The Changing Face of Medicine: Artemis Medical Society

When we first conceived the Beyond Chicken Soup project, one of the goals we discussed among ourselves was the potential to inspire young audiences to explore medicine as a career. I admit to some skepticism: didn’t Jewish kids get enough of this kind of “inspiration” from their parents? But I wasn’t considering all of our audiences (we serve all students in Baltimore and the surrounding counties in Maryland), and as I learned more about the contemporary American healthcare landscape I began to understand how important it is that America has a diverse healthcare workforce.

We decided to conclude the exhibition by celebrating the growing diversity of American practitioners with a panel and slide show titled “The Changing Face of Medicine.” We put out a call for photos and accidentally pinged the Artemis Medical Society, whose mission is “to serve, nurture and celebrate a global sisterhood of women physicians of color. Through mentoring, networking and advocacy, we provide the foundation necessary to create a diverse physician workforce vital to our society.”

This was interesting; I wanted to know more. We got in touch.

Two members of the Artemis Society meet with future doctors in New York during Disney’s “We Are Doc McStuffins” healthcare education campaign, 2013.
Two members of the Artemis Society meet with future doctors in New York during Disney’s “We Are Doc McStuffins” healthcare education campaign, 2013.

Founded in 2012, the Artemis Medical Society has quickly grown to 3700 members living in every major American city, South Africa, the United Kingdom, Italy, and the Caribbean. Since its founding just a few, short years ago, the Society has done public advocacy for the Affordable Care Act, writing articles for Jet Magazine and other media. They have worked with the Association of American Medical Colleges (AAMC) to create a series of lesson plans for a “pre-med club” aimed at fourth and fifth graders, and launched a pre-med club pilot in the Fort Worth public schools. And they reached an enormous audience when they partnered with Disney on the “We Are Doc McStuffins” initiative, a ten-city tour during which the women of Artemis Medical Society helped promote healthy lifestyles and careers in medicine.

The group has been incredibly successful with these efforts. In Fort Worth, 1977 students signed up for Pre-Med Club in the first month, and the Doc McStuffins tour reached some 50,000 children and their parents. They have been successful in large part because they are led by a group of amazing women whose lives exemplify Marian Wright Edelman’s dictum that “service is the rent we pay for being.”

What follows are excerpts from an interview with Dr. Myiesha Taylor, emergency room physician in Fort Worth, Texas, and founding president of the Artemis Medical Society’s board.

Dr. Myiesha Taylor, President of the Artemis Medical Society.
Dr. Myiesha Taylor, President of the Artemis Medical Society.

Dr. Taylor was born to a single mother and grew up in Compton, California, during the height of its violent street culture, “placing me smack dab in the middle of a “statistic,” she says. She was a gifted student, but “my mother had to fight the public school system so I would have access to better teachers, and the opportunity to undertake a more challenging curriculum.  It’s much more difficult to be recognized for academic achievement as a little black girl.”

Her grandmother was a licensed practical nurse and her mother a registered nurse, which introduced her early to the healthcare field. These strong role models encouraged her to pursue her dream to become a doctor for very practical reasons: to ensure financial security, job security, respect, and longevity.

Myiesha developed an early interest in science and medicine. Shown here with her brother Marquis, c. 1985.
Myiesha developed an early interest in science and medicine. Shown here with her brother Marquis, c. 1985.

Taylor graduated summa cum laude in 1996 from Xavier University of Louisiana, and earned her MD at the University of Southern California Keck School of Medicine in 2000. Having chosen emergency medicine as her specialty after her father was shot and killed during the unrest sparked by the Rodney King trial verdict in 1992, she served her residency at Los Angeles County King Drew Medical Center in South Central Los Angeles, which was a premier training program in the heart of one of the most violent cities in America.

Myiesha, on right, with her mother, Carolyn Bartlett, her grandmother, Margaret Montgomery, c. 1990.
Myiesha, on right, with her mother, Carolyn Bartlett, her grandmother, Margaret Montgomery, c. 1990.

“I was the only female in my residency class of about twelve, and only one of three in the entire program of about forty residents.” While there, she and her husband had decided to start their family.  “I was the lone woman with very little support from hospital leadership, so being pregnant as a resident was very difficult.  Having a young infant was only possible with extensive support from family.  I handed the baby to my husband and told him, “see you in 2 ½ years.’”

Taylor and her husband, William Schlitz, now have three children, who have all expressed interest in following in their mother’s footsteps.

JMM: What kinds of support do women of color in medicine need?

MT: A support group is essential.  Oftentimes we are the only woman/person of color in our medical groups, with no mentors or colleagues to lean on.  Sharing common experiences with others helps decrease anxiety and normalize situations that may contribute to depression.  We share tips and coping mechanisms to avoid burnout.  And, the ability to advocate when there are issues that affect us, is non-existent without a collective.

I mean, how can you even articulate what’s wrong? How can you describe “what’s going on for me”? I can’t articulate that very well without talking with other people who have similar problems and who will say, “yeah, it’s like that,” or “I remember when one time this happened to me,” then you can formulate an understanding about the issues.

JMM: What are some issues that affect women physicians of color?

MT: There are those issues that negatively affect women in our society, from lack of leadership opportunity and professional recognition, to compensation inequities, and there are special issues affecting people of color.  For example, when we move through the world, we don’t necessarily feel safe. When getting pulled over by the police for speeding, even if you were speeding or not, and you have kids in the back seat, you might be very, very nervous.  What are they going to do? It’s not necessarily going to be fair. After I get to the police station I’m wondering, am I going to live through this experience? If I go to church and open up my heart to invite a stranger in, are they going to get out a gun and shoot me and my pastor and everybody down? And then I go outside and there’s this flag that kind of represents everything that’s bad with this country, and there’s this battle as to whether or not it should still fly there. How do I go to work and pretend all this doesn’t affect me?

Being a woman physician and of color means you are affected by a combination of many of these issues in a very unique way.  For example, it is not uncommon for a patient to flat-out refuse to let black or brown physicians care for them.  This isn’t just hurtful—it has measurable consequences. Patient satisfaction evaluations are frequently tied to compensation, and when patients don’t “like” your skin color, it’s impossible to get high ratings by these metrics, and compensation is lowered.  Likewise, when the prevailing image of a physician is an old, white guy, a young woman of color is rarely recognized as the leader of the health care team. This causes confusion as people–staff and patients alike–try to figure out “who the doctor is.” Worse, it creates an environment where the patient receives lower quality health care because trust is diminished and it is difficult to establish rapport.

JMM: Wow. I think most of us believe that once you’ve earned your MD, you’ve earned the right to respect and recognition. What else?

MT: Female physicians of color overwhelmingly work in primary care, and are more likely to work in communities of color where there are huge disparities in health care access and quality.   And after a history of dehumanizing scientific experimentation by the “American medical establishment,” our patients in communities of color are often understandably distrustful of the healthcare system.  As a result, working in these communities is a very stressful endeavor.  The patients are often sicker.   They may not have the capacity to follow medical advice.  All of this makes doctoring them much more difficult.

JMM: And nowadays physicians are measured based on the “outcomes” in the health of their patients. How does that work out for you?

MT: It is not uncommon for the physicians in these communities to have poorer “outcome measures” due to these complex issues, which are then cause for lower pay and even reprimand.  Working in high stress conditions, with complicated patients, low autonomy, decreased compensation, under-appreciation, and widespread disrespect are a set-up for burn-out.

JMM: Which brings us back to the need for a support group. Are there experiences that all women in medicine share?

Of course.   First, there are the issues that all career women have: who to marry, when to have a baby, will we slide down our career ladder because we get pregnant at thirty-five after waiting as long as we could, and how will our careers stack up with our husband’s. Do we take a back seat and let him move ahead while we have babies, raise them, and take care of our parents, and his parents, and everybody in the community?

In medicine, gender bias is pervasive. Female physicians are frequent targets of gender stereotyping and discrimination.  Women in medicine make up only one-third of physicians and are profoundly under-represented in various specialties. We earn 37% less than our male colleagues, get promoted less, and are under-represented in leadership roles, including top ranks in academic medicine.

Patients give male physicians more respect while women are often mistaken for nurses.  And women of color are often mistaken for “the help.”  Female assertiveness is off-putting, and often penalized, by colleagues and ancillary staff, or by patients themselves.   How women dress, wear their hair, and carry themselves—these things are magnified and scrutinized.

And, according to a 2015 study in the Journal of the American Medical Association (as reported in the Dartmouth Undergraduate Journal of Science), “women represented under a third (30%) of all funded biomedical researchers, although differences between males and females regarding graduate degrees attained were negligible …. The monetary value of start-up support varied dramatically according to gender: the average value for men was $889,000 while that for women was $350,000.”

So, yes, there are many experiences that all women in medicine share: everything from when to start a family, to how to get promoted in academic medicine, to equitable funding for research.

 JMM: What about men of color in medicine? 

 MT: There is a severe dearth in African American men in medicine.   In fact, black men are the smallest demographic in medical schools according to the AAMC.  African American men aren’t doing as well as women of color when it comes to several measures:  numbers in college, educational achievement levels, home ownership, and life-expectancy. The reasons for this disparity range from lack of mentors and lack of role models, to systemic racism.

JMM: The Artemis Society has gone beyond advocating for women of color who are already medical students or physicians. You have initiated the “Pre-Med Club” as a way to reach out to students in underserved communities. What are the primary roadblocks for students from communities of color in becoming physicians?

MT: Roadblocks affecting students in communities of color are numerous.  A huge one is the lack of physician (and scientist) role-models.  In order for a child to achieve a goal, they have to first formulate the goal.  This entails seeing someone who looks like them doing something that they might consider doing, and then believing that they, too, can achieve that status.

Also, the poverty in many of these communities causes a domino effect of negative outcomes, and each of these becomes a major roadblock to students seeking careers in medicine.

I believe that organizations like Artemis can help students in these communities overcome some of these roadblocks by taking time to talk with students, work with students, and inspire the students.  As the student realizes it’s an obtainable goal, we are there to help mentor them, serving as role-models, and helping them navigate the process.

JMM: It’s a very exciting program. Why have you focused on 4th and 5th graders?

MT: I feel like the future is still so bright for 4th or 5th graders.  A lot of the programs that are out there are aimed at high school seniors, college pre-med students—and that’s important, you need mentoring and guiding at that level—but you can’t begin there. You can’t just make someone a [future] doctor in their senior year in high school. Without the proper guidance, it’s difficult for many kids to navigate things like which classes to take, which AP tests to take. You have to start before middle school because in middle school is when schools start to track students as college bound or not. You want them to arrive in middle school ready to work, ready to tackle advanced studies because their peers in more advantaged communities are doing it. They are going to science summer camps, and they have mentors and gifted programs at their schools, they’re not hungry, their teachers aren’t spending 80% of their time on discipline.  The kids that don’t have that, whatever color they are, are so far behind by then. But we also know–studies show—that one teacher or one principal, or one good program can really make a difference.

JMM: The Beyond Chicken Soup exhibition presents a picture of a very homogeneous body of physicians during most of the 20th century: white, male, Protestant. Jewish men entering the profession in the 1920s through the 1950s stood out and presented a threat to the hegemony of this group, but they were still white and male. Why do you think it’s important that we have a truly diverse group of physicians today?

MT: Research shows that a diverse medical school class is a much richer and more effective learning environment for all students because it offers exposure to different cultures, allows medical manifestations that present differently in various communities to be studied, offers heightened civic engagement, and engenders an element of cultural competency and sensitivity.  In sum, diverse medical training makes all doctors better – and is necessary in a diverse America, making diversifying our physician work-force a worthy goal for everyone.

Future doctors from City Springs Elementary/Middle School, Baltimore, explore the Beyond Chicken Soup exhibit, 2016
Future doctors from City Springs Elementary/Middle School, Baltimore, explore the Beyond Chicken Soup exhibit, 2016

Post by curator Karen Falk.