Business consultant, coach, and granddaughter of heart failure (HF) survivor Erica Noelle Duncan calls for the wider adoption of the appropriate standard of care for African Americans with heart failure in a recent article in The Huffington Post. She explains how Bidil – a combination drug which has been proven to be tremendously effective for the African-American population – was successful in treating her grandmother and has since motivated her to promote the widespread use of the medication. Duncan writes, "Just as heart disease seems to disproportionately affect black individuals, doctors have an obligation to use whatever treatment has been scientifically proven to be most effective for black individuals."
Straight from the Heart
For over two years now, I have offered my thoughts on this blog to share my experiences in business and hopefully help some of you use those lessons to reach new heights in your careers. As Oscar Wilde once wrote, “The only thing to do with good advice is to pass it on.” And so today, I’ll try to do that again, but on an entirely different subject – and one that hits close to my heart, literally.
While many of you probably know my background as an attorney and business coach, I’m also the daughter of a renowned cardiologist and have always been fascinated by my dad’s profession. It’s an evidence-based field of work, one where drug trials, statistics, and previous experience reigns supreme. But even in medicine, there are occasions where numbers are ignored, and effective treatments are passed over for reasons having more to do with habit than logic. And as my dad knows all too well, one example of this unfortunate reality is a glaring failure in the treatment of African Americans with heart disease.
More than half a million African Americans are living with a severe form of heart disease known as heart failure, or HF, that occurs when the heart is not strong enough to pump blood sufficiently throughout the body. While various treatments exist for HF, one – a combination drug called Bidil – has been proven to be tremendously effective for the African-American population. In various trials, the drug has shown to reduce mortality in blacks by a whopping 43% and first-time hospitalizations by 39%. Yet, despite that overwhelming evidence, only seven percent of eligible patients receive the regimen, leaving thousands of individuals across the country with a treatment for HF that is much less effective than it could be.
Researchers aren’t sure why the drug seems to only help black patients – skin color clearly serves as a proxy for some unknown genetic factor – but the racial disparity in effectiveness is likely the reason that so few doctors are prescribing the drug. In raw numbers, however, our inability to provide this standard of care is leading to nearly 7,000 premature deaths every year.
Heart disease is the number one killer of all Americans, but African Americans are particularly vulnerable, with nearly half of the black community facing some form of heart disease in their lives. And just as heart disease seems to disproportionately affect black individuals, doctors have an obligation to use whatever treatment has been scientifically proven to be most effective for black individuals.
Personally, I know what the appropriate standard of care means for a patient. For years my grandmother has been treated for HF as one of the lucky ones that is given Bidil. Fortunately for her, my father’s understanding of the science ensured that she has been given the very best care that modern medicine can provide. But others have not been offered that same opportunity. That’s unacceptable and it’s why I’ve chosen to stray from my usual musings on entrepreneurship for this column.
In my research on the topic, I’ve learned that I’m not the only one to find the disparity in care so troubling. The National Quality Forum, with support from the Association of Black Cardiologists, recently endorsed a quality measure that could lead to much wider adoption of the appropriate standard of care for African Americans with heart failure. If the federal government supports that conclusion, doctors will be given an incentive under Medicare to use the treatment that has been critical to the continued health of my grandmother and may save thousands of lives per year.
Being creative getting help when you need it, and working through seemingly impossible challengesare all key elements of entrepreneurship, but they also can offer lessons to our healthcare system. Regardless of one’s business or industry, adhering to evidence – even in the face of a difficult transition – is always going to be the right course of action. In other words, if a business fails to adopt an innovative technology, it would face critical consequences. Similarly, the medical community should expect the same treatment when it fails to treat any patient with the most effective care available.
For more information on the issue, you can visit www.minorityhearthealth.org. If you have any stories about your experiences with heart disease and are open to sharing, feel free to write me firstname.lastname@example.org. As always, I’d love to hear from you!