Casting a Light on Race and Racism in Optometry

During my first week of optometry school, a classmate told me I seemed more like a Jamal than an Eric. Later, as a practicing optometrist, I had a patient thank me for “not being like all the other Black men with their rap music, tattoos, and dreadlocks.”

MANAGING MICROAGGRESSIONS

The term coined to describe encounters like those described above is microaggressions.¹ These indignities can occur so frequently that they become exhausting for the injured party to process. One almost needs a rubric to determine which aggressors should get a pass and which would benefit from a teaching moment. The bizarre part is that the perpetrator is often oblivious, and occasionally well-intentioned. In fact, many offenders truly think they don’t have a biased, racist, or privileged bone in their bodies—and because of this, they tend to be offended by a rebuke and, in turn, villainize the victim.

In professional settings surrounded by fellow colleagues, faculty, and executive teams, people of color are far outnumbered. Who will validate and support our concerns?

THE WORLD THROUGH OUR EYES

I asked several colleagues to share experiences from optometry school or in the practice of optometry in order to highlight the unfortunately common occurrence of racism, bias, and discrimination, not only in the world in general, but also in the health care professions, where even education and training can be questioned or dismissed. Here are some of their stories.

Judging the Book by Its Cover

I’ve been overlooked as the doctor, referred to as “the help” in a clinical setting, and asked if I was married and had kids. The list goes on and on. One time, I was told by a prospective preceptor not to return after an in-person interview because I “didn’t look like a good fit for the office.” After that incident, I decided I could no longer blindly show up for interviews, so I began including a photo with my resume because apparently my name, and the facts that I was attending a historically black college or university (HBCU) and was in a National Panhellenic sorority didn’t provide enough contextual clues for preceptors to deduce that I am a Black woman.

— Essence Johnson, OD, FAAO, Dipl(ABO)
Optometrist, Parkland Hospital Dallas, Texas

A Need to Bite the Tongue

As a Black optometrist, I’ve had my fair share of negative experiences with patients, from being asked, “Are you sure you know what you are doing?” to flat out being called a racial slur. As a Black male in a professional setting, however, you dare not get offended or display an emotional response.

— Jacobi Cleaver, OD, FAAO
Optometrist, Baylor College of Medicine
Houston, Texas

Patients Holding on to the Past

At a retail chain store that I filled in for frequently, I had an incredibly pleasant encounter with a particular patient. But then he left a scathing review online complaining that I wasn’t a “real” doctor and that he was so glad when he finally saw a “real doctor” once he left the exam room. (He was referring to the optician who also happened to be the only White employee in the clinic that day.) The patient went on about how he missed the “old days” and wondered why there weren’t more of the “old guard’” remaining, though I’m not sure which days he was referring to, seeing as he was a White man in his early 30s.

— Rosalyn Coleman, OD
Mobile Optometry
Atlanta, Georgia

Dealing With Disbelief

“Are you the doctor?” I’ve heard these words more often than I would like as I’ve entered an examination room. I’m young, Black, and female, so I expect a little surprise from patients due to any one of those three factors, yet the connotation is always different when I walk into the exam room to see a Black or minority patient versus a White patient.

On one occasion, I had a White patient ask me where I had gone to school and how long I had been practicing. This was all before I even introduced myself. She promptly walked out of the room and refused to complete the exam. Unfortunately, this will continue until we begin to dismantle the current systems that are in place, not only in health care but beyond.

— Christie Person, OD, FAAO
Optometrist, Grady Health System Atlanta, Georgia

Witnessing a Perpetuation of Stereotypes

When I was in optometry school, a professor presented a lecture to our class regarding what to expect as we entered clinic. He stated repeatedly that the patients we would serve in the school clinics would likely be single mothers with three or more kids from different fathers with dialects that would oftentimes be hard to understand. This confirmed for me, as a person of color, that these notions of who we are as a people are truly systemic and institutional.

— Adam Young, OD
Owner and Optometrist,
First Class Eye Care
Atlanta, Georgia

More Than Meets the Eye

As a resident, I had a patient who had light perception–only vision in each eye come in for an exam with a complaint of eye irritation. During the examination, he began to talk about how much he didn’t like Black people. He was accompanied by his daughter, who was clearly mortified. She tried to interrupt him, but he was determined. When he finished his rant, I informed him that I am Black. He was very embarrassed and tried to apologize. He praised my care of his eye condition, but I never saw him again. Needless to say, this experience was awkward and disparaging, but also eye-opening.

— Parres M. Wright, OD, FAAO
Assistant Professor, Midwestern University, Chicago College of Optometry
Chicago, Illinois

Turning the Other Cheek

On multiple occasions I’ve had new patients suddenly come up with an excuse to cancel their appointments upon entering the office and seeing that I am a young Black man. Conveniently, these patients never return to my office. Experiences such as these only fuel me to become an even better optometrist.

— Chase T. Parker, OD
Eyeconic Eye Center
Nashville and Hendersonville, Tennessee

A Cultural Teaching Point

When I was growing up, I was taught the importance of addressing older Black adults by their last name. It is viewed as a sign of respect and can often go a long way in building rapport with patients, especially as a younger doctor. This should be emphasized in diversity and cultural competency training for providing patient care to different populations.

— O. Vanessa Avery, OD, FAAO
Assistant Clinical Professor, UC Berkeley College of Optometry
Berkeley, California

No Filter

I called a new patient back for her exam. Before she approached my room, she looked at me, then stopped by the front desk and asked to see a different doctor. When she was told there was no one else available, she reluctantly headed to my room. Halfway through the exam, she admitted to me that she was initially afraid of me but now felt comfortable. I am a 5’1” Black woman, and at the time I was 31 years old. The patient thanked me for being so kind and professional. This was an unusual circumstance in which I had someone openly voice their racist perceptions of me.

— Britney Hale Koehler, OD, FAAO
Optometrist, W.E.Care Optometry
San Antonio, Texas

THE TIME FOR CHANGE IS NOW

Stereotype threat occurs in all work and academic settings and is essentially anxiety felt by someone at risk of conforming to a negative stereotype. Studies have shown that underrepresented minorities in health professions and first-generation college students are at risk of negative psychological effects and possibly academic performance gaps due to this, compared with majority groups.^2,3

We can all agree that no one should be treated differently, questioned, ignored, or talked down to based on their race, culture, gender, age, or any other factor. Optometry school is hard enough without the distractions of isolation, microaggressions, marginalization, invalidation, imposter syndrome, etc. Diversity, inclusion, admission access, privilege-checking, and the willingness to address the elephant in the room must be priorities at every level of optometric education. Outside the world of academia, employers should follow suit as well, ensuring that they offer and encourage a diverse and inclusive workplace.

A growing awareness of this issue and the introduction of several new initiatives offer the promise of a future filled with fewer discriminative experiences such as those shared above. We need to keep the momentum going in order to realize this promise and achieve the goal of a future with no discrimination.

How? Be a mentor to a young Black optometry student or optometrist. Be seen and get involved: Join your state optometric association, become a Fellow of the American Academy of Optometry, partner with industry, and submit talks for upcoming optometric conferences. The world is a vast place, but we can start small and make strides in our own professional community.