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Serina Floyd (SF): My name is Dr. Serina Floyd, my pronouns are she/her, and I’m the Vice President of Medical Affairs/Medical Director for Planned Parenthood of Metropolitan Washington D.C.

PPMW: What inspired you to follow a career in medicine?

SF:  When I was young I lost a sister to  cancer, when she was seven and I was 12. Even though I was only 12 at that time, what she experienced throughout that process, and being a witness to it, led me to develop an interest in medicine. For many years I had planned to practice pediatrics because the experience of losing my sister to cancer made me want to be able to help other children. But in medical school I found another love, and that was obstetrics and gynecology (OB/GYN).

PPMW: Did you have any mentors who helped shape your professional career choice?

SF: During my early  residency at Duke University, a new OB/GYN department Chair was hired,  Dr. Haywood Brown. Dr. Brown is a Black male who was not only the first Black male chair at Duke, but who also held other firsts within the OB/GYN department and within the hospital system. When he came on board, he was very invested in addressing health inequities and health disparities in women’s health, a particular interest of mine. He was an unusual Chair in that he also devoted a great deal of energy and attention to the residents who were in the program, and really tried to make sure that the residents of color in particular were supported because he understood all too well how difficult it could be for us. His advice, support, and his guidance have served as some of the best mentorship I have been fortunate to receive over the years.

PPMW: When it comes to abortion, or even just general gynecological care, what are some of the misconceptions that you continually run up against?

SF: Aside from common misconceptions both providers and patients have about things like who may be eligible for certain interventions, especially the different types of contraception, it still surprises me, and really saddens me when I encounter patients who don't know much about their own bodies or little about their own health. They may not understand how some systems work or how certain disease processes and health conditions arise, why they received a particular test or treatment, or even what their alternative options were. Whenever this happens, what it tells me is that no one has ever taken the time to educate this patient, or to answer their questions in meaningful ways that they are able to understand. I don't fault patients for that. I fault the lack of opportunities that they've had to learn those things, either because a provider has not taken that time with them or because they have no one else who can educate them. 

I can't tell you the number of times I've had a patient come in and, after I've explained something they've said to me, "You know what? No one's ever taken the time to explain that the way you just did” or “I was never given the chance to ask questions” or “I didn’t really understand what they said but couldn’t get more information.”  I hear that unfortunately way more often than I should. People, especially marginalized people, are often rushed through a visit, given limited options or just told what needs to happen. 

PPMW: American medicine’s well documented mistreatment of Black and brown people casts a long shadow that we still see today. How do you, as a provider, recognize the past while providing care to your patients?

SF: The history of medicine and its treatment of BIPOC people in this country is very deep, and very, very problematic. And it goes well beyond the Tuskegee experiments, which is what most people are familiar with and cite. It goes back to the treatment of slaves and the original  indigenous peoples and the horrific ways in which they were used by the medical establishment, with complete and utter disregard for the fact that these were human beings.  And this traumatic treatment has been carried through to the present day, it just looks a little different now but is based on the same racist principles and practices as in the past.

When you consider the abuses of the past and allow them to inform the present, it becomes clearer why we see the inequities in health outcomes that we do today, such as with maternal and infant morbidity and mortality, heart disease, cervical cancer, breast cancer, etc. Individuals who are the most marginalized historically and in the present are frequently unable to receive the care they need and deserve. 

As a provider, I take what I know of that history and allow it to shape my interaction with a patient. I consider the individual before me and try to imagine the context in which they live their life, try to consider what their lived experiences might be, and I LISTEN to what they tell me.  And as a Black female who has her own lived experiences, I have a perspective that allows me to build a relationship with them that may look different than prior provider relationships a patient may have encountered.

PPMW: What are some of the tips you have for folks to best advocate for themselves and their loved ones as they are navigating the medical establishment?

SF: There's a power dynamic that is always in play whenever a patient interacts with a provider. I think probably the number one thing I'd say is that it is always okay to take power back as a patient and level the playing field. Never be afraid to ask questions, and ask questions unapologetically. You have every right to ask for explanations, to ask for reasons why, and to challenge if need be. Nobody knows you like you know you. Nobody knows your body like you know your body. So, when people are trying to dismiss things that you're telling them, be assertive. Say, "No, this is not right. This is not normal for me. I need something to be done about it." And understand that the person sitting in front of you is not your only option. 

Also I would say to talk to those you know and trust. Ask others who they've seen and the experiences they've had with those individuals. Look up providers online and get some information about them. And it's okay for you to interview a provider. As a physician, I've had patients come in and say, "Well I don't know if I'm going to have you as my provider. I'd like to interview you to see whether I want to establish this relationship," and that's 110% okay. Bring your own advocate or support to a visit and take notes. Patients need to first and foremost always realize they have more power than they think. They just have to utilize it.  And, if you're not getting what you need, then make noise, make noise loudly and make it widely.