In a powerful speech at the Gold Humanism Summit, Florencia Polite, MD, shared how clinicians can make healthcare safer for women, address disparities, and reduce barriers to care
Like all good storytellers, Florencia Polite, MD, set the stage for her audience. Dr. Polite, an obstetrician-gynecologist and fierce advocate for health equity and women’s health, began her keynote speech at the 2024 Gold Humanism Summit, held in Atlanta February 29-March 2, by reviewing the essentials: What are the definitions of humanity, equity, autonomy, and intersectionality? How does a clinician’s own experience create the lens through which they practice medicine? And what does it mean to truly center the patient in their own care?
Then she told a story about her grandmother and brought these ideas home.
Dr. Polite’s grandmother was a patient care technician in a labor and delivery unit, part of three generations of healthcare workers with a focus on women’s health. Despite her role in the healthcare industry, she was compelled as a patient to take extra steps to humanize herself to her doctors and care team.
At Dr. Polite’s wedding, guests received as a party favor a Mardi Gras-style beaded necklace that featured a medallion of the traditional medical caduceus, a nod to Polite’s position as a physician.
Her grandmother saved that necklace and wore it to every medical appointment. She was hoping that someone would ask about it and she could share that her granddaughter was a doctor.
“I realized she donned this medallion like a shield,” said Dr. Polite. “She understood disparities and she understood that we have a tiered system. She was hopeful that they might take her pain seriously, that someone might actually think about her as being a person who was worthy of better care.”
Addressing disparities in healthcare
After her grandmother died of an undiagnosed cancer, Dr. Polite’s interest in working to reduce health disparities and create better, patient-centered care was solidified.
In her talk, Dr. Polite — a Professor of Clinical Obstetrics & Gynecology, Chief of the Division of General Obstetrics & Gynecology, and Vice Chair of Clinical Operations in the Department of Obstetrics & Gynecology at Penn Medicine — shared troubling statistics showing how Black and brown patients are developing, and dying from, cancer at disproportionate rates. She noted that these statistics are often framed around race.
“But we really should be talking about racism and cancer,” said Dr. Polite. “And we should all be changing how we talk about the effects of racism on these outcomes. There’s nothing biologically different about Black people that is making us more likely to get and die from cancer. But there are a lot of things in the system that are making us more likely to die from cancer.”
Dr. Polite also highlighted the disparity between white and Black maternal mortality, with data showing that Black women face a mortality risk of up to 5 times that of white women during pregnancy and childbirth, even when education—which can help predict things like getting prenatal care—is taken into account.
She stressed the need to standardize protocols, address bias, diversify the workforce, and learn to listen to patients.
“We have to actually have some acknowledgement about the gaps in our system,” said Dr. Polite. “We have to have some acknowledgement about the ways that systemic racism and sexism are affecting the ways that we care for our female patients.”
Protecting the vulnerable
As an OB-GYN, Dr. Polite sees first-hand how legal issues have complicated the care that women are able to receive. These challenges affect all women, but many women are made even more vulnerable by circumstances beyond their control. She told stories of women who have experienced sexual assault, and how that trauma was compounded by the inability to receive emergency contraception. She related how women who found out their pregnancy wasn’t viable – or even dangerous to their own health – did not have the option for a safe termination.
“The effects of these bans and restrictions are going to have a ripple effect in healthcare, in our communities,” she said, noting that half of the trainees in OB-GYN residency programs across the nation may not have the opportunity to learn how to perform an abortion. “And I think about our medical students, many of whom, like me, want to just make sure they can do anything that’s needed for a patient.”
Dr. Polite spoke of the importance of restoring autonomy over their bodies to women, and urged people to remember the shades of gray in every situation.
“My charge to you all is to recenter the female patient in these encounters,” said Dr. Polite. “If you can’t get behind protecting access to abortion, I need you to work to strive to decrease some of the barriers to contraception. I need you to work to make pregnancy safer in this country.
“We have to say: ‘If I have a female patient in front of me, how do I make this encounter better, easier for her? How do I make it safer for her? How do I provide that level of compassionate care?’”
Creating change through patient-centered care
Dr. Polite delivered a clarion call to action to attendees. “How would you take care of the patient in front of you, if that was the only goal that you had?” she asked. “Because that’s the way that I think about this. My goal is to provide compassionate care. That’s it.”
And in a moment that came full circle, she reminded the audience “to think about my grandma and the shield. And maybe we can have a health care system where people don’t need shields.”