Dr. Stanley Frencher, Jr. is medical director of surgical outcomes and quality at Martin Luther King, Jr. Community Hospital and lead physician, urology at Martin Luther King, Jr. Outpatient Center. He is also assistant professor-in-residence at UCLA’s Department of Urology — and an active medical researcher with close to two dozen articles in peer-reviewed journals. 

This interview is part of In the Spotlight — a HASC series profiling people connected to the association pursuing innovative, impactful work in their communities. It explores the question of why patients delay care during the ongoing COVID-19 pandemic — also addressed by California Hospital Association’s Care Can’t Wait campaign.

From 2008-11, Frencher directed prostate health research as part of the Black Barbershop Health Outreach Program, a national effort aimed at distributing critical health information to the Black community. In 2012 he teamed with Grammy-award-winning singer-songwriter Charlie Wilson for multi-city appearances in which the pair discussed what men can do to protect their prostate health.

Black men experience prostate cancer more than other groups. One in nine U.S. men will be diagnosed, but for Black men, the rate is 76 percent greater — and they are twice as likely to die from it compared to white men. Lifestyle factors, including diet, play a significant role in risk, in health equity and outcomes.

Frencher sat down with HASC Strategic Communications to reflect on the ongoing pandemic, on health and care, and to share several personal stories.

A five-minute audio supplement to the interview is available here. A link is also posted at the bottom of this item. (Note: the segment may take a few seconds to load after clicking.)

Thanks for agreeing to speak with us, Dr. Frencher. You’ve completed several projects with one goal — urging men to see their doctors and pay attention to prostate health. Unfortunately, during the pandemic many are delaying necessary checks and procedures. What do these behavior changes mean to doctors who work in hospitals?

Fear of COVID-19 has functioned like copay or co-insurance — posing yet another obstacle in the path of vulnerable populations to seek health care. In the same way financial concerns lead patients to avoid both needed care and elective care, so too is the challenge for patients in knowing when to face their fears of COVID-19 and seek the advice and care of a physician in person.

As a result, we’ve seen patients delay cancer care or forgo even emergency care. My father, a primary care physician in Michigan, has lost patients due to their acute exacerbations of chronic illnesses such as congestive heart failure or chronic obstructive pulmonary disease.

Your outreach campaigns have taken unique routes to connect with Black men and the African-American community. What have you learned about effective communication aimed at health outcomes — and about connecting with underserved groups? What works, what doesn’t work?

Fundamentally, speaking to men where they are is the key, both literally and figuratively. 

Where? In barbershops, at church, during sporting events, while hitting the gym, wherever we as Black men are comfortable is the place to have these conversations. Medical care and health education must extend and begin beyond the walls of health care facilities  (e.g., hospitals, clinics and emergency departments). 

How? Again, meeting men where they are. Speaking their language. Breaking down medical jargon and complex concepts into digestible and memorable conversations.

The word ‘doctor’ means teacher. We have to embrace the notion that in order for our patients to trust us we must be able to convert what we know into their understanding. I find that the conversations in the barbershop or at a BBQ or after church are ripe for addressing questions, concerns and dispelling myths. It’s where you as a physician, if you are willing to listen, will hear what your patients really think about their health.

COVID-19’s impact has been felt disproportionately by communities of color in Southern California. Working on the front lines at MLKCH, what have you learned that may go deeper than our reading in the Los Angeles Times and other news outlets?

COVID-19 exposed the ills of our health care system. It didn’t create them. Lack of equitable care, under-insurance, maldistribution of medical resources, racial disparities and social injustice existed before the pandemic. Those of us who dedicate our careers to the safety net, know this all too well because we live it daily. Our patients deserve better. We need to divorce ability to pay from our health care delivery system. It’s deplorable that we as a society have chosen to pick winners and losers based on socioeconomic status. And I insist that it’s a choice. We can change it.

I have patients who continue to need surgery, cancer treatment, and other needed therapies that go without because of our focus on COVID-19. I contend that when we reflect on these last seven months, we may observe untoward health outcomes due as much to what we weren’t able to do for patients because of COVID-based care avoidance. Perhaps even greater than the direct morbidity the virus caused.

The COVID crisis affects hospitals on multiple levels — exhaustion, possible illness, workforce shortages and revenue shortfalls have been widely discussed. What aspects impact you personally?

Personally I feel more concern for my kids and others like them as it pertains to the measures we’ve had to take to protect them. This is time they will not get back — high school graduations, cheerleading at football games. Those are areas in our lives we need to actively look to recapture as opposed to postpone. Much like health care, there are consequences to delay or avoiding them. 

During this time, my father, a primary care physician for 30-plus years in Michigan was diagnosed with a rare form of cancer (multiple myeloma/plasma cell leukemia). We wrestled with whether to take him to the emergency room as we debated his potential diagnosis. He was concerned about the under-resourced hospitals we would encounter, and possibly the COVID19-distracted clinicians and staff. And the possibility he would have to endure it alone given visitor restrictions.

Even with all the resources at our disposal and literally a half dozen physicians in our immediate family, the idea of seeking hospital care was daunting. And our fears were substantiated by our experience. From service lines decimated by layoffs to billing/health plans struggling to process prior authorization to avoid delays in life-saving chemotherapy.

This was our lived experience as health professionals seeking lifesaving care this past month! We need to continue to care better for our patients. COVID-19 or no COVID-19.

Contact HASC Publications Director Erik Skindrud with comments or ideas for future In the Spotlight interviews. 

Contact:
Erik Skindrud
(213) 538-0728
eskindrud@hasc.org