How Lack of Representation in Healthcare Influences the Patient Experience with Physician Assistant Kendra Patton Silverman

We can all relate to the experience of finding some comfort in having a conversation with someone who shares similar experiences and values as our own. This shows up in different relationships, including our relationships with healthcare professionals. Whether the shared experience or value is related to race, gender, spiritual beliefs, or another part of our identities, the like-minded perspective or the openness to a perspective leaves room for providers to connect with patients on a personal level. It also takes away some of the need to explain things that are due to cultural differences. For example, in the Black community there are often unspoken beliefs related to hair, how one should speak to their elders or the importance of attending church every Sunday. These shared beliefs and values allow providers to reach beyond their training and into their personal experiences which may be useful to the patient, depending on the present concern. These nuances between the patient and provider are lost when the demographics of providers are homogenous.  

Kendra shared that she was the only Black student, of 67 students in her Physician Assistant (PA) program. If you do a quick search for statistics of healthcare providers in the workforce currently, or simply reflect on your experiences with healthcare providers throughout your life, it’s easy to notice the lack of Black people who work in these roles. This lack of representation in healthcare can have life-altering consequences for some, leaving many feeling a sense of mistrust toward their provider, and others less forthcoming with information needed to appropriately address their treatment needs. The importance of representation in healthcare shows up in Black women being up to 6 times more likely to die from complications during childbirth when compared to White women, and Black men being more likely to receive preventative care when they meet with a Black physician. It’s also evident when there continues to be misinformation that categorizes groups based on race and ethnicity, along with other aspects of identity, and attributes various physiological phenomena to these constructs. For example, one nursing textbook came under scrutiny for encouraging nurses to treat pain symptoms according to culture such as Black, Native American, Jew, etc. These stats remind us that, although medicine has come a long way, we are still a long way from where we need to be.

One way to address the need for more Black people in healthcare is to educate our youth about their options related to various healthcare roles. Kendra provided us with some key things to know about the role of a PA: 

  • PAs are Board Certified Healthcare Professionals, trained to practice medicine in many healthcare settings.
  • PAs have a Master’s Degree and can practice medicine in all 50 states. 
  • In the 60s there were not enough practicing physicians during the Vietnam War, so in an effort to alleviate this need, the Physician Assistant role was created. 
  • PAs are not assistants to physicians. They are advanced practice providers who work with physicians on a healthcare team. 
  • PAs must have some training in healthcare (typically 1 year full time, or a few years part time) prior to beginning their training to become a PA.
  • Prior experience includes nurse assistant, home health aide, emergency room technician, respiratory therapist, nurse, etc.
  • PA programs are approximately half the time of medical school, typically lasting between two to three years. 
  • PAs write prescriptions and can see their own patients. 
  • PAs are able to work across different areas in their field, and are not required to receive additional training in order to do so, which allows flexibility in their role. 
  • Black PAs represent only 3.7% of the clinically practicing PA workforce in the US.
  • PA programs around the US struggle with recruiting Black students, which highlights the need for education and mentorship in medicine. 

Kendra Patton Silverman is a board-certified Physician Assistant (PA), practicing clinically in Internal Medicine and Family Medicine. She cares for patients of all ages at several outpatient clinics around the San Francisco Bay Area. She is also the Director of Clerkship Education at the Stanford University School of Medicine, Master of Science in PA Studies Program. In this role she ensures PA students obtain the highest quality clinical experience, training with healthcare professionals within the Stanford Health Care community, the San Francisco Bay Area, and healthcare institutions across the country. Kendra completed her undergraduate education in Biomedical Physics at Wayne State University (Detroit, MI), and her master’s degree in Physician Assistant Studies at Rosalind Franklin University of Medicine (North Chicago, IL). She has been a practicing PA for 7 years. Her clinical experience includes emergency medicine, internal medicine, family medicine, women’s health, and urgent care. She has a strong interest in nutrition and its importance in obtaining and maintaining optimal health.

Featured Image: Photo by Anna Shvets from Pexels