How can your peers make sure their private/group/academic practice is appropriate with ethnic minorities?

Wendy W. Lee, MD: Being at a university, we have strict guidelines in place to ensure the ethical treatment of all, which includes appropriate behavior of ethnic minorities. It is important to have guidelines in place no matter what type of practice you are in, and these guidelines should apply to providers, patients, and staff.

José Raúl Montes, MD: We have to elaborate a universal Mission Statement with specific guiding principles, that promotes inclusiveness and repudiates discrimination based on race, ethnicity, gender, and sexual preference.

Jeanine Downie, MD: My peers can make sure their practice is appropriate with ethnic minorities by hiring ethnic minorities, training everyone in cultural sensitivity and racial diversity, and being aware of ethnic differences and practices.

With racial issues and diversity, common sense rules. If you think something is offensive, then simply avoid it.

How can anyone become a better, more capable, and more empathetic physician to race and race issues with patients of color?

Dr. Montes: The phrasing of this question has an implicit bias due to the plea for becoming “empathetic.” The fact that empathy is required admits that there’s a position of privilege. Someone who has to make a conscientious act of showing empathy is clearly standing on a pedestal.

Empathy is a concession that people make toward others; not a change in their way of thinking. If anything, you should take care of yourself first in order to become educated and freed from your own prejudice.

Dr. Lee: Awareness comes from keeping an open mind and listening to all points of view. It is important to place everyone on an even playing field, no matter the color of their skin. Be sensitive to others and how they may have been mistreated in the past, working with them to change that behavior and make them feel comfortable and safe.

Melissa Kanchanapoomi Levin, MD: As physicians, we cannot deny that we are in positions of power and privilege. With this collective power and privilege, we should be at the forefront of these conversations. The public health crisis of COVID-19 has demonstrated the systemic and underlying racism in our health institutions.

There are steps an individual aesthetic physician can take:

  • Acknowledge our biases, the lack of diversity in our field across medical school and residency training, research, leadership, and clinical exposure.
  • Get involved in mentorship to support and provide mentorship and opportunities to black communities.
  • Perform a comprehensive review of your practice: clinical expertise, hiring practices, staff training, marketing, communication. Focus on ensuring that your practice and skillset is inclusive to all patients and staff members. Create a plan to work on your practice’s biases and how to dismantle them.

Dr. Downie: Everyone can be a better and more empathetic physician to race and race issues with skin of color patients by listening, reading, and caring. Cultural sensitivity training and awareness is critical, and I believe there should be more of it within our academic halls when we are giving conferences.

Care enough to treat all of your patients the same—with respect and dignity.

There is a doctor from New Jersey who will remain unnamed. I was rotating with him and considering taking a job offer with him back in the late 90s when I was just finishing my chief residency year at Mount Sinai Medical Center. He would go in the white patients rooms’ and say “Good morning, Mr. [Last Name]. How are you? It’s a pleasure to see you. I’m Dr. [Anonymous], etc.”

However, in the rooms with African-American patients, he would walk in and say “What’s up, my man? How you doing?” and embarrass the heck out of me and say it in some crazy Bill Cosby type of voice. I was horrified. Not the place for me to work, I decided rapidly!

What can your specialty do to support its members who are part of racial/ethnic minorities and/or to support permanent positive change in terms of racism?

Dr. Lee: ASOPRS is very supportive of not only its members, but also staff, volunteers, members in training, attendees of our meetings, and vendors who participate in our meetings. Our society does not discriminate based on gender, age, or race and is very aware of and sensitive to issues in the world surrounding inequality with a no tolerance policy.

Dr. Downie: I have mentioned some different things that pharmaceutical companies and industry can do. In addition, we need to have more ethnic minorities become residents in the many different dermatology programs across the country. We need to foster proper discussion of what is racist and what is not racist, even if it makes some people/docs uncomfortable. It is better to make doctors uncomfortable than to make patients upset.

Permanent positive change comes from being anti-racist. It is not enough to consider yourself not a racist. If you hear something, say something. The best example of this that I can give is if you are constantly listening to your Auntie Louise talking smack about black people, gay people, or Latino people, say something. Aunt Louise doesn’t feel comfortable talking to ethnic minorities about her racism at all. But she feels comfortable talking to you. So take her down. Defend us. Say something. Speak up. Silence is not helpful, and that’s how this idiocy has been allowed to continue for as long as it has.

Be sympathetic, be empathetic. That is all. Read more, listen more, and learn. That is the most effective way to combat ignorance and hatred in our society. I always say, “If you’re not part of the solution then you’re part of the problem.”

Defeating widespread and systemic racism will be a slow and steady process. I firmly believe that it can happen. It will happen with one person at a time. Minorities cannot take on this fight by ourselves. It is not up to only minorities, it is actually up to all of us. We need help, and we would be obliged if everyone from all backgrounds would lend us a hand.

Access Part 1 of this dialogue online here.