The Importance of Black/African American Owned Direct Primary Care Clinics
Many doctors in the Hint community have only recently begun their DPC practice and we love to celebrate the growth of these individuals and recognize the difference they are making in their local communities. We recognize Black history as part of American history and are thrilled to support doctors who identify as Black/African American and are making history by venturing out of the fee-for-service model and embracing direct care. Dr. Margaret Towolawi opened the first Black-owned DPC clinic in Washington state last spring and was recently recognized as one of the top 10 Black women who made history in 2021. Dr. Towolawi opened a direct primary care practice, Nurture Well Center and a dermatology direct care clinic, SkinStatMD focused on the skin care needs of people of color.
Like many physicians amid the pandemic, Dr. Towolawi experienced intense burnout and gave four and half months notice of her resignation in mid-April of 2020. Without a clear plan, Dr. Towolawi had the courage to step out of a dynamic that was not only not working for her, but not working for her patients either. Her personal experience and desire for a more holistic care approach led her to go into direct primary care. Dr. Towolawi also saw a need for dermatological care focused on deeper skin pigments from her frustrations with poor customer service with dermatologists in the area and misdiagnoses. Dr. Towolawi shifted from a panel of over 2,000 patients at Swedish (where she worked full-time previously) to growing her direct care practices to care for no more than 200 patients.
Disparities in Care
A personalized approach to healthcare via direct primary care does indeed provide better outcomes for all stakeholders and can offer services to patients who would otherwise not have access at all, such as the uninsured or underinsured, or would have to settle for suboptimal care. Due to the exorbitant costs of health insurance premiums, deductibles and other out-of-pocket expenses, socioeconomic factors greatly contribute to the disparity of care in America, but that is not all. It’s no secret that there is inherent bias in the way Americans of different races and ethnicities receive health care. The National Academy of Medicine found that “racial and ethnic minorities receive lower-quality health care than white people—even when insurance status, income, age, and severity of conditions are comparable.”
Furthermore, the National Institute of Health conducted studies on the maternal mortality rate in the U.S. and found that non-Hispanic Black women are dying at a rate of 3.5 times more than non-Hispanic White women mostly from preventable causes such as blood pressure disorders (preeclampsia or eclampsia), hemorrhage, or embolisms. Unfortunately, there are gaps in care that are leading to deaths particularly in marginalized communities.
If there is a more focused approach with primary care at the center many of these preventable health problems can be found early and be mitigated. These gaps in care can be addressed by removing insurance and the barrier to quality primary care. All physicians in the U.S. take an oath to practice medicine and most physicians do their best to honor this. However, when physicians are overwhelmed and have little time with patients, it is very easy for implicit bias and the healthcare system to impact their decision making without them even realizing it. When physicians have a better quality of life and are able to take their time with patients, their cognitive abilities and desire to honor their oath will allow them to be more aware and counter implicit biases that contribute to gaps in care.
An opportunity for Black owned DPCs
There are more and more direct primary care offices opening around the country including those by Black/African American doctors. Dr. Chelsea Mooreland opened Life Cycle Direct Primary Care in Albany, Ohio last September. Dr. Jamal Lawrence opened Harvest Health, Savannah, Georgia’s first black owned DPC in March of last year. Dr. Byron Jasper opened Byja Clinic becoming the first black owned DPC in Louisiana state in September 2020. Dr. Garrick Baskerville who is a part of the Hint community, founded Metsi Care in Austin, Texas back in November 2019.
More diverse doctors are important to have to serve diverse communities and we know the best way to serve the community is by bringing back the doctor-patient relationship with direct primary care. We are happy to support Black/African American doctors and health practitioners who are embracing the DPC movement. We know that creating more opportunities for Black doctors to thrive in direct care can help address some of the gaps in health care that many people of marginalized communities experience.