With new patient appointments booked until late November, those looking for care at Brandon Gynecology Associates seek something worth the wait — a Black female gynecologist.
Black female physicians make up just 2% of active physicians, according to athenahealth. This small number means Black women often don’t have access to care from doctors who look like them and understand their needs, Rochelle Brandon, a fellow of The American Congress of Obstetricians and Gynecologists and principal of Brandon Gynecology Associates in Charlotte said.
“Quality health care depends on communication and understanding. When we’re sick and when we’re seeking care, it helps to have somebody who is familiar with your culture and your background. It needs to be culturally appropriate communication. One level of that is seeking out somebody who you think you may have a rapport with, and for a lot of African-American women, that’s another African-American woman,” Brandon said.
Black women report experiencing racism within the medical field, leading to their increased desire for doctors who look like them, according to Brandon.
“The burden of health care morbidity and mortality is proportionally greater in the African-American community than in the wider community. There are feelings of just plain old racism, that they’re not being treated appropriately and they feel that they won’t experience that by coming to see somebody who looks like them, somebody who is from the similar cultural background,” Brandon said.
Brandon’s practice focuses on caring for women at different stages of their lives, offering physical, as well as mental support and guidance. This support is crucial for Brandon’s Black female patients who often perform a majority of the caretaking for their families, Brandon said.
“The African-American patients that I take care of are the most stressed group of people, and it ties into health, you know, hypertension, diabetes, obesity, mental health and everything,” Brandon said. “We are doing everything. It’s hard to step down and step back from your responsibilities for your children, parents, in-laws, husband and house or rent. Then also the stress you undergo at work, the microaggressions, the racism that you deal with at work.”
Gender and racial socialization play a large role in Black women’s overwhelming presence in care work, both within their homes and professionally. Historically, Black women served as caretakers as part of the master/slave dynamic, according to Assistant Professor of Sociology Lyndi Hewitt. Today this pattern continues in their involvement in service work and caretaking roles.
“Care work of all kinds is feminized, and that has always been the case,” Hewitt said. “These behaviors are not necessarily expected of men.”
The COVID-19 pandemic continues to increase the amount of work expected of Black women in their homes and at work.
“I had a patient and she said, ‘I’m working from home and I don’t log off ‘til about 2 a.m.’ I was like, ‘That’s ridiculous,’ and she’s like, ‘Well, they gave us so much work and I want to perform well.’ I said ‘But still, you’re setting the expectation that you’ll work until 2 a.m. You know, you’re going to have to log off at 5 p.m. and exercise and eat and get some rest because this is not sustainable to work till 2 a.m.,’” Brandon said.
With growing numbers of sick family members and increased time at home due to online schooling and quarantine, Black women face unprecedented levels of stress, Brandon said.
“There are women that are working two jobs and have children, there are women who are taking care of children with special needs, as well as work and as well as whatever household things. It’s a lot,” Brandon said. “There are women who don’t have good child care, there are grandparents who are babysitting grandchildren and helping grandchildren with the virtual learning who are stressed out because they don’t know how to do this virtual learning. It’s very stressful.”
After receiving a bachelor’s degree in chemistry at UNC Chapel Hill and a doctorate of medicine from the UNC School of Medicine at Chapel Hill, Brandon completed postgraduate training in obstetrics and gynecology in 1997 at the Eastern Virginia School of Medicine in Norfolk, VA, she said.
Upon finishing school, Brandon spent two years working at a small hospital. At the time, she was the only female surgeon. Nearly 20 years later, four Black female surgeons work at that hospital and she hosts a group for 10-20 Black female OBGYNs in the Charlotte area. She said supporting fellow African-American physicians helps make sure the number of women in the profession continues to rise.
“My gosh, I used to be the only African-American female gynecologist at the hospital, and now we have four of us practicing at the hospital,” she said. “It’s getting better, slowly but surely.”
Brandon, who spent 15 years delivering babies, now focuses primarily on gynecology at her practice.
“One of the reasons I gave up obstetrics was because my body was not tolerating it well. It’s hard to give that part up but with bad asthma and blood pressure increases and blood sugar getting crazy, there comes a point where you get to choose to be reasonable and live long rather than working into the grave,” Brandon said. “I gave up that part and not because I didn’t like it, not because I didn’t love delivering babies and my moms and babies, but because my body said, ‘enough is enough.’ Gynecology, now, I love it. I love my patients. I love being able to run it the way I want to run it. It is not for everybody but I really love it and I have a great staff. I have wonderful patients.”
Brandon Gynecology Associates exists outside any hospital system, meaning Brandon controls the way the office runs. According to Brandon, she set up everything, including her waiting room decor, to reflect the comfort she hopes to provide patients.
“The office is a little bit different because it’s independent. I chose the colors, lavender and purple, and the artwork is real artwork. It’s not the corporate abstract flower artwork type of thing that they do. When you walk in the door, it’s a different feeling than you will get when you go to other places and my patients love it,” she said. “It has a personality and it has us, African-American women, in the paintings.”
Working outside the system does have its pitfalls, though, according to Brandon. Most insurance only covers specific hospital systems, meaning women who seek independent care must pay out of pocket.
“If you are looking at doctors in the same system, you’re looking at doctors in the same system,” Brandon said. “For example, you go down a grocery aisle looking at the cereals and there are all these cereals, but there may be only three or four companies offering those cereals. You don’t have as much choice as you think you have. The same thing with physicians, a lot of times you’re choosing between one or two big hospital systems and you don’t really have many independent systems to choose from. You get the same kind of answers and formulas working within the same system, even though you may have gone to a different doctor.”
These economic barriers can keep women, particularly women of color, from accessing the care and physicians they desire, she said.
“The choices are limited before you even start looking. There are insurance plans that make you go to one hospital system. So anybody outside that hospital, whether they’re independent or the other hospital system, it won’t pay for that at all. You’ll go out of network and you pay for itself. The economics of health care and the cost of health care is a lot for women’s health care budgets,” Brandon said.
In addition to physical care, Brandon places emphasis on providing her patients with support and resources for seeking mental health care. She said making mental health care accessible remains as important as physical health care.
“I strongly encourage counseling. We need to help fund counseling for people, marriage counseling, post rape counseling, domestic assault counseling,” she said. “Money should not be a reason why somebody can’t get counseling.”
Student Body President at UNCA London Newton said she struggles to find adequate mental and health care provided by Black women that is also affordable.
“You don’t have the privilege to take care of your mental health when you don’t have money. My mom literally works for Novant Health and our insurance still does not cover a lot of therapists. There are a lot of therapists that don’t have that or don’t take Novant. And on top of that, there’s not a lot of Black female therapists. So it’s a lot for me to finally even admit like ‘OK, I need to go to therapy’ is one thing, but now I’m literally having trouble finding a Black female therapist,” Newton said.
Without proper mental health care, Newton must seek out support in other Black women, similarly to how Brandon’s patients seek support in her. Together they work through their traumas in an attempt to heal and break down commonly held stigmas.
“I think in the Black community we don’t tend to talk about a lot of things because of how traumatizing it is being Black,” Newton said. “The fact is that a lot of us don’t have time to unpack our trauma. So while I’m glad I learned how to be so strong, it’s helped me get through a lot, it makes it where it’s hard for you to really talk about and work through your feelings.”
Program Director at Christine W. Avery Learning Center in Asheville Kyla Morton, who was placed in the Minority Medical Mentoring Program growing up, said by working in a caretaking role within her community, she’s able to teach other people about medical access they may not know about, such as African-American doctors and mental health care providers.
“I have a health care background, which is strange because I’m not in health care this time, and I feel like a lot of African-Americans and minorities that I’ve met, a lot of the things that they experienced in the health care setting was because of lack of knowledge. I just really wanted to be there to provide because I felt like a lot of people didn’t have the resources to be able to get the information they needed,” Morton said.
By building up young Black women and encouraging them to prioritize their mental and physical health, Morton said communities can limit behaviors that lead to burnout among Black women, such as not asking for help or taking on too many roles.
“I would say that I haven’t seen anybody get burnt out, and honestly, even in saying that I feel like that’s one of those things that we’re taught, to be strong and not let others see you weak. So, I really haven’t seen it a lot, but I know it can lead to it for sure,” Morton said. “Just encouraging self care and taking that time for yourself. When your body says you need to rest, go ahead and take that rest.”
Brandon echoed the need for supporting Black women, saying while their care work remains necessary, it overwhelms them. Providing quality medical care only goes so far, she said. Black women also need access to good-paying jobs, child care and support to continue providing for and supporting their communities.
“African-American women aren’t doing all of this to prove that they’re strong. They do it because it needs to be done,” Brandon said. “They’re doing for their kids, they’re doing for the things at work, they’re supporting your coworkers and they’re supportive of their family members and their parents. They’re supportive in doing things at church. You’re doing things for the youth church. They’re participating in church activities. They’re doing things in the community, in the neighborhoods because it needs to be done, not because they are strong. There are less of us, just sheer numbers, there are less of us and the need is so great. I have to monitor myself and remind myself that I can say, ‘No,’ but that’s hard when there’s so much need in the community.”