1/I want to express an appreciation for last week's JAMA "Piece of My Mind" -Eradicating Racial Injustice in Medicine—If Not Now, When? by by @vince_randy , surgeon & fellow in urologic oncology
2/So many brief points made simply: sitting in his med school as 5 of 120 African American students. Dr. Randy heard an endless recitation of conditions that disproportionately affect African Americans with nary a comment as to why or how. That's got to be disconcerting huh? 
3/Health disparities have been "on the radar" for 20 years, but @vince_randy suggests many of us in medicine still should move through 4 stages of "adult learning" (1) unconscious incompetence, (2) conscious incompetence, (3) conscious competence, and (4) unconscious competence.
4/Implicit bias, he says, is just one aspect. When access to care is adjusted for, racial ðnic minorities receive lower care quality. Clearly more going on there. FYI: In VA, process of care measures are similar for Whites & Blacks. But otcomes differ healthaffairs.org/doi/full/10.13…
5/"Our patient is a 65 year old African American woman with diabetes". Dr. Randy asks us to think about whether we are "blindly" hashing race into both algorithms and clinical presentations. There are (I suspect) many unexamined assumptions in both acts.
6/Diversifying in medicine: there's been a long decline in Black men entering medical school. Dr. Vince touches on pilot programs re: culturally aware mentorship. When we mentor, we should ask ourselves & the mentored person what assumptions we're making that might be wrong.
7/Sometimes it's grounding and "more real" for a person, a doctor in this case, to just describe their experience and how it informs a view on what many of us are discussing today. Hats off to Dr. @vince_randy
