Students coordinate Black History events, celebrate impact

“Are all your health care needs being met?” That’s the question Anton Gunn, executive director of community health innovation and MUSC Health chief diversity officer, asked people in the community as he went door to door in the late 1990s seeking their input.

Gunn shared his earliest experiences with community health needs assessments and the Affordable Care Act at one of several Black History Month events hosted by MUSC’s Office of Student Programs and Student Diversity. Michael A. de Arellano, Ph.D., senior associate dean for diversity, also held a presentation, explaining how a lack of diversity in medicine negatively impacts patients and family members and highlighting some steps the College of Medicine is taking to ensure its students come from the communities they will one day serve. 

Gunn, a University of South Carolina Gamecocks lineman turned health care policy expert, was instrumental in the passage of the Affordable Care Act, former President Barack Obama’s health care law. He explained how he got involved in health care policy.

“Twenty years ago, my first job after college was working for a nonprofit organization assessing how low-income residents of public housing communities were accessing the health care system,” Gunn said. “People would say, ‘What do you mean are all my health care needs being met?’ ‘Well, do you have a doctor that knows your name?’”

Gunn said in every city in America there are two types of hospitals. “The first is the type where patients go to get better. That’s where you want to be because you know you’ll receive the best care available. The second type is where you don’t want to be. That’s where patients go to die. For example, if you live in Chicago, patients will say. ‘Don’t take me to Cook County, take me to Northwestern.’ In Columbia back in 1996, they said ‘Don’t take me to Richland Memorial; take me to Providence.’ Every city has two types of hospitals.’”

Which type of hospital is available to a patient is still determined too much by race, socioeconomics and luck, he explained.

“As I spent my time learning about the health care system and focusing on health care disparities, health care became the thing I was most passionate about. I believe if you’re not healthy in your mind, body and spirit, you can’t live out your God-given potential. And every day I knocked on doors in the community, I heard stories of individuals who had great potential that went unfulfilled because they were sick and couldn’t afford treatment, because of undiagnosed mental illness, because they were cutting pills in half to make a 30-day supply last 60 days. I heard thousands of these stories from every county in this state,” Gunn said.

Gunn wanted to do something about the problems he saw, and ultimately, he decided to run for the South Carolina State House — losing by a few hundred votes in 2006 and winning by a few thousand in 2008. He became the first African-American to represent his district. Gunn’s work on the Medical Affairs committee and his national reputation as an advocate eventually earned him a place in the Obama administration, helping to design and implement key provisions of the ACA. He became one of the Obama Administration’s chief spokespersons on the ACA, explaining the law to state lawmakers, business leaders and the public, and quickly earned the nickname, “Mr. Healthcare.”

In 2014, Gunn left the Obama administration and brought his experience to MUSC. “My job is to increase diversity, health equity and cultural competency,” he said. “Cultural competency is being able to apply cultural knowledge to enhance clinical skills and being able to tailor health care delivery to patients’ social, cultural and linguistic needs.”

Increasing cultural competency, he explained, reduces medical errors and legal risks and improves quality of care, patient satisfaction and positive outcomes.

One of the best ways for a health care organization to build cultural competency, Gunn said, is to hire doctors representative of the communities they serve, who bring far more than just their medical knowledge to the job.

Though he is not a physician, Gunn himself brings a diverse viewpoint to medicine.  

“Heath care is what I do, but hip-hop is who I am,” he said. “As a young black man in America, hip-hop gave me a sense of culture. I was 14 years old before I knew who Malcom X was, and I didn’t learn it in school. I learned it from hip-hop records.”

Building a diverse pipeline of doctors starts early, said Michael A. de Arellano.

“Diversity means better outcomes,” he explained. “Academic medical centers that welcome and embrace a plurality of backgrounds and identities are more likely to excel on all levels. Diversity leads to innovation. You can hang out with folks who have similar backgrounds and similar interests, but if everyone brings something similar to the table, you’re all going to be terrible problem solvers. Having a diversity of perspectives really does enhance the chances of new and better ideas.”

Pipeline programs like Student Mentors for Minorities in Medicine and retention programs like Mentoring Ensures Medical School Success are equally important to ensuring a range of backgrounds are represented in each College of Medicine class. The College of Medicine also reviews each applicant holistically, focusing on more than just test scores.

 “Past a certain threshold, MCATs are just not a great predictor of whether or not a person will be a good doctor,” de Arellano explained. “We’re also interested in your accomplishments outside academia, your unique background, the added value you bring to the table.”

The emphasis on things other than MCAT scores doesn’t mean test scores suffer in medical school, though. Surprisingly, the opposite is true. Since introducing diversity initiatives, the College of Medicine’s graduation rates have continued to climb to its current rate of 98.5 percent and other indicators of success are up too.

MUSC is a national leader for the number of students it graduates each year who are underrepresented in medicine (URM). The College of Medicine now ranks fifth in the country for number of African-American medical students and is in the 96th percentile in African-American graduation rates, after only historically black college and universities. Nineteen percent of the class of 2017 was comprised of URM students — more than five points above the national average.

“The idea that we have to choose between diversity and high standards is a bunch of malarkey,” de Arellano said.