The Emergency Physician Tackling Racism in Health Care

A black woman looks at the camera in this portrait. She has shoulder-length dark hair and is wearing a high-neck tank top with feathers and hoop earrings.
Photo-Illustration: by The Cut; Photo: Diane Zhao

Five years ago, Dr. Uché Blackstock had a perfect life on paper: a prestigious job in emergency medicine, a family with two kids, an apartment in Brooklyn. She and her twin sister, Oni, had made history as the first Black mother-daughter legacy at Harvard Medical School (their mother paved the way in 1977) and secured impressive positions in their respective fields. But privately, Dr. Blackstock was struggling. Fewer than 3 percent of physicians are Black women, and when she spoke up about the racism and inequity she said she saw at work, she got pushback from peers and higher-ups; when she took on a leadership role, she felt her initiatives were ignored or undercut. 

Finally, she started her own consulting firm, Advancing Health Equity, to combat racism in medicine outside of her full-time job. But it was too much. Her marriage was faltering and she was on the verge of burnout. At the end of 2019, Dr. Blackstock left her faculty position, publicly citing “a toxic and oppressive work environment that instilled in me fear of retaliation for being vocal about racism and sexism within the institution.” She got a part-time job in urgent care — considered a huge “step down” — and kept consulting. 

Then the pandemic hit, and her diversity work was suddenly catapulted into the international spotlight. She became a regular talking head on MSNBC, and her company was flooded with clients, including large hospitals and health-care systems. Today, Dr. Blackstock is also a newly published author. Her memoir, Legacy: A Black Physician Reckons With Racism in Medicine, details her own experiences as a doctor, a patient, and a Black woman, and addresses the work that remains to be done in a country where racial health inequities have worsened in the past several decades. Dr. Blackstock lives in Brooklyn with her two sons. Here’s how she gets it done.

On her morning routine:
I usually wake up around 6 or 6:30 a.m. I love getting up before the kids so that I have my own quiet time. I’ll have some tea, stare out the window, just sit. I might do five minutes of meditation with the Peloton app, I might journal. I’m not rigid about it. I appreciate the quietness of the early morning when I don’t have to be anywhere or do anything.

On getting the courage to quit a prestigious job:
I went to Harvard undergrad, then Harvard Medical School. Then I was an associate professor of emergency medicine at another university. I had absorbed that my value was tied up in those affiliations. I had to go through a long unlearning process and a lot of therapy to understand that I, on my own, was enough.

I started my company, Advancing Health Equity, in early 2019 to address the problems of racism in medicine that I was seeing firsthand. I figured I’d build the company for a few years and transition to running it full-time eventually. But then it became clear that I had to do that sooner — my job was making me feel more and more unappreciated, and I couldn’t stay in that toxic work environment if I was going to show up for my children and myself. When I look back at pictures from that time, I had bags under my eyes, I had lost weight, and I wasn’t taking care of myself. It was extremely difficult to leave a career that I’d built for almost ten years. I had multiple titles. I was financially secure. But by stepping away from all that, I was actually saving myself.

On learning to use her voice:
Coming from an academic environment where I felt like I couldn’t speak up or be authentic because I would be retaliated against, it was striking for me to have my perspective seen as valuable. I remember my talent agent saying to me, “Uche, when you go on-air, they want to hear your perspective. You’re not regurgitating the news. They call for you because they want to know what you think.” I started to cry because I was like, “Someone actually wants to hear what I have to say?” I had made myself so small in my previous work environment. I didn’t have to do that anymore.

And learning to set boundaries:
For most of my life, I would answer emails at all hours. I would do work on the weekends and late at night. That’s the mentality of academic medicine. You work all the time in ways that are visible so you can get acknowledgment and accolades. Then, once I had kids, I was like, “I can’t keep doing this.” Out of all the jobs I’ve had — I’m a physician, I’m a health-equity advocate, I’m now an author, I’m an entrepreneur — parenting is the hardest. I credit my kids in teaching me how to make boundaries and protect my time.

On being hard on herself:
My sister is this way too, and so was our mother — we’ve always coped with challenges by being super high-functioning. We get the work done, we don’t complain. From an early age, I bought into that, because I wanted to be well respected. But what I realized over the last six or seven years is that it comes at a cost, and that cost is exhaustion. That productivity was driven by anxiety. It wasn’t always coming from a healthy place. I’m incredibly hard on myself. But what I learned in my marriage is that I can be hard on other people, too. I don’t want to be hard on my partner or my kids. I try to be more intentional about that now. If I mess up, I try to acknowledge it.

On getting divorced amid a career change:
I came to the conclusion that I needed to ask for a divorce at the same time that I needed to leave my faculty position. I realized that there were a lot of expectations I had put on myself, that I felt from family and from society, of how I should be as a wife and mother and a person. Those expectations didn’t always align with me. People used to see me with my ex-husband and our children and say, “Oh my goodness, you are such a beautiful family.” I felt almost dishonest when that would happen because I was so depressed and unhappy. I had to ask myself, “In this relationship, are you ever going to be able to get what you need?” We went to counseling and the answer became obvious. The very painful decision to ask for a divorce was also an incredibly freeing one. It didn’t mean that I had failed. It meant that I was evolving.

On co-parenting:
My ex and I each have the kids 50 percent of the time. I have them every Monday and Tuesday. Their dad has them every Wednesday and Thursday. We alternate taking them on weekends. We also live in the same co-op, which consists of two buildings, and so my ex lives across the parking lot from me. It’s a huge relief that the boys have adjusted so well. That was my biggest worry when we first separated. I was like, “Are the children going to be okay?” What I realized is that your children are okay when you’re okay.

On taking care of herself physically:
I used to be obsessive about working out. That’s where I channeled all of my anxiety. I’ve since realized that I don’t enjoy working out every day. So I’ll do the Peloton bike maybe three times a week, and on other days I’ll do strength training because I’m in my 40s and I don’t want to lose muscle mass. I also love going on long walks and listening to podcasts in the middle of the day, which is a benefit of being able to arrange my own schedule. My favorite podcasts are The Daily and The Brian Lehrer Show — I like to stay on top of current events.

On managing finances as an entrepreneur:
I was not initially comfortable talking about money, because I thought I never had to be. Going into academic medicine, I knew I would have a salaried position. What I didn’t know until I finished my training and started talking to my colleagues is that there would be a pay disparity. After my second year on faculty, the department administrator came and said to me, “I want you to know that so-and-so, who was hired the same time as you, and who has fewer qualifications, he’s making $10,000 more than you.” And I was like, “Okay, thank you, but what do I do with that information?” Once I started my company, I realized that I had to learn how to have conversations about money. I had to get comfortable saying to a client, “This is what we charge for X, Y, Z,” and not back down.

I have to advocate for myself, because not only am I supporting my family, but I also have a team that works for me and I feel a responsibility for them. For the first year or two, I would get very nervous. I didn’t know that there would be fluctuations in business. Now we’re more prepared and intentional about marketing. But I’ve also learned that we will get through those tricky spells. I tell myself that the work we’re doing is so important and necessary that clients will come. I also have a bigger platform now and my exposure brings in more business.

On a typical week:
I don’t take meetings on Mondays and Fridays, and I try not to work on those days either. Tuesday, Wednesdays, and Thursdays are when I meet either with my team members or with my operation manager or my project manager. I do a lot of media, so I might be on MSNBC or NBC News, or be interviewed for a podcast. More recently, I’ve been doing a lot of book promotion. I’m learning that when you write a book, writing it is only half the job — promoting it is the other half. On days when I have the kids, I get them from school at around 4 or 5 p.m. and we come home, do homework, eat dinner, talk, and then get ready for bed.

On winding down:
I know it’s not the best way to de-stress, but I usually catch up on social media in the evenings. When people message me or comment on something, I think it’s important to try to reply to them. Then I have my whole skin routine. Now that I’m in my 40s, I want to do more than just wash my face with one soap. I have a three- or four-step skin routine before bedtime, and I really enjoy it — it helps relax me. I also have a lavender spray that I spray on my pillowcases before I go to bed. I’m in bed by 9:30 p.m. most nights because I need at least eight hours of sleep.

On outsourcing and the people who help her get it done:
I feel very fortunate to be in a position where I outsource what I can. If I need to go to an event or want to go on a date, I have wonderful caregivers I can call on and know my kids are in good hands. I have someone I’ve known for ten years who helps clean my apartment. I use Instacart. As soon as I could afford to have someone else do my laundry, I did. I haven’t done laundry in maybe ten years.

Work-wise, I recently brought on more staff at my company to free up my time and my mental space. We have about 20 contractors working for us now. I recently hired an operations manager and I have a project manager. What’s great about my career now is that I can be the leader I always wanted — compassionate and empathetic and encouraging of my team to take risks. It’s incredibly gratifying.

The Emergency Physician Tackling Racism in Health Care