- 2 months ago
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00:00My name is Chantelle Reed and I'll allow the rest of the guests to introduce themselves.
00:06But I'm Chantelle Reed and I'm the Deputy Director for the New Orleans Health Department.
00:11And good afternoon and welcome everybody!
00:16My name is Dr. Marquis Pierre and I am the Vice Chancellor of External Affairs at LSU Health in Shreveport, Louisiana.
00:27Good afternoon, good afternoon.
00:29My name is Dr. Eric Griggs.
00:31I'm the Community Medicine Director for Access Health, Louisiana and Health Educator for WVUE Fox 8.
00:42Alright, thank you Dr. Pierre and Dr. Griggs.
00:46So today we really, really wanted to go into the importance of cultural competency with your healthcare provider.
00:53It was really, you know, near and dear to us with, you know, everything that Dr. Pierre does and everything that Dr. Griggs does in the community.
01:01Really, you know, speaking to your provider and really discussing and having a conversation and relationship with your provider.
01:08I want to start with Dr. Pierre and really kind of talk about, like, what is cultural competency and what does that mean, especially in the healthcare environment?
01:17Absolutely.
01:18That's a great question.
01:19You know, when you talk about these big words, cultural competency, there are so many things that people talk about.
01:24But let's just be simple about cultural competency.
01:28It's about awareness and it is about being present and understanding and recognizing that we have various cultures that are in our communities and being respectful of those cultures when they come into our systems, our healthcare systems.
01:47It's just as simple as that, being aware and recognizing and making sure that you're being respectful to them when they walk in the door.
01:58Dr. Grace, you want to tackle that?
02:01Yeah, so I get the question a lot.
02:04What is community medicine?
02:07Community medicine is three things.
02:09It's people, it's practice, and it's policy.
02:12The problem that we have a lot of times, even when we practice medicine, is that the people is the most important part.
02:19How many times, by show of hands, have you gone to the doctor and you smile as though you understand everything they said, but you have no idea what they just said?
02:30Am I the only one just, yeah, hypercholesterolemia, yeah.
02:33The whole point is you are the main character in your own play and your own healthcare.
02:40So you have to make sure that when people are talking to you and addressing the community, that they're talking in a language that you both can understand.
02:48So there's mutual respect and mutual understanding.
02:51Thank you, Doc.
02:53So we've all heard stories, right?
02:55So we've heard a lot of anecdotal stories and talk about, I've gone to the doctor, I've had this issue, I've had this concern.
03:04Like, how does a person, just a layperson that doesn't work in healthcare, that doesn't have the background, how do they go about building that relationship and having those conversations so that the provider truly listens to them, right?
03:18So I'll give you an example.
03:20We're all on social media.
03:21We have all of these questions.
03:22We have all of these things that come up.
03:24And they said, oh, I went to my doctor, they diagnosed me with something, but I really didn't know what that meant.
03:32How should you approach having those conversations with your provider in order to make sure that you understand and you can address those health concerns?
03:40So I think that's a twofold question.
03:43So first of all, the provider has to recognize and respect cultural competency and understand that there is diversity in the patients that they are seeing and recognize that everybody needs different things.
03:59Our culture is very rich and diverse, and our healthcare should be just as well.
04:03And so when a patient walks in, you should be able to recognize whether or not that patient is actually understanding what you are saying as a good physician.
04:16What we have seen is, and that's why we have so many health disparities, is that a physician does not recognize, they talk over the patient, but as a patient on the other side of that, you need to be able to say, hey, wait a minute.
04:33I don't understand what you're saying.
04:35I need you to break it down and ensure that I am understanding exactly what you are telling me.
04:43And you have to be comfortable enough to be able to say that, and the provider has to provide that environment that allows you to do that.
04:52It's an educational component on both sides of this, from the community as well as from the healthcare provider.
04:59Dr. Greggs, I'm sure you have experienced a number of these issues when that comes up.
05:05Yeah, one of the things that you have to remember as a patient is that you are the number one player.
05:13Were it not for you, there would be no doctor there to see you.
05:16That's right.
05:16It's your right.
05:18It is your right to demand another doctor.
05:20You can pick and choose.
05:21One of the issues that we deal with, you talk about health disparities and health inequity, a lot of it starts in the educational system.
05:29Only 2.6% of all the doctors in the country are African American.
05:342.6%.
05:35These numbers are on par with what we had...
05:38I'm sorry, the African American males.
05:41Only 4% roughly are African American.
05:44And the numbers are on par with 1948 and closer to 1978.
05:50This is 2022.
05:52So it's hard to feel empowered with a system that you don't quite understand.
05:56That you feel you really don't want to be there anyway when you're trying to get out.
05:59We have to empower ourselves by having these conversations outside of the clinical environment, by asking questions to the people that you have supporting you.
06:09And I might know a doctor that might go with you and put on a baseball cap and be your play cousin or something.
06:14I don't know nothing.
06:16I think that that brings up a really good question.
06:18We have issues because when you talk about physicians that don't look like you and me in this room, what do we do about that?
06:26I work in the School of Medicine, the School of Allied Health Professions, the School of Graduate Studies.
06:31And one of the things that we can do is to be more deliberate and intentional about trying to recruit those particular types of individuals into the school.
06:40Now listen, it doesn't start when they get to college.
06:43We really have to begin even further along than that with pipeline programs in our K-12 institutions.
06:51Listen, when we start talking about precision medicine and biomedical research, our kids don't know what we're talking about.
07:00And we have to break those down.
07:02And we have to make sure that we are putting individuals that look like Dr. Griggs and myself in front of them so that they understand that they can be that as well.
07:12If we don't start changing and making sure that we have more physicians and faculty members that look like you and me, we're never going to get there.
07:24And I appreciate you bringing that point up, right?
07:27Because a bedrock of cultural competency is do I identify with that provider?
07:34When I speak to that provider, do they speak the same language?
07:36Am I understanding the cues that they're giving?
07:42Do they understand my community?
07:44When you brought up, Dr. Pierre, really kind of brings me to another point.
07:49And I know you have a lot of experience in this.
07:51But one of the frameworks of when you go to the doctor and the doctor understanding your needs and your issues and your concerns is really what happens in the research.
08:03And we hear it often a lot, like, how do we participate in research?
08:07Are we really, truly supporting?
08:10And you know, right, even to vaccine hesitancy, we've said, oh, I'm not getting that shot.
08:17It's not going to happen.
08:19I'm not going to be a guinea pig.
08:20I'm not going to put myself at bay.
08:23But how, if you can speak to the importance of black people, right, persons of color really participating in research, in clinical research from the medical perspective?
08:35I'm glad you asked that question.
08:37You know, I work with a program called the All of Us Research Program.
08:40I'm not sure if you guys are familiar with All of Us Research Program.
08:43But, you know, they're working to build a database of a million people.
08:48But the component of the program that I work in is the educational component.
08:53And that is to introduce these career pathways to high school students in biomedical research.
09:03Also ensuring that I am bringing biomedical researchers in front of them, it is extremely important to ensure that we have health care that is tailored specifically toward us.
09:20Through these types of programs, we can ensure that we have the type of health care that we need.
09:27But we need to make sure that we understand what those words mean.
09:31We can't be afraid to say and ask the question, what is biomedical research, if that's something that you're not quite sure of what it is.
09:42I understand the hesitancy.
09:44I understand when a physician talks over you.
09:47But we also have to understand that we are number one when it comes to our health care.
09:54And it's important to see that we have black researchers that are participating in this research that we have in genomic sequencing and pathogens to ensure that they are looking at issues that are important relative to our own community and what happens in our bodies.
10:13Because sometimes it's different in different cultures.
10:17Well, and it shows when we go to the doctor and we take a medicine.
10:23And we get a side effect that isn't listed on the side of the bottle.
10:27If we don't have any of us participating in the clinical trials, then how can we have a medication that works with us?
10:35But I want to go back real quick to what you talked about earlier.
10:38Not only does it start in the school system, for those that know me and have known me over the years, y'all finally got me out of my scrubs.
10:46For a minute, anyway.
10:47Everyone was like, oh, doc, are you doing surgery?
10:50What is that about?
10:51The problem I had as a kid with being a doctor as a little black boy in Winston-Salem, North Carolina, is that I didn't see any doctors when I walked around.
11:01Now, I saw lawyers.
11:03Lawyers that had the slick suits, the pretty women, and the convertible Volkswagens.
11:07So I thought I wanted to do that.
11:09But I didn't see any doctors.
11:11So I made it a point to intentionally be in the community.
11:14If I speak at a school, I wear my scrubs.
11:16If I go to the barbershop, not only do I wear my scrubs, but I take a stethoscope.
11:20It costs $15, $20.
11:22If a kid, a two-year-old wants to play with it, I give it to him.
11:25I say, what is it?
11:26It's a stethoscope.
11:28Three years old.
11:29Stethoscope.
11:30Is that a blood pressure cuff?
11:31No.
11:32It's a sphygmomanometer.
11:34Say it with me.
11:34It's sphygmomanometer.
11:37But at three years old, and I give it to them.
11:40It costs me $20.
11:41That's lunch.
11:42But that might be a lifetime opportunity, opening the world up to a child.
11:47I'm the president of the 100 Black Men here and part of the national organization.
11:51Our motto is, what they see is what they'll be.
11:54And we're beautiful, and we're brilliant, and we can do anything.
11:58Because Miki and Corbett showed what we can do with research.
12:01So we have to keep showing them these things.
12:04And it starts outside of the classroom and with us.
12:06I want to hit on something that he just said.
12:09Absolutely.
12:10I have to tell you.
12:11So I work with the School of Medicine students in our Office of Diversity Affairs.
12:16And I have a story to tell you.
12:18So I had a student, and this was a young man, and probably about six foot seven, a third-year
12:26medical student.
12:27He gets on the elevator with his white coat on, his nice khaki pants, and his loafers.
12:36He's got his pad in his hand and his stethoscope around his neck.
12:43And one of the faculty members looks at him when he gets on the elevator, and he says,
12:49hmm, you should be playing basketball.
12:53Oh, those are the things that we are working to overcome in bringing about awareness and
13:02importance of understanding.
13:05Listen, this is a third-year medical student.
13:08This is an old white man that's been a physician for about 20-plus years in an elevator.
13:16And when I tell you when the student came back to my office, he was low.
13:21He was really, really low.
13:25And you have to remind them to say, listen, you are black excellence in its flesh right
13:34now.
13:35And encourage them and remind them that they are in their third-year medical school.
13:43The third year, they got one more left to go.
13:46We have a lot of work to do to continue to encourage our young black men and black women
13:54to move into these career pathways because they are necessary in order for us to have
14:01better health care outcomes in our own community.
14:05Thank you, Dr. Pierre.
14:07I think it's really important that you bring it up, right?
14:10As, you know, in the academic community and really kind of seeing this front-hand line,
14:16where do we sit as a community?
14:18Where do we sit in what our responsibility is in making sure that we have these opportunities?
14:24There's so many things that happen that can discourage.
14:27But what do we do to make sure that we're not only investing in these young people, but
14:33also empowering patients, right, to be able to choose their provider and understand that
14:41you don't have to accept what is given to you.
14:45You take control of that.
14:47So, I understand that it's a two-pronged approach, but the way I look at it is, one, we have
14:54to be receptive to black excellence when we see it.
14:58We have to be able to say, you know what, I'm going to see that doctor because that doctor
15:03looks like us.
15:04Say that again.
15:06Yeah, absolutely, right?
15:07Because studies have proven that black doctors have better outcomes.
15:12With black patients.
15:13Yes, absolutely, because they have that empathy factor.
15:17They have all of those things happen.
15:19So, what can the community do?
15:20I see the people sitting here, and they're saying, like, you know, I don't work in academia.
15:26I don't work in clinical medicine.
15:28What can they do as the community in order to be able to support those, you know, moving
15:35those forward?
15:36Uh-oh.
15:36Dr. Egon.
15:37Uh-oh.
15:37So, I get choked up.
15:39Um, you can do what the community's done for me.
15:44Um, every time you want to take a picture, every time you tell me, thank you, I'm proud
15:50of you.
15:51Uh, this pandemic, I'm just, we, we family, it woe my, it woe me out.
15:57And it was the smiles, and it was the word of encouragement.
16:02Back when, I had hair, and when the big afro was a little boy, and you did well in school,
16:06it made your day when the adults, particularly the older adults, like, baby, you're doing
16:11good.
16:12Baby, I'm proud of you.
16:13Here, look, let me give you a little extra, even during med school, I'm going to give you
16:17an extra scoop of beans, because I want you to do good, because you're making us proud.
16:21Keep that going.
16:22Start young, and even when we're going to our jobs, I know I'm not the only one.
16:27You'll be having a bad day.
16:28You'll get in the elevator.
16:29Someone will recognize you, and they'll grab your arm and say, thank you, you're doing such
16:33a good job, because you feel that big.
16:36That's exactly right.
16:37The other thing is, you know, we have to continue to bring about awareness.
16:42You can't be afraid when it's your health care.
16:47You can't be afraid.
16:48If you are uncomfortable having a conversation and a dialogue with a physician that you are
16:54scheduled to see, see another one.
16:57Ask for someone else.
16:58It's okay, because it's your health.
17:02You control it.
17:04It's important.
17:05If you have a problem with something that somebody has said, say something.
17:10Go to the administration.
17:12Ask them about their cultural awareness program.
17:16If they have one, do they have a diversity program?
17:21There is such a lack of diversity in health care, in faculty members, in staff members.
17:29When you look at students, I'll just, you know, I can speak from LSU Health Shreveport because
17:34I'm there.
17:34It was only because of our intentional and deliberate efforts from our school of medicine
17:39class last year that we were able to have 21 black students that successfully matriculated into
17:48that school when typically we would have one or two.
17:52But that's because we were deliberate.
17:53We went out to every HBCU in Louisiana and we signed MOU agreements with them.
18:01And we said, when you start in as a freshman and you do this, this, this, and this, we will
18:07guarantee you an interview and we will move you from the number 6,000 up to number 1 so
18:14that you can go through the admissions process.
18:17We'll help you with your medical school application process.
18:21We'll help you with your MCAT test if you need some additional training.
18:27Find the programs.
18:29They're out there.
18:30They're available.
18:31But continue to encourage your young people to move into these career paths because it's
18:38just important.
18:39It is critical that we have a foundation of cultural competency in our health care systems,
18:48in our academic systems, in our communities, and we can go on and on and on and on.
18:54Right.
18:54And, you know, you bring that up.
18:56One of the things I want to say is I look around the audience and I see so many different
19:00professional women and men in this audience.
19:04I want to say that we have a responsibility, right?
19:07We have a responsibility not only to just encourage but really to do a little more, right?
19:13I was taught that, you know, somebody reached their hand down to me.
19:18So what you're supposed to do is reach your hand down to lift somebody else up.
19:21We have to be able to do that in order to make sure that those opportunities exist.
19:28But we also need to make sure that they're there so you know that they are available to
19:33young people.
19:34It's not going to affect your child.
19:36It may not affect so-and-so or whomever, but it might affect the neighbor, your church
19:42member, your cousin.
19:43You have to be able to hear these opportunities because I'm listening.
19:46And I'm like, you know what?
19:48We have to figure out where we go.
19:50And I got to make sure that everybody I know who might want to go into medicine hears about
19:54this program, right?
19:55Because that's the only way that we build up a workforce.
19:59That's the only way we build up.
20:00When you go to the doctor, they are truly listening and understand I'm commanding your attention
20:07to know this is what I need in order to make me feel how I'm supposed to feel.
20:11So another thing I do want to bring up, and I know we are almost at time, and I know there's
20:17supposed to be some opportunity to maybe ask questions or whatever, but I would be remiss
20:21if I'm sitting here and I don't mention something very simple as get checked, get fit, get moving,
20:26right?
20:27I can't not mention it.
20:28But I want to bring it back to you, Doc Riggs, and really kind of talk about, you know, we're
20:35talking about the provider.
20:37We're talking about with the community.
20:40But get fit, get checked, get moving really kind of started with you walking in the neighborhood,
20:47right?
20:47What else can we do?
20:49What other opportunities do we have in order to be able to be our best self?
20:55She threw that one right by the rim, huh?
20:57Yeah, so get checked, get fit, get moving.
21:00Get checked means starting with those conversations in your family.
21:04Going to the family as a doctor.
21:06I don't know if we have any Saints fans in here, but whenever it's about to be football
21:10season, everybody need to go to the doctor because we all need our heart check, including
21:14the babies, right?
21:15Go to the doctor.
21:16Eating healthy foods.
21:17Healthy foods are the ones that grow in the ground.
21:20They have simple ingredients.
21:21The main ingredient in the orange is an orange.
21:23Main ingredient in chicken is chicken.
21:25Main ingredient in water is water.
21:26It's really simple.
21:28The easiest thing to do that everyone has to do is walk.
21:32Get moving.
21:33Find something you like to do and do it.
21:35Even if it's gardening, find something simple to be active.
21:39Talk to your family.
21:40Go to the doctor.
21:41Eat healthy foods.
21:42Walk.
21:43Drink water.
21:43And most importantly that I had to learn the hardest, get some sleep, y'all.
21:47Please get some sleep.
21:47We walk around cranky.
21:49Take care of yourself.
21:50I was about to say we negate sleep.
21:53I know we're almost at time.
21:55Are there any closing remarks?
21:57Are there any questions from the audience that we can really kind of expound upon and
22:00really kind of hit some of the points that we've hit today?
22:03Yes.
22:08Yeah, look.
22:10Let's get to my speech.
22:11Hard to hear you.
22:15My question.
22:16Sorry.
22:18You're about to speak.
22:18Come over here.
22:19My question would be us as individuals in the community advocating for ourselves.
22:27I think it's important that we understand that as we take care of ourselves and as we
22:32go to the doctor, if we're in the hospital or if we're caretakers, not to be scared to
22:38ask the questions and not to be scared to say we don't understand as you stated before,
22:43but also to not agree with what they're saying and to speak up to that.
22:48So what are other ways that we can advocate for ourselves in the medical community?
22:52Because I feel that's really important and that's really missing because we don't, we
22:57just take what the doctor says and thinks that's okay.
23:00Absolutely.
23:01That's a good point.
23:03Go ahead.
23:03Go ahead, Dr. Mey.
23:04So that's a really good point when it comes to if you've had a conversation with your physician
23:11and you disagree with it, you don't have to agree.
23:14You can ask for another opinion, go see someone else, but you need to make sure that you are
23:21comfortable with the responses that you are getting.
23:26No one else can speak on your behalf.
23:30We have to empower our community to make sure that they understand that they're the ones in
23:36control.
23:37Another thing as a, as a healthcare provider, one of the things that we've got to do, especially
23:42in our rural communities is to break down the information that we are putting out so
23:47that we're not talking over individuals.
23:50It's too important to, to make sure that we are going to, um, address healthcare disparities.
23:56We got to start with how we talk to people and the information that we're putting out there and
24:01being mindful about it and being respectful to one another.
24:05And I understand that we don't always see that when we go into those communities, which is once
24:11again, why we need more people that look like us in the, in those, uh, those doctor's offices.
24:16And I know we are almost at time, but I absolutely want to say another important thing to your
24:22question is don't be afraid to share it with your doctor.
24:27Um, there's so many different things.
24:28Like we live in New Orleans, right?
24:29I noticed, oh, I'm, I'm having headaches.
24:32I'm noticing I'm having headaches.
24:33The very real conversation that I had with my doctor was my doctor said, he looked like,
24:39he looks like me.
24:39He said, well, what are you drinking?
24:42Brown or white?
24:43Everybody can identify with that in here, right?
24:45You can identify with that.
24:47He said, well, the sugars and the brown alcohol is going to give you more headaches.
24:52Like, you know, we researched those things.
24:54You cannot be afraid to really share with your doctor because who else doesn't know your body
25:00besides your significant other, then your doctor and they should know you and they should
25:05know your habits and all of those things.
25:08Those are critical in order to make sure that you're as healthy as you need to be.
25:12So you got to tell them the truth, y'all.
25:14Yes.
25:14You can't, you can't just tell them, oh, I had.
25:17You ate all of the cookies.
25:18A little headache.
25:20You got to give them all the information.
25:22We going to find out anyway.
25:26Yes.
25:27Yeah.
25:27Yeah.
25:28Yeah.
25:28But thank you very much.
25:31I really, really appreciate your attention.
25:34Thank you to Dr. Pierre, Dr. Griggs.
25:38Get checked.
25:39Get fit.
25:41Get moving.
25:43Listen, guys.
25:43You can find me at marqueewpierre.com.
25:47Marqueewpierre.com.
25:48And please follow me on my blog, From Marquee's Heart.
25:52Go get the information about going to medical school.
25:55And I'll share that information about LSU HealthStreetPort School of Medicine.
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