When someone says doctor, do you think old white guy? Tell the truth. →

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A Delta flight attendant is looking for a doctor during a recent in-flight medical emergency. When Dr. Tamika Cross volunteers to help the unresponsive passenger seated in front of her, the flight attendant tells her, “Oh no sweetie put your hand down, we are looking for actual physicians or nurses or some type of medical personnel, we don’t have time to talk to you.” The crew continues to call for a physician until an older white guy shows up. Dr. Cross apparently does not look like a doctor. Neither do the nine women physicians who share similar stories here. So what do doctors look like on airplanes? 

Maybe this should be Delta’s announcement: ”We have a medical emergency. Is there a tall, gray-haired, white man on the plane?”

A female surgeon in a white coat introduces herself to her patient as Dr. Smith and completes her preoperative exam. She explains all the risks of the surgery, then asks for questions. The patient says, “Can you get me some ice? When will the doctor be here? I want to talk to him.” Dr. Smith apparently does not look like a doctor even when dressed like a doctor inside a hospital. So what do doctors look like inside of hospitals? 

Facts:

* When a male medical student and a female doctor enter a patient room, the male is frequently assumed to be the doctor and the female is the nurse or assistant.

* Female physicians are frequently mistaken for nurses, lab techs, food service, janitors, hospital transport, and candy stripers. Even after introducing themselves in proper attire with name badges and stethoscopes patients actually ask these women to toast their bread or change their diapers. 

* The darker the doctor’s skin, the more likely she is assumed to be housekeeping or a cafeteria worker. The lighter the skin, the more frequently she is assumed to be the nurse.

Don’t get upset with me. I’m just the messenger sharing the truth about life in a patriarchal medical model. And yes, discrimination is worse for those with darker skin.

So what do doctors look like?

I asked Dr. Google. I went incognito on Chrome, typed “doctor,” and pressed images. I analyzed the first 100 photos. Here are the results:

Male doctors 74% (66% of practicing physicians are male)

Female doctors 26% (33% of practicing physicians are female)

White male doctors 59%

White female doctors 18%

Black male doctors 7%

Black female doctors* 3% (2% of practicing physicians are black women)

Little white boys dressed as doctors  2%   

*2 of the 3 black female doctors were Dr. Cross

Google images exposes society’s most harmful stereotypes. In this case it skews the lack of diversity in medicine and reinforces the notion that doctor = white male. Public opinion is heavily influenced by media images. Female physicians are underrepresented on Google images as are dark-skinned women physicians. Two of the 3 black women physicians in the first 100 images were Dr. Tamika Cross. If Dr. Cross were not in the news, there would just be one black woman represented.

Meanwhile 2% of images were of little light-skinned boys dressed up as doctors. No little girls dressed up as doctors. No little dark-skinned girl doctors popped up either. In fact, if Dr. Tamika Cross were not in the news, the number of white boys dressed up as doctors would exceed the number of grown black women physicians.

Good thing Dr. Tamika Cross is reminding us of all the underrepresented doctors out there. Reality check: Half of all medical school graduates are now women. More than half of all obstetricians are female. A whopping 85% of all Ob/gyn residents are women and 75% of all pediatricians-in-training are women.

Next time you’re in the hospital, don’t ask the dark-skinned woman in the white coat for a cup of coffee. She’s busy taking care of your newborn. Got a medical emergency on a plane? Let’s hope the doctor below can get past the flight attendant to assist you.

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Yep! The face of medicine is changing.

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Pamela Wible, M.D., is a family physician dedicated to eradicating the widespread human rights violations in medicine. She is author of Physician Suicide Letters—Answered.

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Female physicians told to sit down, shut up, and get out of the way during emergencies as patients nearly die →

It’s true. Man nearly dies on plane because crew didn’t believe black woman was doctor. The medical fiasco on Delta airlines has now gone viral after a Facebook post by Tamika Cross, M.D., the physician who was turned away from caring for an unresponsive passenger. Tamika joins a long list of female physicians who have experienced the same discrimination. Meet them here. In their own words . . .

Tamika Cross

Tamika Cross, M.D. ~ OB-GYN Chief Resident

“I was on Delta flight DL945 and someone 2 rows in front of me was screaming for help. Her husband was unresponsive. I naturally jumped into Doctor mode as no one else was getting up. Unbuckle my seatbelt and throw my tray table up and as I’m about to stand up, flight attendant says, ‘everyone stay calm, it’s just a night terror, he is alright.’ I continue to watch the scene closely. A couple mins later he is unresponsive again and the flight attendant yells ‘call overhead for a physician on board.’ I raised my hand to grab her attention. She said to me, ‘oh no sweetie put your hand down, we are looking for actual physicians or nurses or some type of medical personnel, we don’t have time to talk to you.’ I tried to inform her that I was a physician but I was continually cut off by condescending remarks. Then overhead they paged ‘any physician on board please press your button.’ I stare at her as I go to press my button. She said, “oh wow you’re an actual physician?” I reply yes. She said ‘let me see your credentials. What type of Doctor are you? Where do you work? Why were you in Detroit?’ (Please remember this man is still in need of help and she is blocking my row from even standing up while bombarding me with questions). I respond ‘OBGYN, work in Houston, in Detroit for a wedding, but believe it or not they DO HAVE doctors in Detroit. Now excuse me so I can help the man in need.’ Another ‘seasoned’ white male approaches the row and says he is a physician as well. She says to me ‘thanks for your help but he can help us, and he has his credentials.’ (Mind you he hasn’t shown anything to her. Just showed up and fit the ‘description of a doctor’). I stay seated. Mind blown. Blood boiling . . . Supervisor verified that with me afterwards. In emergency, they never ask to show credentials. This could have been life or death. We didn’t know if he had a pulse or anything!”  

Kadijah Ray

Kadijah Ray, M.D. ~ Anesthesiologist

“In response to the horrific treatment of Dr. Tamika Cross on Delta Airlines! I’ve received that same treatment on 2 different flights while trying to help people in distress. They passed me up for all whites. A female pharmacist and nurse. And a male MD who I believe was something like radiology. I can’t remember exactly his specialty but I remember him telling them, ‘trust me you want her to help before me’ when I told him I was Anesthesia. And no, I ‘don’t have my credentials with me.’ You wouldn’t allow me to carry that on! Would far exceed your weight and size requirements.” 

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Trupti Shah M.D. ~ Emergency Medicine

“On an Egypt Air overnight flight from Cairo to JFK, the lady seated in front of me was having difficulty breathing. I heard the commotion but did not understand the conversation since it was in Arabic. I asked if I could help and identified myself as a doctor. I was told by the male head flight attendant to sit down. They then announced overhead asking for medical help. I got up again but was ignored. A male cardiologist, from NY, who was fluent in Arabic offered assistance and was immediately ushered to the woman. He noticed that I was trying to help but was not allowed. While they went to get him the medical kit on board, we spoke. He had trained at my hospital. As soon as he was handed the medical kit, he immediately gave it to me but the flight attendant tried to take it back. He had to intervene in order for me to help the woman; he translated. The woman had started taking Amoxicillin given to her for a sore throat and developed a rash, itchy throat and shortness of breath. I checked her blood pressure and lungs. Then I gave her Prednisone, Benadryl, and Pepcid from my carry-on (all of which I carry with me when I travel abroad.) She felt better after 30 minutes. An hour later, the meals were served. I had reserved a vegetarian meal but when I requested it, the same male flight attendant told me that ‘you people always lie.’ He argued and refused to believe me. He asked for proof and I showed him my printed flight itinerary. He then brought me a completely burnt tray.”

Jessica Kiss DO

Jessica Kiss, D.O. ~ Family Medicine Chief Resident 

“Same thing happened to me on the side of the freeway. Car overturned, glass in head, pouring blood. People questioned me as I ran over in horror as they kept moving him around to check the wound. I say ‘I’m a doctor. Please lay him down. Someone keep his neck still. Someone hold pressure on the wound.’ The other lady on scene tells me to prove it! Go away, lady, I’m trying to keep this guy from dying from your negligence.” 

Mariam Anwar MD

Mariam Anwar, M.D. ~ Internal Medicine/Geriatrics

“On an Emirates flight the Flight Manager asked for my credentials and wouldn’t let me help. Let a white nurse help though without asking for her credentials. Of course I helped anyway. It was an elderly male with [emphysema] COPD exacerbation, hypoxic and also having an anxiety attack. We had to calculate if we would have enough oxygen to last the trip without having to land… would not make it if he needed more than baseline (5 Liters). The manager put him in business class and gave us seats too. We monitored him for several hours, he became unresponsive, hypertensive. I checked an EKG, glucose and after several sternal runs he woke up. Of course I lost several hours of sleep on a long flight and a flight attendant had to take care of my toddler while I assisted him. When his shift was over another manager came (he was Arab). He told me to go back to economy class and he let the white nurse stay in business class the entire flight! Blatant discrimination and lack of respect!”

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Susan Goldberg Cohen, M.D. ~ Internal Medicine/Palliative Care

“Had same issue on a plane when sick passenger was in row behind me but ‘Marcus Welby’ in tweed jacket ran from way back of plane…. Flight attendant admonished me for not taking my seat when there was a medical emergency in progress—ugh . . .”

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Amina Moghul, D.O. ~ Family Medicine

“Had something similar happen to me. A patient syncopized [fainted] right next to my seat. I identified myself as a physician and was pushed out of the way and told to step aside for an older white male RN to tend to the passenger. I was so stunned, I froze for a few seconds before politely introducing myself to the nurse as a physician and recommended we work together. The flight attendant continued to ignore me and direct questions and offers to get help or equipment to the male nurse. I thought it was just me that had experienced this…”

Ashley Denmark, D.O.

Ashley Denmark, D.O ~ Family Medicine

“On Delta 2215, a flight attendant requested over the intercom a doctor or nurse to report to front of cabin to assist a passenger. Without hesitation, I made my way and was greeted by two Caucasian women and a Delta flight attendant. I quickly asked, ‘What’s going on?’ Then I stated, ‘I’m a doctor. How can I help?’ Immediately, I was greeted by puzzled looks from all three women. The flight attendant asked, ‘Are you a doctor?’ to which I replied ‘Yes.’ My response only left a more puzzled look on the attendant’s face. She turned around and began to talk to another flight attendant. I stood there in bewilderment because someone on the plane was in need of medical assistance and no one was escorting me to the passenger in need. Finally, one of the Caucasian passengers who came to assist spoke and stated that she and the other passenger present to assist were both nurses. Then she asked, ‘Are you a doctor?’ to which I responded ‘Yes’ …..again. She immediately responded ‘Well you need credentials to show you are a medical professional.’ I gave a funny look but, remained composed and quickly quipped ‘I have my hospital badge which should be enough.’ The Delta flight attendant continued to look puzzled then stated, ‘We have two nurses here who came first. You can have a seat now and we will let them handle it. If we need more help we will come and find you.’ As I walked back I scanned the cabin. I looked for someone in distress, unresponsive wondering who was this person who needed help. At that moment the gravity of the situation hit me like a ton of bricks. Apparently the nurses and flight attendants didn’t think I was a doctor. Why else were nurses being allowed to take charge in a medical situation when a doctor was present?  Surely it couldn’t be the color of my brown skin? So here I was, the doctor with 11 years of training being asked to take a seat and not partake in caring for the passenger in need. As an African American female physician, I am too familiar with this scenario. Despite overcoming and excelling academically and obtaining the title of Dr. in front of my name, I still get side-eye glances when I introduce myself as Dr. Denmark. Commonly, I’m mistaken for an assistant, janitor, secretary, nurse, student, etc even when I have my white coat on.” Read more on Dr. Denmark’s Delta discrimination here.

Janelle Evans, M.D.

Janelle Evans, M.D. ~ Urogynecologist

“We were in the middle of the Atlantic on Delta Flight 200 to Johannesburg, South Africa, when a man had a GI bleed, hypotension, and became unresponsive in my aisle. Of the four physicians on board, only I had credentials with me and the purser denied the man care until one of us produced it. I am a urogynecologist and there was also an ICU physician, but she was told she could not help (she was Latina and similarly petite like me). I told her to ignore the purser and assist. While we worked to stabilize the patient, the purser would not put the lights on to start IVs and adequately see the medical kit. The kit was less than 1/2 stocked with no aspirin, no nitro, nothing. She tried to start drink service while we had a fully naked man in the walkway between lavatories and bloody stool all over one side of the plane. We successfully stabilized him and no sooner had we done so that she angrily declared that we were relieved of medical duty because she was going to deal with the in-flight phone physician rather than us. I had made it clear I wasn’t leaving the area and personally spoke with the ground doc who confirmed that his condition required in-flight assistance. I never heard from Delta until my article got published. It did not go viral like Dr. Cross, but they did call and comp our flight. I never received a thank you from the purser and left the plane with the patient, covered in bloody feces. In the aftermath, apparently the purser tried to cover it up and only reported it as a minor incident. My information was not included.”

Racism and sexism on airlines

Salma Elfaki. M.D. ~ Pediatrician

“In 2012, I experienced the same thing as Dr. Cross on a transatlantic flight. The flight attendant dismissed me initially and asked me to sit back at my seat as they needed a real doctor. At that point a black male acquaintance of mine (also a doctor) was being escorted back to the patient. He called me across the aisle to come help him. The flight attendant appeared shocked. She confirmed with him that I am indeed a doctor.  He told her, ‘She’s a pediatrician and a very good one.’ He proceeded to examine the patient and I requested their medical kit. Once I received it I got to work to see what I could use and took it from there with my colleague, an adult cardiologist. We were both able to work together and help the patient. They didn’t ask me for credentials, but clearly had to take a man’s word for it!”

More stories coming . . .

Contact Dr. Wible to add your story.

This article picked up by The Washington Post and also by TIME Magazine. As a result, now a policy change at Delta!

Pamela Wible, M.D., is a family physician who has offered medical care during 2 in-flight emergencies. Nobody ever asked for her credentials. They did offer a bottle of wine as a parting gift. She doesn’t drink.

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“Died suddenly at home” is not a diagnosis. How medical institutions cover up suicides. →

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This week I learned of yet another medical student suicide. Ari Frosch, a second-year student at Penn, died by suicide by walking onto the northbound tracks as a Boston-bound Amtrak train passed through Mansfield station. Amtrak trains do not stop at Mansfield station. Police have surveillance tape of the victim trespassing and walking right onto the tracks. There’s no mystery surrounding this medical student’s very public suicide.

Yet his medical school reports that Ari died suddenly last week at home with family in Newton, Massachusetts. Except that he was not in Newtown. He was in Mansfield. He was not with his family. He was not even at home. He was at a railroad station—where he died. 

Why hide the truth in a lie? So nobody will know that each year more than one million Americans lose their doctors to suicide. So nobody will know that physician suicide is a public health crisis. So nobody will know how many medical students we lose to suicide each year. 

Censorship just ensures that these suicides will continue. Next week our doctors will still be jumping from hospital rooftops, overdosing in call rooms, found hanging in hospital chapels. And these suicides will still be covered up by some of our hospitals, clinics, and medical schools—often with these handy little euphemisms.

  Euphemisms to cover up medical student and doctor suicides

  • Doctor passed away unexpectedly in his sleep.
  • Doctor found dead in hospital. Declared non-suspicious. 
  • His light went out too soon.
  • Medical student passed into eternity.
  • Doctor died by “accidental overdose.” 
  • Medical student died suddenly at home.
  • She passed away peacefully.
  • He went to be with the Lord.

Euphemisms are vague, indirect expressions substituted for facts to avoid something unpleasant or embarrassing. That’s not science. It’s deception. Word matter. 

Here’s a simple idea—Let’s just tell the truth. 

Pamela Wible, M.D., is author of Physician Suicide Letters—Answered. She was once a suicidal physician and now helps her colleagues find their way out of despair and hopelessness in medicine. Contact Dr. Wible here. Please reach out for help if you are suffering. You are loved.

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An ingrown toenail is not a lung transplant (how primary care is being held hostage to tertiary care) →

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Here’s a quick review of health care delivery basics:

Primary care – Stuff you can get handled with your primary care doctor in your neighborhood. Example: ingrown toenail.

Secondary care – Stuff your primary care doctor refers to a secondary specialist down the road. Example: colonoscopy.

Tertiary care – Complex stuff you need to deal with at a big-city hospital. Example: lung transplant.

Simple. Right?

Here’s the problem: In modern medicine we’re holding primary care hostage to a tertiary care delivery model. 

If you’re getting a lung transplant you need a 5-story hospital with helipad, medical team, insurance coding/billing software (you actually need insurance to cover the $500,000+ bill) and all sorts of special machines and complicated equipment. If you’re getting a colonoscopy, you need one person to shove a tube up your butt in a simple office with a few staff. If you’ve got an ingrown toenail you need one primary care doc in one tiny exam room with a pair of scissors. 

When we force ingrown toenails and buttholes to subsidize 5-story hospitals, helipads, medical teams, and insurance systems, we create incredible inefficiency and expense. In fact, all that crap is not only unnecessary, it just gets in the way and makes your $100 toenail or $1000 colonoscopy cost hundreds and thousands more! 

When we force primary care to pay for the infrastructure of tertiary care medicine, we end up with  assembly-line medicine in which patients are forced through 7-minute visits. Both high volume and price gouging are required to pay for the unnecessary helipads and hospitals for your ingrown toenail.

I’m a family doctor and I’ve been delivering primary care to my community for decades. I’ve removed ingrown toenails and metastatic lung cancer. I’ve cared for psychiatric patients and complex neurologic conditions. In fact, I can deliver care for 99% of what ails my patients right in the comfort of my 280-square-foot office. Just two chairs. One exam table. And no staff.

All I really need is my brain. And my brain tells me we must stop allowing buttholes to design primary care delivery in America.

Contact me for a free guide on how to launch your ideal clinic

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Pamela Wible, M.D., is founder of the Ideal Medical Care Movement and author of Physician Suicide Letters—Answered.  Jorge Muniz, PA-C, is an internal medicine physician assistant, illustrator, and author of Medcomic: The Most Entertaining Way to Study Medicine. Image credit: Medcomic.com.


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Want to hang out with diabetic truckers with erectile dysfunction? Or hippie women with chronic yeast infections? Who’s your ideal patient? →

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Attention doctors: If you’re not attracting your ideal patients, don’t blame them. They probably have no idea how to find you. That’s your job.

So who do you really want to see? What patient population makes you excited to jump out of bed every morning? Seriously. Who the heck do you want to spend 40+ hours per week hanging around? 

Are you interested in seeing parents of kids with ADHD in Washington who are curious about vegetarian diets but feel confused in the grocery store surrounded by tofu? What about hippie women with chronic yeast imbalances intrigued by homeopathy in Oregon? Attracted to diabetic divorced long-haul truckers with erectile dysfunction passing through Interstate 81 in Virgina?

Anyone getting excited yet? Then keep thinking . . .

Do you love obese republican women in Missouri with fibromyalgia? Or would you rather spend your days with runaway teens in Memphis? Or retired gluten-free wealthy women in Dallas? It’s your choice. Remember there IS someone for everyone. 

So who’s YOUR ideal patient? If you don’t know, they won’t know either.

Here are three doctors who have figured it out. And three patients who—against all odds—have found their ideal doctors. These are doctor-patient matches made in heaven! And all these folks couldn’t be happier.

Parents of kids with ADHD in Yakima, Washington, who want to try vegetarian diets love Dr. Yami Lancaster, a pediatrician who does house calls where she even dives into the family pantry, refrigerator, and freezer to remove hidden culprits that sabotage health. She accompanies overwhelmed parents food shopping, guides them to healthy foods and may even cut the family grocery bill in half! Then she’ll lead a private cooking lesson at their home that will keep the kids busy in the kitchen so parents can finally relax. 

Hippie women with chronic yeast imbalances who want to try homeopathy in Happy Valley, Oregon, adore Dr. Kat Lopez, who believes in the body’s innate ability to heal. No more phone trees, cafeteria-style waiting rooms and five-minute quickie visits with doctors who look sicker than patients. Dr. Lopez spends a full hour with clients who leave with a comprehensive plan to restore health using nutrition and lifestyle so they can wean off drugs. Naturopathic doctors, an acupuncturist, and massage therapists are on site as well as a holistic dental hygienist, and a hyperbaric oxygen chamber. 

Diabetic divorced long-haul truck drivers with erectile dysfunction passing through Raphine, Virgina, now have their prayers answered with Dr. Rob Marsh. The big truck stop off Interstate 81 offers diesel, a hot shower, a good dinner, and now a doctor. This small-town family doc needed more patients to keep his solo practice afloat. With a underserved patient population of 20,000 long-haul truckers who are never home long enough to have their own family doc, Dr. Marsh took the job! He treats everyone who walks in and even does U.S. Department of Transportation physicals. He gets paid mostly in cash (win-win!) and now the truck stop owner plans to open an pharmacy.

So who’s your ideal patient? Don’t wait. Need help? Contact Dr. Wible.

Grab your free guide to launching an ideal clinic full of ideal patients

Pamela Wible, M.D., is a family physician who pioneered the first ideal clinic designed entirely by patients. She loves helping others find joy in medicine and live happily ever after in their ideal clinics too. (Photo credit: Shutterstock). For a free teleclass on how to attract your ideal patient, please contact Dr.Wible.

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