Racism, Not Race: A Physician Perspective on Anti-Black Racism in America

In this commentary, which responds to the article "Anti-Black Racism as a Chronic Condition," by Nneka Sederstrom and Tamika Lasege, I draw on my experience as a physician who cares for a largely Black patient population. Physicians are trained to "first do no harm" and strive to treat patients to the best of their abilities. However well intentioned, many of us fall short of this goal and witness the consequences of health inequities that disproportionally impact the lives of Black patients. Recent years have brought increased acknowledgment and understanding of social determinants of health, but these modest changes fail to identify the true culprit of health disparities. Racism, not race, is responsible for the negative outcomes that we see in our communities of color. Both subtle and overt forms of systemic racism plague the educational systems and scientific metrics of medicine in the United States. Physicians' training, culture, and biases are founded in White norms. To decenter Whiteness as a normality, medicine must enact a multipronged approach that begins with increasing the diversity of physicians and providers to better reflect the patients that they care for. Bioethicists must publicly state that racism is real and that we are dedicated to changing it, but to get beyond statements, we must also have a measure of improvement and success in battling racism.