Fewer than 5 percent of American physicians are black.
For Dr. Louis Sullivan, whose accolades and advocacy as a black student, physician, educator and politician are the subject of his memoir "Breaking Ground: My Life in Medicine," this statistic isn't good enough.
"I'm happy, but I could be a hell of a lot happier," said Dr. Sullivan, a former member of the Weill Cornell Board of Overseers.
The founding dean of the Morehouse School of Medicine and secretary of Health and Human Services under President George H.W. Bush, Dr. Sullivan visited Weill Cornell Medical College on Sept. 9 for the David Rogers Health Policy Colloquium, where he spoke about his career. Beforehand, he answered questions about his life and influence on medicine.
Born in the Jim Crow South, Dr. Sullivan in 1958 became what was then New York Hospital-Cornell Medical Center's first black intern.
Q: Why did you apply to New York Hospital?
Dr. Sullivan: I was applying for internships at hospitals here in the New York area, thinking that I'd have a reasonable chance of getting into Bellevue. I was the one black student in my class at Boston University and there had never been a BU medical graduate at New York Hospital. But I decided I was going to apply just to get the experience from the interview.
My first interview was with Marvin Sleisenger, who at that time was the chief of the gastrointestinal unit. About a half hour later I was being shown into the office of the chairman — his name was Hugh Luckey. They opened the door, and a haze of smoke came out; he was a chain smoker. Then he says with the thickest southern accent I've ever heard, "Hi son, nice to meet you."
I said, "Oh, my goodness. Are they just interviewing me because I'm a black candidate?" He asked a lot of questions about my experience in medical school, what I wanted to do. At the end of that he said, "Well, Lou, I'm pleased that you came by. We're not supposed to indicate our preference, but I just hope you're interested in us."
Q: Was there competition among the interns?
Dr. Sullivan: You might say we were friendly competitors. We always wanted to better the other guy, but also help each other, so it was a really positive competition that we had.
Q: It seems you've nurtured some strong relationships that have helped you. What can you tell students today about the need to stay close to peers in the field?
Dr. Sullivan: Always look upon each individual for their own strengths and learn from them. Secondly, always try to have the highest standards in whatever you do. Although I had grown up in a segregated society, that's not an excuse. I want to be judged by how good I am.
Q: When did you know you wanted to be in medicine?
Dr. Sullivan: When I was age 3 or 4, I was going to be a fireman or policeman, but by age 5 I wanted to be a doctor. My father was an undertaker in Blakely, this rural town in southwest Georgia, and he operated an ambulance service taking ill people to the hospital.
There was only one black doctor in southwest Georgia, Dr. Joseph Griffin. Many blacks who could afford a doctor would not want to go to the white doctor in Blakely because they'd have to go around back in a separate waiting room; this was their way of resisting segregation. It was the same with my family: Dr. Griffin was our family doctor, so my parents would drive 45 minutes south to see Dr. Griffin.
My father would ask me to go along to help him. I was quite young, so I wasn't really doing any helping; my father was imprinting Dr. Griffin on me. Dr. Griffin built a 25-bed clinic and was a general practitioner. I was in awe of him. He had powers and capabilities nobody else had, so I said I wanted to be just like Dr. Griffin.
Q: You helped change lives as dean of the Morehouse School of Medicine, then as secretary of Health and Human Services. Do you feel you were able to change lives on the national stage?
Dr. Sullivan: Changing lifestyles really is a decades-long process. Tobacco use is one of the best examples: We just had the 50th anniversary of the surgeon general's report [on smoking, 1964], yet we still have a significant health problem from tobacco use in America.
Seatbelt use has increased tremendously. Forty-seven percent of drivers used seatbelts in 1989 when I started as secretary. We supported educational programs and worked with the automobile industry, community groups and state legislators to encourage legislation. With these educational efforts and state seatbelt laws, we now have some 95 to 96 percent of drivers using seatbelts. That has resulted in reducing injuries and fatalities.
Q: What healthcare issues are you focusing on at this point in your career?
Dr. Sullivan: First, I'm still pushing very hard to increase diversity in the health profession. We need to have more diversity. Health outcomes depend on two things — having well-trained health professionals and being able to communicate effectively with your patients so that they understand what you're saying, and they comply.
The other is continuing to improve the health behavior of Americans. The 20th century was a remarkable century of discovery, from the development of vaccines to the human genome project. That's all great, but if we do not find a better way to get people to improve their health behavior, we still are going to have significant health problems.
Q: You support the Affordable Care Act. Why, and what's the next step in improving American healthcare?
Dr. Sullivan: It's not going to be repealed. I think it's far too successful; repealing it would be a national catastrophe. The reality is the health system is so large and complicated that it's impossible to pass one bill where everything's going to work perfectly.
I think the Obama administration made a mistake in not more aggressively educating the public about this. People didn't know what was in it, so the people opposed to it had a free field to give their impression to the public.
But it's good because we have some 16 to 17 million people who now have health insurance who didn't have it before, either through the expansion of Medicaid or the expansion of private health insurance. That's still not enough. Plus, we have too much waste in the system, a problem with fraud, and we really have poor health behavior on the part of our citizens. The classic example is tobacco use, but we also have problems with obesity and diabetes related to lifestyle. Obamacare supports programs to improve health behavior, which will lead to enhanced health status and a decrease in diseases affected by lifestyle.
Q: Assess the progress made in bringing quality healthcare to minorities, and in getting more minorities into the healthcare field.
Dr. Sullivan: There's a responsibility that we have as a larger society to remove the barriers, but there also is a personal responsibility that we have as individuals and family members to see that the environment the young people grow up in is supporting them and reaffirming them, rather than pushing them aside or ignoring them.