While Some Pharma companies have begun targeting various ethnic groups, the National Medical Association (NMA) has been undertaking
that effort for more than a century. Founded in 1895, the NMA represents the interests of more than 30,000 African-American
physicians and the patients they serve, and is dedicated to eliminating health disparities across racial lines.
Sandra Gadson, MD
Sandra Gadson, MD, NMA president and medical director of the Northwest Indiana Dialysis Center in Gary, Indiana, says one
sea change she's noticed is how people are now more open to discussing health inequalities. But still, there needs to be a
larger focus on fine tuning the roster of tactics that will take the healthcare system closer to achieving that goal. Here,
Dr. Gadson sits down with Pharm Exec and offers her view on the issues surrounding enrollment of seniors in Medicare Part
D, targeted advertising and promotion, and participation of minorities in clinical trials.
Total Physicians By Race/Ethnicity 2004
How do you think the new Medicare Part D prescription drug program will affect doctors?
It will add length in terms of hours to patient care. It's cumbersome because there are so many different plans, and patients
have to pick the plans that are most accommodating to their medications. The challenge for physicians is to be able to maneuver
and maybe change medicines around so patients can get their drugs covered in a particular plan.
Are the efforts to educate minorities about Medicare Part D adequate?
That's one of our biggest challenges. We recently made a call to action to educate seniors with regard to the health plans
and the need to sign up. We often talk about health disparities. If patients don't sign up on time, they will end up losing
out and that just would increase the disparity. It also would probably entail more expense because more seniors would seek
hospital care, given the fact that they are unable to manage their conditions by getting prescriptions.
But the simple fact remains that you have 47 million people who have no insurance—be they black, white, or Hispanic. This
goes across color; this is a policy issue. Something needs to be done [to increase access] because you can have the most advanced
technical equipment, but if a person can't get a simple cardiac test, then I don't know how much we're accomplishing. Just
look at our infant mortality rates and how high they are compared with some other countries—there's still a lot that we're
not doing. So the organization takes a stand that there needs to be some type of universal health coverage, but how you define
that still needs to be worked out.
What unique challenges do African-American physicians face?
African-American physicians tend to work or practice in underserved areas. A lot of their challenges surround not getting
the monies to run adequate centers—you needs some funds to see that the necessary supplies and equipment are there.
That's a problem when you're treating, for example, patients on Medicaid. Physicians who see an inordinate number of Medicaid
patients may end up not getting any reimbursement whatsoever. So how do they keep their lights on? How do they keep their
doors open? How do they continue to take care of all of the patients?
How does the NMA differentiate itself from the AMA?
One of the differences is the NMA is concerned about healthcare in terms of the underserved. The organization understands
that there's not a level playing field. And so as long as the playing field is not level, there will always be the need to
advocate for the underserved population—that they receive quality healthcare along with the majority population.