New research from UCLA shows that about 5% of all U.S. doctors are Black, and the proportion of Black physicians in the country has grown 4% over the past 120 years. There’s been no jump in the percentage of Black male doctors here since 1940, and they earn about $50,000/year less than white male doctors.
KCRW talks with Dr. Dan Ly, author of the study and professor of medicine at UCLA, plus Dr. Deborah Prothrow-Stith, dean and professor at Charles R. Drew University of Medicine and Science, which is recognized as a historically Black graduate institution by the federal government.
KCRW: Dan, you used Census data from the beginning of the 20th century. What has changed, or more importantly, what hasn't changed since then to now?
Dan Ly: “In 1900, 1% of physicians were Black, and now it's only 5% today, so that's only an increase of four percentage points. What was more shocking to me was that the percent of physicians who are Black men is … virtually unchanged since 1940. It was a little under 3% in 1940. And it's a little under 3% today.
And the increase since then has been an increase in Black women physicians, and so it was basically 0% in 1940, and almost 3% today. So that gets us to about the 5% physicians who are Black today, which is very low compared to the 13% of the U.S. population who are Black.”
Deborah, your reaction to these numbers?
Deborah Prothrow-Stith: “This is disappointing, but not surprising. I remember in the 1990s, when the American Association of Medical Colleges initiated project ‘3000 by 2000,’ giving two years to get the number of Black physicians up to 3000. And that goal was not met in 2000. It's met today, now four decades later. But still, it's not sufficient.
As Dan said, 13% of the population and just a bit over 5% of the physicians is a problem. And not surprising, given all that we know about medical school but also professional racism in society. What's happening with the police doesn't just stay at the police. It is really all over every profession we have.”
Why is it so difficult to get Black men interested in a career in medicine, for them to succeed in becoming doctors?
Deborah Prothrow-Stith: “At Charles Drew University, we have a very good record of training Black and Brown physicians. We are a partner with UCLA and looking to start our own medical program, where we can even increase those numbers. But roughly 25%, but of a small class of 28, is in fact Black and Brown male medical students. So it can be done. But it does take extra effort.
… The George Floyd knee on the neck, if we use that metaphorically and understand that there are race-based decisions that negatively affect the Black community and Black men in particular, we just happen to know on camera what's happening with policing. And I think this period of anti-racism in the United States gives us an opportunity to really take and make some strides forward. We know some of the things that work — we just need to do them.”
It starts with children — in grade school.
Deborah Prothrow-Stith: “Even before [grade school]. We have a pipeline program that's now about 25 years old, that starts kindergarten through 12th grade, and it focuses on STEM [science, technology, engineering, and mathematics]. And so that is a huge way of moving this ball forward.
But public education has to embrace science and math, and has to get better at providing adequate education for students as they enter that pipeline. One of the places that the pipeline leaks is once students enter college and say they want to be a physician.
And we have been working with some of the historically Black colleges and universities (HBCUs) to model what Xavier University in New Orleans does with its pre-medical academy, and they have tremendous success.
We know you have to be intentional about this. You have to be anti-racist and make some affirmative decisions. And what we've learned at Charles Drew is that our students, to be successful, sometimes need … old-fashioned support for some life events, like the death of a parent, or financial crisis in the family. And those events can derail students, the loans that they have. So we really have to pay attention to them.
And fortunately, Bloomberg announced the $100 million to the HBCU medical schools. And that just gives us a lot of hope and a lot of potential to provide scholarships for students. Like I said, we know what to do. We just need to do it.”
Dan, you found a $50,000 pay gap between Black male doctors and white male doctors. Is it because Black doctors are entering less remunerative specialties than white doctors?
Dan Ly: “I wasn't able to quite examine why that [is]. … My main hypothesis is that a doctor is not just a doctor. Doctors are trained in different specialties. And unfortunately, in our medical system, different specialties are compensated in different ways. … Black physicians aren't represented in certain more well-compensated specialities.”
Deborah, do you have a hypothesis as to why there's that pay gap?
“I think specialty does play a role in that. I think many of the students that we train are committed to serving in under-resourced communities and inter-primary care, and as a result get paid less.
It's part of the problem we have in medicine: that attracting primary care physicians often means trying to figure out how to help them pay back some of those loans and supplement salaries. LA Care as a foundation has put money in their safety net to try to help residents and junior faculty pay back their debt if they are practicing in an under-resourced, underserved community. So those are the kinds of things that can make difference. And I think we just have to, again, look at ways to do more of that.”