As 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).
I. Historical Retrospective
It is axiomatic that patients must trust their doctors, otherwise the treatment that would be given will not succeed. The purpose of this article is to explore the elements of trust as applied to the doctor-patient relationship, especially as it is viewed by African American and other minority patients and healthcare providers. It is necessary to go back in history and determine what the situation has been for African Americans, because our history has been unlike that of any other sub-population group in this country.
When blacks first came to this country in 1619, one year before the landing of the Mayflower, they came in chains and in bondage, snatched from their native Africa and loaded aboard slave ships and transported here through the Middle Passage.
Once here, they were subjected to the most atrocious living and working conditions imaginable, and when they became ill, they were treated with massive doses of cathartics and other medicinals more fitting for treating horses, such as croton oil, which induced heavy diarrhea, and tartar emetic, which caused effusive vomiting.
Thus cleansed and purged, the slave who was unfortunate enough to become ill was immediately returned to work in the fields, because the master did not want sickness to cause a loss of his revenue brought in by his slave’s labor.
A slave was a commodity, and commodities had to be maintained in top working condition in order to maximize income on the plantation. Needless to say, the slaves did not trust the master’s medical ministrations, and they preferred to use their own treatments, which consisted of voodoo and hoodoo potions, practices and folk