Inspirational Black Men and Women in Medicine: Anthony Armstrong On 5 Things You Need To Create A Successful Career In Medicine

An Interview With Jamie Hemmings

The best surprise is no surprise.

This is one of the things that drives me the craziest. We all have to be proactive either as individuals, a hospital or hospital system, and in organized medicine as well. We all know that hindsight is 20/20, but at the same time we have all been prone to short-term myopic thinking without thoroughly analyzing the long-term ramifications of decisions that we make — whether intentional or not.

In the United States today, black doctors are vastly underrepresented. Only 5% of physicians nationwide are black. Why is it so important to have better representation? What steps can be taken to fix this discrepancy? In this interview series, we are talking to successful black men and women in medicine about their career, their accomplishments, and how others may follow their path. As a part of this series, I had the distinct pleasure of interviewing Dr. Anthony Armstrong.

Dr. Anthony Armstrong is an obstetrician-gynecologist practicing in Toledo, Ohio. He is a past-president of the Ohio State Medical Association (OSMA), and serves on Ohio’s Minority Health Task Force.

Thank you so much for doing this with us! Before we dig in, our readers would like to get to know you a bit more. Can you tell us a bit about your childhood “backstory”?

Every life experience contributes to the development of a person’s character. Our role models, relationships, triumphs, failures and tragedies are the blocks by which we build our identities, and I’ve had all of those.

My parents were two of my most important role models growing up. My mother is a recently retired federal magistrate judge. My father is deceased and was an OB-GYN who practiced for 50 years. As a toddler, I remember making house calls (I will never forget the smell of moth balls) and hospital rounds with him. Most of the time the nursing staff would babysit me while he did patient care.

As a young child I often dreamt of becoming an actor. On weekends and summers I took acting lessons and participated in performances. I continued acting through high school, and even did some commercials during medical school residency. My parents agreed to let me join my older brother at a Catholic military school where I attended second grade to junior high because I missed him. The school was close enough that we were able to come home for just over 48 hours on weekends during the school year.

As you can imagine, it was quite an adventure for my older brother and me. It wasn’t “acting school,” but more like “learning how to act right school.” I learned discipline, perseverance, and team skills. Tragically, I lost family during my adolescence. That made life difficult and often seem impossible at times. I didn’t know then that this profound loss would help shape the remainder of my life, and provide inner strength I didn’t know I possessed.

I returned home to go to a progressive private college prep school for high school. The learning environment was quite different, and discipline was 180° from my former military school. My high school provided opportunity for motivated students to accelerate their education. That school was my springboard to a professional career — I followed my father’s footsteps to become an OB-GYN, graduating from Wright State University Boonshoft School of Medicine. I’ve been practicing medicine for more than 20 years.

Can you tell us a story about what brought you to this specific career path?

As I mentioned, my parents were two of my most important role models growing up. They instilled in me the values I have today, and that have guided my entire career as a practicing OB-GYN. I am proud that I followed my father’s footsteps in this specialty of medicine, and remember fondly the experiences I had when I was a young child and was able to accompany him on house calls.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

One of my father’s dearest friends who was a well-respected and very accomplished physician who trained at Johns Hopkins once told me, “You know what my patients see when they step into my office for consultation? They see pictures of my family, my friends and my hobbies. Patients and fellow physicians may not know your background. They may not know where you went to medical school or did your residency training but what they will know is that you’re a good person and that you practice sound medicine.”

Till this day, this holds true, and is something I instill in my practice every day. A practice is largely built on referrals, and it never ceases to amaze me how some patients choose to travel distance solely based on your reputation.

Can you share the most interesting story that happened to you since you began your career?

That’s a tough one but I guess I would go back to my first year of practice. My father’s office could not accommodate both of us, so I spent the first year essentially in a solo practice. We would often operate together, and the staff would remark on how well we seem to work together.

My rebuttal was “Of course, it only took me 34 years, but I think he’s finally coming around.”

You are a successful leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?

I have an easy-going personality with a good sense of humor. I come prepared, and work efficiently with humility and respect for others. I believe in the philosophy of “be demanding, not demeaning.”

Thank you for all that. Let’s now shift to the main focus of our interview. This might seem intuitive to you, but it would be helpful to articulate this expressly. Can you share three reasons with our readers why it’s really important for there to be more diversity in medicine?

Minorities constitute about a third of hospitals’ patients — and a lack of healthcare leadership opportunities for minorities is part of the problem.

Most agree that fixing healthcare’s diversity problem will only come when leaders begin to talk openly about race. They say it starts with the Board. You start thinking about the police officers that need to be brought into the conversation, the schools, the businesses, then you start getting the diverse voices that you need to solve those issues. I believe some of those voices also need to be more present inside healthcare organizations.

As part of my involvement with the Ohio State Medical Association (OSMA), where I previously served as president, I am proud to be currently chairing the organization’s Diversity, Equity, and Inclusion Task Force. With this group, we are working to develop strategies to help healthcare organizations increase diversity and inclusion in the practice of medicine, with the goal of creating more equitable healthcare delivery for patients in our state and across the country.

While there is still much work to be done to increase the representation of minorities in healthcare — which in turn will impact the health outcomes of patients — I am encouraged by the increasing work in this space.

As things stand today, what are the main barriers for black men and women to enter the medical field?

The unfortunate reality is there are several barriers for Black men and women entering the medical field.

First and foremost, we need to do a better job of developing a common language to better understand and engage in difficult conversations, especially around race-related issues. To illuminate racism, we need to develop shared language to present real meaningful data, describe conditions and outcomes and identify root causes of inequities.

An example of this is institutional racism in our education system. Any school system that concentrates underserved populations often is the most overcrowded and under-resourced schools with the least qualified teachers compared to the educational opportunities of white students. This is an example of institutional racism — and one that often prevents Black youth from the opportunity to pursue higher education, not to mention medical school.

Unfortunately there seems to be more pushback on addressing disparities than I would have ever imagined. Some people falsely believe that by trying to restore balance through eliminating disparity and inequity, the result conversely becomes a system that is disparate and inequitable to previously privileged populations. But that is just not the case.

Historically marginalized populations must have fair and equitable financial resources. It is imperative that graduate and postgraduate institutions offer services and incentives specifically designed through policy to recruit and retain minority students. My personal belief is that high school counselors must play a pivotal role in guiding minority students. But too often, minority students are either discriminated against and/or discouraged specifically for applying to medical schools as compared to their white counterparts.

Another barrier for minorities entering medicine is the lack of role models, or support from leadership in specifically recruiting Black men and women for key internships, residencies and fellowships. This needs to be a priority for everyone in a health system’s key leadership, including the CEO, COO, Chief Medical Officer, and Chief Medical Information Officer.

From your perspective, can you share a few things that can be done by the community, society, or the government, to help remove those barriers?

I believe that we in the medical profession can do more to be sure we make our services more accessible and inviting. We have to look for ways to make healthcare more accessible to everyone, especially those who are the most vulnerable among us. We know that early intervention of care can significantly lower the chances of necessary chronic medical care later. We all need to be dedicated to assuring that health care is fully inclusive and attainable so that everyone has access to necessary medical services regardless of race, ethnicity, sexual orientation, or any other defining characteristic.

There are six common domains of Social Determinants of Health (SDOH): economic stability, neighborhood, education, food, community/social support, and health care system.

Practices are increasingly looking beyond the clinic walls to understand how patients’ social and physical environment impacts their health. Over two decades of research indicate that SDOH have up to a six-fold greater impact on health than clinical care. Addressing SDOH requires collaboration across multiple sectors, including but not limited to medical care, public health and social service providers.

Non-medical determinants such as the environment, health behaviors and social factors are often greater contributors to premature death than the quality of health care. And, we need to recognize that the interactions among social determinants create an even greater impact on health than any one social determinant alone. For example, people living in poverty-stricken areas often have issues with education, housing, unemployment and stress.

This confluence of negative SDOH and their effects on health status is often reflected in disparities in life expectancy based on zip code.

The profound impact of these factors can persist across generations and drive health inequity based on race, ethnicity and socioeconomic status. These effects can be visualized on a map of life expectancy — and show that only a few miles can translate into a significantly shortened lifespan.

Because of this, it’s imperative that healthcare systems and practices continue to forge collaborations between the public sector and social service organizations to provide holistic care that takes into account not only a patient’s health, but the other SDOH that can contribute to various health issues.

What are your “5 things I wish someone told me when I first started my career in medicine,” and why? Please share a story or example for each.

1 . It was in Atlanta during my internship when I first became exposed to organized medicine. At that time, malpractice judgments were becoming unmanageable for the medical community. Every available attending, resident and medical student was placed on buses and driven to the capital where we united with other physicians across the state and marched for Tort Reform (which passed). I learned an important lesson during that long bus ride: never start arguments with doctors in an enclosed space, and there is strength in numbers when physicians come together to advocate for causes.

2. The only constant in medicine is change.

I’ve experienced many changes in medicine that were unpredictable. Managed care, capitation and a malpractice crisis just to name a few! I was deeply involved in clinical practice, academic and organized medicine when I decided to go back to school to get a master’s in public health from the University of Michigan because I wanted to have more control over the administrative aspects of medical care.

3. Sometimes life has more twists and turns than Chubby Checkers in a blender.

Throughout my medical training, we had unrestricted duty hours then we saw this as a badge of courage. As time passed, it became painfully obvious that we must all find that sweet spot of work-life balance for each of us. I always had the thought of how can we take care of others if we can’t take care of ourselves? We never knew what burnout was until it was called out, but it was always there! Today, I’m proud to be part of OSMA and many healthcare organizations who are making physician well-being a priority.

4 . The best surprise is no surprise.

This is one of the things that drives me the craziest. We all have to be proactive either as individuals, a hospital or hospital system, and in organized medicine as well. We all know that hindsight is 20/20, but at the same time we have all been prone to short-term myopic thinking without thoroughly analyzing the long-term ramifications of decisions that we make — whether intentional or not.

5. Winston Churchill once quoted “We make a living by what we get. We make a life by what we give.”

It’s not “all about the Benjamins.” My father once told me that if you go on the medicine for the money, you’ll be sadly disappointed. He was absolutely spot on. I never would have dreamt that all the personal sacrifices and time that you give towards your profession for the betterment of improvement in the human condition could be so rewarding.

People will not remember you for the expensive cars you may have owned or the big house you lived in. They will hopefully remember that you’ve been a good person, and hopefully a little bit of those virtues in you will live on through others that you have impacted along the way.

You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

The first thing that comes to mind would be public health initiatives where population health policies are developed at the local and state levels based on community needs assessments. These would be by individuals who would be held accountable for reasonable measurable outcomes for success. These people necessarily — but not exclusively — are local and state politicians but also key leadership in our local educational and healthcare systems.

I think that all politicians that represent a specific region within the state should have policy (such as a bill passed through the Senate and signed off by the governor) that mandates at least twice yearly to have town halls where the public has an opportunity to voice concerns and simply just be heard.

We are very blessed that some very prominent names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them.

Here are three choices in no specific order:

Doctor Sanjay Gupta. As a fellow physician, obviously, I think they are many shared experiences that we could commiserate over as well as have some great laughs.

Denzel Washington. People often say I look a lot like him, and I just wonder what he would be like in person.

Hillary Clinton. She was very instrumental in healthcare and actually inspired me to be part of organized medicine after listening and briefly meeting her at a national advocacy meeting in Washington, D.C. many years ago.

How can our readers best continue to follow your work online?

You can learn more about the work we are doing with the Ohio State Medical Association at www.osma.org.

Thank you for these fantastic insights. We greatly appreciate the time you spent on this.