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In the winter of 2022, Dr. Stanley Berry says he tried to raise a “very serious” issue with his colleagues at Wayne State University’s medical school: Bias against Black patients in health care, especially when they report pain.
Of particular concern for the veteran doctor was residents potentially harming pregnant Black women ― without realizing it ― by sending them home despite their excruciating pain ― which he said happened at least once.
Not only does this conflict with the compassionate practice of medicine, he would warn his colleagues, but it’s unsafe and the results could be catastrophic.
But nobody did anything, Berry alleges, except lash out at him for raising the issue of implicit bias, calling him a “bad apple” and claiming his outspokenness was a turnoff among colleagues.
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“They don’t love you, and I don’t think they ever will,” the medical school dean allegedly told Berry in the spring of 2022, when he delivered Berry another blow.
Berry was denied the top job at the Department of Obstetrics and Gynecology. He was the interim chair of the department and a full-time professor with three decades of experience on the university faculty. Berry alleges the job went to a “less qualified” candidate: an associate professor who is white.
So he sued.
‘All of us … are capable of bias’
In a civil rights lawsuit filed in U.S. District Court, Berry alleges Wayne State and three individuals, including School of Medicine Dean Wael Sakr, unlawfully retaliated against him for engaging in protected activity ― that is, voicing his concerns about racial bias in health care.
According to the lawsuit, Berry was trying to raise awareness of implicit bias by residents who may be putting pregnant women and babies in harm’s way without realizing it.
“All of us need to be aware that we are capable of such bias, and the only way to eliminate such prejudices from our practice is to continually be aware that we may harbor them,” Berry wrote to colleagues in a January 2022 memo.
In a follow-up email the next day, Berry invited his colleagues to a meeting to discuss the issue.
“In my 38 years of working with and teaching trainees, I understand that mistakes are made every day by everybody, and when these mistakes pose a real danger to patients, they need to be discussed openly, honestly and in a timely manner,” Berry wrote in the January 2022 email, in which he expressed concerns about residents sending pregnant women home in pain. “I am disappointed that some of you consider my urgent effort to end this substandard medical practice (is) in poor taste.”
Berry’s meeting never happened. A med school official canceled it and a separate meeting was called.
Berry was not invited.
Wayne State defends commitment to patients, diversity
As of Saturday, the university had not yet been served with the lawsuit, though the Free Press informed Wayne State officials about the litigation as the Board of Governors met Friday afternoon.
The Board of Governors is listed as a defendant.
The university declined to comment on specifics in the lawsuit, citing policy not to comment on pending litigation. But in a statement to the Free Press, it said:
“No entity is more committed to the overall health and well-being of Detroit’s diverse population than Wayne State University. We are proud of our commitment to diversity and inclusion, it is at the core of everything we do.”
‘I can’t believe’ this happened in Detroit
For employee-rights attorney Amanda Ghannam, Berry’s experience at the medical school is troubling on a number of fronts.
Perhaps most puzzling, she said, was that Berry was retaliated against at a university in Detroit ― a predominantly Black city that has long struggled with infant and maternal mortality rates.
“I just can’t believe that in a majority Black city, that it would be considered (wrong) for Dr. Berry to bring this to people’s attention,” Ghannam said. “It’s such a serious issue that he was trying to draw attention to. And for that he was just attacked. People wanted him not to have contact with residents anymore.”
Ghannam, one of the lawyers representing Berry, also took issue with the dean’s treatment of her client.
“The dean tells him, ‘They don’t love you?'” Ghannam said. “It’s just really disturbing that in these times, people are still being retaliated against for raising these concerns.”
What drove Berry to court
Berry also has filed a discrimination complaint with the U.S. Equal Employment Opportunity Commission, and plans to add additional claims if the EEOC grants him a right-to-sue letter.
Meanwhile, these are the events ― as alleged in the lawsuit ― that drove Berry to sue his university employer:
On Jan. 25, 2021, Berry was appointed to serve as interim chair of the Department of Obstetrics and Gynecology. He assumed the new role three months later and appointed his colleague, Dr. Lanetta Coleman, to serve as executive vice chair of the department.
Ten months later, Coleman raised a concern about a resident’s interaction with a Black patient at Sinai Grace Hospital who had a history of preterm birth. She raised how “unrecognized bias can adversely affect patient cre and clinical outcomes.”
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The head of the residency program met with the resident at issue, though Berry “was left with the impression” that the concerns were not being taken “as seriously as the matter necessitated.”
So he intervened.
‘It’s not acceptable’ to send a pregnant woman in ‘extreme pain home’
On Jan. 23, 2022, Berry asked Dr. Satinder Kaur, the director of the medical school’s residency program, to address the issue of implicit bias in health care and relay this message to residents:
“It is not acceptable to send a pregnant woman in the third trimester who is complaining of extreme pain home. (This) does not comport with the humane/compassionate practice of medicine … (or) the safe practice of medicine because there is always a chance that this woman may have been in preterm labor.”
The next day, the residency director sent all obstetrics and gynecology residents a link to a presentation titled: “It Starts with You: Examining Implicit Bias in Healthcare Settings.”
But that didn’t address Berry’s concerns about Black pregnant women in pain getting sent home. So he sent a memo to the OB/GYN trainees, faculty and private attendings, and mentioned the resident whose interactions with the Black pregnant woman at Sinai Grace raised red flags.
“Residents, fellows and attendants need to be aware that the possibility of implicit bias may exist in these situations regardless of the race or ethnicity of the provider,” Berry wrote in the Jan. 26, 2022 memo. “The decision-making on the part of the resident in this case is an example of care that should not occur in our program or our institution regardless of whether implicit bias is a factor.”
He added: “All of us need to be aware that we are capable of such bias.”
In a follow-up email, Berry invited the department to discuss the issues at a meeting the next day.
“The best way to care for a particularly vulnerable community is to consistently deliver the best medical care possible and that is the sole objective of my communications,” his email read.
A dean canceled the meeting. The department held a separate meeting, though Berry and Coleman were not invited.
According to the lawsuit, at this meeting, medical school colleagues called Berry and Coleman “bad apples,” claimed Berry had a “history of hostility” and implied that “residents shouldn’t have to work with Dr. Coleman.”
That same day, the lawsuit says, a survey was sent to all residents, asking them about Coleman. It listed only two choices: “I would prefer NOT to work with Dr. Coleman” and “I have no preference one way or the other.”
Over the next few months, the dean and a faculty member at Wayne State continued to badmouth Berry “and solicit negative feedback” regarding his attempt to raise the issue of racial bias in maternal health care, the lawsuit says, also alleging a movement to remove him as interim chair.
The final straw
On April 22, 2022, Berry submitted his CV to the head of the search committee that was looking to hire a permanent chair of the OB-GYN department. Berry, however, learned the search for a new chair was not active. A month later, he learned that a white colleague had applied for the job, so he again expressed interest.
“On July 6, 2022, Dean Sakr told Berry that he would not be considered for the permanent chair … (and) that their colleagues … were not willing to work with him,” the lawsuit states .
“Dean Sakr told Dr. Berry: “They don’t love you, and I don’t think they ever will.”
Then Sakr delivered Berry another blow: He was giving the job to an associate professor, while Berry was a full-time professor.
“Dean Sakr confided that his decision to appoint the other candidate was ‘not ideal,'” the lawsuit states, “but that he felt he had little choice in the matter.”
Berry now holds the title of professor of obstetrics and gynecology at Wayne State.
Lawsuit tells bigger story: Black patients not getting help for pain
Berry’s lawsuit shines a light on what medical experts have described as “a real documented phenomenon” in the health care industry: Black patients not being treated properly for pain, in part due to implicit bias.
According to a 2016 study published in the Proceedings of the National Academies of Science, half of white medical students held one or more false beliefs about Black patients’ experiences of pain. The findings also include:
- 40% of medical students endorse beliefs that Black people have “thicker skin.”
- Medical students who believe that Black patients are less sensitive to pain than white patients are less likely to treat Black patients’ pain appropriately.
- An analysis of 20 years of studies found that Black patients were 22% less likely than white patients to receive pain medication at all.
As the authors wrote in the study, There is “clear evidence that the underprescription of pain medications for Black patients is a real, documented phenomenon.”
Tresa Baldas is an award-winning courts and legal issues reporter and was awarded the 2023 Wade H. McCree Award for the Advancement of Justice by the Michigan Press Association. Contact her at tbaldas@freepress.com.
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