When I was a brand-new doctor, I was fresh, eager, and determined to succeed. I grew up poor, so I worked and worked—full-time during the week and taking travel assignments on weekends to make ends meet. Many of these travel assignments were in areas with less diverse populations, places where I was often the only Black doctor in the hospital.
One such assignment took me to Hannibal, Missouri, the hometown of Mark Twain. It was a quaint town, and I worked at a local urgent care clinic. Most of the patients I saw were white, and I rarely encountered people of color. But on one particular day, I witnessed firsthand why diversity in medicine truly matters.
A colleague of mine was treating a young child who was biracial. The child had a kerion—a severe inflammatory reaction to a fungal infection of the scalp, essentially a complication of ringworm. I had seen this condition many times in urban hospital settings, particularly among Black children. My colleague, however, prescribed only a topical antifungal cream, which I knew wouldn’t be sufficient.
For this condition, an oral antifungal medication was necessary to effectively treat the infection. More importantly, I understood that applying a cream to the scalp of a Black child with tightly coiled hair would be ineffective. It simply wouldn’t penetrate the hair or reach the scalp properly. The child was also deeply distressed about their hair loss, which I knew, from my own cultural experience, was particularly devastating in the Black community. Growing long, healthy hair as an African American requires significant effort and care, and hair loss is often emotionally traumatic.
I stepped in and explained to my colleague why the treatment plan needed to change. We adjusted the approach, and the child returned weeks later, grateful that their condition had improved and their hair was beginning to grow back.
This moment stayed with me because it highlighted how my identity—as both a woman and a physician of color—allowed me to better understand and connect with the patient. It wasn’t just about medical knowledge; it was about cultural competence and empathy.
Unfortunately, there are countless instances where cultural incompetence leads to poor patient outcomes, particularly for Black women. Studies have shown that Black women’s pain is often underestimated or outright dismissed. One widely cited study published in Proceedings of the National Academy of Sciences found that medical trainees were more likely to believe false stereotypes that Black patients have higher pain tolerance, leading to undertreatment of pain. This bias can have devastating consequences.
Women’s pain—especially heart attack symptoms—is dismissed too often.
It’s not just Black patients who experience medical bias. Women, in general, face significant disparities in medical treatment—especially when it comes to heart attacks. Research has shown that:
- Women’s heart attack symptoms are more likely to be misdiagnosed or dismissed compared to men’s.
- Female heart attack patients are less likely to receive immediate, lifesaving treatments such as aspirin, nitroglycerin, or cardiac catheterization.
- Women wait longer in the ER before receiving treatment for chest pain compared to men.
- Women experiencing heart attacks are more likely to be diagnosed with anxiety, indigestion, or musculoskeletal pain, delaying crucial care.
One study published in the European Heart Journal found that women experiencing heart attacks were 50 percent more likely than men to be initially misdiagnosed. Another study in JAMA Internal Medicine found that women waited, on average, 11 minutes longer than men to receive treatment in the ER for chest pain—which, in a heart attack, can be the difference between life and death.
Why does this happen? There are a few key reasons:
- The “Hollywood heart attack” myth – Many people (including some physicians) associate heart attacks with the classic symptoms seen in men—crushing chest pain radiating down the left arm. However, women often present with different symptoms, including nausea, shortness of breath, dizziness, or jaw pain. When these “atypical” symptoms occur, they’re often dismissed.
- Implicit bias – Studies show that women’s pain is often taken less seriously than men’s. Women are more likely to be labeled as “emotional” or “anxious,” leading to delayed diagnoses.
- Lack of research on women’s heart health – For decades, heart disease research focused primarily on men, leading to gaps in knowledge about how heart disease presents in women.
This delay in care is deadly. Heart disease is the leading cause of death for women, yet women are far less likely than men to receive aggressive treatment for it. This is why gender diversity in medicine matters—female doctors are more likely to recognize and correctly diagnose women’s symptoms, leading to better outcomes.
A life-or-death example: Sickle cell pain and medical bias
I saw this firsthand when I worked in an ER in Bonne Terre, Missouri. A Black woman with sickle cell disease came in, screaming in pain. The nurses immediately labeled her a drug seeker, even though they had never seen her before. When I asked if they had any reason to believe she was seeking drugs beyond her distress, they simply assumed it.
I pulled up her chart and saw that she had a history of sickle cell disease, a condition that causes excruciating pain and can lead to life-threatening complications like acute chest syndrome. I reminded my team that when treating sickle cell patients, we must always take their pain seriously first and consider drug-seeking behavior second.
We treated her aggressively, and sure enough, she developed acute chest syndrome. We transferred her to a hospital equipped to manage it, likely saving her life.
This case wasn’t an exception—it was the rule. Black patients, and especially Black women, are consistently undertreated for pain. This is why diversity in medicine is not just about representation—it is a matter of life and death.
Diversity in medicine saves lives.
Additionally, studies show that:
- Black patients have better health outcomes when treated by Black doctors. A 2020 study published in Proceedings of the National Academy of Sciences found that Black men seen by Black doctors were more likely to agree to preventative care measures like cholesterol screenings and vaccinations.
- Female doctors have better patient outcomes. A JAMA Internal Medicine study found that hospitalized patients treated by female doctors had lower mortality and readmission rates compared to those treated by male doctors.
Diversity in medicine improves patient care, reduces health disparities, and strengthens the overall human experience. When we strive to understand different cultural perspectives, racial backgrounds, and gender experiences, we become better doctors—and better people.
I want to live in a world where differences are celebrated and understanding is a shared goal. I want to live in a world of collaboration instead of isolation, where we work together instead of in silos. Because when we do, we not only improve medicine—we save lives.
Pamela Buchanan is a board-certified physician, speaker, and thought leader dedicated to transforming health care and championing mental well-being. With more than 20 years of medical experience, she is a TEDx speaker known for her powerful talk on “Emotional Flatline,” which explores the emotional toll of high-stress professions, particularly in emergency rooms during the pandemic. As the author of The Oxygen Mask Principle and Emotional Flatline, Dr. Buchanan teaches self-care as a revolutionary act for working mothers, health care professionals, and high achievers.
In addition to her work as a physician advocate and ambassador with the Lorna Breen Foundation, her work extends to coaching and consulting, focusing on helping physicians navigate burnout and preventing burnout in medical students and residents. She strives to keep more physicians practicing. Dr. Buchanan’s mission is to help people break free from burnout, prioritize self-care, and live with purpose.
Dr. Buchanan is the founder of Strong Medicine and can be contacted for coaching, workshops, and speaking engagements. She can also be reached on TikTok and Instagram.
