Episode 8: Dr. Richard Ferguson: Black Physicians Breaking Barriers

Dr. Richard Ferguson, Chief Medical Officer at Health Choice of Utah and founder of Black Physicians of Utah, shares his journey from military surgeon to health equity champion and discusses strategies for improving healthcare outcomes for Black men.

• Board-certified in family practice with experience in emergency medicine and military service
• Founded Black Physicians of Utah to increase representation and provide support for Black physicians
• Military service as a battalion surgeon in Iraq profoundly influenced his humanitarian work
• Currently leads Black Physicians of Utah with approximately 30 Black physician members
• Organizes community health events focused on brain health, Alzheimer's awareness, and cardiovascular fitness
• Addresses cultural barriers to mental health treatment within Black communities
• Advocates for regular preventive care visits, bringing support to medical appointments
• Recommends 150 minutes of physical activity weekly and utilizing public health resources
• Emphasizes the importance of early intervention and not waiting until symptoms are severe
• Creates pathways for Black students to enter medicine through mentorship programs

To learn more about Black Physicians of Utah and upcoming events, visit bpou.org or find them on Instagram, TikTok, and LinkedIn under Black Physicians of Utah.

#blackphysiciansofutah

#blackphysicians

Bad Science: Changes in politics and ideology do not change our need to be vigilant.

Chapters

• 0:00 Introduction to Real Health Black Men
• 1:05 Dr. Ferguson's Background and Journey
• 6:24 Military Service and Humanitarian Impact
• 11:11 Black Physicians of Utah: Mission and Vision
• 20:11 State of Black Healthcare in Utah
• 27:04 Recent Events and Upcoming Programs
• 34:51 Trends in Black Men's Health
• 41:04 Faith, Mental Health, and Community Support
• 46:56 Insurance Decisions and Healthcare Access
• 51:28 Improving Health Outcomes for People of Color

Transcript

Grantley Martelly: 0:11

This is the Real Health Black Men podcast, where we empower men to take control of their health. We provide vital information and build community support. Join us as we discuss everything from major health challenges to mental wellness to physical fitness. So if you're ready to level up your health and your life, you're in the right place. Let's get started. So welcome back to Real Health Black Men Podcast, and today my guest is Dr Richard Ferguson of the Black Physicians of Utah. He's a board certified in family practice. He's also practiced emergency medicine and has served as a brigade surgeon in the United States Army. He's going to tell us more about himself as we get into it, but Dr Ferguson is also now the Chief Medical Officer at Health Choice of Utah. So welcome, Dr Ferguson, to our podcast.

Dr. Richard Ferguson: 1:13

Thank you for having me here. I'm excited for our discussion.

Grantley Martelly: 1:16

I'm excited too. So let's take a couple of minutes to introduce yourself. Tell us a little bit of things about you that you think our audience might be interested in, and then we'll get into the discussion.

Dr. Richard Ferguson: 1:25

Yeah, I think probably the easiest way is I'm a Washington DC native born and raised, did most of pretty much all of my schooling there and then went off to do college or finish college at Northwestern out in north of Chicago and then did a little bit of stint in Japan as I started on my path to join the military. Actually, I commissioned as a young second lieutenant when I was in Japan right after graduating in undergrad in genetics and then getting into med school. A lot of my passion of going to medicine has been inspired because of what's happened in my family. I think that many Black families have experienced where there was often preventable diseases or preventable conditions. That was a lot of my primary motivation but also my strong sense of service to my family.

Dr. Richard Ferguson: 2:20

My father was prior Navy, I had prior Force and my uncles and Navy and Army and my uncle so service being a DC Beltway or, I guess, a child of the Beltway, it seemed quite normal for me to join the service but also to pursue medicine because of some of the institutions that influenced me during my youth in Washington DC.

Dr. Richard Ferguson: 2:46

So, to kind of sum that up, I spent seven years active duty doing my training and actually my initial residency was actually in ophthalmology. I did that for about a year and a half before I separated and then finished in family medicine and then eventually just practiced emergency medicine for the last 13 years now. And then my day job is in health insurance, which I'm trying to have a larger impact on our health system and try to put less barriers to care when it comes to access, because insurance can definitely be sometimes part of that barrier. And then I started Black Physicians of Utah because I realized that some of the ways we can best address health equity for black and marginalized groups throughout our nation is really trying to get more doctors that look like myself in medicine. And that's probably me a little bit in a nutshell.

Grantley Martelly: 3:42

Okay, well, that's a good introduction. So you also served in the military as a military surgeon? You touched on that. Tell us a little bit in a nutshell. Okay, well, that's a good introduction. So you also served in the military as a military surgeon? You touched on that. Tell us a little bit about what that was like and what that entails.

Dr. Richard Ferguson: 3:52

So I think sometimes when we use the term surgeon it means something different in role in the military than it does sometimes when civilians refer to surgeon. So I initially was a battalion surgeon when I was in Iraq and when I was there for that was my longest deployment 15 months. A battalion is just usually a unit that's 900 to up to about 2000 troops that you will be managing the care for and usually you have like a PA troops that you will be managing to care for and usually you have like a PA, several medics that will be under my sort of medical team and I'm part of the senior leadership that would be along with that of the colonel and the executive officer. That's part of that larger battalion and so it's based on. So surgeon really in the Army, depending on your residency, training status is a title that just goes to a physician that's in a deployable unit and as the unit gets bigger it becomes brigade surgeon. So now it's 5,000 or more and you're the chief doctor for those number of folks. But they give you the surgeon title, which often doesn't mean I'm operating, it just means I'm the head physician for that organization size. So then the next after that is division surgeon, and so that's several thousands, that's tens of thousands. That would be a part of that, so several brigades that make up a division Anyhow.

Dr. Richard Ferguson: 5:24

But during my time it was really just maintaining, doing preventative care and making sure that many of my soldiers got off the specialist. If they need them, I would treat them or supervise my PAs. That would be treating many of my soldiers. That would either have been when we were in country or excuse me, not in country, when we were based in the US versus when we were forward deployed. I would be the chief, almost kind of medical officer role for that unit. Usually I would have then a more senior doc that I could go and ask something to, such as a brigade surgeon. But at the battalion level it was just often me and the colonel, who's non-medical, and my PA that I would work along with taking care of acute needs, chronic care and often trauma and death that would occur to soldiers in and out of the US.

Grantley Martelly: 6:21

Okay, you said in your short bio that that had a profound effect on your life. What do you mean by that?

Dr. Richard Ferguson: 6:30

Well, I think it probably has led to me wanting to do a lot of humanitarian care, because I was part of General Petraeus' hearts and minds, part of his underlying mission to try to not have America seen seen as so much our troops seen as an enemy uh, between 2007 to like 2010, I would say, when we uh, when a lot of our servicemen were there, and so he would use some of the medical components to try to build this bridge so that smaller militias would pretty much rat on the insurgents that would set bombs and be disruptors in our area of operation in Iraq and often those red zones. So we would try to befriend some of the sheiks, local sheiks and local community leaders by providing medical care. So that's part of the hearts and minds and that has had a profound impact. And that's once I exited the Army. I then would pursue to lead medical missions or be a part of a medical mission in former war-torn areas or underserved regions of the world, or also when just responding to humanitarian disasters. So I went to take care of Haitians after the earthquake. I actually had an opportunity to go to Nepal after their big earthquake in 2015.

Dr. Richard Ferguson: 8:00

But the way that things were occurring at that time I didn't go because the troop leader said, or the leader of the mission actually said, you can come, but you know we really need somebody that knows how to do. You know that's a crane operator because we don't really need more doctors on the ground. And he says and I don't know, because of the amount of medical supplies coming in, we can't really guarantee that you can leave in two weeks to get back to work. So I ended up not going to that disaster but I've been able to be a part of.

Dr. Richard Ferguson: 8:31

You know, there's unfortunately a lot of migration that's occurring in North Africa, in the Middle East, because of so much unrest and there's a lot of displacement and so a lot of people aren't getting their care needs met, got a lot of preventable diseases, dysentery, that there's just not enough healthcare providers and there some of them are even in undocumented UN camps, right? So who takes care of people that the UN doesn't really have visibility of? And so that's where I would join certain aid teams to go and provide care for seven to 10 days. So that probably is the longest impact from my time in service. And but that community service has also birthed. You know it was able to birth BPU and wanting to continue to give back and not have to find an organization to do that with, I just created my own.

Grantley Martelly: 10:43

Well, let's get into talking about Black Physicians of Utah. You said you created it. Tell us a little bit more about how you got to that point and your vision and your focus, and what are some of the major projects you might be working on in that area.

Dr. Richard Ferguson: 10:53

I would say, well, my vision for wanting to do it. It started with another uh organization doing we're working, you know, often towards the same means and it's called black men in white coats, and they made a movie called black men in white coats that was shining a light on the deficit and the, you know, very slow, non-growing numbers of black male physicians in America, and some of that being that, you know, a black male, 18 to 45 has a higher likelihood of being incarcerated instead of being in a position wearing a white coat, like myself, you know, complaining, medical training, completing residency. There's so many forces from this vestiges of prior oppression to just stereotypes of fear and anxiety surrounding black men in America, and so you got some of those things there that make it harder for us to really enter this field and just sometimes it's just role modeling and examples by other Black men, so that you know, those of us that are here can definitely pull several brothers up to show them or get them to go onto this path, and it has been shown in several studies that people are more likely black folks particularly are more likely to be more compliant, feel more respected, their concerns believed, if they're receiving care from someone that has a similar background or racial aspect as them, and so I realized that we could improve the care, quality of care, access to care for many of those in the Black community and also outside of the Black community. I mean, it's actually come out to say if you have a physician of color, you're likely to receive a higher chance of culturally competent care and get more of your questions answered, less likely to be dismissed Because there might be a shared struggle or sense of that in the room. And, uh, when you're having a provider that's coming from a marginalized group and that's what bpl you wanted to do or has been doing, uh, it was actually a small world.

Dr. Richard Ferguson: 13:10

I ran into one of our mentees yesterday. He was with his family, uh, in the uh group parking lot of Smith's yesterday and he had to decide between University of Utah School of Medicine and Morehouse and he was really struggling with that when we last spoke at the end of March. But the thing is he's in a position that he has an option to choose which med school to go to, and so I was so happy and his mom was so thankful because we did mock interview prep for him. We did quite a bit of prep helped him with his personal statement application, and he did well, and the only problem, though, is I think he might be the only Black student in this incoming year out of 125 for the leading med school in the state. So there's a lot of work that my institution has to do or, excuse me, university of Utah has to do, but it's going to take sort of external partners like myself, I think, to try to help with that.

Grantley Martelly: 14:10

Okay, so he's choosing to go to University of Utah over Morehouse. I guess that's what you're saying. Yeah, yeah, okay.

Dr. Richard Ferguson: 14:19

So let's talk yeah, go on sir.

Grantley Martelly: 14:21

So let's talk about Black physicians in Utah. Are there many Black physicians in Utah, or maybe physicians of color? I'm sure that you have many people in your organization who are not necessarily Black.

Dr. Richard Ferguson: 14:33

So I look at it this way. So I wouldn't use the term many, but we also have to look greater at Utah. So just in regards to doctors per capita, I think we're 44th in the nation of number of, let's say, just use primary care providers. I think there's one primary care provider. I have to look at our ratio. I want to say it's one primary care provider per patient 700 people here in Utah, which isn't a great ratio and so. But on top of that, we don't have enough primary care physicians in the state, so it leads to a very long wait time. And then, on top of that, how many of them have gone through training so that they practice less bias when they're providing care? So then you have that makes the number even smaller.

Dr. Richard Ferguson: 15:32

So right now, not including residents, there's about 30 black physicians that are members of my organization. There are a handful, three or four, I would say about three that don't align with my mission. That's probably a separate discussion. I think it's sometimes that it may be with my leadership style. It may be, hey, I'm busy or I'm content with what I give to the black community, don't need to be part of an organization, whatever it may be. But there's about 30 and there's probably, I think, about 10 to 12 that are in residency or fellowship training that are Black in Utah.

Grantley Martelly: 16:15

Yeah, I lived in Utah for 30 years so I didn't run into many Black physicians in Utah. We had good medical care because of the university and um there and both utah state and university of utah, but not many, not many black physicians that I that I ran into there when I was here, uh, when I was training here, I saw just the resident that was ahead of me.

Dr. Richard Ferguson: 16:46

Her name was Dr. Erica Baden, who's now an active part of my group she's actually our vice president for BPLU and Dr Jessica Jones, and that was about it. And then for years when I was just doing traveling emergency medicine, I would always come back and I'm like, wow, I know there's got to be more of us. So I said, well, let me create a home, let me create an organization that people can belong to, black doctors can belong to, maybe a provider directory. Now, mind you, much of the population can't, don't really have reasons to see these black doctors because they're all highly subspecialized. So you know, we have a black cardiologist that's down in Southern Utah, in St George. He's an interventional cardiologist. So unless you're getting a stent placed in your heart or needing his involvement when you're having a bypass or after you receive your bypass, or getting significant medication management after a heart attack, you're not going to just go and see him.

Dr. Richard Ferguson: 18:05

We have another cardiologist that's local, that's at the? U, but she specializes as a cardiologist for heart transplants. So you know your general mill. I want to see a black cardiologist. You just can't easily see her. We have two black obs, but one of them is only for high risk. So if you're not high risk, you're not going to be able to see her, right. So we have all these high. So if we were larger, if there was more of us, we'd have more. Those were generally accessible to the public more pediatricians, more family docs, internal medicine but it takes many years to grow a doc and also they have to feel supported. In Utah and that's the bigger thing about BPU, we're a support system for Black physicians because we know they're going to face some form of microaggressions and racism. It won't be the ugly racism of, say, the Southeast, but it's here.

Grantley Martelly: 19:02

Yeah, I know that from living there.

Dr. Richard Ferguson: 19:08

It's kind of that nice in your face.

Grantley Martelly: 19:09

racism- yeah, nice in your face, racism.

Dr. Richard Ferguson: 19:12

Yeah, it's like you know things. An example would be, or this would be, a racial microaggression. Wow, you speak really well for a fill in the blank, or that was really well articulated. I was a bit surprised. Hmm Is that a compliment, finding it as an insult.

Grantley Martelly: 19:32

Yeah, we run into a lot, lots of that. Let's talk about the upcoming events and projects that you may have, but what are some of the things that your organization is doing?

Dr. Richard Ferguson: 19:44

Wow, I mean, can I give a quick recap of what we did for Juneteenth week?

Grantley Martelly: 19:49

Yeah, that'd be a great start, yeah.

Dr. Richard Ferguson: 19:51

Yeah, so we were very busy, but once again, my soul, my heart, was full because of what I was able to convey and share. So June not only it being containing Father's Day and also Juneteenth our overarching theme that we as BPLU have on our homepage, that we send out our newsletter, was on brain health. And then part of brain health is not so much addressing a vascular issue, say, like stroke, but it's really addressing early signs of cognitive decline that can be evidence of dementia that we feel. Many that are Black, latino communities. We often are seeking help for our loved ones that may be experiencing early cognitive decline and not getting them screened sooner so they have more opportunity to delay the disease process that's leading to the cognitive decline. Right, there's new treatments now that are for Alzheimer's that if you don't catch it, it's and it only can be provided at a certain stage. So, but if you're not screened, how will someone know the stage? And then, so we did an, we did an event last Wednesday, day before Juneteenth. That was Alzheimer's, you know what you need to know. And we had a black gerontologist that's. Our name was Donell Hubbard, who is the regional director for Alzheimer's Association for the Mountain West. So she came out. We also had a local aging services specialized licensed clinical social worker. Actually, both backgrounds are licensed clinical social workers, but they were great.

Dr. Richard Ferguson: 21:31

I went on there. We had a stage. It was in downtown Salt Lake City. We had about 26 people registered for the event. Highly informative. A lot of people were getting some answers, sharing personal stories about how the impact to a caretaker is that we, you know, we sometimes don't realize. Uh, it's happening when someone's going through the development or worsening of dementia. So we talked about what it is, how dementia varies from actual aging. Uh, and then what resources that people have locally.

Dr. Richard Ferguson: 22:05

And then the next day, uh, we went on to have our uheteenth event. That was at PBS, with Roots and Culture hosts Lonzo Liggins and I think his name is Darren, but they're the hosts of a local show on PBS here in Utah called Roots and Culture Roots, race and Culture, and we discussed what was the significance of Juneteenth. So I kind of put on a medical hat and lens and said what are some of the parallels between Juneteenth and health equity? We wanted equality for treatment for those that were undergoing emancipation and that was a challenge just to get to that point and also to get those that were enslaved in Texas made aware of it. There are challenges to science right now and challenges to scientific dogma that we're trying to do as well to make sure people are able to get their health needs met, and our current administration is sometimes making that a little harder. So I spent that evening discussing that during the PBS event.

Dr. Richard Ferguson: 23:13

And then this past Saturday we had our Unity Freedom 5K run, where I tried to then connect heart health and brain health together, because if your heart's not healthy, your brain will eventually undergo decline at a more rapid rate if you don't keep your vessels and your heart healthy. So it was a great event. We had over 60 people, some people signing up just that day uh, great refreshments, prizes, a lot of first timers for a 5k uh, many people. You know, the best thing I can hear is oh, this was so much fun, I want to do it again and that's what I want. I want, I want my black community active, moving, active, eating healthy, and often I'm trying to give tips on nutrition and cardiovascular fitness that we can make easy and keep ourselves accountable for regularly big events. I would say.

Dr. Richard Ferguson: 24:08

August 16th we have a back-to-school mental health that's going to occur at Sorenson Unity Center in Salt Lake City and that's going to be a morning to sort of early afternoon event where parents and children middle school and high school can come together with our team of mental health therapists and they're going to go through a set of presentations and breakout groups on how to overcome some of these fears and anxiety that even our children are having, given the current political unrest going on. You know people feeling that families are going to be broken up because of ice raids and civil liberties that people are feeling they're going to be encroached on, especially when it comes to just your First Amendment rights and your right to protest. That's affecting our students and we want to be able to teach coping strategy, how to have that tough conversation with your child so it doesn't lead to untreated or developing anxiety or depression with a child, because we're, I think, number four for suicide for children in our nation, taking our lives, so it's a real problem here in Utah. We at Mental Wellness Alliance are going to work to try to equip parents and teens and preteens with the skills to have these tough conversations. So, yeah, that's August 16th, november and then October 25th uh, november and then October 25th, I believe.

Dr. Richard Ferguson: 25:32

Yeah, october 25th, it's another Saturday and that's, uh, one of my biggest events of the year.

Dr. Richard Ferguson: 25:36

It's called medicine immersion day and it's something that actually black men in white coats, the national organization with their various chapters, does, but it's pretty much a mini med school and residency training rotations that I do for high school students and those that are out of high school that are interested in becoming physicians.

Dr. Richard Ferguson: 25:55

So I start off the day with black doctors sharing their path, their experience, how they got into medicine. Then we break everybody up into groups in the hospital. They go to the inpatient service, they go to the OB service, they go to the ER, they go to the surgical suite and they all review cases and discuss patients. Then they all come back together and they do for about another 90 minutes hands-on specialty care with training, mannequins, learning how to do CPR suture closer, knowing how to do a lumbar puncture of the spine on a child, knowing how to use an ultrasound device to look at a baby a lot of stuff that we'll do in the afternoon. And then they have lunch with black doctors and allied physicians that want to support these students to go into medicine, and then a job fair after that. So it's a pretty big day. So those are some of my upcoming events.

Grantley Martelly: 26:42

Yeah, you got. You got a full calendar. That's lots of stuff going on there for the black physicians of Utah. So this program is about black men's health and the health of men of color and, like you said at the beginning, the focus of this program also, like it was for you younger years about trying to prevent unnecessary deaths in the community. Things that should be treated, things that should be handled at an early stage if it can be detected and tested for, can be helped. So what are some of the trends that you're seeing in this area and that you're excited about and some that may have you concerned?

Dr. Richard Ferguson: 27:23

For Black men itself. Well, I think one thing that has me a bit concerned is the amount of misinformation that's occurring when it comes to health needs, and the reason I bring that up is as someone that's on the insurance side for my day job. We pay attention to what the CDC and the Advisory Committee for Immunization Practices is recommending, because you have to understand some of the social determinants of health, unless you have a certain job that gives you access to insurance you sometimes have and then you're hoping that the insurance will cover preventative services such as vaccinations, and so something that I'm worried about that's going to impact not only children but adults as well, is when we have folks that are coming in that are skeptical of what's been vetted science for so long on. You know, if you have diabetes, heart disease or lung disease or sleep apnea, you should get the pneumonia shot shot. Well, if we start having people that now are going to be in this advisory committee that once said this is what we strongly recommend, now you've been replaced it with people that are going to question something that has been saving lives, preventing hospitalizations. I don't know if people remember, but Bernie Mac the comedian. He was in his 40s and died of pneumonia. Why did he die of pneumonia? He probably didn't get off of the pneumonia shot, he probably didn't totally need it, but even I got the pneumonia shot and I got it in my early 40s to protect us from that. So that's one thing that I think is going to affect not only all Americans. But you have to understand Black men and, trusting to receive care, they will often dismiss some of their care concerns. So when someone is trying to do the right thing, they may not be offered or they may have to come out of pocket now for something that was covered because of the myths and poor science that the current administration is putting out. So that's one fear.

Dr. Richard Ferguson: 29:30

But emerging trends when it comes to Black men's health. I've seen it with our mental health team, where it's becoming more community based and some more culturally tailored interventions. Say, an example we're trying to get barbers to talk about health topics while black men are accessible and in their chair or in their space right, or barbers being a part of doing a health fair event where they're like, hey, get your haircut, get your vaccine at the same time. So I feel that you know these barbershop-like programs is one recognizable way to have a highly effective venue for preventative care, and this could lead to more blood pressure screenings, because we have to remember that's a leading cause of death for Black men and we don't need to necessarily wait on doctors to do this. We can do it with a nurse. We can have many of these community-based initiatives for screening care done with a pharmacist, as I said, nurse, nurse practitioners, pas.

Dr. Richard Ferguson: 30:38

So I feel like some of that, the grassroots approach. That's something I'm hopeful for, that more of us are doing. And I also feel that there's a trend for more digital health. So I think there's an app called Mobile Men and there are other telehealth offerings that are empowering Black men to manage their chronic conditions remotely. So that's one thing that I'm hopeful for. And then there's been this shift since George Floyd and that fallout from it, that Black men's mental health forums, but other forums where they're going to try to increase research participation and health knowledge for Black men. So, where I'm, of course, if we had a study that was going on, I would definitely try to recruit more African-American men to be represented in more research studies.

Dr. Richard Ferguson: 31:30

And then, lastly, I'd say, another trend is we're doing a better job at destigmatizing seeking mental health care.

Dr. Richard Ferguson: 31:38

It's not seen as weakness, it's not seen as something that you can pray away. But many Black men will struggle with trauma either abuse earlier in life, you know, seeming worsening anxieties because of how they're treated on the job or tasks they're asked to do on the job, or just fear because of certain unrest going on in various cities today where you feel that you might unfortunately be targeted as a Black man by either the police or heck, even by, say, an ICE raid at this time, just because you happen to be Black or brown. So that, to me, increases this need to have our mental health coping skills knowledgeable so we can. Or more knowledge, more knowledge for coping skills when it comes to mental health stressors. So, uh, peer support networks are growing on social media for black men, uh, and I feel that we are actively reframing that it's okay to be vulnerable. You know, vulnerability is actually strength and let's help to dismantle this, this longstanding stigma that we, as black folks, don't need to seek mental healthcare.

Grantley Martelly: 32:53

Yeah, that's a good point and that's something that is very relevant in our day and age. You said something there that I wanted to pick up on about, you know, distinguishing the mental health and this, this traditional belief that sometimes you know you can pray the way. If you just believe in God more, if you pray harder, it will go away. And the thing that I've been promoting and some of the social workers for me promoting it's okay to have a religious belief, it's okay to pray, it's okay to be a person of faith, but faith doesn't exclude you from getting the help you need when you need to get the help.

Dr. Richard Ferguson: 33:36

I often try to. You know some of the pastors when I go and I speak in churches here throughout, from Ogden to Salt Lake City. One thing the pastors always say is God gives us resources to help us take care of ourselves and some of what God gives us are people that tell us how to take care of ourselves and some of what God gives us are people that tell us how to take care of ourselves. So he says religion's important, your faith, you know faith can be healing. But we have Dr Ferguson here and his organization of docs, we have his therapists that are also God put here as a resource to us. So he says you would be a fool not to take advantage of this resource that God has put in front of you. So it's great when it's rephrased that way, saying yes, have your faith, but realize this is a resource that God would want you to have. So it's helpful when I have a church leader that is able to echo those concerns because he clearly believes in it.

Dr. Richard Ferguson: 34:35

You know many faith leaders are counselors in themselves. They have some counseling background, but sometimes it has such a faith core to it that some people that are turned off and won't seek because there's often in religion. You know, depending on how you practice, which faith you're a part of, you're often judged. There's a lot of judgment when it comes to religions and how you practice. Which version of the Bible do you use?

Dr. Richard Ferguson: 35:07

We've got some people that don't see the LDS faith as Christian right Because of some of their belief structure not being the dogma that say, like the Holy Trinity that Catholics have or Protestants have in their belief structure.

Dr. Richard Ferguson: 35:25

You know they have planets and angels and almost seems like mythology and almost seems like mythology that goes along with some of the LDS. That may not seem as old Christian doctrine but the thing is, does it bring them solace, does it bring them calm, does it reduce emotional pain by having this belief structure? Then I support it. But just remember, you've got professionals that have studied how to resolve mental health issues or concerns or how to address an anxiety or depression-based disorder. So we need to make sure that we are readily seeking help and knowing how to identify signs. So that's a lot of what our our mental health forms that we have almost every week. We have three uh every month in some lake county and weber county uh. That's free and available to black men and women, uh, and they just want to be commune with like-minded black men and women and you have a therapist there if you're going through something and they can give you some guidance. We even offer to pay first people that are underinsured or completely uninsured therapy sessions if they're in acute crisis.

Grantley Martelly: 36:44

Yeah, and me. I also, as an ordained minister. I always tell people Jesus and therapy goes hand in hand. They're not necessarily exclusive? Yes, they're not. They're not necessarily exclusive. Like you said, you have to know when to take advantage of the opportunities that God has given us. You also mentioned something about the social determinants of health. Just talk a little bit about that, just for our listeners, who may be listening for the first time and that's a new term to them.

Dr. Richard Ferguson: 37:15

Oh, sdohs, yeah. So this is something that has been out for a while. I think the first time I saw the little wheel that some people if you just type in Google, social determinants of health. It's aspects outside of healthcare that actually determine how healthy we are likely to be. So, for example, just out of the recent program last week, when it comes to education, the higher level degree that you're able to attain, it shows a strong correlation. And if you have a higher degree you're likely to live longer, you're likely to have a higher income. You're also less likely to develop dementia at an earlier age because you're using your brain to stave off. But also you've had access to learn about more resources and knowledge to know what is healthy to do. So if you're around, if you get through college and you're around a bunch of peers and gone to classes sociology, physiology and you understand wow, smoking is really bad. That's why you'll have more and more people that if you have a graduate degree and higher, the likelihood of them smoking is far less than someone that didn't go to college at all.

Dr. Richard Ferguson: 38:30

So that's one aspect of how social determinants of health. So that's education. If you have a job and employed employment, it often determines what zip code you'll live in, if you're going to have be around clean or dirty air, uh, often, by what you can have, housing you can afford to live in. So affordable housing and actually having food security. So you need accessible food and housing to probably, if you're going to have a family, for your child it's going to have a place to do their homework and to have a meal, because if you don't have proper nutrition your brain won't function well. Then you're not going to be able to finish your grades or finish your classes and get good grades. So, once again, education being one of those factors of social determinants of health. And then health access itself. So that either being insurance allowing you access or you happen to live in a community where there's a dearth of doctors, right Like Utah. If you're in Salt Lake County you're not doing too bad, but if you're in Cache or you're in Montauk or Roosevelt, you don't have great access to doctors or specialists that can determine how great your health outcome will be. So, once again, social determinants of health. And then, one thing that can sometimes be involved in there is community resources that one can have. So are you near a grocery store to be able to address that food security. So when I think about the wheel, we've got food, education, health access, employment and I would almost say, like legislation, there's some impact on laws that will determine how healthy you can be, such as, for example, we as a state sometimes make the news for the wrong reasons right, and we are one of the states that in Utah, that we got rid of fluoride from our water.

Dr. Richard Ferguson: 40:27

No dentist supports that. There was never high enough. That was causing toxicity to the brain was never high enough that was causing toxicity to the brain. Not high enough in our state. But now in a couple years probably not even a couple years within probably one to three years, you'll start to see an increased rate of caries in children Because we no longer have fluoride in our water. Go Utah.

Grantley Martelly: 40:51

Okay, that's great. Thank you for that explanation and for bringing that out and how people understand that. Now the next question I have was not one I told you about before, but I think some of the people are going to ask this because you said you work in healthcare as a health physician, medical officer, in insurance. So just if you want to talk about this a little bit or not, many people are confused about how insurance companies make decisions about health care, and do you mind spending a minute or two just trying to explain why that seems to be so complicated to people and it's such a foreign concept?

Dr. Richard Ferguson: 41:37

Yeah, yeah. So I think we have to understand the history of why health insurance is there to begin with. To begin with, it was before it is in its current state, because there's profit behind it, and I think whenever there's profit behind healthcare and it can lead to you know, if you so, there's one or two ways to look at it, because a lot of things were based on utilization what do we use? What do you do? Doing utilization right? So it's often been some of this belief if you utilize more, if you utilize services more, or you tend to do more or more as a doctor or perform more surgeries, you get higher compensation. So the more you do, the more you get paid.

Dr. Richard Ferguson: 42:42

On the health insurance side, we are concerned about fraud, waste, abuse, outliers of care. There's this myth that insurance companies have pushed for a while, even though I'm kind of talking against my own industry here. They use some really old and biased studies saying we will keep costs down because we're going to stop outliers in duplication in care. So, for example, we are going to make sure that someone has, if they have a prior authorization, a request that your doctor has to put in because a certain procedure needs to be approved by the insurance plan. That's a prior auth. It'll come to someone that's probably not as specialized as possibly your doctor, but bigger insurance plans often will have someone that'll be reviewed by the same specialty. Let's say, for example, a lot of family medicine, internal medicine. Pediatricians are reviewing prior authorizations that will come in and we will look at its medical necessity and then sometimes the Center for Medicare and Medicaid Services, cms, will put together guidelines that we will often use when it comes to approving services. But sometimes it will vary from one insurance company to another on what they'll approve. A doc is always at the core of making the decision on what we will accept and we do make modifications If we feel something is too restrictive. We'll remove that barrier of a prior authorization. Which docs in the community hospitals hate prior auths. They dislike them.

Dr. Richard Ferguson: 44:12

But the reason they're there is it's a cost-controlling measure so that we say, well, we don't want this person to get this test twice, so we put a prior authorization there so we can stop it from being requested twice. We don't want someone to jump to get an MRI of their knee because they sprained their knee while hiking on a trail and we don't have an exam that shows what is it that they're trying to image right, and they don't have an exam that shows why advanced imaging is warranted. And then we would probably need to see well, many things can get better with physical therapy before you need to jump to an MRI. So that's why we'll say, hey, we're going to put a criteria here that you have to meet before you get something that's a little bit more expensive. We'd rather pay for something that's cheaper, that's proven to work, before we go and just jump to advanced imaging. Because if everybody gets an MRI for their knee or everyone gets it for a sprained wrist, costs of care are going to really go up. So that's why some of the purpose of health insurance being there.

Dr. Richard Ferguson: 45:23

But it can be very confusing, especially when people are denied care and they're trying to understand why they're denied. And I think that's often the bigger misunderstanding that I try to explain to not only my fellow providers but also the greater community when it comes to advocating for their care. Because there's a lot of things that health insurance will cover but many people aren't aware because they don't ask or they assume if they had one plan that didn't, the next plan won't cover. So preventative services many of those are covered. But then people have to deal with certain deductibles. Right, how much do I have to spend and come out of pocket before my insurance company will even kick in that I'm paying for every month Because there's profit in it? Right, it's shared.

Dr. Richard Ferguson: 46:16

You know Obama was trying to address this with the ACA and having a uniformed, universal or an attempt at universal or universal health care, because the way it works well in other developed nations is healthy people paying to the system. But you've got healthy people saying, well, I'm not sick, why do I want to pay for someone else that's sick? So it's that community will, or that community good to want to do better. As a nation, we're kind of very capitalist, and being capitalist is often fairly selfish. It goes against. You know, it's hard to have capitalism and then have great health care at the same time One of them is going to get hurt. So you either spend more on care, thus you make less money, or you spend less on care and you make more money. Okay.

Grantley Martelly: 47:06

Well, that's a good introductory discussion. I think I need to do an episode specifically on health care and insurance. Oh yeah, Insurance on health care and insurance. It's very confusing.

Dr. Richard Ferguson: 47:15

Intentionally. So I want to say Intentionally so, intentionally, so.

Grantley Martelly: 47:24

Well, how do we improve health outcomes for people of color?

Dr. Richard Ferguson: 47:26

Oh, I think sometimes one way to start is go get seen, for if you haven't been seen, if you're 35 or 40 year old man, let's just start there. Hey, 25 year old man, don't wait until you're sick to get seen. That year no-transcript, and then there's less options to treat by the time you get seen. So one thing I think that will improve healthcare outcome is go to the doctor at least once a year, even though you're not sick. Second I would say is don't go to a visit by yourself. Put a friend on speakerphone, bring a family member, bring a friend, call a friend. Because if you, if you're someone, as many black folks, they go long gaps in between seeing a doctor and then the doc probably doesn't have a lot of good news. So that brings up a lot of fear and people they shut down, they don't want to listen, and then when the doctor's just giving you a piece of paper, it's like well then, follow these. You're still stuck on him possibly dropping a precancerous lesion, and that scared you and you didn't ask any more questions. You just sort of nod your head and then you leave. You didn't ask any more questions, you just sort of nod your head and then you leave and you've got more questions and now you're spending time the next day trying to call the doctor's office after you were just there.

Dr. Richard Ferguson: 49:20

But if you have someone else that can listen in for you, as I do for my own mother in Orlando when she goes to her meeting, she puts me on speaker and I listen to the whole conversation and I go, mom, is there anything you're worried about? Is there anything we can do this with our friends and families? That's one thing I think will. That's the second thing I think that will help prove healthcare outcomes for black folks. Third is I would try to go to your local public health department's websites. They often have tons of tips of information that you should be following recipes for heart health, recipes for diabetes, recipes, or how to know for signs of elevated blood pressure, tips on how you can lose weight so you can address your blood pressure. You can address your blood pressure. So I would look at your local public health, state or city's page.

Dr. Richard Ferguson: 50:25

And then probably the fourth thing to try to improve healthcare outcomes is oh man, if you're able to try to get at least 150 minutes a week of vigorous physical activity Brisk, walking, running, swimming, biking, just upper body weightlifting. You don't need to belong to a gym to be healthy. I'll put it that way there's a lot we can do in the comfort of our home, outside in the street, to just get a heart rate up, because sedentary is killing us. 75% of the US is overweight. Majority of African Americans, particularly African American women, are like 54% or obese. So obesity is leading to tons of other secondary health conditions, such as cancers. It can predispose you to certain cancers because it just causes so much inflammation in your body and your cells just keep turning over and turning over and they're going to make more mistakes. So let's try to do more that we can bring into our control, that's with nutrition, trying to exercise regularly and try to go to the doctor at least once a year. Don't wait until it hurts.

Grantley Martelly: 51:35

Those are some great action points that our listeners can follow. Are there any other topics that you wanted to touch on that we didn't touch on?

Dr. Richard Ferguson: 51:43

Oh, wow. I don't want people to give up hope. There are professional societies, my organization being one American Academy of Pediatrics, the American Academy of Family Physicians, american College of Obstetrics and Gynecology. We are still strongly believing in science and meeting the healthcare needs and trying to address and providing equitable care, either through lobbying, either through our various roles in medicine. I'm trying to do it with some of my access to academic medicine when it comes to teaching medical students so that the next generation understands bias in medicine, understands how to get people to advocate for themselves when they're seeking care.

Dr. Richard Ferguson: 52:38

So don't lose hope. There are docs on the right side that are going to be on the right side of history as we get through some of this. What appears to be rolling back of some of the great strides we as a nation have made as being a leader in science and technology, and there's fears that we're going to no longer be a leader and that's going to be taken over in the next year or two. So don't give up. There are those of us in the nation here that want all of us to be healthy.

Grantley Martelly: 53:11

Thank you very much and for our listeners and the Black Physicians of Utah and you can also reach Dr Ferguson there at B-P-O-U B as in boy, p as in physician, o as in of U as in Utah, b-p-o-uorg, and there's lots of information there. I've been on your site looking at some of the information you have there. So I want to encourage our listeners if you want to reach out to Dr Ferguson, reach out to him at bpouorg or you can send us an email here at AboveTheNoise24 at gmailcom and we can forward that as well.

Dr. Richard Ferguson: 53:52

We have an Instagram and YouTube page and LinkedIn. We're all over. We have a TikTok too.

Grantley Martelly: 53:59

You've got it all. They're all under BPOU?

Dr. Richard Ferguson: 54:03

Just type in Black Physicians of Utah. There's only one of us under TikTok, instagram, linkedin. Give us a follow. We put out health education videos pretty much every week and we have an event. If you're local to utah, uh, there's. There's a lot going on here that we do to support our community well.

Grantley Martelly: 54:21

Thank you very much, and I want to thank my nephew, uh junior from um Trident Concierge in Salt Lake there, who introduced you and I to each other. I look forward to continuing conversations with you and continuing to grow our friendship. Thanks for joining us today.

Dr. Richard Ferguson: 54:38

No, my pleasure. Next, health insurance.

Grantley Martelly: 54:41

Yeah, next I'll bring health insurance. Write us at realhealthblackmen at gmailcom. Realhealthblackmen at gmailcom. Real Health Black Men at gmailcom. To support this podcast, go to buymeacoffeecom forward. Slash Real Health Black Men. Buymeacoffeecom /Real Health Black Men and to become a corporate sponsor, send us an email.