Inspirational Black Men and Women in Medicine: 3M’s Dr. Melissa Clarke On 5 Things You Need To Create A Successful Career In Medicine

In the United States today, black doctors are vastly underrepresented. Only 5% of physicians nationwide are black. Why is it so important to have better representation? What steps can be taken to fix this discrepancy? In this interview series, we are talking to successful black men and women in medicine about their career, their accomplishments, and how others may follow their path. As a part of this series, I had the distinct pleasure of interviewing Dr. Melissa Clarke, chief population officer for 3M Health Care’s Health Information Systems Division.

Dr. Melissa Clarke, an emergency medicine physician and former assistant dean of medical education at Howard University College of Medicine, focuses on health care transformation and health equity in her current role as Chief Population Health Officer for 3M Health Care’s Health Information Systems Division. She is board certified in medical quality and authored the health consumerism book “Excuse Me Doctor, I’ve Got What?” She spearheaded community-based strategies to mitigate the COVID-19 pandemic’s effects on vaccine hesitancy in communities of color, including being a co-founder of the Black Coalition Against COVID and a member of the D.C. health department’s Scientific Advisory Committee for the Development and Implementation of a Safe, Effective, and Equitable COVID-19 Vaccine Distribution Program.

She has led or consulted on implementations of health-equity informed population health programs using telehealth, precision medicine, pharmacist-led medication management and care coordination for Medicaid beneficiaries, and advised major U.S. health care systems on integrating effective population health management approaches, including developing effective partnerships with community-based organizations.

Thank you so much for doing this with us! Before we dig in, our readers would like to get to know you a bit more. Can you tell us a bit about your childhood “backstory”?

I grew up knowing about the importance of health because my Dad was a pharmacist in the country of Jamaica, where my family lived when I was ages 5–12 year old. One Saturday a month, he and a small medical team consisting also of a doctor and a nurse would go to various rural areas in Jamaica to see patients and I sometimes got to tag along. What made an impression on 8-year-old me were the long lines of people that would wait to see them. Waits would sometimes be hours in the hot sun, or inside where there was standing room only due to the shortage of hard, pew-like benches. I understood from that early age how important access to medical care was and what it meant to people who were geographically and economically isolated from care. Seeing that firsthand planted the seeds for a future career in medicine.

Can you tell us a story about what brought you to this specific career path?

My decision to go into Emergency Medicine (EM) was not formed until I got to medical school and worked in the Emergency Department (ED) at San Francisco General Hospital. One of my first patients was a young woman who had abdominal pain. She was frightened and in tears due to the intensity of the pain. She had no permanent place to stay and had been dealing with the pain for weeks. She had been to a free clinic earlier, but they didn’t do anything for her, and she couldn’t afford regular medical care. We were able in a relatively short time to diagnose her, ease her pain, give her antibiotics, and schedule her for the operating room treat a pelvic abscess.

That was the start of the realization that not only can you make immediate differences in people’s lives in Emergency Medicine but also address the concerns of people who fall through the cracks of our disjointed medical system. This is especially true for people of color who because of racism, discrimination, mistrust, and economics sometimes receive sub-optimal care. The Emergency Department is sometimes the only care some people can access and can be the site of meaningful interventions.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“Be the thermostat and not the thermometer.” I read that in an Archie comic book as kid and for some reason it stuck with me. For me, it means don’t be reactionary, be strategic and set the temperature of an interaction. In the long run you will be more effective as a leader and team member — whether in the high-pressure environment of an ED or in high-stakes health policy discussions.

Can you share the most interesting story that happened to you since you began your career?

There are always “interesting” stories in the ED…extracting items from body orifices where they don’t belong, caring for victims of life-threatening trauma, comforting a child having their first asthma flare, or even caring for public figures you admire…it runs the gamut.

But I would say one of the most impactful events was when I was a patient myself in the ED. I has a sports accident that I thought was minor, but over the course of the next three days I developed excruciating neck pain, preventing me from turning my neck. I felt like I couldn’t breathe when I lay down. So, on day four, at 3 a.m., I reluctantly went to the nearest ED. I was given pain meds and had a neck CT scan, which was actually the wrong test because, as I discussed with the ED doctor, I needed an MRI. However, the doctor was reluctant to call the MRI tech to come from home in the middle of the night. The CT was normal. He diagnosed me with anxiety because of my complaint about feeling like my breath was cutting off, and then discharged me. Tired and drugged up, I went home.

Luckily, the Black nurse who cared for me that night had worked with me before at another hospital and notified the ED medical director in the morning about what happened. The director called me back later that same afternoon to have an MRI, which showed a ruptured neck muscle and a collection of blood associated with it that was pushing on my windpipe. I had emergency surgery that evening and have been fine ever since.

This event illustrated a few things to me:

1. The potentially life-threatening consequences of not taking a patient seriously.
2. Bias in medicine toward the complaints of women and people of color.
3. The importance of advocacy, which even I, as a physician, needed to get the proper care.

It was one of the many inspirations for the book “Excuse Me Dr- I’ve Got What?! Taking Ownership of Your Health and Making Healthcare Work For You,” that I wrote to help health care consumers be their own best health advocates. It also propelled me to go into population health and focus on health equity, influencing those factors that can lead to people being healthier and getting high quality medical care.

You are a successful leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?

Curiosity — Always having an inquiring mind. In health care this is especially important because science is ever expanding our understanding of health and the human body; new techniques and therapeutics emerge as a result; and new solutions are developed for how to solve some of our most vexing issues with health care delivery. Curiosity has served me well in not just keeping up with advances, but also researching to develop innovations to address issues related to health care access and equity.

Discipline — I went to medical school and residency (medical specialty training in Emergency Medicine) at an age where friends and peers were working, earning money, having children or out having fun. It helped that I loved learning and the training process, but there were occasions when being in the library on a Saturday night caused me to question what I was missing out on. Having the ability to focus and be disciplined helped get through those periods. And now with the benefit of hindsight, I can say it was definitely worth every minute.

Centeredness — I definitely did not have this early in my career but developed it along the way. Being centered is very important for health care providers, especially in Emergency Medicine, because you encounter so many different people, situations, and challenges in the course of one shift, that you can easily let it wear you down or throw you off balance. Having a practice that helps ground and renew you in any situation — whether its meditation, exercise, or a hobby — is essential to success, especially if you define success as peace and well-being. What centers me is music, meditation, and laughter with friends.

Let’s now shift to the main focus of our interview. This might seem intuitive to you, but it would be helpful to articulate this expressly. Can you share three reasons with our readers why it’s really important for there to be more diversity in medicine?

1. Diversity improves communication and outcomes: Just as in the story I mentioned about myself as a patient, diversity in medicine allows the profession to be infused with the voices and experiences of different communities. As a result, there is more likely to be more empathy, deeper listening and respect, which is unfortunately far from being universally present in current physician-patient interactions. This becomes increasingly important as the U.S. population becomes more diverse with current “minorities” being the fastest growing segments of the population. Black physicians are also more likely to return to their communities and provide care, increasing much needed access.
2. Diversity fosters greater trust — There is a history of communities of color, and their healing traditions, being disrespected and even abused by the medical community. Examples of inhumane experimentation on Black people in the Tuskegee study, under-treatment of pain of Latino patients, and forced sterilization of Black and Native American women are only a few of the documented instances. And today, during the height of the COVID-19 pandemic, Propublica and others documented numerous stories of people of color’s symptoms being minimized, being inadequately evaluated/treated for COVID-19, and being discharged from the ED and dying at home. These breaches of trust result in individuals from these communities not seeking care proactively from providers. Widening the diversity in medicine can help to repair trust with individuals from these communities.
3. Diversity allows for advances in medicine — Imagine if Patricia Bath never practiced medicine. We would not have a precise and painless way to treat cataracts. No Charles Drew? We may not have safe ways to store blood for transfusion. No Daniel Hale Williams? We wouldn’t have had the first successful open heart surgery. They are all African American. I could go on and on, but the bottom line is racism, discrimination and all the other barriers to pursue a medical career, depletes the talent pool for the advancement of health care. Just imagine where we would be if everyone had equal access to entering the medical profession? We have already lost out on an innumerable amount of talent and brain power over the years. Now is the time to widen the net of opportunity for us all to benefit.

As things stand today, what are the main barriers for black men and women to enter the medical field?

• Education: Just as poorer resourced hospitals are found in black and brown neighborhoods across the country, poorer resourced schools are as well. The quality of education is inferior, not allowing children to get the kind of education that would equip them for a medical career. This is no accident since the resources given to schools are based on the tax base in the neighborhood and not equally distributed regionally. Neighborhood wealth was in turn created through redlining, where in the mid- to early 20th century, African American families were restricted to certain communities and denied home loans, the principal way wealth is generated and inherited. Racism and discrimination within the educational process is also a factor as well.
• Finances: Lack of finances or the financial literacy/awareness to navigate loans and scholarships to finance post-secondary education is another barrier. A significant percentage of black and brown people are first time college attendees, so often must navigate the system for the first time without the benefit of parental experience. First-time college attendees also have to work more often while in school, which further sets up barriers to them graduating and sustaining a high enough GPAs to be competitive for medical school.
• Exposure to medicine as an attainable career: The lower percentage of Black doctors means there are fewer role models that young Black people get exposed to at a formative time in their life. People often choose careers based on the ability to see themselves in that role, which is heavily influenced if they see people like themselves doing it. Conversely, if they have a negative experience in health care as a child — because of discrimination, poor communication, etc., it may turn them away from pursuing a career in medicine altogether.

From your perspective, can you share a few things that can be done by the community, society, or the government, to help remove those barriers?

• Funding public school education in a way that equalizes the quality of primary and secondary education, regardless of the neighborhood you live in.
• Expanding “pipeline” programs that identify children early in their education and expose them to mentors and experiences in math, science, and health care.
• Expanding financial options for young people who are first time college students to attend secondary education.
• Reaffirming the commitment to affirmative action. Black citizens of the U.S. have had more than 350 years of unfettered discrimination in higher education. This will not and has not been erased by one generation of affirmative action.

What are your “5 things I wish someone told me when I first started my career in medicine,” and why? Please share a story or example for each.

1. You belong here! When there are only a few people who look like you, in this racialized society, you may get bombarded by messages that imply or state explicitly that you have to prove yourself and your worth in being there. In addition, affirmative action was weaponized to alienate Black students by implying they were lesser qualified and did not belong. My classmates and I constantly had to prove that we did belong.
2. Each person is unique in what they bring to the table — let your light shine brightly! My early response to having my belonging and worth questioned was to become invisible or inconspicuous. I eventually learned that it is the variety of experiences drawn from individuals of diverse backgrounds that make us stronger as a profession and as a society in being able to tackle and solve problems. Being encouraged to let your light shine because your uniqueness is a superpower, is something all young people should hear.
3. “Race” is not a biological reality. It is only a made-up social classification. Several algorithms in medicine and research are based on a presumed biological or genetic difference between individuals with different skin pigmentation and hair texture. The reality is we as humans are 99.9% genetically similar and among people of the same “race” there is actually more genetic variation than between people of different “races.” Not understanding and teaching this has led to the practice of bad medicine. Thanks to the current crop of Black medical students and residents, who have begun to call out these discrepancies, most famously in removing race from estimates of kidney function, we are getting much more accuracy in how we diagnosis and treat disease.
4. “It’s ok to give a patient a ride home.” A few years ago, I was with my husband at the funeral of a mentor and a giant in medicine, Dr. William Matory. There, we saw my mother-in-law’s cardiologist, who was also mentored by Dr. Matory. My mother-in-law loved her cardiologist, was one of his first patients, and thought of him as the consummate physician. He explained to us how Dr. Matory, as his mentor, was the first doctor he ever saw give a patient a ride home. He then turned to my husband and said, “and your Mom was the first patient I ever gave a ride home.” In other words, seeing it modeled that “professionalism” in medicine could be synonymous with embracing one’s humanity allowed him to realize this simple act was ok, if needed. Far too often in medicine, we think compassion and professionalism can’t coexist, when really, balancing them makes us better physicians.
5. Patients are greater than the sum of our parts. Medicine classically has focused solely on how our bodies function at the expense of accounting for our culture, social milieu, and spiritual beliefs. Synthesizing this is often left up to the individual physician, rather than explicitly teaching how to do “whole-person care” effectively and helping to change our system so that it becomes a standard approach to care.

You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

I have mentioned this already but, increasing funding for pre-K through 12 education and equally funding schools, no matter the neighborhood. Combining that with universal broadband access would help to level the educational playing field and give more children access to opportunities.

We are very blessed that some very prominent names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them.

Former First Lady Michelle Obama — she has tremendous influence. I admire how she maintains equanimity and grace under pressure. Furthermore, from a health perspective, she chose organic gardening and fitness as two of her causes while serving as First Lady. These are crucial to health empowerment, which is my mantra.

How can our readers best continue to follow your work online?

You can follow me on LinkedIn or on my website, drmelissaclarke.com

Thank you for these fantastic insights. We greatly appreciate the time you spent on this.