An Interview with Dr. Wayne Frederick, Provost and Chief Academic Officer Howard University: The Black Physician Shortage

Sep 17, 2013 by

Michael F. Shaughnessy

1) Dr. Frederick, could you tell us a bit about yourself and your background and education?

I am originally from Port of Spain, Trinidad. I came to the U.S. to attend school with the goal of becoming a physician in 1988. I participated in Howard’s Bachelor of Science MD program, which is a two-year undergrad, four-year medical school experience, and graduated in 1994.

I then trained in general surgery at Howard University Hospital, secured a post-doctoral research fellowship and subsequently a clinical surgical oncology fellowship at the University of Texas MD Anderson Cancer Center. I then left to go to University of Connecticut, where I was a junior faculty member doing GI surgical oncology and also involved in the general surgery program. I returned to Howard seven years ago to become the Cancer Center director and the Associate Dean of the College of Medicine, before taking on my current position.

2) Now, is there really a physician shortage—or is it that most physicians do not want to work in Alaska, Montana and the less populated states?

It is a combination of both. There clearly is a physician shortage; even when you look in urban areas, access to care is still predicated by the number of physicians. When you look at specialties as well as primary care, there just aren’t enough physicians to serve the entire population. Obviously some of the access is dictated by whether the patients have insurance because of how costly health care is.

And so a lot of patients aren’t accessing the system through normal ambulatory routes, but they are accessing it for acute care. In urban areas, emergency rooms and so on, you tend to see clustering where people go to emergency care centers instead of seeking more preventative medicine. And that is not how it should be?

3) A follow up question: is there a Black physician shortage, and if so, what do you attribute this to?

U.S. census statistics suggest that the black population makes up 13.6% of the U.S. population, and black doctors make up 4%. When you look at it based on those numbers, clearly there is an underrepresentation of black physicians in the physician work pool.

4) I always see this PA-C (Physician-Assistant-Certified) around–is this another medical option for African American males and females?

Absolutely. It is an option for both patients and health care delivery specialists. It is something that America as a whole has to move towards more quickly. We may not produce enough physicians, but I think we have enough health care providers and other health care professionals in the form of nurse practitioners, physician assistants, etc. that we currently underutilize. Thus, PA-C is certainly an option from a professional and a patient point of view in terms of accessing health care.

5) Is this the newest attempt to provide health care under Obama?

I wouldn’t necessarily say that. I think President Obama has been clear that he is trying to provide access. What we need to do in the medical profession is dictate what that access will look like. And yes, other health care providers are certainly a means to getting that care to the patient population.
6) Let’s take one city–Detroit–what does the mayor or governor, or the President need to do to turn that situation around and help those Black kids get to college and later medical school? What can be done to ameliorate that situation and provide mentors?

I think how we approach the pipeline to solving the problem of the shortage is a very complicated one. However, I think there are lessons that we have learned at Howard University that we can impart nationwide.

First, I would mention our middle school, which is located on Howard University’s campus. It’s a math and science-focused middle school where we have demonstrated at the charter school level how you can influence the pipeline. Coming into the middle school, the students represent a broad range of experiences and academic achievements. But when you look at what the school is producing with regards to testing when the students leave, and the fact that more than 95% attend college, you can appreciate the fact that giving students first class exposure in an environment with people who have the motivation and dedication to help them to succeed pays off. One lesson learned from that is we have to start very early and provide a very focused environment.

The second part of the pipeline that is critical is the mentorship in high school and later on. We have to get more physicians to participate in the mentorship of the younger part of the population who are trying to make decisions about career choices. A significant number of the students who come to the Howard University Medical School describe a mentor experience that led them to a career in medicine, which is important.

Also, at a higher level, there is an unconscious bias concerning how we view whether or not blacks can obtain the same academic aptitude as their Caucasian counterparts. We need to dispel these myths so opportunities can be given more broadly. Several professors on our campus are currently writing about this topic, producing a body of research supporting the fact that if black men and women are given the same opportunities and instruction in the same environment, they are just as apt to succeed.

7) I have read several of Ben Carson’s books and seen the made for TV special. Do these events or books help the cause?

Any opportunity where you can tell the story of that type of success against the odds will inspire. I have benefited from a Ben Carson experience that is more personal and speaks to environment and mentorship. As a student, I traveled to Washington, D.C., from Baltimore to speak to Ben Carson, as I was trying to make a decision about going into surgery.

To my astonishment, he spent thirty minutes with me between surgeries. His words of wisdom have stayed with me to this day. He was very direct, encouraging and open about his own experiences. It’s great to see mentors on television and read their books. However, direct contact between mentors and mentees can make a big difference as well.

8) Have you found a preponderance of Black physicians in any one field? And how do you encourage diversity?

If you look at the subspecialties, there aren’t enough African-Americans. But on the same token, the drought is just as bad in the primary care field. So really this is one of those situation where all the wells are dry and need to be filled. Any opportunity to fill one of the wells is a good opportunity, so let it rain!

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