Why an HBCU Med School Decided to Put CARES Act Money Into Students’ Pockets

Why an HBCU Med School Decided to Put CARES Act Money Into Students’ Pockets

NASHVILLE, Tenn. — Just before students at Meharry Medical College went home for Thanksgiving, Dr. James Hildreth, the school’s president, emailed them a video message that he acknowledged seemed hard to believe. Or at least they had to give it a second listen.

“We’ll gift each of you $10,000 in cash,” he said, looking at the camera. “You heard me right.”

They were told to expect a direct deposit the next day or pick up a check in person. Hildreth, an expert in infectious diseases who helped lead Nashville’s pandemic response, explained that this gift with no strings attached was money from the CARES Act, a major covid-19 relief law passed by Congress in 2020. He asked only that they be “good stewards” of the windfall.

After deep consideration, Meharry’s administration decided to give roughly a third of its CARES Act funding — $10 million — directly to its future doctors, dentists and public health researchers. All told, 956 students received payments.

Meharry’s students had already been heavily involved in the pandemic response, staffing Nashville’s mass covid testing and vaccination sites. But the money isn’t so much surprise compensation for volunteer efforts as it is an investment in a future career — and an assist in overcoming financial hurdles Black students especially face to become medical professionals.

While Black Americans make up roughly 13% of the population, the Association of American Medical Colleges finds Black doctors account for just 5% of the nation’s working physicians — a figure that has grown slowly over more than a century. And studies have found that Black patients often want to be cared for by someone whom they consider culturally competent in acknowledging their heritage, beliefs and values during treatment.

Meharry graduates more Black physicians than almost any other U.S. school. And half of its M.D.s enter the high-demand but lower-paying specialty of primary care.

“We felt that there was no better way to begin distributing these funds than by giving to our students who will soon give so much to our world,” Hildreth said.

Cheers erupted in the library as students clicked the video link.

Andreas Nelson fell silent, he recalled later. He went to his banking app and stared in disbelief. “$10,000 was sitting just in my bank account. It was astonishing,” he said. “I was literally lost for words.”

The Chicago native is finishing a master’s degree in health and science at Meharry with hopes of entering its dental school. The average student loan debt in the program totals more than $280,000. So, undoubtedly, 10 grand won’t make much of a dent in the debt.

But the money in his pocket eases his top concern of making rent each month. Nelson said it feels as though he’s being treated like an adult, allowing him to decide what his greatest needs are in getting through school.

“It’s motivating,” Nelson said. “Because that means they have trust in us to do with this money whatever the cause may be — whether it be student debt, investing or just personal enjoyment.”

Across the board, students at HBCUs rely more on student loans than students at historically white institutions. Roughly 80% take out student loans, according to an analysis by UNCF, formerly known as the United Negro College Fund, and they borrow considerably more.

Meharry was founded a decade after the Civil War to help those who had been enslaved. But the 145-year-old institution has always struggled financially, and so have its students.

The reasons are rooted in the country’s racist past, which has left the institutions with less money potentially available for scholarships than other universities. And students’ families generally have less wealth to tap into since Black households across the country have averaged around $17,000 in net worth — about a tenth of the average for white families.

Meharry’s average student debt is far higher than other area schools of medicine at Vanderbilt University and the University of Tennessee, representing both private and public institutions.

Virtually all colleges and universities received allotments under the CARES Act, but HBCUs have been much more aggressive about funneling substantial amounts directly to students, who tend to have greater need. More than 20 HBCUs have erased outstanding tuition balances. Some have canceled student fees.

But Meharry, one of the few stand-alone HBCU graduate schools, is a rare case in cutting checks for students.

“These young people are rising to medical school against all odds,” said Lodriguez Murray, who leads public policy and government affairs at UNCF. “Of course, they have to borrow more because people who look like them have less.”

During the pandemic, major philanthropists have taken new interest in supporting the few HBCU medical schools. Michael Bloomberg committed $100 million to four institutions, including Meharry, to help educate more Black doctors.

Students at Meharry can now apply for $100,000 scholarships. The $34 million from Bloomberg Philanthropies is also going toward other kinds of financial support.

The school is now offering, for no additional fee, expensive test-prep services through a Boston-based company, MedSchoolCoach. The service, which entails paying a doctor by the hour to help with studying, can cost thousands of dollars.

While the price is often out of reach for students tight on cash, acing the benchmark exams toward board licensure is key to landing coveted fellowships, qualifying for lucrative specialties or just finishing on time. And Meharry’s four-year completion rate of roughly 70% is below most schools. The most up-to-date national average is around 82%.

For some, Murray said, a $10,000 windfall may make all the difference in whether they cross the finish line and become a doctor who can afford all their medical school debt.

“Many of those students are borrowing a lot of money to complete their dream, and to become relatively high earners in the future,” Murray said. “The fact that these students are largely coming from lower socioeconomic backgrounds means that the funds that Meharry turned around and gave to the students are particularly impactful.”

This story is from a partnership that includes Nashville Public Radio and KHN.

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How Black Pharmacists Are Closing The Cultural Gap In Health Care

How Black Pharmacists Are Closing The Cultural Gap In Health Care

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.”

Psychiatrist Stays Close To Home And True To Her Childhood Promise

Psychiatrist Stays Close To Home And True To Her Childhood Promise

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.