Dr. Tamika Perry, a primary care physician and Associate Regional Medical Director in Texas, emphasizes the critical importance of listening to patients. Her own experience with a misdiagnosis, stemming from assumptions based on stereotypes, has deeply influenced her philosophy: “A lot of times, people are blinded by what they see in front of them instead of getting down to the root of being a clinician: you listen to the patient, you examine the patient, you hear their story.” This patient-centered approach, learned in medical school, has enabled her to identify serious conditions that others may have missed.
Setting Aside Bias for Accurate Diagnosis
Dr. Perry stresses that accurate diagnosis begins with clinicians setting aside biases related to race, gender, age, or socioeconomic status. She firmly believes that “Patients say all the time, ‘I know my body,’ and they are absolutely right.” The clinician’s role, she explains, is to apply medical knowledge to the patient’s narrative, combining the two for the correct diagnosis.
She shared a personal encounter with a dermatologist who misdiagnosed her hair loss as traction alopecia, based on a stereotype about Black women’s hairstyles. When Dr. Perry tried to explain she didn’t wear tight braids or weaves, her concerns were dismissed. A second dermatologist, however, listened, ordered blood work and a scalp biopsy, revealing she had androgenetic alopecia, a genetic condition inherited from her father.
The Impact of Implicit Bias in Healthcare
Dr. Perry has witnessed firsthand how implicit bias affects the quality and urgency of care, from ER visits to routine checkups. She points to the persistent, disproven myth that Black patients have a higher pain tolerance, which can still influence treatment decisions. In one ER visit after returning from Thailand unwell, she was initially dismissed until she identified herself as “Dr. Tamika Perry” and presented her differential diagnosis, at which point her treatment immediately changed.
“But not everybody has the luxury of saying, ‘I’m a doctor.’ We need to treat every patient appropriately and believe what they say,” she urged. Dr. Perry noted that even when she asked for pain management options, the doctor inquired about her preferences, something not always offered to other patients. “At the end of the day, I’m still Black, and bias affects the care we receive,” she added.
Cultural Competence: More Than a Training Module
For Dr. Perry, culturally competent care involves understanding a patient’s beliefs, priorities, and lived experiences. This includes respecting religious restrictions, like those of Jehovah’s Witnesses regarding blood products, and considering lifestyle factors, such as how hair care concerns might affect a Black woman’s willingness to take certain medications. “If a patient believes her blood pressure medicine is making her hair fall out… it doesn’t matter. If the clinician dismisses it, the patient won’t take the medicine. You have to address what matters to the patient,” she explained.
She advocates for clinicians to immerse themselves in the communities they serve, learning the language and norms to adapt their approach without compromising medical standards. Her experience working in diverse neighborhoods—including underserved Black and Hispanic areas, middle-class suburbs, and LGBTQ+ communities—reinforced the importance of engaging with patients on a cultural level.
Listening to How Patients Describe Symptoms
While medical conditions may present biologically the same across races, the way patients describe their symptoms can differ. Dr. Perry cited a study finding that Black women reported fatigue with higher intensity and frequency before a heart attack compared to white women. “Too often, that’s dismissed as diet, exercise, or anxiety. Really, she’s telling you: ‘I’m about to have a heart attack,’” Dr. Perry warned. “Clinicians need to look past the face in front of them and listen to what’s actually being said.”
Hope for the Future, with Continued Work Needed
Dr. Perry is hopeful that younger clinicians, who receive more training on implicit bias, will make a difference. However, she cautions that bias is not exclusive to any single group and “we all have to recognize it.” She also notes that mistrust can be mutual, as some patients question the competence of physicians of color due to ingrained societal prejudice. “I’ve had patients surprised I was their doctor because I was Black. Some even said friends asked why they’d go to a Black doctor. That comes from decades of society teaching them not to trust us,” she shared. “It’s deeply ingrained, and changing it will take time, education, and consistent proof through care.”
The statistics on health disparities are stark, illustrating the need for Dr. Perry’s approach. Studies show Black women have a higher death rate from breast cancer and receive CPR less frequently during cardiac arrests, not due to biology, but access and quality of care. “The data is clear: people of color get less CPR, Black women have worse outcomes in breast cancer—not because of biology, but because of access and unequal quality of care. We have to keep spreading the message: this is real,” Dr. Perry emphasized.
A Message to Patients and Clinicians
Dr. Perry offers simple yet powerful advice: To patients: “You are your own advocate. If you feel something is missed, speak up, get another opinion. No one loves you like you.” To clinicians: “Pretend every patient in front of you is your mother, father, brother, or sister. Treat them as you would treat your own loved ones. If you do that, you’ll do right by them.”
What are your experiences with healthcare providers listening to your concerns? How can we foster more culturally competent care? Share your thoughts in the comments below!