Long Road To Breaking Down Barriers
When Alvin V. Thomas Jr., MD, FCCP, accepted the CHEST presidency in 2007, he had a mission in mind, one that he had been formulating for a long time. His goal was to highlight health care disparities and raise the consciousness of his colleagues to an issue that was affecting large communities of people suffering with lung disease.
Dr. Thomas, who is currently Emeritus Chief of Pulmonary and Critical Care Medicine at Howard University Hospital, and his wife Zorita, recently took the time to talk with us about their involvement in equity issues and working with underrepresented communities. This conversation was sparked by a letter sent last year by Dr. Thomas; Dr. David Gutterman, Master FCCP; and Dr. John Studdard, FCCP, calling on CHEST to be leaders in the area of equity for people of color. This topic is also the current focus of the CHEST Foundation Listening Tour.
Dr. Thomas saw how issues of health equity and access impacted health care throughout his education and early medical career. In addition to working extensively in underserved communities, Dr. Thomas has been a principal investigator or participant in several studies on preventive care in Black men. Dr. Thomas notes that when he joined CHEST in the early 1980s, “the problem of disparities in health and health care were just beginning to be major topics of discussion at a national level.”
“The medical profession is one of the last areas to really have to deal with the issues of equity and diversity. I’ve seen pushback on this issue, even though diversity and inclusion are essential.”
He began laying the groundwork for a call to action. By the time he became the first (and only so far) African American President of CHEST, Dr. Thomas felt the college should take an active role in addressing barriers to care and aggressively mentor minority clinicians into leadership roles.
“It was clear that a lot needed to be done, and people didn’t really have an organized way to try to do it. You highlighted the disparities in health. You highlighted disparities in care. But there weren’t a whole lot of easy solutions because it really dealt with deeper issues,” explained Dr. Thomas. There was little impetus for change by the medical community at large.
One change Dr. Thomas focused on was the inclusion of annual meeting sessions related to disparities in health care. “But of course, there was a barrier there, too, and not from the college,” said Dr. Thomas. “People just didn’t attend.”
Then and today, Dr. Thomas stressed the need to integrate discussion of health issues in diverse populations into every learning opportunity to increase awareness for all clinicians. This a a step CHEST has already begun incorporating.
When President, Dr. Thomas stated that addressing disparities should be part of the “cultural fabric” of all CHEST programs. He noted the need to seek funding for patient transportation programs, community-based interventions, and training in cultural competencies for physicians— issues currently highlighted in the Foundation’s Listening Tour. As Dr. Thomas’ time in leadership came to an end, attention eventually shifted away from actively pursuing diversity issues.
“The medical profession is one of the last areas to really have to deal with the issues of equity and diversity. I’ve seen pushback on this issue, even though diversity and inclusion are essential,” noted Dr. Thomas. He believes problems of diversity and inclusion in medicine will improve when there is greater commitment and success in increasing the number of Black and Brown persons as medical students, medical faculty, and practicing medical care providers.
Last year, with the rise of the COVID-19 pandemic and the social unrest resulting from the death of George Floyd, CHEST was asked once again where it stood on the issues of health care disparities. “We can and should be a thought leader in the pulmonary and critical care community on this issue,” said Dr. Thomas both in 2007 and today.
Some visions might take longer, but they are not forgotten. We are all challenged to take up that vision through our actions in whatever form they take – mentoring, advocating, donating, or leading.
WORK WITHIN COMMUNITIES
While her husband may be the physician in the family, Zorita Thomas is the activist focused on community-based service. Ms. Thomas participated in and led the CHEST Foundation community-based service program, the Ambassador Group. The members coordinated lung health education events and outreach to underserved communities internationally. At one point, the program was so extensive that the members were regular attendees of the CHEST annual meeting, holding their own sessions and programs.
“This program was started by two women who went out into the communities in San Francisco, to the schools, to talk about asthma. Then it opened up, and [the program] kept getting bigger,” explained Ms. Thomas. “The focus was on what each of us can do in our own communities.” Together, Dr. and Ms. Thomas believe the best way to help is to work within the community.
In this way, the CHEST Foundation Listening Tour is right on track by bringing patients, caregivers, community leaders, and community physicians together. The Foundation’s community service microgrants for clinicians who want to help at-risk populations during the pandemic provided food and supplies, health-care quality masks, and oximeters.
“Get in the communities, identify the people in the community who the people trust, and then work with them,” said Dr. Thomas. “Finding community workers who people know and trust, that’s what it takes to really get things done. It takes time, but that’s the kind of granularity that’s necessary.”
Alvin and Zorita Thomas have actively supported the CHEST Foundation’s efforts in diversity and health equity as Lifetime Members and community leaders.
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