We’re shining the ProjectIMPACT Spotlight on Claire Hollins, MD, an individual who is making a positive impact in healthcare by reducing racial bias in medicine. Dr. Hollins is interviewed by Autumn Saizan, 4th-year medical student at the University of Rochester and VisualDx Student Advisory Board member.
AUTUMN SAIZAN: Please describe your job and your favorite aspects of your current position:
Dr. Hollins: I am an assistant professor of Dermatology and serve as the vice chair of Diversity, Equity & Inclusion for the Dermatology Department at Penn State Health in Hershey, PA. My job is primarily patient-care focused, but also centers on education and research. I serve as the director of Central Pennsylvania’s only Skin of Color Clinic, focusing on skin and hair conditions more likely to affect deeper skin toned individuals – and serving patients who have traditionally been underserved. I also spend time with the dermatology residents, precepting their clinics and teaching them about the craft of dermatology. Finally, I am in academic medicine, which is such a fun, stimulating place to constantly learn while also contributing to literature with my work in disparities research.
One of the best aspects of my position is the relationships I get to develop with the people in Central PA! Whether it’s interacting with patients, residents, medical students, co-workers or our team, there is a genuine kindness here that is really special!
as: What do you see as the biggest challenges in reducing bias in healthcare?
Dr. Hollins: The biggest challenges in reducing bias are removing systemic barriers that must be thoughtfully deconstructed, as well as removing bias on a personal level, which is integral to being conscientious, practicing physician.
There is an undeniable amount of research demonstrating that bias not only exists in healthcare, but also causes adverse patient outcomes. That is unacceptable in a field whose motto includes, “first do no harm.”
From a systemic barrier perspective, for example, pulse oximetry monitors, which are devices used to determine the amount of oxygen in the blood, have been found in one study to be three times less accurate in Black patients compared to readings in patients with light or white skin. This deprives already vulnerable populations of an accurate reading which can have major health implications—especially during times of COVID-19, when knowing that information can mean life or death. That’s a system issue that even the most unbiased physicians will be affected by.
From a personal perspective, it is often at the individual level where a physician might not provide adequate pain management to Black and Brown patients in their clinic—or an individual provider might not take a woman’s heart attack symptoms as seriously as they do a man’s. So, from systemic to individual barriers, we, as a collective, need to recognize biases, and once we do, make a choice to be part of a movement to eliminate them as we treat patients.
as: what Are you currently working on that addresses healthcare inequity?
Dr. Hollins: Something that I am working on is my Skin of Color Clinic in Harrisburg, PA. I specialize and have an interest in hair and scalp disorders. There is an epidemic of hair loss in the Black community, and many women are hiding that loss under wigs, weaves, and other styles; not because they do not care, but for many other reasons.
For one, hair loss and scalp itching is often normalized in our community. It is so pervasive that many young ladies think hair loss around the edges is an inevitable part of growing up! In addition, often these patients do not feel that they get good guidance when they make it to a dermatologist, feeling like their hair or issue is not understood. Finally, this brings up one last issue: access to a dermatologist. Many Black and Brown patients do not live close to dermatologists, which has larger implications that just devastating hair loss.
Sadly, studies have shown that lack of access to a dermatologist increases the risk of being diagnosed with later stages of the most dangerous type of skin cancer, melanoma, which can absolutely be diagnosed in skin of color and is indeed what killed Bob Marley! All that to say, we need to educate, reach, and ultimately treat our patients of color, and I am proud to be helping do just that.
as: What or who inspires you?
Dr. Hollins: The physician leaders who mentor me have constantly inspired me. I think about physicians like Dr. Jim Marks, Dr. Susan Taylor, and my own father, Dr. Dennis Hollins, who are all so good, and so passionate about their work and life. I learn how to persevere through all sorts of challenges from all three. I have learned how to be there for my colleagues and patients, and how to enjoy being at work from Dr. Marks; from Dr. Taylor, I have learned grace and grit and just how much one person can “change the game” in their respective field; and from my dad, I continue to learn love in all its forms: of family, friends, the sciences, spirituality, how the world works, compassion for all living creatures, and for sports!
as:What advice would you give to students or residents who are interested in addressing healthcare disparities?
Dr. Hollins: The advice I would give would be to just do it! It is easy to get overwhelmed—know that and manage it. I learned that from my mother; she always says, if you’re feeling overwhelmed or not sure what to do, set a time limit to experience the overwhelm, then when time’s up, it’s back to work. I typically aim for an hour max, but the time limit is absolutely a personal decision! Don’t think about it too hard, don’t let your feet get “stuck in cement.” Just get out there and find what you’re naturally drawn to in the plethora of disparities to tackle.
Meet mentors and colleagues who will be your peers throughout your career. Look into programs that explicitly state they are working to address disparities. Then get creative with how to fix it. Collaborate with like-minded folks, keep learning, and always put other people’s humanity first. See everyone’s humanity—and I mean everyone—and the rest will take care of itself. Always work for positive progress!
as:How do you pledge to make an impact to improve health equity?
Dr. Hollins: I pledge to continue my specialty clinic to improve health outcomes in my community and continue to raise awareness of the medical conditions affecting patients of color with heart and with facts. People’s eyes will glaze over if you only hit them with facts. Facts matter, but so does your passion and the way you frame the issues. You need as many people on board to improve health equity as possible. You do this not by shaming people, but with compassion coupled with the (sometimes hard to hear) truth.
Come armed with love and light and truth and understanding and you will lead the way. Others will follow you. I try to do that every day. . . lead with light that is from the fire within. The idea that we are all created equal is foundational to our country. I am going to try to see that come true in a real and measurable way in my lifetime in whatever way I can.
This Project IMPACT blog series was created to highlight leaders who are making a positive impact in healthcare by reducing racial bias in medicine.