Is a Black Doctor Directory Racist?
Why the lawsuit against "Find A Black Doctor" asks the wrong question
How We Got Here
On May 19, 2026, a white Colorado Dermatologist named Dr. Travis Morrell filed a lawsuit in Manhattan federal court against Find A Black Doctor and its founder, Dr. Dina Strachan. Morrell was joined by Do No Harm — a conservative non-profit founded in 2022 with an explicit mission of opposing diversity, equity, and inclusion (DEI) initiatives in medicine.
The complaint argues that the directory's eligibility requirement — limiting listings to "Black physicians and dentists in active clinical practice" — violates federal civil rights law, specifically 42 U.S.C. § 1981, a provision derived from the Civil Rights Act of 1866 that prohibits racial discrimination in contracting.
The Civil Rights Act of 1866 was enacted immediately after slavery to protect newly freed Black Americans from exclusion from economic and civic life
Morrell says he applied to join in December 2025, never received a response, and that his application was "constructively rejected because he is white."
He is seeking compensatory and punitive damages, a permanent injunction against race-based listing requirements, and an order that his application to the Black physician directory be accepted.
Do No Harm's statement frames the directory as something that "indefensibly robs some physicians of valuable advertising exposure."
The lawsuit also takes direct aim at the concept of racial concordance — the evidence that patients may have better outcomes with physicians of the same race — calling it a "pernicious and debunked myth."
This is not the first time Do No Harm has pursued this strategy.
Earlier this year, the group reached a settlement with Penn Medicine (The University of Pennsylvania’s Health System) over a similar Black Doctors Directory, which was subsequently renamed and broadened in scope as a part of the resolution.
Find A Black Doctor was originally founded in 2005 and relaunched in 2019 by Dr. Strachan, a Harvard and Yale-trained Dermatologist, as a national resource for Black patients seeking culturally competent care. African Americans make up roughly 13% of the U.S. population but only 5% of practicing physicians.
The directory exists, in part, because that gap has consequences — and patients know it.
On its surface, the lawsuit appears to ask a coherent legal question: should any professional directory be allowed to restrict membership by race?
But that framing obscures a much more pressing question:
Why did patients feel the need for a directory like this in the first place?
The lawsuit focuses on the directory itself.
This essay focuses on why such a directory came into existence to begin with.
What Black Patients Are Telling Us
The demand for Black physicians didn’t arise in a vacuum.
It emerged within a healthcare system where many Black patients describe a familiar pattern: feeling dismissed, stereotyped, unheard, or treated differently than the other patients because of their race.
Not every encounter is discriminatory. Not every physician is biased.
But when enough people report similar experiences across different cities, hospitals, clinics, and generations, the pattern itself deserves attention.
Most people assume physician choice is mostly about logistics —who takes my insurance? who is accepting new patients? who has an office close to home?
But in reality, patients often choose doctors for another reason.
In the case of Black patients, many are trying to maximize their chances of being heard.
That calculation becomes especially important when previous encounters have left them feeling misunderstood, judged, or unsafe.
The data reflects this. More than one in five U.S. adults report experiencing discrimination while receiving healthcare, with racial discrimination being the most commonly reported type. Among Black Americans specifically, over one-third report discrimination in clinical encounters.
In a study of more than 92,000 participants, nearly half of Black participants reported experiencing healthcare discrimination—compared to just over one-third of White participants.
But perhaps the most troubling finding of all is this:
22% of Black Americans report avoiding healthcare altogether because they anticipate discrimination.
As a physician, I find that number hard to ignore. After all—healthcare is one of the few institutions people are meant to turn to when they are scared, vulnerable, in pain, or facing the possibility that something is seriously wrong.
What does it mean that millions of Black Americans are so fearful of harm from our institution that they avoid it entirely?
The remarkable fact is not that some Black patients actively seek out Black physicians.
The remarkable fact is that enough Black patients have reported discrimination, dismissal, and unequal treatment to create demand for an entire physician directory.
Before asking whether a directory like this should exist, we should ask what conditions made it valuable.
Trust Is a Clinical Variable
Trust is not simply an emotional issue—it is one of the most consequential variables in healthcare.
I’ve spent enough years in medicine to see the healthcare system from multiple vantage points: as a patient, as a caregiver, as one of the 5% of practicing Black physicians, as someone involved in teaching medical students and residents and as someone in healthcare leadership responsible for healthcare operations and quality.
What became apparent from each of those different vantage points is that trust is not simply byproduct of good care—It is one of the essential conditions that makes good care possible.
A healthcare system can have the most advanced technology in the world, the newest medications, the most sophisticated diagnostic tools, and the most highly trained clinicians—None of that matters if patients do not feel safe enough to engage with it.
Trust influences whether someone seeks care when symptoms first appear or waits until a problem becomes more serious. It influences whether patients disclose sensitive information, whether they believe a diagnosis, whether they follow a treatment plan, and whether they return after a disappointing encounter.
Every clinician worth their salt understands this intuitively.
The patient who does not trust you tells a different story than the patient who does.
They hold things back for example. They delay. Sometimes, they disappear entirely. They seek second opinions.
And sometimes—they avoid the healthcare system altogether.
The consequences of distrust aren’t just interpersonal—They are clinical.
That is why the finding that nearly one-quarter of Black Americans have avoided healthcare because they anticipated discrimination is so important. It suggests that distrust is not a vague, peripheral phenomenon; but that it is quietly shaping whether people access the system at all.
Trust, then, is not merely a feeling.
In healthcare, trust functions as clinical infrastructure.
The Data Suggests Black Patients Are Not Imagining This
At this point, a skeptic might reasonably ask whether these concerns reflect perception or reality.
In other words, are Black patients actually being treated differently? Or are they simply interpreting ordinary frustrations with the healthcare system through the lens of race?
It’s an important question.
And fortunately, it’s one researchers have spent decades studying.
The evidence is remarkably consistent here. Here’s what we know:
Healthcare providers demonstrate measurable pro-White and anti-Black bias
A systematic review of 37 studies found that 31 demonstrated pro-White or anti-Black implicit bias among healthcare providers across multiple disciplines and training levels.
A separate review confirmed that most healthcare professionals show implicit bias at levels similar to the general population — and that this bias was significantly related to patient-provider interactions, treatment decisions, and health outcomes.
Perhaps most telling, every study that examined real-world clinical interactions found that providers with stronger implicit racial bias communicated less effectively with Black patients.
This is not a fringe finding—It is one of the most replicated findings in the health disparities literature.
Black patients' pain is systematically under-treated
For years, researchers have documented that Black patients are less likely to receive adequate pain treatment than White patients presenting with similar symptoms. This disparity has persisted despite decades of awareness and equity initiatives. The evidence is robust, and exists across multiple settings, study designs, and time periods.
For example, a large analysis of over 42 million pain-related emergency department visits found that White patients were 1.26 times more likely to receive an opioid prescription than Black patients — 40% versus 32% — even after adjusting for pain type, severity, insurance status, and geographic region. Black patients with long-bone fractures were 66% more likely to receive no painkiller at all despite similar expressed pain levels.
Perhaps most troubling: researchers found no meaningful change in the magnitude of these disparities over a 22-year period from 1999 to 2020. A follow-up meta-analysis reached the same conclusion — the gap has persisted despite a decade of policy changes and equity initiatives.
Part of this disparity appears to stem from persistent false beliefs about biological differences between Black and White people. A landmark study found that half of white medical students and residents endorsed false beliefs about biological differences between Black and White patients — including that Black patients have thicker skin or higher pain tolerance. Unsurprisingly, those who held these beliefs rated Black patients' pain as lower and made less accurate treatment recommendations.
These ideas are scientifically unfounded. Yet studies continue to find that they influence clinical judgment — and fit in seamlessly with a long history of racial pseudoscience that medicine has been slow to fully repudiate.
The result is a pattern of under-treatment that has been documented across emergency departments, surgical settings, and outpatient medicine.
Black patients receive fewer life-saving cardiac interventions
Black patients are less likely to be referred for cardiac catheterization, thrombolysis, implantable cardioverter-defibrillators, mechanical circulatory support, and heart transplantation—standard-of-care cardiac interventions that influence whether patients live or die.
In the studies, the referral gap is not explained by clinical presentation.
It IS explained by race.
When viewed collectively, these differences are difficult to dismiss as isolated incidents or individual misunderstandings.
They represent a pattern.
Perhaps nowhere is that pattern more visible than in maternal health.
Maternal mortality disparities persist across socioeconomic status
In the United States, Black women are three to four times more likely to die from pregnancy-related complications than White women, even when after adjusting for income and education levels.
Black infants are approximately twice as likely to die as White infants.
The usual explanations—education, income, personal responsibility, access to insurance—help explain some of the gap.
But they don’t explain all of it.
This is one of the most powerful examples in medicine of a disparity that defies the standard explanations. I will return to it.
The issue is no longer whether racial health disparities exist—Medical literature clearly says they do.
The question is why they persist. And to answer that, it helps to understand where they came from.
This Didn't Start Yesterday
One of the most common mistakes in conversations about race and healthcare is treating distrust as though it appeared out of nowhere—as though millions of Black Americans independently arrived at the same conclusion for no particular reason.
But distrust, like trust, is earned.
The false belief that Black patients experience less pain, for example, is not a modern misunderstanding.
It is one of the oldest ideas in American medicine.
In the 1840s, J. Marion Sims—often called the father of modern Gynecology—performed experimental surgeries on enslaved Black women without anesthesia, despite the availability of ether and his use of it on White patients. The justification rested in part on the widely held belief that Black people experienced pain differently than White people.
The details of the theory have changed over time.
The underlying logic has not.
For generations, medicine repeatedly transformed racial assumptions into scientific facts, then used those “facts” to justify unequal treatment.
Decades before Sims, Thomas Jefferson speculated that Black people had a “lack of lung capacity” compared to White people. Louisiana physician Samuel Cartwright later transformed that pseudoscientific speculation into medical doctrine, claiming that Black lungs were inherently “20% deficient” and that forced labor was a “physiological corrective”.
These claims were used to justify slavery.
But they did not remain confined to the era that produced them.
For generations, the assumption that Black lungs were inferior was quietly embedded into the medical software used to interpret breathing tests — meaning Black patients were routinely told their lung function was normal when it wasn’t, because the machine had been calibrated to expect less from them.
Perhaps the most consequential betrayal came later.
From 1932 to 1972, the U.S. Public Health Service deliberately withheld effective syphilis treatment from 399 Black men in Tuskegee, Alabama — never obtaining informed consent, actively deceiving participants into believing they were receiving care, and denying them treatment even after penicillin became the accepted standard of care.
The disclosure of Tuskegee in 1972 didn’t just damage trust — it killed people.
Researchers later estimated that the revelation was associated with a 1.5-year decrease in life expectancy for Black men at age 45, driven entirely by medical avoidance in the aftermath.
That is the measurable health cost of institutional betrayal.
Events like these matter because they show that Black patients' fears were sometimes justified. Many times over, the institution entrusted with protecting health had instead been a source of harm.
The uncomfortable reality is that medicine has often treated Black patients differently—not only in individual encounters, but through the design of institutions, research practices, and clinical tools themselves.
Nor is this purely historical.
A 2025 review identified dozens of risk calculators, medications, and laboratory tests that continue to incorporate race as a clinical variable.
The American Thoracic Society issued an official statement to clinicians that explains why race and ethnicity should no longer be considered factors in interpreting the results of spirometry—It came out in 2021. In it, they acknowledged that people of color may experience “delayed disease diagnoses or reduced access to therapies” under the existing race-based standard of care lung testing method.
The race-adjusted eGFR equation, which assigned higher kidney function to Black patients and could delay referral for transplantation, was not revised until 2021.
To medicine's credit, many of these practices are now being reexamined. Major medical organizations increasingly recognize race as a social category rather than a biological one and have begun removing race-based adjustments from clinical practice.
That is progress.
But it is recent progress, arrived at slowly, against resistance, after centuries of the opposite.
When Black patients approach the healthcare system with caution, they are not responding only to the encounter in front of them.
They are responding to a history that has repeatedly taught them that medicine does not always deserve the trust it asks for.
It's Not Just Poverty
One of the most common responses to racial health disparities is that—they are not really about race at all.
They are about poverty.
And to a significant extent, that argument is correct.
Socioeconomic factors matter enormously. Income, education, employment, housing, and insurance access explain a large share of health differences between Black and White Americans. One detailed analysis found that these factors account for roughly 80% of the Black-White life expectancy gap in men and 70% in women.
That is not a trivial finding.
If America eliminated poverty tomorrow, many racial disparities in health would likely shrink dramatically.
That reality matters. Too often, discussions about racial disparities become trapped in a false choice between racism and socioeconomic status, as though only one can be true.
In reality, they are deeply intertwined.
The problem though, is that socioeconomic explanations, while important, don’t fully explain what we observe.
Even after accounting for income, education, employment, and other socioeconomic factors, roughly 20–30% of the Black-White life expectancy gap remains unexplained.
If poverty were the entire explanation, there should be little disparity left after adjustment. Instead, significant differences persist.
One of the most striking findings in the literature is what researchers call “diminished returns.”
The idea is simple.
When White Americans gain additional education, income, or occupational status, they generally experience corresponding improvements in health.
Black Americans experience those improvements too—but often to a lesser degree.
In other words, equal socioeconomic gains do not always produce equal health gains.
Researchers have proposed several explanations.
Higher-income Black Americans are often more likely to find themselves in predominantly White institutions where they encounter discrimination, social isolation, or the chronic stress of being viewed as an outsider.
Residential segregation can persist even at higher income levels.
Wealth gaps remain larger than income gaps.
And experiences of discrimination do not disappear simply because someone has a graduate degree or a high-paying job.
The result is that two people may appear similar on paper—similar education, similar income, similar employment—and yet experience different health outcomes.
This is why, again, the maternal mortality data is so unsettling: Education does not erase the disparity. Income does not erase the disparity. Professional status does not erase the disparity.
The usual explanations account for part of the story.
But they don’t account for all of it.
And if 20–30% of the gap remains after the standard explanations have been exhausted, then we are left with a more uncomfortable possibility:
Something beyond socioeconomic status is contributing to the difference.
And one of the places we have to look is the healthcare system itself.
Why Some Patients Seek Black Physicians
This is the section that is most likely to be misunderstood, so I want to be precise:
Seeking a Black physician is not, for most patients, a rejection of White physicians.
—Not directly anyway.
Much more than that, it is a search for trust, understanding, and shared experience. Black patients are often looking for a doctor who may require less explanation of certain things, who may be more alert to certain patterns, and with whom the work of establishing trust may begin from a different baseline.
The evidence supports this as a rational strategy.
A landmark randomized trial found that Black men assigned to Black physicians were significantly more likely to receive diabetes testing (49% increase), cholesterol screening (71% increase), and flu vaccination (56% increase) than those assigned to non-Black physicians.
A cohort study across more than 1,600 U.S. counties found that Black people have longer life expectancies in areas with more Black primary care providers—a 10% increase in Black primary care physician representation was associated with 30 additional days of life expectancy for Black individuals.
Patients seek physicians who share aspects of their identity all the time.
Women seek female physicians for certain concerns. Members of religious communities seek physicians who understand their beliefs. Immigrants seek physicians who speak their language. Members of the military often seek clinicians who understand military culture. People living with disabilities frequently seek providers who understand disability not as an abstract concept, but as a lived reality.
Most people don’t find these choices surprising.
Most of us intuitively recognize that shared experience can sometimes make communication easier, trust quicker to establish, and misunderstandings less likely.
The same logic helps explain why some Black patients actively seek Black physicians.
It’s not because they want a segregated healthcare system. It’s because they believe a physician who shares certain lived experiences may be more likely to understand concerns that have historically been minimized, dismissed, or misunderstood.
In the end, trust matters deeply in medicine. And that trust is shaped by history, personal experience and whether patients believe they will be listened to, taken seriously, and treated fairly.
Medicine has systematically damaged the trust of Black patients and they are making rational decisions in response to that damage.
Any honest reading of the evidence has to reckon with that.
When Institutions Fail, People Build Workarounds
At this point, it becomes easier to understand what a directory like Find A Black Doctor actually is.
It is not a political statement…It’s a workaround.
After all, workarounds are predictably what happen when institutions stop meeting peoples needs reliably enough, for long enough.
Long COVID patients built their own research networks when the medical establishment was slow to take their symptoms seriously. Disability communities have long maintained informal guides to accessible and respectful care. Patient advocacy groups for rare diseases often know more about cutting-edge treatment options than the average specialist. Mutual aid networks fill gaps that social services leave open. Disease-specific support groups become repositories of practical knowledge that clinical settings don’t offer.
This is true far beyond healthcare as well.
When public transportation is unreliable, people organize carpools. When formal childcare is unavailable, families build informal caregiving networks. When government systems fail, communities often create parallel systems to fill the gap.
Find A Black Doctor belongs within this broader pattern. It is not an anomaly. It is an instance of a recognizable human behavior: making your own map when the one you were given doesn’t show you what you need.
Long before Find A Black Doctor existed, patients were already creating their own maps of the healthcare system. They asked friends who to see. They warned each other about clinicians who dismissed symptoms. They shared recommendations in churches, barber shops, beauty salons, community organizations, and family group chats. They traded names. They compared notes. They built informal networks of trust.
The internet simply made those networks easier to scale.
The lawsuit treats the directory as the problem.
But the directory did not create the demand…The demand came first.
The directory is simply one community’s attempt to solve a problem that many of its members felt was not being adequately addressed elsewhere.
In the end, all of that raises a deeper question:
If enough Black patients felt the need to create, use, and sustain a resource like Find A Black Doctor, what exactly are they telling us about the healthcare system they are navigating?
Because people rarely build alternative systems when the primary system is working well.
Workarounds are often diagnostic.
They reveal where institutions are failing.
And sometimes they reveal failures that institutions themselves are reluctant to acknowledge.
The Wrong Question
The public debate asks: is the directory discriminatory?
That is a legal question, and courts may eventually answer it.
But it is not the question that explains anything important about American healthcare.
The more important question is: why did enough patients feel they needed it?
Do No Harm has already demonstrated what winning looks like for them: a renamed directory, broadened to include doctors who are not Black, its original purpose diluted into something more palatable.
That outcome tells us exactly what this lawsuit is for. It is not about advertising exposure—not really. It is about making race-conscious tools legally untenable — one settlement, one injunction at a time — in a specific political moment that has made that strategy viable.
Until we are willing to confront why a Black physician directory exists in the first place — what experiences led to it’s creation, what evidence sustains it, what institutional failures feed it — we risk making the same mistake the lawsuit makes.
Mistaking the response for the problem.
Because if the demand for a Black physician directory is ultimately rooted in experiences of discrimination, dismissal, unequal treatment, and distrust, then eliminating the directory does not eliminate the underlying problem.
It simply removes one response to it.