For nearly two decades, Dr. Tamika Perry has been a primary care physician in Texas, currently serving at WellMed. In addition, she is an Associate Regional Medical Director for Quality and Risk Adjustment, overseeing care across the state. Dr. Perry’s reputation isn’t built on titles alone, but on her ability to truly hear what patients are saying.
“A lot of times, people are blinded by what they see in front of them instead of getting down to the root of being a clinician: you listen to the patient, you examine the patient, you hear their story,” she tells BlackDoctor.org.
This philosophy, which she learned in medical school, has helped her identify life-threatening conditions that other physicians had missed.
Listening Beyond Assumptions
Dr. Perry stresses that a proper diagnosis starts with setting aside bias. All too often, clinicians allow assumptions based on race, gender, age, or socioeconomic status to cloud their judgment. She emphasizes that patients know their own bodies best.
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“Patients say all the time, ‘I know my body,’ and they are absolutely right. They’ve been with their body their entire life,” Dr. Perry says. “The patient does know their body, but it’s the clinician’s job to apply medical knowledge to what the patient is telling you. You put the two together, and usually, you will come up with the right diagnosis and solution.”
She recalls a personal experience with a dermatologist who quickly concluded her hair loss was due to tight braids or weaves—a diagnosis rooted in a stereotype about Black women’s hairstyles.
“He immediately said, ‘You have traction alopecia because you wear tight braids or weaves.’ I told him, ‘I’ve never worn tight braids or weaves, especially around my edges.’ He dismissed me,” she says.
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Determined to get a second opinion, Dr. Perry went to another dermatologist who actually listened. “He said, ‘We can’t make that assumption, especially given your history.’ He ordered blood work and a scalp biopsy. That’s when we found out I had androgenetic alopecia—genetic, from my father,” she adds.
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The Impact of Implicit Bias
Dr. Perry has seen and personally experienced how implicit bias can affect the quality and urgency of care, from ER visits to routine checkups. She points out the persistent myth that Black patients have a higher pain tolerance—an idea that has been disproven yet still quietly influences treatment decisions.
“Another time, I went to the ER after returning from Thailand very sick. I walked in disheveled, in my teenage daughter’s clothes, in pain. At first, I was dismissed. Then I said, ‘My name is Dr. Tamika Perry. Here is my differential diagnosis.’ Immediately, my treatment changed,” she explains. “But not everybody has the luxury of saying, ‘I’m a doctor.’ We need to treat every patient appropriately and believe what they say.”
“At that ER visit, the doctor asked me, ‘What would you like for pain?’ I knew the options. But many patients don’t. It shouldn’t take being a physician to be believed. At the end of the day, I’m still Black, and bias affects the care we receive,” she adds.
Cultural Competence in Action
For Dr. Perry, culturally competent care is more than a training module; it’s a commitment to understanding a patient’s beliefs, priorities, and lived experiences. This includes respecting a patient’s religion, such as a Jehovah’s Witness patient’s restrictions on blood products, and lifestyle factors. For example, recognizing how hair care concerns can affect a Black woman’s willingness to take certain medications.
“If a patient believes her blood pressure medicine is making her hair fall out, even if it’s more likely due to relaxers or dyes, it doesn’t matter. If the clinician dismisses it, the patient won’t take the medicine. You have to address what matters to the patient,” Dr. Perry explains.
She believes clinicians must immerse themselves in the communities they serve, learning the language and norms and adapting their approach without compromising medical standards.
“When I had practices in underserved Black and Hispanic neighborhoods, middle-class suburbs, and LGBTQ+ communities, I made it a point to engage in churches, weddings, [and] cultural events,” she says. “If you don’t know what’s important to your patients culturally, how can you treat them as a primary care physician?”
Recognizing How Patients Speak Their Symptoms
While medical conditions may present the same biologically across all races, how patients describe them can differ.
“A study in the American Journal of Critical Care found that Black women reported fatigue with higher intensity and frequency before a heart attack compared to white women. Too often, that’s dismissed as diet, exercise, or anxiety. Really, she’s telling you: ‘I’m about to have a heart attack,’” Dr. Perry notes. “Clinicians need to look past the face in front of them and listen to what’s actually being said.”
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Hope for the Next Generation, With Work Still to Do
Dr. Perry is hopeful that younger clinicians entering the field with more exposure to implicit bias training will make a difference. However, she clarifies that bias isn’t limited to any one group.
“Just because you’re a person of color doesn’t mean you don’t have bias. We all have to recognize it.”
She also points out that mistrust cuts both ways. Some patients still question the competence of physicians of color—a belief shaped by decades of systemic prejudice. “I’ve had patients surprised I was their doctor because I was Black. Some even said friends asked why they’d go to a Black doctor. That comes from decades of society teaching them not to trust us,” she adds. “It’s deeply ingrained, and changing it will take time, education, and consistent proof through care.”
The statistics on these disparities are stark. For example, a 2015 study in the American Journal of Public Health found that Black women had a 40 percent higher death rate from breast cancer compared to white women. A 2017 study in the journal Circulation: Cardiovascular Quality and Outcomes found that Black patients received CPR less frequently than white patients in out-of-hospital cardiac arrests, with similar disparities in in-hospital settings.
“The data is clear: people of color get less CPR, Black women have worse outcomes in breast cancer—not because of biology, but because of access and unequal quality of care. We have to keep spreading the message: this is real,” Dr. Perry shares.
A Message to Patients and Clinicians
Dr. Perry’s advice is simple yet powerful:
- To patients: “You are your own advocate. If you feel something is missed, speak up, get another opinion. No one loves you like you.”
- To clinicians: “Pretend every patient in front of you is your mother, father, brother, or sister. Treat them as you would treat your own loved ones. If you do that, you’ll do right by them.”
For Dr. Tamika Perry, the foundation of better healthcare is simple but powerful: listen first, respect always, and never let assumptions do the diagnosing.
