The emergence of African Americans as acclaimed leaders in the field of surgery over the last century is a triumph of personal struggle, brilliant minds, and sheer determination.
Disparities in educational and professional opportunities related to racial/ethnic identity persist, but LaSalle D. Leffall, Jr., MD, FACS, fondly recalls a favorite quote from pioneering African American surgeon Charles Drew: “Excellence of performance will transcend artificial barriers created by man.” The goals and abundant talent shared by the membership of the American College of Surgeons (ACS) and Society of Black Academic Surgeons (SBAS) are testimony to the ongoing dissolution of these artificial barriers.
Parallels are evident between the history of organized surgery in America and African American efforts to achieve health care equity. While the spectrum of surgical procedures mushroomed in the late 19th century, surgical training was characterized by inconsistency and instability. The ACS was established in 1913 with the mission of “improving the care of the surgical patient and to safeguarding standards of care in an optimal and ethical practice environment.”
Significant disparities in medical and surgical care existed for African Americans in this era. During the decades following the Civil War, black citizens were routinely denied care or they received substandard care delivered in segregated hospitals. Medical education opportunities for African Americans were nearly nonexistent.
Nonetheless, African Americans mobilized their talent and energy to address the same threats to quality medical care as those faced by the ACS founders, but having to overcome even greater obstacles in the form of systematic racism and exclusion.
Chicago’s Provident Hospital and Training School (the first African American-owned and -operated hospital) was established in 1891. Howard University College of Medicine in Washington, and Meharry Medical College in Nashville, Tenn., founded in 1868 and 1876, respectively, remained the predominent options for prospective African American medical students for several decades. Because African American medical professionals were denied membership in the American Medical Association, they formed their own professional society, the National Medical Association, in 1895.
In contrast, Dr. Daniel Hale Williams, founder of the Provident Hospital and founding member of the National Medical Association, was a charter member of ACS in 1913. However, more than 20 years passed before another African American surgeon (Louis Tompkins Wright, MD, FACS) became a Fellow of the College.
The number of African American surgeons in the College grew steadily after World War II, and in the past 3 years, approximately 6% of ACS inductees have been African Americans.
The value of race/ethnic diversity in optimizing quality of care is summarized by Dr. Otis Brawley, Chief Medical Officer for the American Cancer Society and past Director of the Office for Special Populations Research at the National Institutes of Health: “The practice of surgery is both a science and an art. Part of the art is understanding the patient’s needs and communicating well. Modern medicine has used the phrase ‘cultural competence’ to describe this. While a physician of one race certainly can and often does provide excellent service to a patient of another, diverse membership in the surgical community is essential for cultural competence of that community.”
Pioneering black surgeons
The following lists a few of the many African American surgical luminaries who fought incredible obstacles in order to improve health outcomes for all:
• Daniel Hale Williams, MD, FACS (1856-1931): Founder of Provident Hospital; performed one of the first successful open heart surgeries; charter member of the ACS.
• Louis Tompkins Wright, MD, FACS (1891-1952): Second African American admitted to ACS Fellowship (in 1934) amid much debate and controversy, despite graduating cum laude from Harvard Medical School and having an illustrious career as a decorated Army surgeon. Dr. Wright was the son of a slave (Ceah Ketcham Wright, MD) who pursued medical education at Meharry after obtaining his freedom.
• Charles Richard Drew, MD, FACS (1904-1950): Pioneer transfusion researcher; first American Red Cross Blood Bank director. Dr. Leffall, a Drew trainee, recalls, “After several applications for fellowship in ACS, Drew was approved for admission at the annual convocation October 1950. He was killed in an automobile accident April 1, 1950, en route to a medical meeting in Tuskegee, Ala. In a highly unusual action, the College’s Board of Regents approved him for posthumous fellowship October 1951.”