In this MD Newsline exclusive interview with internal medicine physician Dr. Greg Hall, we discuss Dr. Hall’s podcast, “Bridging the Gap: Conversations with Dr. Hall.” We also discuss how to provide culturally sensitive care and improve treatment adherence.
Can you please tell us a bit about your podcast, “Bridging the Gap: Conversations with Dr. Hall”? What were your motivations for creating this podcast?
Dr. Greg Hall:
“Bridging the Gap” is produced by Pri-Med, a continuing medical education (CME) company. I reached out to Pri-Med after my book, Patient-Centered Clinical Care for African Americans: A Concise Evidence-Based Guide to Important Differences and Better Outcomes, was published. I wanted to work with Pri-Med’s platform to teach providers how to provide better care for African Americans.
For example, some of my wife’s African American patients have come to her with their hypertension having been previously treated with a beta-blocker or an ACE inhibitor. These treatments aren’t appropriate for African American patients. The data suggest that African American patients should use a calcium channel blocker or hydrochlorothiazide. And that’s what I teach my medical students to do when treating hypertension in African American patients.
This podcast helps to reach providers who may not have known about the important disease and treatment differences that exist for African American patients. We have well over 200 physicians, nurse practitioners, and physician assistants who tune in to the podcast once a month. We talk about ways to build trust, treatment adherence, and better patient outcomes. We’ve also talked about COVID-19, the COVID-19 vaccine, and overcoming vaccine hesitancy, which is really high among African Americans.
When I got COVID-19 in November, I came back in January and discussed my experience with COVID-19 in the ICU on the podcast. I got over 100 questions in an hour about my experience with severe COVID-19. So, it’s a fun way to get CME, and I’ve gotten the go-ahead to continue the podcast for the next 5 months.”
How have you been able to implement culturally sensitive care in your practice? Do you believe doing so improves treatment adherence?
Dr. Greg Hall:
“There’s no question being culturally sensitive improves patient treatment adherence. It’s a matter of identifying with the patient and having them develop trust in you. The analogy I use with my residents is asking for directions. I have a terrible sense of direction. So, I often end up stopping to ask someone where I’m going. If I don’t trust the answer, if they pause, or don’t deliver the instructions well, I smile and nod, and then go and ask someone else.
Our patients are the same way. They’re not going to take your medications if they don’t trust that you have their best interest at heart. So, I spend a lot of time building trust with my patients. And 45% of African Americans distrust healthcare providers, regardless of their race or ethnic background. So, it’s crucial that we work on building trust with our African American patients.
About 10% of my practice includes Asian American and East Indian American patients. And my approach to these patients with different racial/ethnic backgrounds is different. If you listen, they’ll direct you as to what you should do and what topics you can broach, etc. And that’s just being sensitive to others.
In my book, I briefly discuss the abuses that African Americans have faced historically at the hands of the American healthcare system. It explains why they don’t trust doctors. It’s not a random distrust. It’s an earned distrust if you know the history. And we just have to spend a little bit more time with them to earn their trust.”
Responses have been condensed and lightly edited.