Your doctor’s education should be free, according to physician Louis Sullivan, onetime Health and Human Services director under former president George H.W. Bush.
The University of Missouri-Kansas City School of Medicine hosted Sullivan on Friday for an address on the state of minority health.
In an informal question-and-answer session at the end of the speech, Sullivan said he saw high student debt as an obstacle to closing health disparities between white and minority communities. He said the high cost of medical school has tended to drive new doctors and their formidable college debt away from impoverished communities with more uninsured customers and Medicaid recipients. Doctors typically are paid less for treating those patients.
Eliminating student debt would remove a a big obstacle to bringing health care to impoverished communities, Sullivan argued.
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“Now, when I went to school, tuition was $900 a year,” Sullivan said. “It’s actually probably closer to three times that with inflation.
“But still, that’s a far cry from tuition of $40,000, $45,000.”
Sullivan acknowledged that free medical school is an “extreme” proposition that would take a lot of legislative muscle and political courage, things that make it an unfamiliar concept rather than a bad one.
“It’ll cost us less by not loading up people with debt when they do everything they can to discharge that,” Sullivan said.
Free medical school, he said, would also eliminate a cost barrier that has helped keep black doctors from broader participation in the profession.
Sullivan’s presentation included research showing that 2 percent of doctors were African American in the 1950s, a community that made up 10 percent of the population at the time.
Today, the U.S. black population has slightly increased to about 13 percent. But Sullivan said the number of black doctors has only better than doubled to just less than 5 percent.
“I’m often asked, ‘Why is it important? Why does it matter, diversity?’” Sullivan said.
“It’s not only an issue of equity and opportunity,” he said citing a 1996 study that said minorities were three to four times more likely to locate in low-income neighborhoods than their white counterparts.
What’s more, Sullivan described the offices these doctors start as “economic centers of opportunity.” opening positions for physician’s assistants and office personnel.
Outside of cost, Sullivan cited the problematic tautology that generally describes the shared condition of minority participation in any field: there are no minorities coming into the profession because there are no minorities in the profession.
Black youth are finding it hard to imagine a future in medicine, he said, because they can’t tie it to anything or anyone concrete.
Sullivan, a founding dean of the Morehouse School of Medicine until he was called to lead the federal health agency, is still involved in education through The Sullivan Alliance, a nonprofit organization devoted to increasing minority participation in health sciences through a catalog of partnerships and initiatives. Those include broadening the understanding of career opportunities within health care and developing the necessary role models to drive participation.
Sullivan said he was fortunate enough to have such a role model early in his life.
He recalled living in Georgia with a family that spurned the white doctor’s office and the racial custom of the time: being received through the rear of the building.
“An indignity,” Sullivan said.
“My parents — like so many black parents — were in a segregated environment and we really did everything we could to push back against that,” he said.
So, they drove the 40 miles south to be received at a black doctor’s office.
The 2-year-old Sullivan’s senses were on high alert seeing what for him was a rarefied figure.
“Just seeing him in his green scrubs opening the door to his clinic, and the smell of ether — a mysterious smell to me still — and the fact that he knew what to do: have appendixes taken out, or tonsils, whatever it was.
“I thought he was a magician,” he said. “I was in awe of him.”
“And he could do something no one else could do: he could cure people,” Sullivan said recounting the moment that becoming a doctor became his dream job.