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  • 7 months ago
The Senate Health Committee held a hearing on Thursday on the Shortage of Minority Health Care Professionals and the Maternal Health Crisis.

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Transcript
00:00:00 Today, our committee is going to focus on two extremely important health care issues
00:00:07 that must be addressed.
00:00:08 First, the major need for more black, Latino, and Native American doctors and medical professionals.
00:00:15 Secondly, the alarming rate of maternal deaths in America that is disproportionately impacting
00:00:21 black, Latino, and Native American women.
00:00:24 In the midst of a health care system that, in my view, is largely broken and dysfunctional,
00:00:31 where we spend almost twice as much per capita on health care as the people of any other
00:00:35 country, where 85 million Americans today are uninsured or underinsured, and where we
00:00:40 don't have enough doctors, nurses, dentists, mental health specialists, or pharmacists,
00:00:46 we have another crisis on top of all of that, and that is that that problem of lack of medical
00:00:54 personnel is extremely, especially acute in black, Latino, and Native American communities,
00:01:00 which is the subject of our hearing today.
00:01:03 Despite making up almost 14% of our population, just 5% of all doctors in our country are
00:01:09 black, less than 4% of all dentists, and just 6% of all nurses in America are African American.
00:01:16 Further, despite making up over 19% of our population, just 6% of doctors and dentists
00:01:23 and just 7% of nurses in America are Latino.
00:01:29 We cannot forget the Native American community, which makes up 1.3% of our population, but
00:01:35 just three-tenths of 1% of all doctors in our country are Native American.
00:01:42 Why is this an important issue that we have got to address?
00:01:47 The answer is that study after study has shown that when black, Latino, and Native American
00:01:51 patients have access to black, Latino, and Native American doctors, their health outcomes
00:01:57 substantially improve.
00:01:59 They are more likely to receive preventative services.
00:02:02 They are more satisfied with their care, and they are more likely to live longer and happier
00:02:07 lives.
00:02:08 In my view, it is unacceptable that life expectancy on average, which is low in America in general,
00:02:16 is about five years lower for black Americans and 11 years lower for Native Americans than
00:02:21 it is for white Americans.
00:02:23 It is unacceptable that black Americans are more likely to die of heart disease and have
00:02:27 the highest rates of cancer of any other group in America.
00:02:32 It is not acceptable that black Americans are more than twice as likely to have diabetes,
00:02:36 an issue that we are dealing with right now, a major epidemic in America, twice as high
00:02:41 in the black community than the white community.
00:02:43 One of the most alarming and troubling health disparities in America is the maternal mortality
00:02:49 rate, which is the other major focus that we will be talking about today.
00:02:53 In America today, we have the highest maternal mortality rate and the highest infant mortality
00:02:59 rate of any other wealthy country on earth.
00:03:02 In fact, the maternal mortality rate in America is 19 times higher than Norway, four times
00:03:09 higher than France.
00:03:10 Incredibly, according to the CDC, women in America today are twice as likely to die from
00:03:16 childbirth than their mothers.
00:03:21 And as bad as this crisis is overall, it is much, much worse for black women and infants.
00:03:28 In America today, black women are nearly three times more likely to die from pregnancy-related
00:03:33 complications than their white counterparts.
00:03:36 The crisis is also getting significantly worse for Latina women.
00:03:40 Between 2019 and 2020, the Latina maternal mortality rate skyrocketed by 44% in just
00:03:46 one year.
00:03:47 Meanwhile, black infants in America are almost four times more likely to die from complications
00:03:52 due to lower birth weight than white infants.
00:03:55 So the question then becomes, given that reality, what are we going to do about it?
00:04:00 How are we going to address what is obviously a major health care crisis in America?
00:04:04 And that is what we'll be discussing this morning.
00:04:07 Just a few things that I think we've got to do.
00:04:09 We need to substantially increase the class sizes of historically black colleges and universities.
00:04:14 And we'll be hearing from representatives on one of them today.
00:04:18 We need to pass the Black Maternal Health Momnibus Act introduced by Senator Booker
00:04:23 and Senator Butler.
00:04:24 Senator Butler will be talking about that today.
00:04:27 We need to substantially increase funding for the Women's Infant and Children's Program.
00:04:32 We need to substantially increase funding for the National Health Service Corps.
00:04:36 And in my view, we need to cancel student debt and make all public colleges and universities
00:04:40 tuition-free so that all people, regardless of background and income, will be able to
00:04:44 get the education they need, including going to medical school.
00:04:47 And in fact, the good news is that making tuition, medical school tuition-free, is a
00:04:52 growing idea.
00:04:53 In fact, four medical schools in America, including the New York University School of
00:04:57 Medicine, are currently tuition-free, while five others have made tuition temporarily
00:05:02 free or are offering free tuition to working-class students.
00:05:06 So we've got a lot to talk about today, and I look forward to a serious discussion about
00:05:14 a serious issue.
00:05:15 And I thank our panelists who are here with us.
00:05:18 Senator Cassidy.
00:05:19 Thank you, Chair Sanders.
00:05:21 This committee has covered the shortages of physicians and other health workers extensively.
00:05:25 Shortages hurt the delivery of health care in all communities.
00:05:28 My home state, Louisiana, projected to have the third-worst shortage of physicians of
00:05:32 any state by 2030.
00:05:34 We need more doctors, particularly in the underserved areas lacking sufficient health
00:05:39 care resources.
00:05:40 My practice as a physician was for 25 years in a hospital serving the uninsured and the
00:05:45 poorly insured, which is to say Medicaid.
00:05:48 So this is something which I have spent my professional life attempting to address.
00:05:53 Today we're going to look specifically at minority doctors and health professionals
00:05:56 underrepresented in our health care system.
00:05:59 For example, African-American physicians account for only 8 percent of all physicians, despite
00:06:04 comprising 13.6 percent of the population.
00:06:07 Now, if you're listening carefully, you'll note that my statistics are different than
00:06:11 the Chair's.
00:06:12 His is 5 percent and mine's 8 percent.
00:06:15 My data is more -- he uses the Association of American Medical Colleges 2019 data, and
00:06:22 I am using the Bureau of Labor Statistics, which is 2022 data.
00:06:26 That's important.
00:06:27 2019, 2022.
00:06:28 Government data, a little bit more up-to-date, a little bit more valid.
00:06:33 Maybe there's progress being made.
00:06:35 And as we look at something which needs to be addressed, we can also say that if we've
00:06:39 gone from 5 to 8 percent, there may be progress being made, and that is a good thing.
00:06:47 But it's interesting to note that this disparity is not felt across all minorities.
00:06:51 African-American doctors account for 22 percent of all physicians, but are only 6.8 percent
00:06:56 of the population.
00:06:57 And this is an important nuance as we address this situation.
00:07:01 It's also important to note, as the Chair notes, that we have a limited number of GME
00:07:06 residency slots to train new doctors.
00:07:09 And these residency positions are not allocated or dispersed to reflect where underserved
00:07:13 communities are.
00:07:15 Unfortunately, this topic is under finance jurisdiction, but it's an important context
00:07:20 and needs to be considered in any conversation about addressing healthcare workforce shortage.
00:07:27 It's kind of a truism that a physician will practice within 100 miles of where she or
00:07:34 he does their residency.
00:07:36 If the residency spot is not in an underserved area, it's not going to be within that 100
00:07:43 miles.
00:07:44 But access to opportunity is crucial.
00:07:46 I want to highlight, brag on, Xavier University, a historically black college and university
00:07:51 in my state of Louisiana.
00:07:52 This week they announced an agreement with Ochsner Health to open a medical school in
00:07:57 New Orleans at Xavier.
00:07:59 And many of the doctors trained at Xavier, which has had a traditional mission to serve
00:08:03 the underserved and to provide opportunity for minorities, they will stay in Louisiana
00:08:09 and go elsewhere to serve those populations.
00:08:11 So I'm proud of Xavier, and I look forward to continuing to support their effort.
00:08:15 Now as a doctor, I am so aware and desire to support those nurses who have climbed the
00:08:23 career ladder by building credentials over time through upskilling.
00:08:28 Despite from benefiting the individual, it benefits the capabilities of our workforce.
00:08:33 It also benefits their family, as their child sees the impact of their mother or father
00:08:41 seeking through education and delayed gratification greater opportunity that results in more prosperity.
00:08:48 There's a woman I worked with named Olive, who went from a nurse's assistant to a LPN,
00:08:54 to an RN, to a nurse manager, and the clinic in which she formerly was the NA, she ultimately
00:09:00 ended up being the manager of.
00:09:04 Incredible story.
00:09:05 We will have someone here today with a similar story.
00:09:08 Dr. Jonas Andrades will tell us how she has done that in her career, and that is something
00:09:14 that we need to think how to enable.
00:09:16 We should also look at other challenges to ensure our healthcare system meets the need
00:09:20 of all, especially the underserved.
00:09:23 Making sure that patients from all walks of life can participate in clinical trials, which
00:09:28 oftentimes gives the most advanced treatment to those who have the most advanced disease.
00:09:37 And as I mentioned from my career, making sure that all have high quality medical treatment
00:09:43 is something I am passionate about.
00:09:45 One of our witnesses today, Dr. Brian Stone, will tell us how he is trying to address these
00:09:50 issues in his community.
00:09:52 The committee will also discuss maternal mortality, a topic incredibly important that has been
00:09:59 a priority of mine in Congress, and it's important to acknowledge that this issue disproportionately
00:10:05 affects African Americans.
00:10:08 As a doctor, again, who worked in Louisiana's charity hospital system, I know this community
00:10:12 from my practice, and I know that this community is at high risk.
00:10:16 That's why I'm pleased to have U.S. Representative and Dr. Michael Burgess testify.
00:10:21 He's an OBGYN who stayed up many nights delivering medical care to pregnant moms and their babies
00:10:26 in an underserved population of Dallas.
00:10:29 Now as a legislator, Dr. Burgess is a leader in addressing racial disparities in healthcare,
00:10:34 and it's been an honor to work with him on legislation specifically tackling maternal
00:10:39 mortality.
00:10:40 We were unaware that we were having a members of Congress panel until Sunday, so we greatly
00:10:45 appreciate him joining us on short notice when actually they were adjourned last night.
00:10:50 His participation helps make clear that Congress understands the severity of the issue and
00:10:54 is working to address.
00:10:56 I'm also proud to have led several bipartisan legislative efforts to improve maternal mortality
00:11:01 and reduce healthcare disparities.
00:11:03 In 2022, Congress passed the Maternal Health Quality Improvement Act, which helps address
00:11:08 maternal mortality, particularly that disparity within African Americans.
00:11:12 It also supports research examining the best practices to reduce and prevent racial discrimination
00:11:18 in the American healthcare system.
00:11:20 The same year, Congress passed my legislation, the John Lewis National Institute on Minority
00:11:26 Health and Health Disparities Research Endowment Revitalization Act.
00:11:32 It's a mouthful, but it's a good piece of legislation that provided funding to institutions,
00:11:36 including Xavier, to conduct research and address minority health disparities.
00:11:41 And last year in this committee, we passed the Preventing Maternal Deaths Reauthorization
00:11:45 Act, the legislation led in the House by Dr. Burgess, and the bill directs the CDC to provide
00:11:50 hospitals and other providers information on best practices to prevent maternal mortality.
00:11:56 This reauthorization has not yet become law, but we're pushing for passage as Congress.
00:12:01 All this work shows a bipartisan commitment in Congress to addressing health disparities,
00:12:05 but there is more to do.
00:12:07 The Connected Maternal Online Monitoring Systems, or the Connected Mom Act, Dr. Senator Butler
00:12:13 -- I was about to demote you or promote you by calling you doctor -- which I introduced
00:12:17 with Senator Hassan of New Hampshire of this committee, promotes Medicaid coverage of remote
00:12:22 monitoring technologies for those who are pregnant at higher risk of complications.
00:12:27 The need for moms in underserved, urban, or rural areas to travel, sometimes hours, on
00:12:31 public transportation to a doctor's office can be a major impediment to care.
00:12:37 This legislation allows a physician to remotely monitor her health, watching for indicators
00:12:41 of potential complications.
00:12:43 It's bipartisan, it improves access to crucial health care for moms, and it prevents maternal
00:12:48 deaths.
00:12:49 While this bill is in finance jurisdiction, I look forward to the discussion today on
00:12:52 how we can continue to make progress on maternal mortality in the HELP Committee.
00:12:57 Thanks to our witnesses for being here and providing your expertise on how we better
00:13:01 address these important issues.
00:13:02 With that, I yield.
00:13:03 Thank you, Senator Cassidy.
00:13:05 Our first witness will be Senator LaFonza Butler, a senator from California.
00:13:09 Senator Butler is a longstanding advocate for the health care workforce and increasing
00:13:13 opportunities for students from underrepresented and disadvantaged backgrounds in the health
00:13:17 professions.
00:13:18 She's also a strong advocate for reducing maternal health disparities and combating
00:13:23 the black maternal health crisis.
00:13:25 Senator Butler, thanks for being here.
00:13:27 Thank you, Chairman Sanders and Ranking Member Cassidy for the hearing today.
00:13:32 Thank you to other members of the committee for joining.
00:13:36 Your leadership on this issue is demonstrable.
00:13:41 Thanks for having me.
00:13:42 It's an honor, truly, to sit before today's committee to bring added amplification to
00:13:49 the lack of diversity within our nation's health care system, as you both have outlined
00:13:55 so clearly, and in addition, the worsening maternal health crisis.
00:14:01 Before I begin my testimony, I would like to acknowledge those leaders who have been
00:14:05 championing this issue prior to my arrival in the United States Senate.
00:14:10 It is leaders like Representative Lauren Underwood, our colleague Senator Booker, who introduced
00:14:17 the Black Maternal Health Momnibus in the Senate, and Representative Alma Adams for
00:14:22 their leadership in developing the Black Maternal Health Caucus and the leadership.
00:14:29 I also could not sit here without recognizing Vice President Kamala Harris, who introduced
00:14:35 the first version of the Momnibus while serving in the Senate.
00:14:40 She continues to lead the Biden-Harris administration's efforts to improve maternal health outcomes.
00:14:46 These are champions that I am proud to stand alongside.
00:14:52 I want to also take a brief moment to highlight Dr. Michael Galvez, who is a witness in today's
00:14:56 hearing and is also a resident of California and one of my constituents.
00:15:01 Dr. Galvez is a board-certified plastic and reconstructive surgeon specializing in pediatric
00:15:07 hand surgery in Valley Children's Hospital in Madera, California.
00:15:12 He co-created National Latino Physician Day to bring attention to the fact that while
00:15:17 Latinos make up 19 percent of the population, they account for only 6 to 7 percent of the
00:15:22 physician workforce.
00:15:24 Thank you for being here today, Dr. Galvez.
00:15:28 Our health care system and the state of maternal health in this country is at an inflection
00:15:33 point that requires the urgent attention of this committee.
00:15:38 The numbers should alarm all of us.
00:15:42 The United States has the highest rate of maternal mortality among high-income nations.
00:15:47 Within recent years, thousands of women have lost their lives due to pregnancy-related
00:15:52 causes.
00:15:54 Over the past decade, while the birth rate in this country has declined by roughly 20
00:15:59 percent, maternal mortality rates have steadily risen.
00:16:04 The crisis is exacerbated in communities grappling with the lack of access to essential maternal
00:16:09 health care.
00:16:11 According to a report produced by the March of Dimes, one-third of counties in the United
00:16:15 States are considered maternity care deserts, meaning there are no hospitals providing obstetric
00:16:21 care, no birth centers, and no obstetric providers.
00:16:26 Think about that.
00:16:28 Imagine your loved one preparing to give birth and bring new life into your family and having
00:16:32 no choice but to drive hours away from home to seek the care they need.
00:16:38 We know from the research and the numbers that this crisis has not been felt equally.
00:16:44 Among black and native indigenous communities, maternal mortality rates are two to four times
00:16:48 higher compared to those of white communities.
00:16:53 Two to four times higher are black and native American women more likely to die in a pregnancy-related
00:17:01 death.
00:17:03 While black and brown communities experience the highest rates of maternal mortality and
00:17:07 morbidity, these populations also remain starkly underrepresented within the health care field.
00:17:13 While an estimated 13 percent of our country's population identifies as black, only about
00:17:18 five percent of physicians in the United States are black.
00:17:23 Research suggests that under the care of black physicians, the mortality rate for newborns
00:17:27 decreases by over 50 percent, which is why I applaud and urge this committee's continued
00:17:34 efforts to not only bolster the health care workforce but to use every tool to ensure
00:17:39 that that workforce is diverse and equipped to provide unbiased, culturally competent
00:17:46 care.
00:17:47 Only then can we begin to change the course of our nation's current health care system.
00:17:53 We know that this must not mean focusing exclusively on physicians.
00:17:57 For families, mothers, and babies, this means doulas, nurse midwives, nutritionists, and
00:18:03 the full spectrum of reproductive health care professionals that contribute to their health,
00:18:08 well-being, and birthing experience.
00:18:11 Having access to a comprehensive care team can make the world of difference for families.
00:18:16 For example, in my home state of California, the Martin Luther King Community Hospital
00:18:20 in Los Angeles has reimagined the birth experience for women serving within its service community.
00:18:26 When I visited the hospital, I saw firsthand how doulas and nurse midwives were integrated
00:18:32 into their overall maternal health care model to ensure that birthing mothers receive the
00:18:37 highest quality, most comprehensive care.
00:18:40 The leadership of Dr. Elaine Batchelor has made an indispensable difference.
00:18:45 And even as we have existing models and we consider other proposed solutions to this
00:18:51 crisis, I implore this committee to advance the Black Maternal Health Momnibus Act led
00:18:57 by Senator Booker.
00:18:59 The momnibus is comprised of 13 individual bills that would combat the black maternal
00:19:04 health crisis and make historic investments to address comprehensively and deliver -- and
00:19:10 the every driver of maternal mortality, morbidity, and disparities in the United States.
00:19:16 This legislation is not just about the life and death of black women.
00:19:21 Its enactment will improve birthing outcomes for all women.
00:19:26 The momnibus includes bills such as the Kira Johnson Act, which would make necessary investments
00:19:31 in community-based organizations that are leading the charge to protect mothers and
00:19:35 support culturally competent training within maternity care settings.
00:19:39 This bill is named after Kira Johnson, a black mother who in 2016 checked into a hospital
00:19:45 with her husband Charles to give birth to their second child, Langston.
00:19:50 Despite being in excellent health, Kira died from a hemorrhage in the hours after delivering
00:19:55 young Langston.
00:19:57 Kira should be here today.
00:20:00 The lives of her husband and her sons have forever been changed.
00:20:04 The Johnson family's tragic experience and that of so many other families should be a
00:20:08 wake-up call for us to act with urgency to address the need of unbiased, patient-centered
00:20:14 care.
00:20:16 Today's hearing is an important step in the right direction.
00:20:20 I urge this committee to hold additional sessions focused on the black maternal health crisis,
00:20:25 an important legislation that my colleagues and other advocates have introduced and researched.
00:20:30 This committee, which holds the primary jurisdiction for the black maternal health momnibus and
00:20:35 so many other maternal health policy solutions, has had a recent hearing on the topic.
00:20:43 Last month, during Black Maternal Health Week, I convened a roundtable of prominent maternal
00:20:48 health leaders and experts for discussion on how we can work together to combat the
00:20:52 maternal health crisis.
00:20:54 We discussed the hurdles that lie ahead in advancing the momnibus and similar legislation.
00:20:59 Those advocates shared with me that they believed that they would have to remove the word "black."
00:21:05 They believed that only then would the legislation be likely to gain the necessary support for
00:21:12 passage.
00:21:14 After spending some time with my colleagues in the Senate, spending time with many of
00:21:18 you, I don't believe that to be true.
00:21:21 I know this committee is filled with senators, public servants, who represent black women
00:21:26 living in each of their states.
00:21:29 I'm here to stand with you and to show every American watching that I stand with leaders
00:21:35 on this committee who, together, demonstrate our commitment to the black and brown women
00:21:40 and their families who suffer the most in our health care system.
00:21:44 We have solutions at the ready, and I know that anti-black sentiment will not serve as
00:21:49 a barrier towards progress.
00:21:52 While I serve in this chamber, I'll continue to stand with all of you loudly and proudly,
00:21:56 ensuring that we deliver the investments required to meet this moment for caregivers, health
00:22:01 care personnel, the mothers and families in California and throughout the nation.
00:22:06 I look forward to working with this committee and my colleagues in both chambers as we advance
00:22:11 comprehensive solutions and utilize every level to prevent maternal deaths in this country.
00:22:18 Thank you.
00:22:19 Well, thank you very much, Senator Butler.
00:22:21 Our next witness will be Congressman Michael Burgess, representative from Texas, I think.
00:22:25 Senator Cassidy, you wanted to introduce the congressman.
00:22:27 Yeah, it's a pleasure to introduce a witness and a friend.
00:22:32 The Honorable Michael Burgess, an OBGYN.
00:22:35 I represented for 20 years the 26th District of Texas in the House of Representatives.
00:22:40 He's the chair of the Budget Committee of the Health Care Task Force, chair of the Rules
00:22:45 Committee.
00:22:46 He serves on Energy and Commerce.
00:22:48 He has used his wealth of knowledge in maternal health and in building the health care workforce
00:22:53 to advance key pieces of legislation addressing these issues.
00:22:57 He has, as you might guess, a unique perspective as both a policymaker and as a practitioner.
00:23:04 So, Dr. Burgess, thanks for being here.
00:23:07 Thank you, Dr. Cassidy.
00:23:09 Chairman Sanders, members of the committee, thank you for allowing me the opportunity
00:23:14 of testifying here this morning.
00:23:16 I do represent the 26th District in the state of Texas.
00:23:19 In the House, we have congressional districts.
00:23:21 So, that's the area near the Dallas-Fort Worth Airport, just to locate it for you.
00:23:29 Before coming to Congress, I spent nearly three decades practicing medicine in that
00:23:33 area.
00:23:34 Look, I know practicing medicine can be very complex.
00:23:38 I chose obstetrics because if there is attention to detail, the results can almost always be
00:23:47 satisfactory.
00:23:48 I spent time in residency as an OB/GYN at Parkland Hospital.
00:23:53 Statistically, Parkland has some of the best outcomes in the country due to its emphasis
00:23:59 on proper care and attention to detail.
00:24:03 When I started my residency, I remember Dr. Jack Pritchard, who was the leader of the
00:24:08 Department of Obstetrics and Gynecology at the time, pointing out that in practicing
00:24:12 OB, you're unique in medicine.
00:24:16 Those privileged enough to continue are going to be charged with taking care of the simultaneous
00:24:22 care of two patients with a combined life expectancy of 100 years.
00:24:27 Nowhere else in medicine does that occur.
00:24:31 The patient population for Parkland, the Dallas County Hospital District, serves both rural
00:24:37 and urban communities in and around Dallas.
00:24:40 In my time, the clientele was multi-ethnic, almost completely uninsured or underinsured.
00:24:49 But again, they have some of the best statistics in the country.
00:24:53 And the lesson for me there always was, it doesn't have to be this way.
00:24:58 You can do better.
00:25:00 And I would like for us to focus on that with whatever our public policies are going forward.
00:25:06 For myself, I've delivered in private practice over 3,000 babies, treated patients who suffered
00:25:11 from miscarriages, ectopic pregnancies, stillbirths, sickle cell, and other life-threatening conditions.
00:25:16 Whether my responsibility was to step in and deliver a baby or save a life, I did it without
00:25:21 hesitation.
00:25:22 For this reason, I've spent my career trying to increase access to quality health care
00:25:27 for patients through both my experience as a physician and a legislator.
00:25:32 In 2005, through what I describe as the miracle of redistricting, I picked up an area of the
00:25:39 east side of the city of Fort Worth.
00:25:42 It had one of the highest infant mortality rates in the country.
00:25:46 And despite the challenges, it took years of concerted effort, but eventually I was
00:25:51 successful in getting a federally qualified health center with a pediatric unit in that
00:25:57 part of Fort Worth.
00:26:01 In conjunction with a Democratic County Commissioner, Roy Brooks, the mayor of Fort Worth, Mike
00:26:06 Moncrief, who was a prior Democratic state senator, it was through that joint effort
00:26:13 and the experience and the expertise and the passion that led us to championing those issues.
00:26:18 Now, in Congress, I've continued that as well as other health care issues, improving the
00:26:23 health of the nation.
00:26:25 The alarming trend of our country's rate of maternal mortality first came to my attention
00:26:30 in September of 2018 in my copy of the Green Journal, the Journal of Obstetrics and Gynecology.
00:26:36 The original research cited in the journal stated that the maternal mortality rates increased
00:26:41 in Texas between 2011 and 2012.
00:26:46 But then a new study found that the number of maternal deaths in Texas in 2012 was actually
00:26:51 half the number previously reported.
00:26:54 In other words, there was a mistake in the arithmetic.
00:26:58 Because of that, the focus became on how things were counted rather than how do we prevent
00:27:08 these bad things from happening.
00:27:11 The study was retracted, but again, the discussion became about the numbers, not about the patients,
00:27:16 and that was unfortunate.
00:27:18 I personally believe one maternal death is too many.
00:27:21 It's important that we capture these deaths accurately to understand the scope of maternal
00:27:25 mortality in the United States and my state of Texas, and that we have a better understanding
00:27:30 of how to address them.
00:27:31 In combination, we cannot legislate good practice, but we can provide the tools to be able to
00:27:37 come up with the best practices and increase access to maternity care.
00:27:42 These critical points have influenced my policy work.
00:27:45 There are some actual tangible results from that.
00:27:49 Because of the Preventing Maternal Deaths Act, which was signed into law in 2018, and
00:27:54 increasing the dollars spent on maternal mortality review committees, it actually came to my
00:28:01 attention that 53 percent of maternal deaths were occurring one week to one year after
00:28:09 delivery.
00:28:10 I had been focusing on that time actually in hospital, but by broadening the lens out
00:28:16 a little bit, more lives can be saved.
00:28:19 As a consequence, now there was an amendment, a state plan amendment available to Medicare
00:28:24 -- I'm sorry, to Medicaid and CHIP programs that has allowed inclusion of postpartum care
00:28:31 up to a full year after delivery.
00:28:33 Texas, I am happy to say, enacted that March 1st of this year, and now new moms in Texas
00:28:40 are going to have the benefit of an additional year of postpartum coverage.
00:28:47 3338, which was referenced in Senator Cassidy's opening remarks, has passed the House, and
00:28:55 I encourage you to look at that in the Senate.
00:28:58 I think we can do more with our approach that the multidisciplinary maternal mortality review
00:29:05 committees and the causes of maternal deaths.
00:29:11 I cannot stress enough the importance of continuing bipartisan work to reduce disparities and
00:29:17 improve outcomes.
00:29:18 We can bolster our public health workforce.
00:29:22 We can actually start by paying our doctors so they don't retire early or never enter
00:29:27 the practice of medicine in the first place.
00:29:29 That has been a particular concern of mine since coming to Congress, repeal of the sustainable
00:29:34 growth rate formula and the approach to value-based care that followed in its place, although
00:29:40 it's imperfect and we've still got a ways to go.
00:29:44 These are important parameters that will benefit all Americans.
00:29:49 I've had the good fortune of working with your future colleague, Lisa Blunt Rochester,
00:29:54 soon to be a senator from Delaware, my understanding.
00:29:57 I also work with Robin Kelly and Danny Davis, working with Danny Davis to improve the care
00:30:02 of the sickle cell patient, which importantly really had not received any new FDA-approved
00:30:09 therapies in over 40 years until we began to work on that right after the Cures Act
00:30:16 passed.
00:30:17 I know my time is done, but I just want to stress that there are important things we
00:30:22 can work on together, House and Senate, Republican and Democrat, and it's our obligation to those
00:30:28 future Americans that we do so.
00:30:30 This generation of doctors that's coming up is going to have tools to alleviate human
00:30:34 suffering that no generation of doctors has ever known.
00:30:37 It's our job to deliver that to them in a timely fashion.
00:30:41 Thank you for your attention this morning.
00:30:42 I yield back.
00:30:43 Well, thank you very much, Congressman Burgess.
00:30:46 Thank you very much, Senator Butler.
00:30:48 We appreciate your testimony and your excellent work.
00:30:52 We will now hear from our second panel.
00:30:54 Thank you.
00:30:55 (Applause.)
00:31:17 (The bill is signed.)
00:31:47 SENATOR BERNIE SANDERS (D-NY.)
00:32:08 Let me thank all of our knowledgeable panelists for being with us this morning.
00:32:17 And we have five panelists, Dr. Yolanda Lawson, Dr. Samuel Cook, Dr. Michael Galvez, Dr. James
00:32:28 Andradez, and Dr. Brian Stone.
00:32:30 And we thank all of them for being here.
00:32:33 Our first witness will be Dr. Yolanda Lawson.
00:32:36 She is president of the National Medical Association, the largest organization representing black
00:32:41 physicians.
00:32:42 Dr. Lawson is an OB/GYN who is committed to addressing health inequities and improving
00:32:48 diversity among physicians.
00:32:50 She is also committed to eliminating maternal health disparities.
00:32:53 Dr. Lawson, thanks so much for being with us.
00:32:57 Is your mic on?
00:33:02 Press the button now.
00:33:04 Good morning, Chairman Sanders and Ranking Member Dr. Cassidy and members of the committee.
00:33:10 Thank you for the opportunity to appear before the committee to discuss this critical issue,
00:33:15 addressing the shortage of racially minoritized health care professionals and maternal health
00:33:19 disparities.
00:33:20 I am Dr. Yolanda Lawson.
00:33:22 I am testifying today as an OB/GYN practicing in Dallas, Texas.
00:33:26 I'm founder of Madewell OB/GYN and Madewell Woman, which is a birthing center.
00:33:30 I'm currently the executive medical director for maternal infant health at the Health Care
00:33:34 Services Corporation.
00:33:36 Today, I speak to you primarily in my capacity as the president of the National Medical Association.
00:33:44 We are the largest and oldest national organization representing more than 50,000 African-American
00:33:48 physicians and the patients they serve of all racial and ethnic backgrounds.
00:33:53 As a physician, my first duty is to the health of my patients.
00:33:57 As NMA president, my first duty is to fulfill our mission to eliminate health disparities
00:34:03 in this country.
00:34:04 The sad fact is African-Americans, as well as other people of color, are not as healthy
00:34:10 as their white counterparts.
00:34:12 African-Americans experience the lowest life expectancies across a myriad of health outcomes
00:34:17 compared to white Americans, irrespective of their socioeconomic status.
00:34:22 Research demonstrates that such inequities in health outcomes have existed since federal
00:34:27 record keeping began, and they cannot be explained solely by socioeconomic differences, and they
00:34:33 are largely preventable through structural interventions and through the implementation
00:34:38 of equitable health policy and measures before a prospective patient even enters a traditional
00:34:45 medical setting.
00:34:46 In 2020, our nation watched in horror as Black people died disproportionately in high numbers
00:34:53 from COVID-19.
00:34:54 That extraordinary moment spotlighted a chronic problem of the ongoing health disparities
00:35:00 that exist for Blacks in this country.
00:35:03 Black people are disproportionately affected by virtually every major chronic disease,
00:35:08 including diabetes, high blood pressure, and obesity.
00:35:11 Even more disturbing are disparities in maternal health.
00:35:15 You all know the numbers.
00:35:16 Black women are three to four times more likely to die from pregnancy-related complications
00:35:21 than white women, and maternal health disparities persist as a pressing public health challenge
00:35:27 in the United States, despite advances in medical technology and health care delivery.
00:35:33 These disparities are not solely attributable to socioeconomic factors, but are deeply rooted
00:35:39 in systemic racism and unequal treatment, bias, and inadequate access to quality health
00:35:45 care.
00:35:46 This is not just a matter of equity or fairness.
00:35:50 When there are more sick people in our nation, such an imbalanced dynamic creates a bigger
00:35:54 burden on our health care system, reduces workforce productivity, increases disability,
00:36:00 and raises medical costs that ultimately we all pay for, whether through Medicare, Medicaid,
00:36:05 or other high health insurance premiums.
00:36:09 Inevitable health disparities are deeply rooted in the operationalization of structural and
00:36:20 systemic racism and discrimination, and in the persistence of unequal access to quality
00:36:27 health care.
00:36:28 Each of these elements erodes a patient's health care experience and diminishes their
00:36:33 ability to make the best choices in support of their health today and across their lifetime.
00:36:39 So today, I'd like to emphasize a critical piece of the American health care puzzle,
00:36:44 the shortage of black physicians.
00:36:47 Research consistently demonstrates that patients from racial and ethnic minority backgrounds
00:36:52 experience better outcomes when treated by health care providers who share their racial
00:36:58 and ethnic backgrounds.
00:36:59 In short, patients can have better health outcomes when their doctors look like them.
00:37:04 Yet black doctors remain vastly underrepresented.
00:37:09 Representation is critical, and black physicians and health care providers are more likely
00:37:13 to understand the unique challenges that affect black patients' health.
00:37:19 Black patients are more likely to trust and comply with the recommendations of a black
00:37:23 physician.
00:37:24 This country has a legacy of distrust among African American -- among American health
00:37:29 care institutions, rather real or perceived, and this is rooted in historical abuses of
00:37:35 power.
00:37:37 Seventy percent of all black physicians in the U.S. today attended HBCUs.
00:37:43 In the early 20th century, we know that number was reduced after the Flexner Report was released.
00:37:50 Instead of addressing those concerns about the quality of education at HBCU medical schools,
00:37:55 the AMA allowed them to close.
00:38:00 We know that likely the number of black physicians in this country today would be more proportionate
00:38:05 to the black population if those institutions had remained open.
00:38:09 The NMA believes we must create pathway programs to address inequities in the education system.
00:38:16 We must address financial constraints.
00:38:18 For many black students, medical school is a financial impossibility.
00:38:22 We support programs such as the National Health Service Corps and ask for resources for the
00:38:27 HBCU medical schools to address education and infrastructure.
00:38:32 Medical schools must adopt more holistic admission processes.
00:38:36 We must address the higher attrition rates among medical -- black medical students and
00:38:41 residents.
00:38:42 We must advocate in regards to maternal health a companion bill from the Senate to the Black
00:38:47 Maternal Momney Bus Act to focus on preventable maternal mortality.
00:38:52 And finally, we must take steps to reduce the bias in our health care system by establishing
00:38:58 regional centers of excellence to address implicit bias in cultural competency in health
00:39:04 profession settings like Senator Durbin and Representative Robin Kelly's Care for Moms
00:39:10 Act.
00:39:11 So I believe we're at a turning point in my lifetime.
00:39:14 Two major events have significantly exposed the disparities between the health of black
00:39:19 people compared to those of our white counterparts, the COVID-19 pandemic and Hurricane Katrina.
00:39:26 Both catastrophic events revealed the glaring health inequities that are present in our
00:39:34 country.
00:39:35 We have a lot of work to do, but we also have a historic opportunity to change the
00:39:41 story.
00:39:42 Thank you, Senator.
00:39:43 >> Dr. Lawson, thank you very much.
00:39:44 Our next witness will be Dr. Samuel Cook, a resident physician at Morehouse School of
00:39:49 Medicine.
00:39:50 Dr. Cook received his medical degree from Drexel University and is an advocate for improving
00:39:54 diversity of the physician workforce.
00:39:56 Dr. Cook, thanks very much for being here.
00:40:00 >> Thank you, sir.
00:40:02 Senator and Chairman Sanders, senators of the HELP Committee, my fellow esteemed panelists
00:40:07 and guests, thank you so much for having me here today.
00:40:10 I'm Dr. Samuel David Cook, a PGY3 internal medicine resident at Morehouse School of Medicine.
00:40:16 I was born and raised in the Bronx, New York by my two loving parents, Ronald Cook and
00:40:20 Ambassador Susan Johnson Cook, who instilled in me a deep love of God and the impetus to
00:40:24 serve those among us who are most in need.
00:40:27 Though all of us in this room today are red-blooded Americans, my journey to this platform has
00:40:32 been anything but traditional.
00:40:34 The doctors I saw as a child never looked like me, so I made it my life's mission to
00:40:38 be the change I sought in medicine.
00:40:41 During my undergraduate studies at Johns Hopkins University, I was told by my medical school
00:40:45 admissions counselor that my above-average GPA at one of our nation's top 10 universities
00:40:51 was not strong enough to make medicine a reality.
00:40:55 Nevertheless, I persisted and entered a post-baccalaureate pipeline program for underrepresented minorities
00:41:01 at Drexel University's College of Medicine.
00:41:04 In this Drexel Pathway to Medical School program, I thrived in the specialized and supportive
00:41:09 environment and quickly excelled.
00:41:11 I then graduated to become a medical student at Drexel, where I earned top academic awards
00:41:16 above my peers of all races and published my medical research, even authoring a paper
00:41:22 with decorated physicians at Harvard's Medical School.
00:41:26 As the sayings go, you can't judge a book by its cover, and it takes a village to raise
00:41:30 a child.
00:41:32 It is a fact, not an opinion, that historically black colleges and universities have been
00:41:37 instrumental in creating their own pipelines to medical schools.
00:41:41 Between 2009 and 2019, HBCU sent the most black graduates to them.
00:41:46 Last year, HBCU medical schools produced 10% of our nation's black doctors, while only
00:41:50 accounting for 2% of all medical colleges.
00:41:54 Assuming we beat an educational system that is stacked against us, many black students
00:41:59 are then faced with hundreds of thousands of dollars in student loan debt.
00:42:04 For me, the current sum of medical student loan debt plus accrued interest stands just
00:42:09 shy of $400,000.
00:42:13 Though the costs are the same no matter the student's race, the financial impact it will
00:42:18 have on their families is not.
00:42:21 Racially based and systemic wealth inequity is an undeniable truth in our nation, and
00:42:27 one that has barred far too many students of color from becoming the doctors they were
00:42:31 qualified to be.
00:42:32 Thus, we call on you to increase funding for HBCUs to reduce the cost of producing high
00:42:37 quality physicians of color.
00:42:40 This is with the understanding that these institutions have a proven track record of
00:42:44 incubating some of our nation's brightest minds, those nearly snuffed out by the waves
00:42:49 of racial bias and injustice.
00:42:52 How does having a black doctor better serve black patients or save them from undue harm?
00:42:56 I wrote in my testimony about a black woman who was nearly committed and chemically and
00:43:02 physically restrained, all because her medical team didn't know that hitting your head to
00:43:06 scratch an itchy scalp doesn't make you crazy.
00:43:09 It simply means you don't want to mess up your hair.
00:43:13 How it was the presence of a black psychiatrist that saved them and that hospital from what
00:43:18 would have been justifiable malpractice lawsuits.
00:43:22 So this is not just an issue for black American senators.
00:43:25 This is an issue for all Americans.
00:43:28 What's more, a 2016 study found that half of white medical trainees surveyed, 50% believe
00:43:36 such myths as black people have thicker skin or less sensitive nerve endings than white
00:43:41 people.
00:43:42 They continued, participants who endorse these beliefs rated the black patient's pain as
00:43:46 lower and made less accurate treatment recommendations.
00:43:51 In this population of white medical students, we see evidence that negative racial biases
00:43:55 are currently and have long been harming America's black patients.
00:44:00 Senators, I humbly come before you today as nothing more than a mouthpiece for our collective
00:44:06 struggles.
00:44:07 We serve tirelessly, senators.
00:44:10 We resident physicians and medical students of color sacrifice our physical, mental, spiritual,
00:44:17 and financial wellbeings to be the change in the medical field we so desperately seek.
00:44:22 So now we ardently advocate for the reintroduction of legislation, which would specifically fund
00:44:28 and protect the growth of HBCU medical schools like that proposed by chairman Sanders in
00:44:34 2023.
00:44:35 This is what the sentiment that we make these vital pipelines more affordable because the
00:44:39 financial manacles of medical schooling are the greatest impediments and recruiting black
00:44:45 and brown doctors to our workforce.
00:44:47 It frightens me to think that after today, nothing will change to render our physician
00:44:52 workforce more representative of the racial and ethnic makeup of our great nation.
00:44:56 Therefore, I am challenging you senators calling upon you to each assure the American public
00:45:03 and your constituents that you will vote to support our HBCUs and empower future generations
00:45:11 of black and brown physicians.
00:45:13 The time to act is never tomorrow, senators.
00:45:17 It has been and always will be today.
00:45:20 Thank you.
00:45:22 Thank you very much, Dr. Cook.
00:45:25 Our next witness will be Dr. Michael Galvez, who specializes in pediatric reconstructive
00:45:30 hand surgery in Madero, California.
00:45:33 Dr. Galvez co-created the National Latino Physician Day and the phrase 6% is not enough
00:45:39 to bring attention to the need to diversify the physician workforce.
00:45:42 Dr. Galvez, thanks so much for being with us.
00:45:46 Buenos dias, Chairman Sanders and ranking member Cassidy.
00:45:52 Thank you for having me here today.
00:45:54 My name is Dr. Michael Galvez and I stand before you as a husband, father, son of Peruvian
00:45:59 immigrants, surgeon, and an advocate for mi comunidad, my Latino community.
00:46:04 I am honored to serve as a pediatric hand surgeon to help children with complex hand
00:46:09 conditions at Valley Children's Hospital in the Central Valley of California, a region
00:46:13 with significant disparity and need for high quality care.
00:46:16 Hablo espanol todos los dias.
00:46:19 I speak Spanish every day with my patients.
00:46:22 In my practice of medicine, I've come to recognize that my language and culture are as valuable
00:46:27 as my training at prestigious universities.
00:46:30 There is nothing like seeing a face of a Latino child's mother when I come through a clinic
00:46:34 door and begin speaking Spanish, alleviating fear as their first encounter with a physician
00:46:39 that speaks el idioma, the language.
00:46:42 I see complex problems and having the superpower of language proficiency and understanding
00:46:47 the culture adds clarity and connection.
00:46:50 After working at medical institutions across the United States, I've asked myself constantly,
00:46:55 why don't I see more students and faculty like myself?
00:46:59 For that reason, I helped co-found National Latino Physician Day, celebrated on October
00:47:03 1st along with Stanford obstetric anesthesiologist, Dr. Cesar Padilla, to spotlight the underrepresentation
00:47:10 of Latinos and Latinas in medicine.
00:47:12 This effort has rapidly involved into a movement supported by the National Hispanic Medical
00:47:16 Association, the Latino Medical Student Association, and nearly every medical organization in this
00:47:22 country and multiple hospital systems across the country.
00:47:26 We rallied behind the motto, 6% is not enough, in recognition of the public health crisis
00:47:31 affecting our community.
00:47:33 Despite being the largest minority group in the United States, Latinos represent only
00:47:38 6.9% of the physician workforce, which is a big contrast to almost 20% representation
00:47:43 in the nation's population and nearly 40% in the states of California and Texas.
00:47:48 There are not enough physicians to provide high quality care to communities that are
00:47:52 the backbone to our economy and overrepresented in difficult professions such as agriculture
00:47:57 and construction.
00:47:58 Latinos in the US have the fifth largest gross domestic product in the world, GDP.
00:48:05 However, limited access to healthcare, face language and cultural barriers, experienced
00:48:10 poor cancer and maternal health outcomes, and had increased COVID-19 mortality during
00:48:15 the pandemic.
00:48:17 This deeply burdens the nation's social safety nets, more missed school days for children,
00:48:22 and lower productivity, which really stunts the potential of our country.
00:48:27 Our hospitals, our institutions, medical schools, and indeed Congress, have the ethical responsibility
00:48:32 to address the underrepresentation of Latino physicians to meet the needs of a growing
00:48:37 Latino population, which is estimated to comprise one third of the population by 2050.
00:48:43 But the journey to medicine is full of socioeconomic barriers, especially for Latino and minority
00:48:47 students.
00:48:49 In my journey, community college education was key to my success, but it can really just
00:48:54 be the only educational option for some students.
00:48:58 To expand the percentage of Latino physicians and minority physicians in general, it is
00:49:02 critical to meet them where they are, and that is in our nation's community colleges.
00:49:06 The commercialization of medical school admissions and the reliance on standardized tests, such
00:49:11 as the MCAT, overlooks the potential of a compassionate and capable physician candidate.
00:49:18 Having helped excellent students navigate these waters, I'm in disbelief when they're
00:49:22 not recruited, despite our physician shortage.
00:49:26 The National Latino Physician Day highlights the persistent shortage of Latino physicians,
00:49:30 which underscores the need for change and opportunities for action that Congress can
00:49:34 take.
00:49:35 First, expand funding for pathway programs and new medical school programs.
00:49:41 We can increase the minority physician workforce by recognizing the value of lived experience
00:49:46 of Latino-identified individuals through pathway programs that begin at community colleges,
00:49:52 earlier exposures to medicine, and advocate for holistic medical school admissions.
00:49:57 We need a bilingual and bicultural medical school anchored in a Hispanic-serving institution,
00:50:03 partnered with local hospitals.
00:50:05 We can start with regional satellites of medical schools in predominantly Latino areas of California.
00:50:12 We also should not be ignoring language.
00:50:14 Language proficiency by physicians is a proven strategy for improving patient outcomes demonstrated
00:50:19 by the UCLA Latino Policy and Politics Institute, which has shown that concordant language enhances
00:50:25 compliance with treatment plans and medication adherence.
00:50:30 Mandating medical schools to value bilingual skills and community college background.
00:50:36 By tying medical school funding and NIH grants to admission practices that prioritize these
00:50:42 elements, this will drive medical schools to align more closely to their local underserved
00:50:47 areas.
00:50:48 For example, the University of California could be mandated to recruit, accept, and
00:50:52 retain these qualified students to take care of those underserved populations.
00:50:57 Finally, funding loan repayment programs.
00:51:00 In California, I am grateful to be the recipient of a CalHealthCare's loan repayment to serve
00:51:05 patients on Medi-Cal.
00:51:06 But federally, the National Health Service Corps is essential to attract and retain physicians
00:51:11 in underserved areas, ensuring equitable healthcare access.
00:51:15 We can no longer allow the status quo from our medical schools.
00:51:20 As the Latino population increases, we must confront this public health crisis head on.
00:51:25 Necesitamos mas.
00:51:26 We need more.
00:51:27 Thank you so much.
00:51:29 Thank you very much, Dr. Galvez.
00:51:30 Senator Cassidy, do you want to introduce your panelists?
00:51:33 Yes, my pleasure to introduce Dr. Andradez.
00:51:38 Dr. Janice Andradez, who is a certified nurse practitioner, who completed her doctor of
00:51:49 nurse practitioner at Elms College 2020 and her Bachelor of Science in Nursing from Elms
00:51:55 College in 2014.
00:51:56 She is a native of Springfield, Massachusetts, dedicated her professional career to caring
00:52:01 for vulnerable populations with addiction, mental illness, and chronic disease.
00:52:06 She credits her pre-nursing experiences in the hospital setting as a catalyst to pursuing
00:52:11 a career in healthcare.
00:52:12 Her clinical experience as a registered nurse began as a correctional nurse for the Hampton
00:52:18 County Sheriff's Department, where she conducted mental health evaluations and incorporated
00:52:22 a multidisciplinary approach to care.
00:52:25 Later joined the Bay State Mason Square Neighborhood Clinic, providing drug and alcohol abuse nursing
00:52:30 care.
00:52:31 She enhanced her clinical skills as an inpatient staff nurse and joined Bay State Medical
00:52:36 Center team as a trauma surgery nurse practitioner in September 2020.
00:52:40 Her commitment to be a voice for the disenfranchised has allowed her to be a change agent and a
00:52:45 role model for others.
00:52:46 Dr. Andradez, thank you for being here.
00:52:50 Chairman Sanders and Ranking Member Dr. Cassidy, I am Janice Andradez, a nurse practitioner
00:52:55 in trauma surgery at Bay State Medical Center in Springfield, Massachusetts.
00:52:59 It is an honor to present my testimony before you today, and I thank you for the opportunity
00:53:05 and your attention to addressing the shortage of minority healthcare professionals.
00:53:10 I want to tell you a bit of my experience and offer you some insight into ways I believe
00:53:15 Congress can help increase the number of minority healthcare workers in the future.
00:53:21 I went to high school in Springfield, Massachusetts at Putnam High School, an urban vocational
00:53:26 school.
00:53:27 I was enrolled in the cosmetology program, but had dreams of becoming a lawyer.
00:53:33 At that time, I struggled to figure out how to make this dream come true.
00:53:40 Coming from a single-parent home where my mother didn't have the means to save for college
00:53:44 or law school, I was fortunate, though, she did have the drive to instill a strong work
00:53:50 ethic and the foresight to encourage me to contemplate my talents and choose a career
00:53:56 which would offer economic stability.
00:54:00 One day at a medical appointment with my mom, a nurse started talking to me about the opportunities
00:54:05 nursing could offer.
00:54:06 I was intrigued.
00:54:08 To get a better sense of how I would fare on the path to becoming a nurse, I started
00:54:12 taking courses at Holyoke Community College.
00:54:14 I took prerequisites for the nursing program and eventually enrolled to Elms College to
00:54:20 earn my Bachelor's of Nursing.
00:54:23 While I was going to school, I wanted to support myself and thought taking a job at a hospital
00:54:28 to get my foot in the door and learn more about healthcare would benefit me in the long
00:54:33 run.
00:54:34 So, I began working in environmental services as a custodian at Bay State Medical Center.
00:54:39 I worked to keep surgery and procedure rooms clean.
00:54:43 This allowed me to see firsthand what nurses did, what I would need to know moving ahead
00:54:50 in the healthcare environment, and to get advice on how to proceed in my career.
00:54:55 My colleagues offered incredible insight into ways I could fund my education.
00:55:01 They pointed me towards resources like the Western Mass Community Foundation where I
00:55:05 had access to scholarships and interest-free loans.
00:55:09 Without my colleagues, I would not have been able to find these resources which I believe
00:55:13 were instrumental to my education.
00:55:16 These resources need to be made more visible and accessible to students.
00:55:20 I proceeded through my nursing school and stayed at Bay State Medical Center in environmental
00:55:25 services.
00:55:26 Eventually, I was hired as a nurse once I graduated in a community health center, Mason
00:55:32 Square.
00:55:33 There again, with the support of my colleagues, I was encouraged to earn my doctorate of nursing
00:55:38 practice.
00:55:40 I did this at the height of the COVID-19 pandemic, which was not easy, and eventually I was able
00:55:46 to come full circle and take a job as a nurse practitioner in trauma surgery, again at Bay
00:55:52 State Medical Center.
00:55:54 Looking back on my experience, if I could make suggestions to lawmakers on how to improve
00:55:59 the shortage of minority healthcare providers, I would offer a few thoughts.
00:56:04 First, I would say robust college and career planning is very critical.
00:56:10 Any students at all schools, especially those in lower income areas, aware of healthcare
00:56:18 as an attainable career opportunity would go so far.
00:56:22 Letting these students know it is within their reach and that there are resources available
00:56:26 to them to embark on their journey to higher education is key.
00:56:32 At Bay State Medical Center, we have a program called the Bay State Springfield Educational
00:56:37 Partnership, or BSEP.
00:56:39 This is a program for the youth in Springfield which helps connect them with hospital-based
00:56:44 learning and opportunities to learn about different professions within the healthcare
00:56:48 system.
00:56:49 It allows students to engage with professionals and learn from them, like I did while being
00:56:54 a custodian.
00:56:56 But in this program, they're still in high school, and this option helps them evaluate
00:57:03 what healthcare career they could select.
00:57:05 I did not go through this program myself, but I would recommend supporting similar opportunities
00:57:11 for minority youth for early professional mentorship.
00:57:15 There are a number of physicians, physician assistants, and nurse practitioners like myself
00:57:19 who entered BSEP as high school students and now work for Bay State.
00:57:24 Many of the BSEP students also fill other roles in Bay State while advancing their education.
00:57:30 I believe federal support for programs like this could lead to many more minority students
00:57:35 embarking on prosperous careers in healthcare.
00:57:40 Another way to make this journey more accessible is tuition-free community college.
00:57:44 This would allow students to begin their education without taking on a financial burden.
00:57:50 This opportunity to begin to pursue the education needed to become a professional healthcare
00:57:55 provider at a community college should not be underestimated.
00:57:58 Additionally, state and federal grants to reduce loan costs would make their career
00:58:03 paths a more appealing option.
00:58:07 Helping fund the education of minority students interested in becoming professional healthcare
00:58:12 providers is a wise investment.
00:58:14 It fills in demand jobs in the healthcare field and connects people with practical careers
00:58:20 which will allow them economic stability to support themselves and their families.
00:58:26 Thank you again for the opportunity to testify and share my experience with you.
00:58:31 I appreciate your consideration of my recommendations.
00:58:40 Senator Cassidy, you want to introduce your last witness?
00:58:42 And I'll let my senator from Alabama introduce the doctor from Alabama.
00:58:46 Thank you, Senator Cassidy.
00:58:47 Welcome to all of you.
00:58:48 It's my honor to introduce today Dr. Brian Stone of Jasper, Alabama.
00:58:53 Dr. Stone grew up in Birmingham and received his undergrad degree from Rutgers.
00:58:58 He went on to earn his medical degree from University of Alabama, Birmingham.
00:59:02 He was identified as a top urologist in New York and New Jersey in his years of tenure
00:59:07 at Columbia University's College of Physicians and Surgeons.
00:59:12 He has received so many awards for his success, it's hard to count them all, but he's been
00:59:16 honored by the NAACP, Morehouse School of Medicine, the American Cancer Society, and
00:59:21 the American Urological Association.
00:59:26 Because of his leadership on issues like health disparities and prostate cancer, he has served
00:59:31 in many capacities as a consultant and scientific advisor.
00:59:35 He has served in advisory positions on the local, national, and international level over
00:59:41 the years.
00:59:42 He also worked in partnership with pastors in different denominations in Jefferson County
00:59:47 and the Jefferson County Department of Health to educate and recruit black patients to participate
00:59:51 in clinical trials process.
00:59:54 He serves on the committee for underrepresented minorities at the University of Alabama, Birmingham
01:00:01 School of Medicine in conjunction with School of Medicine's National Alumni Association.
01:00:07 He created a medical scholarship program for deserving male students of color from Alabama
01:00:12 who have been accepted into the UAB School of Medicine.
01:00:16 The goal is to increase the number of minority physicians who are from Alabama and are willing
01:00:22 to practice medicine in the state.
01:00:25 He has also worked to increase STEM exposure to K-12 students in the city of Birmingham
01:00:30 in partnership with the Boys and Girls Club.
01:00:32 Dr. Stone is currently the president and chief medical staff of Walker Baptist Regional Medical
01:00:38 Center and the president of Jasper Urology Associates.
01:00:41 I couldn't be more proud to have him here today, and we all look forward to his testimony.
01:00:46 Thank you, Dr. Stone.
01:00:47 There we go.
01:00:48 Good morning.
01:00:49 I'd like to thank Chairman Sanders, Ranking Member Cassidy, Senator Tufferville, and members
01:00:50 of the Health Committee for having me present to speak today.
01:00:51 My background is a urologist.
01:00:52 I've been a urologist for about 20 years.
01:00:53 I've been a physician for about 20 years.
01:00:54 I've been a physician for about 20 years.
01:00:55 I've been a physician for about 20 years.
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01:42:48 >> I think that's particularly helpful in terms of the
01:42:54 recruitment and retention of diverse health care forces.
01:43:00 Would that be helpful in terms of recruiting students of color?
01:43:06 >> Thank you for that question, Senator.
01:43:10 I think that's a really good question.
01:43:16 I think that's a really good question.
01:43:22 I think that's a really good question.
01:43:28 I think that's a really good question.
01:43:34 I think that's a really good question.
01:43:40 I think that's a really good question.
01:43:46 I think that's a really good question.
01:43:52 I think that's a really good question.
01:43:58 I think that's a really good question.
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