Health Equity in the Pediatric ED with Dr. Cherrelle Smith

Growing up in a small, rural community one hour away from the nearest in-network physician, Cherrelle Smith, MD was aware from an early age of limitations on access to health care. She also grew up with a strong understanding of the importance of historically black colleges and universities (HBCUs) thanks to her parent’s teachings. Those two experiences converged at Meharry Medical College, an HBCU, where she continued to foster a passion for pediatrics and the ability to serve as an advocate for her patients and their families.

Now assistant medical director of the Stanford Pediatric Emergency Department (ED), Dr. Smith has focused her efforts on expanding access to care as well as mitigating the behaviors and microaggessions that can marginalize female and black physicians.

How did the experience of attending an HBCU for both undergraduate and medical school influence how you practice medicine?

In college and medical school, I went from being a minority to being in the majority and saw women and minorities in leadership positions and as professors, physicians, academic chairs, and deans. I was able to grow into the understanding that I don't have to be unsure of myself or my capabilities, because I look or sound different. And without the fear of bias or prejudices of others, I was able to truly focus on learning medicine.

Meharry was just a beautiful, nurturing environment that showed me what type of excellence I could achieve, and also bring back my community, to help other people who look like me. I think community service and giving back have always been important to the minority community and a focus for HBCUs. It’s something of a hot topic in medicine now and I feel part of my role is to make sure this isn’t just a fad. How do we move beyond conversation to facilitate care for the underserved? How can we make sure that our staff represents our patient population, and that our patients can see themselves in the people who take care of them?

How does inequity in access to health care shape your worldview?

As a minority, I felt I was aware of health inequity because of geography or lack of resources. But in medical school, I began to understand inequity caused by cultural differences where a doctor may not understand a patient’s needs, circumstances or communication nuances if they don't come from a similar background.

At Meharry, we were affiliated with the city hospital, but I also spent time at other academic institutions in Nashville and was able to see the contrast between patient care at one institution versus another, and inequities across the board when it comes to socio-economic status, racial-ethnic status, or location.

February 2023