ways. But I like to recommend, you know, everybody of color to look in between

[00:17:47] your fingers, your toes on your nails because there can be lesions that have asymmetry and different color, different texture. All of those things are signs of skin cancer. So it's important to know that we as anyone of color, you can get any other

[00:18:07] disease processes and what's happening is it's often not out in the forefront, but it's there and I video on it. So please take a look at it on TikTok and Instagram. OK, so thank you so much for your time today.

[00:18:19] If people want to follow you or get engaged with you or learn from you, where do you direct them? Please check me out at dr underscore B C W on Instagram, TikTok. I'm on Twitter still too. And of course, on LinkedIn, Dr.

[00:18:34] Bio Curry Winshal, please feel free to connect with me. I'd love to share more information because the more we talk about these things, the more we can amplify and elevate and help as many people as possible. So thank you for having me. 100 percent. Thank you for being here.

[00:18:52] Thank you. Thanks for listening. You can learn more about us or this guest by going to our website or visiting us on any of the socials with a handle hit like a girl pod. Thanks again. See you soon.

[00:19:06] Again, thank you so much for listening to the hit like a girl podcast. I am truly grateful for you and I'm wondering if you could do me a quick favor. Would you be willing to follow or subscribe to this podcast or maybe leave us

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