Ngozi Ezike, MD (Host): Hello, everyone. I'm Dr. Ngozi Ezike and thank you for tuning in to another episode of More Than Medicine. I am super excited to welcome this episode's guest, a Pediatric Surgeon, Founder of the Black Doctors Consortium, and a national leader in health equity, Dr. Ala Stanford. Dr. Stanford is on the forefront in helping everyone towards a healthier and happier life, creating a bright future for public health equity.

Please welcome Dr. Stanford, and I'm so grateful to you for joining us.

Ala Stanford, MD: Thank you!

Host: I'm so excited to reconnect with you. I met you during the COVID pandemic. We spoke on some different panels, talking to legislators and the like. And I often, really like to let our listeners get a chance to know a little bit more about our guests. So can we just start by asking how you got started in your career, maybe a quick walk on your path or your journey?

Ala Stanford, MD: Okay, so one, thank you so much for having me. So I, like most people you ask who are in medicine, probably wanted to be a doctor from the time I was like eight or 10 years old. A little bit different. I did love science. It challenged me, but I was tired of being poor, truthfully. And my doctor that I went to at one of the health centers was a Black woman and she seemed happy, she didn't seem stressed, she had a great outfit, and I wondered what is she doing? Cause I want to do that. Then with science, in public school, you got to do special stuff when you were smart. You got to learn, go to a university and do different things like that. And I loved that. So that's what sparked my interest. I went to Penn State undergrad, Penn State med school, downstate in Brooklyn for my first two years, University of Pittsburgh for research and completing adult general surgery. Then I matched in pediatric surgery. I went to Cincinnati Children's Hospital and then I was done. I graduated from high school at 17 and 18 years later, I was a pediatric surgeon.

Host: When you put it like that, I often talk to kids and they're like, how long does it take? And that sometimes is a deterrent. So we'll have to get into why we can't see it like that. Cause you are taking care of people and you're making a difference all along the way. And I love how the representation, that your doctor that really matters. Representation matters. And we'll definitely get back to that. So I really want people to know, about your Center for Health Equity. I want them to know about the Black Doctors Consortium. What was your initial goal with that and then how did your goal, your vision, how did it evolve and match up?

Ala Stanford, MD: Well, for one, it came out of necessity. I'm a pediatric surgeon, but I'm born and raised in Philly, so I am the doc that everybody knows, either through church or through PTO or friends of friends, because a lot of the people I grew up with are still here. When they were going to hospitals in Philly, they were being turned away, for a COVID test because they didn't have a script or their doc wasn't on staff or a myriad of reasons.

So they started to call me. I would then call the hospital and say, you just turned away Mr. Johnson. He meets criteria. He needs a test. And they, oh, Dr. Stanford, we'll get on it right away. I kept doing that over and over, and when I realized that help wasn't coming fast enough, because I owned my own practice, I took my gowns, gloves, masks, and all the PPE to the communities where people were most impacted.

And we did it through churches, through community workers, basically with my pastor, talking to other pastors, asking, can we use your church parking lot, your electricity and bathrooms for staff? I got the information just by going on the city website, phila.gov. I found out where the positivity rate was the highest, all that training we do in med school and residency prepared me for that.

And then I found a church in every zip code and that's how we triaged who was the sickest and who needed us first? So it came out of necessity. Creating the Center for Health Equity after our 10,000 square foot ambulatory care practice for pediatrics through geriatrics and mental and behavioral health and everyone in between came because people kept coming after COVID had sort of plateaued to say, Hey, can you go over this new medication or I have this lump on my body that has been there for a while. I'm a little concerned about, or I haven't seen a doc in a decade. Do you have any openings? And that's how it came about. It was again, need, that the people let us know that they need it.

Host: That's incredible. And I, sometimes, would ask a question like, how did you realize but you just saw it, the need was calling you, the need was showing up to you at church. So it was so clear and you just had to act.

Ala Stanford, MD: And everyone has a different faith and so forth. For me, I feel like God was literally ordering my steps. Just by the blessing of waking up every morning and seeing people. Cause I had every intention of going back to the operating room.

Remember I trained 18 years to do that. But every time I set the plan in motion, okay, we did our part during the pandemic, then someone else would come and say, well, you guys say you're black doctors, do you do stuff other than vaccines? Cause my kid needs a physical and it just kept going. And so, as always, we listen to what the people needed, that's one of our mantras.

Host: Thank you so much for answering the call. So as you have been engaged in this, what would you say are the most essential services that often underserved communities lack?

Ala Stanford, MD: That patient navigator, oh my gosh, that is everything. Because, I just saw a patient today who I didn't operate on, but had an operation on his foot, and he needed a dressing change. And his surgeon said, only if Dr. Stanford is going to be there, because she's a surgeon, she can change your dressing, right?

He took three buses to get to our office. So naturally, when I saw him, his leg is swollen, he's got some drainage, it's a fresh wound. And I said, well, what about calling to get a ride and through your insurance? And, well, that takes so long, and I knew I needed to get there. So I sent him home in an Uber, I said, what about dressing changes? They didn't order dressing changes to your home? You could stay off your foot. I don't know nothing about that doc. I just know I'm supposed to get a change. So I thought to myself, prayerfully, he'll have a good outcome, but what if, after the surgery, someone had went through all of this and knowing he lives alone, he's a widow, he doesn't have any children that live in the home, he was worried about getting cat food for his cat.

That's all he was worried about was getting his medicine and cat food for his cat. Like, what if someone had set that up for him that he didn't have to come clear across town, which he wanted to see me, so I get that part, but that they could have set that up for him and we could have had a virtual call, for example.

I could have looked at his foot over the phone and he didn't have to make his foot swollen coming across the city. So patient navigator, that person who advocates for you, is so necessary. I think that different touch points when we catch people, like for example, our health center was just named a school based wellness center, which is not a small thing.

We submitted it and we're praying we would get it and we did. But now when kids go to school, if they have a new rash on their face, it burns when they pee, they have a stomach ache, they can't see the board. We are so close. We're literally across the street from a high school that the nurse can send that patient over to us.

And they had already been doing that anyway, but when parents are working and offices are closed at five or closed on weekends, that proximity or access is key. And so being able to touch children when they're in school and get them caught up on their vaccines and things is very helpful. And that's even before you get to representation and people who look like you. But that patient navigator to advocate for you, proximity is important, and of course, access, access, access, and representation, you know, cultural sensitivity, not just that we have the same hue, because we know Black doctors are less than 5% in the United States, and surgeons, Black women doctors, less than 1% in the United States.

And so every Black person is not going to have a Black doctor, but the data now shows us that having one Black doctor in a county can improve the outcomes because it's just someone else at the table to help you see things through the lens of the patient, for example. So I say that to say the doctors who don't share that ethnic background It's okay, but you have to be willing to learn from your patient and learn from the community and recognize that you don't know everything about the patient.

You may know everything about diabetes, but you don't know everything about what this patient needs to have the best outcome. Cultural humility means you accept, understand, and you're willing to learn from your patient.

Host: I love and applaud everything you said. And, when you talk about these patient navigators, just, what we have here at Sinai Chicago, what we have really grown out is this role of the community health worker, which is in essence, that patient navigator. And it touches on all the pieces that you say are so necessary because the community health workers, we train them.

There are people who are from the community, right? They are from the community. So they understand the population of patients that we're working with. They are advocates, they are serving the people in their community. They have that same cultural background because they are from this community.

So they will speak a similar language. They will understand the touch points that you talked about. They have been trained to understand what are the resources available, so they can engage. They can go into the homes, they can advocate, they can support, they can be trained to do a specific assessment.

If they had a little surgical, in service, then they know that they're making sure that, do you have the supplies for the dressing change? Do you have somebody who's going to do that? And so our community health workers, and we're actually working on building out a formal curriculum and training program such that they will become certified by our state, and then the next step being able to have those people bill insurance for those services, because right now they're not.

So, we are really working on this quote, patient navigator, community health worker, to be able to be extenders of the health field and provide that extra touch that is necessary to really have people have the best outcomes. So, I hope that that's something that's growing and catching fire in the Philadelphia area too, because I think it's a needed piece to get us where we need to go, especially with the language concordance, and obviously the cultural connection.

So, I know that you have been steeped in this work, you're probably learning something new every day. What are some of the big lessons that you've learned and how are you defining success as you move forward with this really important critical work?

Ala Stanford, MD: So success is a lot of different things. So one is, you know, I have a summer program with my ASCHE scholars and ASCHE is Alas Stanford Center for Health Equity, right? It just, it's happened to spell ASCHE, which is amazing, right? Which is like a blessing, which is thank you, which is hello, and just hearing people say ASCHE, ASCHE. So anywho, we have ASCHE summer scholars, and they are students from predominantly white institutions or HBCUs, historically Black colleges and universities, that have interest in health professions, and this year are all Black, but they could be other underrepresented groups.

So success for me, is training the next generation. I want to see a hundred Dr. Stanford's out here, outdoing me, surpassing goals that I've had for myself to take care of the next generation. That this ambulatory care center that I built will be a staple in the city and maybe expand to others and have an endowment that the center and people who work there only have to focus on taking care of the patients.

Not making payroll, not buying supplies, that they just have to focus on the patient. So that's what success to me looks like. I'm getting to that. Other things are, again, this just happened today. We had a patient come in and remember when all the COVID tests are free now, the COVID tests aren't free anymore.

And this woman's about to travel. She felt under the weather and she needed a COVID test. And my staff was busy doing a bunch of stuff. And she was like, I don't know how to do it. Nowadays everybody knows how to do a COVID test, right? But she was like, I don't know how to do it.

I don't know how far to put it in. And I saw her sort of on her way out looking bewildered. And I said to my nurse, well, how come she looks like that? She doesn't look satisfied with whatever you said. She said, well, she needs someone to help her do a COVID test, but I'm doing this and I'm doing that. She's like, I gave her the test. The instructions are in there. Now, I didn't have a chance to talk to my staff, but she was walking out the building. So I ran after her and I said, can I help you? And she explained the whole thing. And I said, well, let me just do this. And I found like a curb and I just opened the kit. And I said, okay, here are the different parts.

This is how you do it. I said, I'm already out here, so I might as well show you, but this is how far you go in, you do both sides, and I demonstrated for her, and she started crying. She was like, thank you, I just wasn't sure. I remember them saying you've been going too far, and I've never done one myself, and I wasn't sure how to do it.

That to me, may not seem like a big thing, but that's how I measure success by each patient you touch. And I told her, I said, now, of course, when you're home, you wash your hands, you, you know, blah, blah, blah, and read the instructions because they are in there. But sometimes people are visual learners.

So I was explaining how you kind of squeeze the, Q tip to get all the juice that was in your nose, you want that so it'll drip. And I explained that to her. And she just started crying and, and I said, it's okay. And, and she said, thank you, SOR. So here, I didn't even know this was my SOR, I didn't even know.

Thank you so much. I so appreciate you. And I can't believe you came out to help me. I said, it's okay. That's why we're here. So that's how I measure success.

Host: I love that. And I think you being able to be part of training the next generation creates more opportunities like the one you had with your pediatrician growing up. And, and I'm excited for the seeds you're sowing, the trees that you're planting for which other people will enjoy the shade.

That's, fantastic. And people are watching you and knowing you when you don't even know that they know who you are, and, you being able to just further connect those warm touches are everything. I'm so excited about the next set of questions because I am so proud of you. Everyone needs to know that you have a new book coming out.

It's coming out on August 6th. Go! And it's called Take Care of Them Like My Own, Faith, Fortitude, and a Physician's Fight for Health Justice. Please, please, Dr. Stanford, tell us about this book. Tell us why you wrote it. Let's go.

Ala Stanford, MD: It's a little surreal I have to say. The publishing company was like, we're going to put your face. I said, you're going to put my face on the book? It was a little surreal seeing my face. Why did I write it? I always felt like I had a story to tell.

Just, my upbringing, some of the challenges, both personally and professionally that I've had, but been able to rise up, if you will. And some of the things would keep other people down. But for me, a lot of those challenges and adversity just prepared me for the work I did during COVID. I really didn't have fear, except of God, but I really didn't have fear because in my mind, I was like, we may not see tomorrow. So what is the point of being reserved in a moment like this? And so one is, I thought I had a story. Two, during COVID, again, I had a transformation in terms of how vulnerable and transparent, because I realized that when you share more, people see that you're not perfect.

And, you put your pants on one leg at a time like everybody else, you're not superwoman. And that allows them to be vulnerable and also share. I always said I'd never write a book till both my parents were dead. They're both living. So I had to prepare them for some of the things that are in this book before it came out on the shelf, because I didn't tell them.

And then another big part is because we needed to document what happened during COVID. And I know there are lots of books out there. But what we did in Philadelphia was historic. Bloomberg News reported we had vaccinated more Black Americans per percent in cities greater than 500,000 than any other city in the United States.

And that was largely because of our intentional and early efforts going to the communities that were hurting the most. And I know we saved lives. And so when people are like, oh, you should have written up this paper and oh, where's your white paper? And for a moment, I was despondent and I was like, oh, wait a minute, no, I wrote a book, it's in the book.

So, so I chronicle everything. And then the last part is I see it as a DIY, like a do it yourself for achieving health equity. So I give examples if you are young black girl, if you are white and own the hospital, or you're the CMO, well, you're the CMO, but you know what I mean, but I give real practical examples and using the narrative of my story, not of historical things that happened a hundred years ago that people can't relate to, but things that happened in my life that peoplei will be like, wow, that happened in your Dr. Stanford? I can't believe that. Or so often people are like, well, I don't see this bias. I don't see microaggression. I treat everyone the same. Well, let me show you what it looks like in real time. And those are all the things that are in the book. So I am proud of it. I'm excited to have people read it.

And, that's the story.

Host: I'll be definitely waiting for my signed copy, and I know you mentioned your sorority. I think you're an AKA, but I saw that my sorority honored you with the, Dr. Sadie Alexander Torchbearer Award, so congratulations.

Ala Stanford, MD: Thank you. Oh, that was such a special moment. Emotional, for all the work that she did in that history out of Philadelphia, when we were creating hospitals because we were unable to use the hospitals that our tax dollars paid for and that black nurses and doctors were taking care of folks, again, taking care of them like my own.

So when people say, how do we eradicate health disparities? How do we get equitable care for everyone? Take care of someone like they were your wife, your husband, your child, your cousin, someone you love. And just think about, if what I'm doing here is what I would want for my son, that would change your perspective and your delivery of whatever treatment you're recommending a thousand fold for many things that we do.

Host: I always end with the high notes. So, what is making you hopeful and excited for the future for cities like Philadelphia and Chicago that this important work will be advanced?

Ala Stanford, MD: I have to say the excitement around my book. I'm so excited about it. Like for the handful of folks who have read it and they tell me they can't put it down and it feels like I'm talking to them when they're reading it, which I love that because I believe it can be transformative.

It can be inspirational, for people who didn't have an upbringing or similar experience. You feel like you're in the story with me. So I love that. I think that it will be educational. And that medical schools will be reading it, and not just that, but legislators and entrepreneurs in medicine, in the business of medicine, and all that good stuff.

Other things that make me hopeful is this next generation is sort of no nonsense. They don't accept no, which is kind of a pain when I have teenagers, but they don't accept no, they're always why, why, and this isn't fair, and da da da da da. And what I would tell people of color, especially interested and worried about, with the previous president, how there is not affirmative action and people looking at you as the D. E. I. student. I saw something recently that said D. E. I. stands for definitely earned it. I love that. Absolutely love it. Because any program can open the door, but it doesn't keep you there. And even with the potential presidential nominee, everyone stated, well, are they ready? And I would say for people of color in this country, you're always working twice as hard to get your foot in the door, to be recognized for tenure, to be considered for a promotion, that you stay ready, so you don't have to get ready. And so, that is something that's a positive, and yes, it can be a burden, and it can be a heavy load to carry, but rest assured, you will be prepared. And again, for myself, I was prepared. You know, at the time, when you're going through it, it doesn't feel like it. But then, when the opportunity presents, you're able to have all of those things together prepare you for what's ahead.

Host: So I know you've got a super busy schedule, so I just want to thank you so much for joining me. I'm glad this was able to come together. I so enjoyed hearing your story. I'm so proud of you.

Ala Stanford, MD: I'm proud of you. If no one has said to you in a while, wonderful pivot from being government to being out there with the community, but not a lateral move, but an upward move. So congratulations to you.

Host: This is tireless work to advance health equity and trying to advocate for a more equitable future. So I'm thankful for all the work you're putting into it. I'm encouraging all of our listeners to pick up a copy of Take Care of Them Like My Own, Faith, Fortitude, and a Surgeon's Fight for Health Justice.

I know I'll be diving right into the book as soon as you get it to me. And I know that, like you said, legislators and entrepreneurs and medical students and educators, everyone needs to read this and get insights, and I know that you will continue to inspire more and more people, and that we will keep up with this important, critical work.

So thank you so much, and I look forward to connecting with you again soon.

Ala Stanford, MD: Thank you. Can I tell them everywhere books are sold? Amazon, Target, Books A Million, Barnes Noble, all those places. If you just type in Dr. Ala Stanford, and you will find it. And so the more people read it, the better. I really think it will change our way of thinking.

And that's the beauty in books. And there's an audiobook that I did for 8 hours a day, over 4 days, so you can also listen, and it's my voice.

Host: That's awesome. Thank you so much. Have a wonderful day.