Racism in Healthcare is a discussion series brought to you by Everyday Health, WFAE Public Radio in Charlotte, North Carolina, and ClearHealthCosts, an organization bringing transparency to medical costs. In episode three, host Mary C. Curtis, an award-winning columnist for Roll Call and the host of its Equal Time podcast, speaks with Priscilla Pemu, MD, a professor of clinical medicine and the medical director of the Clinical Research Center of Morehouse School of Medicine in Atlanta.
Dr. Pemu trains medical students and new medical doctors in the area of internal medicine. Through her research, which is informed by her daily experiences with patient care, she explores the best ways to improve the long-term health of those who live with chronic illness. In February 2020, she gave a TED Talk on “culturally congruent coaching,” a program she developed with her team in order to empower patients living with chronic illnesses through the care and assistance of a trained coach from their local community.
The following are some highlights from an edited transcript of the interview.
Mary Curtis: Talk a little bit about what your theory of “culturally congruent coaching” looks like in practice.
Priscilla Pemu: For me, I feel it’s the ability to communicate in a way that gets the person to feel comfortable, that shows that person they are understood in their cultural context, that they’re not being judged, and that they are seen, not as a statistic, but as a person. When they’re able to engage in an empathetic way, to have a real conversation, then that person can share things that they ordinarily wouldn't share, but that may be the major roadblock to them moving forward with their health.
When those real conversations happen, then you can benefit from the knowledge and the skill of the provider who's dealing with you. You're able to engage better because you're seeing results, and you're able to meet your health goals.
On the other hand, if I'm giving you advice and you feel like I don't understand what's going on with you, you're only going to go with it for so long. And then if things don't work out the way you expect, you're quick to drop off [from treatment].
So [with culturally congruent coaching] you get the whole concept. And sometimes it's easier when you share a cultural context, but I don't think that's a requirement. We're all human. I think that people recognize when people actually see them, and are engaging them from a place of empathy and understanding, versus from a place of judgment or distance.
Mary Curtis: We've seen some of the challenges people are facing in the healthcare system. What gives you hope that things are getting better?
Priscilla Pemu: What gives me hope are the times when you have interactions with people coming in to seek care and they’re coming equipped. They come with a little notebook, for example. Or if there's an older family member who's coming in, who may not have quite as much wherewithal to ask the questions they need to ask, they might bring another supportive family member or person in their network who comes in or is able to call in. In those cases, that person can help by asking the right questions and saying things that need to be said in order to move the care forward. That gives me hope.
Nowadays, people have access to their patient portals on their phones, so they can pull up and show you [all the medications] they're on, so there's continuity. You're able to take that reliable information and act on it.
Another thing that gives me hope is that, when I talk with a lot of our young doctors and other care providers, people are activated. People are more willing to go outside of, “Oh, I'm just going to give you this prescription and that's going to solve the problem.” People now understand that [health pertains to] the whole person.
There are also resources on the internet that people can go to and find [information that’s] important for them, and that guides them. For example, I recommend MedlinePlus, a government website that is part of the National Library of Medicine, to help you gain information and knowledge. [When people are able to find] good resources that are reliable, and not trying to sell anything — that gives me hope.