The Importance of Cancer Screening in Communities of Color | Dr. Colin Ottey
Dr. Colin Ottey, an internal medicine physician and the Executive Medical Director at Advance Community Health in Raleigh, NC, has a passion for providing care to underserved communities and addressing health disparities.
Interviewed by: Nikki Murphy
Edited by: Katrina Villareal
He discusses the barriers that often prevent people from seeking medical care and offers suggestions on how to improve access to healthcare. He underscores the importance of preventative care, especially crucial for the Black and African American community and people of color. He shares why building trust between healthcare providers and patients of color is vital and how by working together, patients and healthcare professionals can break barriers, improve access, and achieve better health outcomes.
This interview is part of our series Continuing the Dream – honoring Black and African American contributions to healthcare through storytelling and community gatherings
Thank you to AbbVie, Genmab, and Karyopharm for supporting our patient education programming. The Patient Story retains full editorial control over all content
This interview has been edited for clarity. This is not medical advice. Please consult with your healthcare provider to make treatment decisions.
Introduction
I’m an internal medicine physician. I’m the Executive Medical Director of Advance Community Health in Raleigh, North Carolina, which has been around for over 50 years. Advance provides primary care services to individuals in Wake County and Franklin County.
I grew up in Jamaica. I attended college at Brooklyn College and medical school at the University of Illinois at Chicago. I have a special interest in primary care, providing care to the underserved, and working to help reduce health disparities.
What drew me to medicine was the desire to care for people. Growing up, I always liked that doctors were able to prescribe medications that made me feel better afterward. I felt like I would be like those who cared for me as a young child.
As a physician at Advance, I have a great opportunity to serve people, especially those who are underserved or dealing with health disparities, and to influence the care that we can provide as an organization.
Sometimes they feel like they’re better off not knowing if something is wrong with them.
Why People Don’t Want to See a Doctor
Fear is one of the biggest reasons people don’t want to go to a doctor. Sometimes, people don’t want to know they have a medical condition. The lack of knowledge, assumption of what the condition may be, or the outcome of that condition creates a level of fear. Sometimes they feel that they’re better off not knowing if something is wrong with them.
We also have to deal with some social determinants as well. People may not be able to get time off from work to go to the doctor. They have to arrange child care if they have children to take care of. Lack of insurance or financial resources could be a barrier as well. If they live in a rural community, they may have limited specialty services and primary care services as well. If they don’t have transportation, they might not be able to access health care in a center like Raleigh. That’s why we have to make health care more flexible so people can access these services.
One patient who was in his 40s at the time and had a family history of prostate cancer… It turned out that he had prostate cancer, even though he had a normal PSA. Had he not done the digital rectal exam, which a lot of men are afraid to undergo, we would not have discovered his cancer at the time.
Importance of Getting Access to Preventative Care
African Americans or people of color need to get screened because it can help reduce health disparities. Early detection and screening can help people get care much earlier during a disease process than waiting until they start experiencing symptoms, at which time, these conditions could be in terminal stages where very little can be done to treat their conditions.
It’s important to get screening so that we can reduce morbidity and mortality as it relates to those specific conditions. With numerous screening tools available, individuals can access them through their primary care physicians or providers.
I had one patient who was in his 40s at the time and had a family history of prostate cancer, so we always talked about that. He had a normal PSA because we were monitoring. It turned out that he had prostate cancer, even though he had a normal PSA.
The result of one of the exams that I did was concerning to me, so I referred him to a urologist. Had he not done the digital rectal exam, which a lot of men are afraid to undergo, we would not have discovered his cancer at the time. It’s important for men to not be afraid of the digital rectal exam to get screened for prostate cancer. They can always do a PSA test, but the combination is very helpful in terms of screening for prostate cancer. There are a lot of treatments for prostate cancer that could also help reduce morbidity in African-American men.
Providers need to be able to develop relationships with their patients… We have to do is to treat patients the same way we would like to be treated if we were a patient.
How Healthcare Providers Can Build Trust with Patients of Color to Address Health Disparities
We need more healthcare providers of color. People can relate to each other and that will help to build trust. Providers need to be able to develop relationships with their patients. That’s where cultural competency comes into play because sometimes, even though you might identify with the person’s ethnicity if you’re able to develop an understanding of their culture and who they are as a person, you can develop trust with that patient.
Sometimes, patients feel as if providers are delaying care or preventing them from getting certain types of care that they need. What they don’t understand is that we have barriers that we’re dealing with, such as issues with insurance companies that can approve or deny services.
What we have to do is to treat patients the same way we would like to be treated if we were a patient. We have to give patients the level of respect that they need, regardless of their age. See the person as a human being and not as a disease process.
Miss Brown doesn’t just have diabetes. The patient is a diabetic, but she’s a person. She’s a mother and probably a grandmother. She’s probably someone who has been working for X number of years. She could be a person who’s in charge of a department at her job. She’s as important as we are as physicians. We should try to give them that level of respect and allow patients to share their concerns. We should always have room for that in our visits.
Patients should not be afraid to communicate with their providers when they want to ask questions.
How Patients Can Establish Relationships with Their Healthcare Providers
Patients should not be afraid to communicate with their providers when they want to ask questions. They should know their main condition. They should know if there’s something that can be done to treat their medical conditions. They should speak to their providers and say, “I’m X years old now. What things do you think I need as far as my health screening?” They should open that dialogue with their provider and not be afraid to talk to them.
With technology now, we can do a telehealth visit, if they’re uncomfortable with a direct, face-to-face visit with their provider. Telemedicine can help break down some of those barriers. That could be a gateway to get people into the office with a provider directly.
Special thanks again to AbbVie, Genmab, and Karyopharm for supporting our patient education programming. The Patient Story retains full editorial control over all content
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