SHILOH, Ill. — After a health insurance change forced Bernard Macon to cut ties with his black doctor, he struggled to find another African American physician online. Then, he realized two health advocates were hiding in plain sight.
At a nearby drugstore here in the suburbs outside of St. Louis, a pair of pharmacists became the unexpected allies of Macon and his wife, Brandy. Much like the Macons, the pharmacists were energetic young parents who were married — and unapologetically black.
Vincent and Lekeisha Williams, owners of LV Health and Wellness Pharmacy, didn’t hesitate to help when Brandy had a hard time getting the medicine she needed before and after sinus surgery last year. The Williamses made calls when Brandy, a physician assistant who has worked in the medical field for 15 years, didn’t feel heard by her doctor’s office.
“They completely went above and beyond,” said Bernard Macon, 36, a computer programmer and father of two. “They turned what could have been a bad experience into a good experience.”
Now more than ever, the Macons are betting on black medical professionals to give their family better care. The Macon children see a black pediatrician. A black dentist takes care of their teeth. Brandy Macon relies on a black gynecologist. And now the two black pharmacists fill the gap for Bernard Macon while he searches for a primary care doctor in his network, giving him trusted confidants that chain pharmacies likely wouldn’t.
Black Americans continue to face persistent health care disparities. Compared with their white counterparts, black men and women are more likely to die of heart disease, stroke, cancer, asthma, influenza, pneumonia, diabetes and AIDS, according to the Office of Minority Health.
But medical providers who give patients culturally competent care — the act of acknowledging a patient’s heritage, beliefs and values during treatment — often see improved patient outcomes, according to multiple studies. Part of it is trust and understanding, and part of it can be more nuanced knowledge of the medical conditions that may be more prevalent in those populations.
For patients, finding a way to identify with their pharmacist can pay off big time. Cutting pills in half, skipping doses or not taking medication altogether can be damaging to one’s health — even deadly. And many patients see their pharmacists monthly, far more often than annual visits to their medical doctors, creating more opportunities for supportive care.
That’s why some black pharmacists are finding ways to connect with customers in and outside of their stores. Inspirational music, counseling, accessibility and transparency have turned some minority-owned pharmacies into hubs for culturally competent care.
“We understand the community because we are a part of the community,” Lekeisha Williams said. “We are visible in our area doing outreach, attending events and promoting health and wellness.”
To be sure, such care is not just relevant to African Americans. But mistrust of the medical profession is especially a hurdle to overcome when treating black Americans.
Many are still shaken by the history of Henrietta Lacks, whose cells were used in research worldwide without her family’s knowledge; the Tuskegee Project, which failed to treat black men with syphilis; and other projects that used African Americans unethically for research.
“They completely went above and beyond,” says Macon (center) of Vincent and Lekeisha Williams, owners of LV Health and Wellness Pharmacy.
Filling More Than Prescriptions
At black-owned Premier Pharmacy and Wellness Center near Grier Heights, a historically black neighborhood in Charlotte, N.C., the playlist is almost as important as the acute care clinic attached to the drugstore. Owner Martez Prince watches his customers shimmy down the aisles as they make their way through the store listening to Jay-Z, Beyoncé, Kirk Franklin, Whitney Houston and other black artists.
Prince said the music helps him in his goal of making health care more accessible and providing medical advice patients can trust.
In rural Georgia, Teresa Mitchell, a black woman with 25 years of pharmacy experience, connects her customers with home health aides, shows them how to access insurance services online and even makes house calls. Her Total Care Pharmacy is the only health care provider in Baconton, where roughly half the town’s 900 residents are black.
“We do more than just dispense,” Mitchell said.
Iradean Bradley, 72, became a customer soon after Total Care Pharmacy opened in 2016. She struggled to pick up prescriptions before Mitchell came to town.
“It was so hectic because I didn’t have transportation of my own,” Bradley said. “It’s so convenient for us older people, who have to pay someone to go out of town and get our medicine.”
Lakesha M. Butler, president of the National Pharmaceutical Association, advocates for such culturally competent care through the professional organization representing minorities in the pharmacy industry and studies it in her academic work at the Edwardsville campus of Southern Illinois University. She also feels its impact directly, she said, when she sees patients at clinics two days a week in St. Charles, Mo., and East St. Louis, Ill.
“It’s just amazing to me when I’m practicing in a clinic setting and an African American patient sees me,” Butler said. “It’s a pure joy that comes over their face, a sigh of relief. It’s like ‘OK, I’m glad that you’re here because I can be honest with you and I know you will be honest with me.’”
She often finds herself educating her black patients about diabetes, high blood pressure, high cholesterol and other common conditions.
“Unfortunately, there’s still a lack of knowledge in those areas,” Butler said. “That’s why those conditions can be so prevalent.”
Independent black-owned pharmacies fill a void for African American patients looking for care that’s sensitive to their heritage, beliefs and values. For Macon, LV Health and Wellness Pharmacy provides some of that vital support.
Avoiding Medical Microaggressions
For Macon, his experiences with medical professionals of backgrounds different from his own left him repeatedly disappointed and hesitant to open up.
After his wife had a miscarriage, Macon said, the couple didn’t receive the compassion they longed for while grieving the loss. A few years later, a bad experience with their children’s pediatrician when their oldest child had a painful ear infection sparked a move to a different provider.
“My daughter needed attention right away, but we couldn’t get through to anybody,” Macon recalled. “That’s when my wife said, ‘We aren’t doing this anymore!’”
Today, Macon’s idea of good health care isn’t colorblind. If a doctor can’t provide empathetic and expert treatment, he’s ready to move, even if a replacement is hard to find.
Kimberly Wilson, 31, will soon launch an app for consumers like Macon who are seeking culturally competent care. Therapists, doulas, dentists, specialists and even pharmacists of color will be invited to list their services on HUED. Beta testing is expected to start this summer in New York City and Washington, D.C., and the app will be free for consumers.
“Black Americans are more conscious of their health from a lot of different perspectives,” Wilson said. “We’ve begun to put ourselves forward.”
But even after the introduction of HUED, such health care could be hard to find. While about 13% of the U.S. population is black, only about 6% of the country’s doctors and surgeons are black, according to Data USA. Black pharmacists make up about 7% of the professionals in their field, and, though the demand is high, black students accounted for about 9% of all students enrolled in pharmacy school in 2018.
For Macon, though, the Williamses’ LV Health and Wellness Pharmacy in Shiloh provides some of the support he has been seeking.
“I still remember the very first day I went there. It was almost like a barbershop feel,” Macon said, likening it to the community hubs where customers can chitchat about sports, family and faith while getting their hair cut. “I could relate to who was behind the counter.”
Dr. Yamanda Edwards meets with patient Gail Carter at the Martin Luther King, Jr. Community Hospital outpatient clinic in March 2018. (
Dr. Yamanda Edwards, the daughter of a truck driver and a stay-at-home mom, grew up just a few miles from Martin Luther King/Drew Medical Center, at the time an iconic yet troubled hospital in South Los Angeles.
As a child in the 1990s, she knew little of its history — how it rose from the ashes of the Watts riots. And she knew no one in the medical profession.
Still, she wanted to become a doctor. “I didn’t know how I was going to get there, but I wanted to get there,” she said. “I was determined.”
Now 32, she is the only psychiatrist at the new Martin Luther King, Jr. Community Hospital, on the grounds of the old county-run King/Drew and steps away from where she attended high school.
In her lifetime, the community where she grew up has changed dramatically. The population is mostly Latino now, no longer predominantly African-American. King/Drew closed in 2007 amid allegations of malpractice and malfeasance. The new hospital, a private, nonprofit that opened in 2015, is smaller but vibrant, with brand-new facilities, staff and an outpatient medical clinic. It’s part of a broader campus that includes outpatient and public health centers run by Los Angeles County.
What hasn’t changed in the area is the need for doctors like Edwards.
Edwards’ patients have conditions ranging from anxiety and depression to psychosis. Many have never seen a psychiatrist — or any mental health professional, for that matter. Yet the pressures in their lives contribute to poor physical and mental health.
“There are a lot of stressors coming from living in an environment with health care disparities, a lot of access to drugs, poverty, immigration issues,” Edwards said.
The neighborhood surrounding the hospital has higher rates of psychological distress and a greater need for mental health care than the statewide average, according to 2014 data from UCLA. Residents also are more likely to be poor and out of work, though average levels of educational achievement and income have risen somewhat in recent decades.
Edwards teaches her patients about their conditions — what it means to have clinical depression, how it feels to have a panic attack. Many show appreciation for having someone they can turn to. “They’ve tried to do it on their own, but now it’s time to see someone,” Edwards said.
Gail Carter, 62, of Compton, Calif., suffers from chronic pain and depression but said she has been sleeping and feeling better since starting sessions with Edwards. “I didn’t know how to figure it out by myself,” she said. “Dr. Edwards helped me. She gets me to think. And she reminds me to breathe.”
Dreaming Of Being A Doctor
Edwards said she feels some nostalgia for her neighborhood, along with sadness. She escaped some of the worst aspects — violence, drugs and gangs — protected by her family and its high aspirations for her and her siblings. “Higher education was just sort of expected of us,” she said. “I do believe I was somewhat insulated.”
Her curiosity about medicine started in middle school. She attended the King/Drew Magnet High School of Medicine and Science, which allowed her to shadow doctors at the old King/Drew hospital and help with cancer research. “It was almost like we were medical interns, but we were in high school,” she recalled.
Despite the support, she faced setbacks. When she was 15, her father died of colon cancer, four days after he was diagnosed. For some time after that, she didn’t want to set foot in a hospital. “I thought, ‘How am I going to become a doctor when I hate hospitals?’”
Then she reflected on how her dad had encouraged her to pursue medicine, knowing it was her dream, and “that motivated me.”
Edwards remembers wondering, when the old King/Drew hospital closed, where patients in the neighborhood would go for care — and if the high school students would still find hospital internships.
After graduating from UCLA, Edwards attended medical school at Charles Drew/UCLA — next to her old high school — through a program designed for students who wanted to practice in underserved areas. During a student rotation at Kedren Acute Psychiatric Hospital in Los Angeles, Edwards saw bipolar disorder, psychosis and major depression up close, and she was struck by the need for care among minorities, especially African-Americans and Latinos. “This is something that doesn’t really get talked about in either of those communities,” she said.
That propelled her toward a career in psychiatry. She completed her residency in psychiatry at UCLA in June 2017 and started her job at MLK two months later. “It just felt right,” she said.
In addition to working at the hospital, Edwards also belongs to a new outpatient medical group the hospital started last year to expand specialty care for its patients. Hospital CEO Elaine Batchlor said Edwards is exactly the kind of doctor they wanted to attract. “She understands the people who live in our community,” she said. “And she has a deep commitment to them.”
Separating The Old From The New
Patients come in at all hours of the day and night needing mental health care, said Ameer Moussa, a physician who practices at the hospital. “A psychiatrist is something we knew we needed from day one,” he said.
Moussa said Edwards’ calm personality and patience enables her to communicate effectively with her patients. “Trust is a really important thing, and she gains their trust and gains it quickly,” he said.
That helps, especially with patients who recall the difficult history of the old King/Drew, which came to be known in some circles as “Killer King.”
Edwards’ childhood memories of the area help her connect with patients. When they are distressed about their challenges in life, she will often tell them, “I understand. I grew up here too.”
Edwards, who now lives in Cypress, Calif., with her husband and 19-month-old son, spends most of her workweek helping to triage mental health patients in the ER and visiting those who are admitted to the hospital.
MLK’s emergency room has seen twice as many patients as it originally expected when it opened, and many suffer from mental illness.
On a recent afternoon, Edwards saw a woman who was 30 weeks pregnant and threatening to harm herself. Combative and possibly psychotic, she was convinced her baby was an alien. “Let me go,” she screamed as staffers tried to restrain her. “Get off of me!”
Edwards ordered medication to help calm her down. She also placed her on a 72-hour psychiatric hold and started searching for an inpatient bed for her.
Edwards knew that wouldn’t be easy, given the severe psych bed shortage and the woman’s condition. “Psychiatric hospitals can sort of pick and choose who they want to take,” Edwards said. “Pregnant patients are a little more risky to take on.”
Edwards spends much of her time at the hospital dashing in and out of patients’ rooms, attempting — often in fleeting conversations — to assess them and their risk of hurting themselves or others. Many of her patients are homeless, alcoholic or addicted to drugs.
Once a week, Edwards heads to an outpatient clinic run by MLK a few miles away. Some of her patients take a while to warm up to her. She spends a lot of time with them before even raising the idea of medication.
“Coming from a community where there is a lot of stigma about mental health … the acceptance of medication is another barrier,” she said.
Edwards said she does everything she can to help her patients — both outside and inside the hospital. But in the end, Martin Luther King, Jr. is an acute care hospital, not a psychiatric one. Edwards isn’t there round-the-clock, and the hospital can keep certain psychiatric patients for only up to three days. One of the hardest parts of her job, she said, is wondering what will happen to patients when they leave.
“You want to know the end result of what happened, if you did the right thing, if they’re safe.”
KHN’s coverage in California is supported in part by Blue Shield of California Foundation.