From Slavery To Present: Why Blacks Distrust Healthcare Pt. 3

Dr. Richard Allen Williams National Medical Association NMAAs the leader of the National Medical Association, I have the responsibility to provide a perspective to our constituents on key issues in Medicine that are important to us and to the patients whom we serve. One of those issues is TRUST, which has special meaning to people who have been subjected to so many abuses and indignities over the past 400 years. In the tradition and in memory of the late legendary Howard University School of Medicine professor, civil rights activist, former NAACP president, past president of the National Medical Association, philosopher, and my personal mentor and hero, W. Montague Cobb, MD, Ph.D, who was also Editor Emeritus of this Journal, I submit the following perspective on this topic, which will be incorporated into my forthcoming book, Blacks in Medicine: Clinical, Demographic, and Socioeconomic Correlations (Springer Science & Media, 2017).

III. Maintaining Trust

The first point of contact for the patient with the doctor is the office. How the patient is initially received at the office is pivotal in the establishment of a smooth and congenial doctor-patient relationship, and of course this contact usually occurs before the two meet. When the patient walks in the door and goes up to the receptionist, that person must be cordial, well-dressed, and eager to help. The receptionist as well as the rest of the office staff should greet the patient and should think of themselves as an extension of the physician in all of their dealings with the patient. Their behavior should be professional but compassionate at all times, and courtesy must be a hallmark of their attitude. They should become experts in interpersonal relations and must make each patient feel special. Needless to say, they must emphasize and demonstrate that the patient’s medical affairs are strictly confidential (now mandated by law by the HIPAA regulations).

These elements have to be repeated each time the patient visits as well as when the patient is contacted for results of laboratory tests, etc. between visits. Appropriate handling of these elements will serve to strengthen the trust which the patient has built up and will help immeasurably in maintaining it. The doctor must be responsible for how his office staff manages the patient, and he must be the person designated to initiate and oversee their function, along with the office manager or medical assistant.

The doctor himself, therefore, is the key to maintaining the trust that has been instilled in the patient. In addition to motivating his staff, he must maintain a code of cultural competence at all times in dealing with patients. This means always regarding the patient as the center of the medical universe rather than himself, and manifesting a humane approach to the treatment of the patient. This does not have to be time-consuming.