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NMA president speaks on health disparities 

by Heather Woolwine
Public Relations
Recognizing a nation plagued by health disparities, Randall W. Maxey, M.D., Ph.D., National Medication Association (NMA) president, explained the need for an increased effort to eliminate those disparities in an interview Feb.9. The NMA is the largest minority medical association in the United States.

Dr. Randall Maxey

“Health care is only effective when there is adequate communication between the physician and the patient,” Maxey said. “Good outcomes are dependent on trust and communication, and treatment paradigms must be redefined to include African-Americans.”

On Feb. 10 Maxey presented a lecture to MUSC students, faculty, and staff on achieving diversity in health professions. As the 104th president of the NMA, he emphasized the mission and role of the organization to eliminate health disparities through training in cultural competence and the development of evidence-based best practices.

A nephrologist currently residing in Los Angeles, Maxey contributed to research in prevention and treatment of renal failure, especially in cases complicated by cardiovascular disease.

Maxey highlighted some of the challenges still faced by African-American physicians in an earlier interview: “We may not be called names in public anymore, but discriminatory treatment still exists for the black physician. We have more difficulty getting on staff, receive fewer referrals, and are more likely to be investigated or have our patients reviewed,” he said. “Although some progress has been made, the discrimination has not necessarily lessened; instead it has become more complicated and sophisticated.”

Maxey said his organization is focusing its effort to eliminate health disparities with the Healthy 2010 initiative, which strives for a large decrease in the national health disparity percentage rate.

Citing lots of lip service and not much action in terms of health disparities, Maxey outlined several thoughts on how to turn the problem around.

First, Maxey believes it necessary to involve African-Americans in research, not only as the researchers themselves, but also as participants. “I know that the first thing many folks think of right away is Tuskegee,” he said. “But that’s where cultural competence and trust come in. If you, as a physician, aren’t afraid to touch your patients or relate to them on their cultural level, you will gain their trust and they will not only participate, but they will follow your advice or take their medications.

“We also, as human beings, must recognize that health disparities are a problem for all of us. There is no one size fits all when it comes to health care—there are specific ways to creatively and effectively deal with people of various ethnocultural groups. Best practices must be established for the different groups because they require equal, yet tailored treatment.”

Maxey also cited promotion of health literacy among patients, stating that patients from different socioeconomic or ethnocultural backgrounds should be provided with medical directions in linguistics that are easily understood and accompanied by increased patient education.

“We have to commit to assisting and educating people about health risks, why they need to change, and to institute forms of group education through forums like churches and schools.”

Maxey applauded MUSC for its concentrated efforts to improve health disparities in the Charleston area with programs like Lighten Up (a weight loss program conducted in community churches) and the Second Chance Club at Burke High School (a teen pregnancy program designed to educate young mothers and prevent repeat pregnancies).

“Young mothers are an especially important group to educate and reach out to so we may combat health disparities,” Maxey said. “Parents are responsible for creating healthy habits early in life and can assist in what the real goal of health care should be: prevention.”

Patients should know what health risks they have individually and should know their numbers, “and make a commitment to want to live long enough to watch your grandchildren grow or walk your daughter down the aisle at her wedding,” he said.

Medicine Grand Rounds: 
Focus on African-American health care issues
All lectures will be held at 8 a.m., 
Institute of Psychiatry Auditorium
Feb. 17—Racial Disparities in Health Care: Past, Present and Future
Leonard Egede, M.D., Assistant Professor of Medicine, Division of General Internal Medicine, Department of Medicine, MUSC 

Feb. 24—End Stage Renal Disease: A National Problem of Epidemic Proportion
J. Kevin Tucker, M.D., Instructor in Medicine, Harvard Medical School, Associate Physician, Brigham and Women's/Faulkner Hospitals, Boston, Mass.

March 2—Racial Disparities in Stroke
Ronnie Horner, Ph.D., National Institute of Neurological Disorders and Stroke, Program Director, Health Disparities Research, Rockville, Md.

Sponsored by the College of Medicine, Department of Medicine and the Office of Diversity. For more information on the Medicine Grand Rounds, call 792-2911.

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