Exploring the Black health care experience

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For optometrists, patient experience is paramount. It affects relationships with patients, patients’ trust in their care team, a practice’s bottom line, business growth opportunities, staff satisfaction, and, ultimately, a patient’s health. So what can optometrists do to ensure they are creating the best possible environment for their patients? Essence Johnson, OD, FAAO, executive director of Black EyeCare Perspective and director of health care careers at Uplift Education, suggests we consider the overall health care experience of the person in the chair.

In July, Johnson presented a talk titled “The Black Health Care Experience” at the National Optometric Association 2023 Convention in Fort Lauderdale, Florida, and she shared insights into how optometrists can consider the Black experience in health care holistically, while making choices in their care.

“A lot of times, we don’t really delve deep into the different cultural, and just personal experiences that our patients have,” Johnson said in an interview. “So this talk gives some examples of Black patients that I know personally, because they’re my mother, they’re my grandmother and my siblings. And really talking about their experiences in the health care system, it really mirrors many Black or African American patients and the things that we as eye care providers, and health care providers in general, should look out for [when] we’re interacting with our patients.”

Johnson emphasized the importance of clear communication. This involves not only explaining pathologies and diagnoses in a way that patients can understand them, but it also requires self-awareness.

“The question comes up a lot, how do we treat other patients, patients of color, in particular Black patients…. And, a lot of the disconnect that I see from maybe myself versus another colleague interacting with our patients of color is the way that we express ourselves,” Johnson explained. “The time that we’re taking to explain things to them, and the tone that we’re using when we’re explaining these different things to them.”

Doctors may not be aware that they adjust their tone for patients of color or employ phrases with loaded meaning—but the patient will feel the shift. Bias often blinds people to the effect their words have on others, so the first step is to acknowledge personal experiences and opinions that may affect how you speak to others. This expands beyond racial considerations, as people hold biases about everything from preferred contact lenses or dry eye therapies to favorite sports teams. However, these biases are less likely to cause harm than ones steeped in racial prejudice.

Johnson also shares the importance of all communicative cues. Body language and tone convey biases just as clearly as words do.

“When I do this talk and conversation, the pearls that I would like for my colleagues to take back with them is to mind your tone. You know, really pay attention to your verbal and nonverbal tone [and] cues.”

The solution? A large dose of self-reflection is a great place to start. What do you do in your practice that could be construed as cold or closed off to Black patients? What may be insensitive to their experience in health care overall? What can you change today to make your chair a more welcoming, inclusive place to be?

Staffwide racial sensitivity training is always a great option, but the change must start from the top down. Optometrists pledge that the health of their patient will be their first consideration. What are you, the leader of the practice, doing to ensure the whole health of the patient is being addressed? Are you doing everything you can to consider the experience of the Black patient in your chair?