We’re shining the ProjectIMPACT Spotlight on Candrice Heath, MD, FAAD, an individual who is making a positive impact in healthcare by reducing racial bias in medicine. Dr. Heath is interviewed by Uchenna K. Okoji, MD, VisualDx Student Advisory Board member 2020-2022.
Please describe your job and your favorite aspects of your current position
Dr. Heath: I am an assistant professor of Dermatology at the Lewis Katz School of Medicine at Temple University. I am a core faculty member, which means I work directly with residents. One of the things that drew me to Temple is that our practice is housed at the center of a majority African American community with skin of color.
I get excited about coming to work because I am able to positively impact the lives of people from all various states of wellness and backgrounds as part of my daily job.
Although I am a dermatologist, I take it seriously that some patients in the community have never seen a doctor that looks like me. Despite being in the North Philadelphia area, there are not many attending physicians who are African American, so I know that in just showing up, my presence is sending rippling effects beyond the care that I provide.
I am triple board-certified in pediatrics, dermatology, and pediatric dermatology so I see both adults and children, which I greatly enjoy. At many academic centers, you are often expected to focus solely on one area of clinical interest.
I was drawn to Temple because our department is large enough to provide adequate care to the community but still small enough where I can be involved in patient care and research for a variety of adult and pediatric conditions like hair loss and atopic dermatitis. This type of flexibility, as well as being able to work directly with residents, are just a few aspects of my current position that I enjoy the most.
What do you see are the biggest challenges in reducing bias in healthcare?
Dr. Heath: One of the biggest challenges in reducing bias in healthcare is being able to admit that some of the approaches we have taken in medicine have been wrong or ineffective. It is sometimes difficult to admit that the view you may have thought was “good” or “justified” was incorrect and biased because of the limited information you had. Your life experiences and where you come from can really shape your outlook and perspective on things.
To reduce bias, we must forgive ourselves and become open to accepting new approaches or different schools of thought. It often starts with mindset. It is very important to adjust your mindset to one that is ready for change. We must be willing to think beyond our comfort zones and think about what is best for our patients.
Another challenge is that the communities or people that are affected by systemic or structural decisions made in healthcare are often never at the table or included where and when these discussions occur. We need to remove patients from the silo of just being a patient and have them present to provide insight about their lived experiences as well as provide feedback about potential solutions that we as clinicians and researchers develop. It is important that we work hand in hand with the communities that we serve.
What are you currently working on that addresses healthcare equity?
Dr. Heath: I try to infuse and address healthcare equity in everything that I do. I am always thinking about how each project or initiative that I am involved with will move the needle on health equity.
In dermatology, patients with skin of color and/or tightly coiled hair are sometimes treated differently or may have difficult experiences because some dermatologists are not adequately trained to identify and diagnose conditions in patients with their hair texture or skin tone.
Often, treatments that these patients receive do not fit within their skin or hair habits. Through my research and practice, I try to “even the playing field” by providing all dermatologists, regardless of their background, with the tools needed to provide care for all patients. My research papers present step-by-step guidance for dermatologists and dermatologists-in-training to follow when caring for patients with skin of color and tightly coiled hair.
My hope is that my work can help all dermatologist practice with cultural humility to create better clinical experiences for patients with skin of color.
I am also working on challenging myself to do things that I have not done before in order to be able to help more patients. I recently began grant writing for projects on scarring alopecia care and treatment, which has been quite a challenging and overwhelming process. What has driven me to continue with it is the positive impact that I feel that the final product would have on the dermatologic care of patients with tightly coiled hair. When I think about that, I get my “second wind.” Overall, I hope my work and practice makes positive contributions toward health equity.
What or who inspires you?
Dr. Heath: I get inspiration from many sources. I am definitely inspired by my patients. I enjoy speaking to them and learning about their triumphs as well as their challenges. I find myself in awe of patients who have had major successes in their lives, especially in the face of adversity. People often say to me, “Wow, Dr. Heath, you’ve accomplished so much,” but I remind them that it has not been without hard work or struggle.
I am also inspired by my older sister who was born with nevus of Ota. Seeing her struggle and cope with this condition was my initial inspiration to go into medicine and piqued my interest in dermatology. When we were younger, I would accompany her to the pediatrician and one of the few Black dermatologists at the time, Dr. Yvonne Knight. Every year we visited Dr. Knight, we would ask her, “Is there a cure yet?” and every year she would tell us “No, not yet.” Until one visit when she told us that there was something coming: laser therapy.
When laser therapy came about, patients with darker skin tones like my sister were not eligible because of the potential risk of scarring. Regardless of whether the science had advanced for nevus of Ota treatment or not, Dr. Knight would always make sure that my sister left her office with a sense of confidence and high self-worth. This experience helps to remind me that every time I enter an exam room, my words or actions may inspire and impact a patient’s life in some way, just like Dr. Knight did for me. That is why I do not take for granted being a doctor and dermatologist.
During my fourth year of medical school at University of Virginia, I was selected to complete an away rotation in dermatology at Harvard Medical School. During one the lectures, there was a discussion about laser therapy and how it could be used to treat many dermatologic conditions. I remember being fascinated by one person in the room who was leading this discussion. Once the lecture was over, I introduced myself to this gentleman and said, “Wow, you know a lot about lasers!” I came to find out that he was Dr. Rox Anderson, a pioneer in dermatology who invented many of the laser-based treatments and procedures commonly used today. He remained gracious and humble in our discussion and provided me with resources to learn more about lasers.
I often think about these interactions and experiences I have had over my personal and professional life. They remind me that when you work in a field like dermatology where people are constantly learning from you, you must embrace sparks of knowledge from learners and nurture them because these learners become the next generation of experts.
What advice would you give to medical students or residents interested in addressing healthcare disparities?
Keep your eyes open. Use your clinical interactions with patients to drive your research questions to address healthcare disparities. That is going to be key because when you’re the student or resident, you have additional time to gain insight from patients. Use that time to learn from patients and do not be afraid to ask questions that may uncover information that is not obvious. For example, you may ask a patient, “How did you get to our clinic today?” and may be surprised to learn about some of the barriers to care that contribute to disparities. These types of questions can really shed some light on ways that are important to move the needle.
Educate yourself and team up with people who have being doing the work. It is so important to be collaborative in all our efforts. We cannot practice and do research in silos and be competitive. The more we work together and share our findings, the quicker we can create positive change.
Strive to think about things from a health disparities angle. Your department may be known for excellence in melanoma research or for providing excellent dermatology training for clinicians who will practice in rural areas. Regardless of the notable strengths of your program, challenge yourself to think about how you and your colleagues can work to achieve health equity.
How do you pledge to make an impact to improve health equity?
Dr. Heath: I will continue to be strategic about where I work, with whom I work, and the research questions I choose to explore. I pledge to have an impact on health equity in everything that I do, whether it is in my volunteerism, in my teaching, and even in my personal life. It permeates everything that I do. I understand that not everyone’s life affords them that opportunity.
For me, health equity is the thread that ties all the things that I am doing in my life together. I am very passionate and empowered by knowing that the things I am doing can be amplified to make the lives of others better.
This Project IMPACT blog series was created to highlight leaders who are making a positive impact in healthcare by reducing racial bias in medicine.