February 12, 2007
Knoxville Medical Community, City Must Remedy Lack of Black Doctors
By Carly Harrington, The Knoxville News-Sentinel, Tenn.
Feb. 11--Knoxville was still reeling from the World's Fair when James Foster arrived here in 1982 to interview for a new medical scholarship program aimed at bringing more minority doctors to town.
At the time, there were four black physicians practicing medicine in Knoxville.
"For me, it came down to finances. I just liked the idea of someone giving me a job," said the Louisville, Ky., native who became the first recipient of the Walter S.E. Hardy Medical Scholarship, named after the long-time Knoxville physician.
Foster, who specializes in internal medicine, was required to spend at least five years in private practice in Knoxville upon graduation and completion of residency training. Eighteen years later, Foster continues to see patients at his office off Magnolia Avenue, where he has watched other black doctors come and go.
For decades, the number of black doctors in Knox County has fluctuated from upward of 30 to as few as two. Today, there are 19, or 1.2 percent of the county's physicians.
While the area doesn't have a large minority population -- blacks make up less than 9 percent of Knox County's residents -- black community leaders and physicians say the percentage of black doctors should be representative of the black population.
Efforts are under way to recruit a more diverse medical work force to Knoxville, but some question whether the city -- with its lower wages and limited cultural activities -- will be able to compete with larger metropolitan areas that easily appeal to minorities looking for somewhere to go.
"It's a problem that can't be resolved unless you have blacks, but they don't want to come here. It's like a dog chasing its tail," said Bedford Waters, a urologic oncologist and surgeon affiliated with the University of Tennessee Medical Center.
In the 1950s and 1960s, most blacks resided in Mechanicsville or East Knoxville. And when they were sick, they went to see a black physician, whose office was in the heart of the black community.
No longer bound by segregation, black residents live and work throughout the city. Those who want to be a doctor can go to any medical school in the country and pursue a specialized career that was unheard of a half-century ago.
While these opportunities highlight the progress blacks have achieved in the medical field, some say they also have diminished the sense of community that was exemplified by physicians of an earlier time.
"They were role models. You look at the African-American physician population here now, and very few of them live in the African-American community, and very seldom do they get involved in the social life of the community," said Avon Rollins, executive director of the Beck Cultural Exchange Center.
That's unfortunate, he said, because young black professionals need a strong support base and want a diverse social outlet that often is lacking in Knoxville.
"That's not only true for medical doctors but with other professionals as well. Knoxville is not a good place to be. That has been articulated to me," Rollins said.
Waters, who grew up in Mechanicsville, returned to Knoxville in 2001 from Chicago, but only to be closer to his mother.
"I resisted moving here for years," Waters, 58, said. "I eventually did because of my mother, but I may not stay here. I may go back to Chicago."
Waters admits he doesn't have any answers. But people should be concerned, he said, because a lot of blacks don't want to locate here, and "that's a big problem."
When Evelyne Davidson was growing up, there were three black doctors in Knoxville, and her father, E.V. Davidson, was one of them. Since that time, she said, there really have not been that many black physicians to come in.
"What you would have liked to have seen is as one passed away that perhaps you could have gotten another African-American to come in and take over their practice and basically take their place, which did not happen," said Davidson, a Knoxville internist for the past 17 years.
In order to attract and retain black physicians, there has to be, she said, something besides medicine to keep them here.
"When you think about Tennessee, it does not sound like it's a happenin' state," Davidson, 45, said. "You need social or cultural things that are appealing to African-American physicians that you would typically have found in a larger city, that we don't have here in Knoxville."
Part of the problem, Foster said, is there's no formal organization for black doctors. He recently was invited to attend a meeting of Asian-Indian doctors who had gathered for a speaker and dinner. The group has 95 members in East Tennessee.
"We can't do that. We're not organized," Foster said.
The black doctors in town, he said, are a "very eclectic group. Everyone does their own thing."
"I don't speak on a regular basis with other black physicians," Foster said. "I don't know why. I go to church with Evelyne Davidson but probably hadn't spoken a word to her in three years."
The area's lack of diversity didn't deter 32-year-old Lewis Holmes III, from wanting to come back to Knoxville.
A nephrologist at Renal Medical Association, Holmes moved from Charleston, S.C., seven months ago. With its low cost of living and good school system, Holmes said Knoxville was a perfect fit for his family, though none of his three hometown friends, who also happen to be black doctors, did.
"The others all said, 'No way am I coming back to that social environment.' It wasn't a great concern to me because I had seen other African-American physicians come and thrive," Holmes said.
John Bell, surgical oncologist and director of the University of Tennessee Cancer Institute, doesn't view the small black population as an obstacle to recruiting. It's up to the individual. Some people, he said, see it as an opportunity. Others see it as a challenge.
"There aren't that many African-American physicians here," Bell said. "Some come in and say, 'Where are they?' I tell them there's no reason why they can't fit into this community and make a difference."
Bell, as well as other hospitals and physician groups, said they recruit the best-qualified doctors they can find regardless of ethnic background or gender.
"For us, it doesn't really matter what your race is. It's really about their qualifications," said Beth Maynard, director of physician recruitment and marketing at East Tennessee Heart Consultants.
In three years, Maynard has talked seriously with three black job candidates. Of its 42 physicians, none are black.
"It's not by our choice. The candidates are just not out there," Maynard said. "It's unfortunate but a reality of the profession and even more so as a specialty."
When it comes to recruiting, Knoxville has to compete with Atlanta, Birmingham, Memphis, Dallas and other large Southern cities where there are larger black populations, said Mike Fecher, vice president of physician services at St. Mary's Health System.
"We don't get a lot of African-American candidates when we do advertise for an opportunity. And we have lost other physicians to other communities. They tend to go to cities with the population they're looking for," Fecher said.
St. Mary's has 250 doctors on active staff. Four of them are black.
To help the hospital recruit and attract more black doctors, St. Mary's will begin next month to advertise job opportunities in the Journal of the National Medical Association, the largest medical journal that targets black physicians.
It also has started a diversity committee "in an effort to get our staff to reflect the community," Fecher said.
In an effort to provide mentoring and financial assistance to young people in East Tennessee who are interested in health care, the Tennessee Conference Community Development has launched the Hardy Torch program.
It will include an intern program for minority high school and college students who want to further their education in the medical field, as well as a scholarship program for college and medical students majoring in various health-care fields.
"The whole premise behind it was to spark excitement and energy around the medical field," said the Rev. David Walker, executive director of the TCCD.
The first scholarship will be awarded this fall.
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Copyright (c) 2007, The Knoxville News-Sentinel, Tenn.
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