Meet Spora Health Founding Physician, Dr. Terrell Smith
We’re elated for you to get to know the values and visions of our Founding Physician, Dr. Terrell Smith, who is vital to the heart of what we do here at Spora Health. Currently a resident physician at the University of Virginia and holding a Masters in Public Health from UC Berkeley, Terrell knows the inequities of the American healthcare system intimately. Growing up, he witnessed the challenges faced by his single mother trying to care for her type 1 diabetes, and throughout his life, noticed the way his background and experiences were overlooked when seeking his own care as a black male.
Multitalented and passionate about reimagining an equitable and culturally competent healthcare system that empowers both patients and providers alike, Terrell’s contributions at Spora are vast-- from helping optimize patient and clinician experiences to creating educational tools for the Spora Institute to recruiting likeminded providers as we expand to new states; We’re so grateful to have him with us.
Join us now as we deep dive with Terrell into the what, why, and how of the vibe we’re on. Here’s to radically inclusive care and reimagining what feeling better could feel like!
If your patients were to describe you, what would they say?
“Dr. Smith is an excellent listener who has a realistic understanding of my needs as a patient.”
What gaps have you experienced in your own healthcare experience as a patient? How have these experiences informed your ideals as a provider?
Probably the biggest gap I noticed is that not a lot of doctors looked like me. As a patient, this is intimidating. When you are not well represented amongst your doctors, it feels as if your potential healthcare hardships won’t be given equal understanding. This lived experience has made it a priority for me to cater to the unique needs of every patient I see.
How, if at all, has the fact that black males represent the smallest proportions of doctors impacted your career-related decision making?
I knew from a young age that I wanted to become a health care provider. During my training, I recognized that people who looked like me were underrepresented, which ultimately drove my decision to enter primary care. There is no lack of drive for black men to become doctors, it is a matter of providing access and encouragement, which is why I hope to mentor aspiring black male doctors to help bridge this gap.
The better people are reflected by their providers, the better we’ll be equipped to improve patient experience and overall trust in healthcare.
“The better people are reflected by their providers, the better we’ll be equipped to improve patient experience and overall trust in healthcare. “
Given constant time and task pressures, what can doctors realistically do to improve the patient experience during visits?
Take time to get to know your patients outside of just their health. Those extra few minutes with each patient can feel difficult at times, but ultimately give back so much more.
Prioritizing eye contact also really helps-- even for telehealth, which can sometimes present its own set of distractions.
Ultimately, staying conscious of how you yourself would like to be treated as a patient makes these kinds of intuitive adjustments easier to remember.
As simple as it sounds, the best way to improve the patient experience is to build trust by just treating them like people.
What does a trusting relationship between a patient and provider look like?
A joint effort from both the provider and patient is key. On the provider’s end, a trusting relationship considers not only what is best for the patient medically, but what is also feasible for that individual. We need to consider our patient’s health, finances, personal interests, culture, and several other factors when engaging them. For example, the most effective prescription may be financially out of reach for some patients. In such cases, providing a cheaper yet workable alternative is what’s actually needed.
For the patient, it is important to select a provider you feel comfortable discussing your personal health matters with and whose recommendations you genuinely feel open to hearing and considering.
In your view, what qualifies as exceptional care?
When providers individualize care plans for each patient and understand that different cultures and upbringings require different treatment approaches.
My priority is to collaborate with each patient to set the kind of goals that will drive our future interactions in a meaningful and progressive way. The importance of really hearing and understanding a person is not something medicine can teach, even with all the abundant knowledge it has to offer.
It can seem burdensome, but making the initial time investment for something like motivational interviewing, not only furthers trust with patients, but ultimately keeps them in better health.
When patients feel that their provider is on their side and advocating for them from the start, they are more dedicated to improving their own health. They’ll also be more likely to trust provider recommendations. Healthier patients make for happier providers and can help mitigate provider burnout in the long run. If you go the extra mile to gain patient trust in the beginning, you will see the rewards down the road.
Spora Health provides additional training for each provider via Spora Institute. What noteworthy perspectives does the institute offer in its curriculum?
One distinct offering of the Institute comes in the form of learnings and insights from my own journey as a provider; For example, as a black male, I myself have missed the mark by assuming that I know everything about my black male patients. However, when I take a moment to remember that everyone has their own unique journey, it humbles me and allows me to become curious instead; This helps me gain more insight than I would have otherwise and makes way for creating a truly customized plan in partnership with each patient.
The fact that Spora Institute is ever-evolving is what excites me most; As we continue to discover new opportunities and insights from conversations with our providers, we’re continually creating fresh content that further empowers them to transform patient care.
In fact, our curriculum has received such positive feedback and results, that we’re now exploring possible applications for it in other industries that could benefit from creating more culturally competent systems.
“When patients feel that their provider is on their side and advocating for them from the start, they are more dedicated to improving their own health.”
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As patients, what are some ways we can be more empowered in our health journeys? How do we more fully own our desires and capacities to be well?
Understand that as a patient, your health is ultimately under your own control. While your healthcare team is there to provide you recommendations and support, at the end of the day, you get to make the final decisions about how to better your health.
Being the owner of your health journey means you should feel free to bring your own knowledge and opinions into your appointments and expect to have your perspective valued by your provider. Your input regarding your own health is extremely important.
Try to find a provider with whom you can have a balanced relationship based on trust; Collaboration is key, and you should never feel like you are being directed on what to do.
To this end, feel free to say “no” when you disagree with a provider’s recommendation— again, you are the driver of your own health; When a provider has recommendations, you can also bring some information to the table to make for a more equitable conversation.
Whenever you’re given information about your health, get online and do your own research to explore what it could mean. Also don’t take for granted how the health experiences of people in your life could benefit your understanding-- discuss any health conditions with them, too. Friends and family are very likely to have experienced health care problems and successes similar to yours.
Set realistic goals for yourself, so not to set yourself up for failure. If you set your goals too lofty, you can easily become discouraged when life doesn’t allow you the space to achieve those goals so quickly. Slow and steady wins the race.
Be open and honest about your health history, and independently gather as much of this info as you can. Sharing your personal and family histories can help providers better understand your health risks and offer care tailored to your unique body and needs.
Overall, the more you know and communicate about your own health and what works for you personally, the better your provider can understand and pursue the kind of approaches that are best suited for you.
“Demonstrating compassionate and effective care for the black community, the population with the worst outcomes, can powerfully signal to other overlooked groups that healthcare might finally be safe for them to trust, too.”
Why is it particularly salient to begin with the black community when working to shift towards culturally competent care models?
The healthcare system’s uniquely pervasive mistreatment of and disregard for black people is part of a legacy with deep roots tracing back to American slavery. In part due to this systemic inequity, black folks tend to have the worst health outcomes. And so rightfully, the black community is a very skeptical population to treat-- one for whom trust must be carefully and gradually re-earned.
As we advance culturally competent care for black folks, there will be a knock-on effect. Demonstrating compassionate and effective care for the black community, the population with the worst outcomes, can powerfully signal to other overlooked groups that healthcare might finally be safe for them to trust, too.
In this way, and with continual expansions of the Spora Institute curriculum tailored to various BIPOC communities (we’re currently creating course material to help providers better serve the Latinx community), we can progressively help even the quality of care for all.
What can patients do to help advocate for and participate in creating a more equitable healthcare system?
While change has to come from many different parties, the voices of BIPOC patients are critically needed to help highlight the shortcomings of healthcare.
Be your own biggest advocate. It can be overwhelming dealing with providers, insurances, hospitals, pharmacies, and more. However, you the patient are the one at the center of all these touchpoints-- the nucleus of the healthcare system. And so, it’s only by more patients advocating for themselves that we can bring greater attention to the web of issues in this complex system and begin to turn the tides.
When you do have success, share the wealth, and tell others about how you were able to succeed with your health and within the healthcare system. Fostering a collaborative community is key to making healthcare more equitable. And I know we’ve got what it takes here. Our communities are strong and resourceful, often due to necessity borne of inequity. Together, we can help create some big changes by advocating for ourselves and supporting one another.
Don’t underestimate the value of taking the conversation beyond your immediate circles. Get on social media and talk about the successes and pitfalls you notice with your healthcare experience there, too.
And of course, get out and vote.
As a leader in the equitable care movement, how do you suggest that values-aligned providers join you in realizing this vision?
The healthcare system has mistreated communities of color and overlooked their cultural needs as far back as I can remember. As providers, we can be educated about these discrepancies in healthcare and prioritize creating individualized plans for these patients.
Providers also need to work to regain the trust of their BIPOC patients. Even though this generation may have not been the ones who lost that trust, we can be the ones who regain it.
Creating an equitable healthcare system will not be easy, but this new era of providers (myself included) can help usher in a new way of caring for our patients.
“Creating an equitable healthcare system will not be easy, but this new era of providers (myself included) can help usher in a new way of caring for our patients.”
How would an ideal healthcare experience feel for both patient and provider?
As a patient, I want to go into my appointments feeling I can trust inherently that I will be treated individually, fairly, and equally. No matter the color of my skin, my cultural background, religion, political affiliation, etc.
For providers, it feels amazing when you know that your patient is there to work with you and trust your judgement. And it’s palpable when the patient knows that the trust goes both ways; It means something when a patient feels comfortable bringing their own ideas to the table.
Though it might not be the first thought to cross people’s minds-- like patients, providers also want to be treated fairly and equitably, regardless of their background. We also want to be seen as individuals with merit. When you feel respected and valued as a provider, you’re freer to focus on why you’re in the room in the first place-- the joy of practicing good medicine.
Helming a movement can be challenging, draining, and sometimes discouraging; how do you maintain your dedication to your goals?
I keep in focus the world I want to see. The light at the end of the tunnel keeps me going.
An equitable healthcare system where I can be a provider of color comfortable with my job, but also a patient comfortable maneuvering the intricacies of healthcare, from providers to insurance companies to pharmacies to research trials and more.
I also keep a good work life balance, continuing to enjoy hobbies like hiking, watching Netflix, engaging in my community, attending sporting events, and spending time with my friends and family. As providers, we need to remember that we are people, too. It takes a happy, healthy, empathetic, and level-headed provider to help our patients feel well.
Ultimately, trusting that I can affect massive change, one step at a time, is what continues to drive me forward to each next step. My first steps involved becoming educated enough to understand the problem. And in this next phase with Spora, my task now is to support others in taking the needed actions to put this transformation into motion. It’s going to happen.
“I keep in focus the world I want to see. The light at the end of the tunnel keeps me going”
Tell us about your best healthcare experience as a patient. What made the experience so special, memorable, and valuable?
As a medical student, I regularly experienced headaches and went to student health to try to figure out why. I was told that it was likely stress due to medical school and that I just needed to drink more water and relax when possible.
After unsuccessful visits with several providers, a nurse practitioner I met with decided to take some time to deep dive into my medical and family history. Upon doing so, she noticed that my blood pressure was high compared to my normal personal baseline. Combined with my family history of high blood pressure and my increased risk for high BP as a black male, she counseled me that I should check my blood pressure more regularly, alter my diet, and do more cardio exercise like running.
Her time and consideration were game changers, not only in making my headaches go away, but also for increasing my trust and confidence in her recommendations and her ability to care for me as a patient. Her attention to detail was very appreciated.
To this day, I keep an eye on my blood pressure and keep it well controlled with exercise and diet-- so it’s fair to say that this nurse practitioner’s insights have changed my life for the better.
Important to note, however, is that had she not explicitly stated that I was already at risk for higher blood pressure as a black male, I may have continued to play off my headaches as regular medical school stress. Her mention of my unique risk factor was not racist, but instead took my whole person into consideration
Perhaps the most poignant part? I myself knew that I was at higher risk, but somehow still fell into going along with what the other providers were saying and kind of ignored my own self-knowing. It took that nurse practitioner going the extra mile and tailoring her diagnosis and recommendations specifically to me, to help me really appreciate the importance of actively participating in my own care and bringing my own self-understanding into the conversation.
What's been the most transformative insight of your medical career so far?
Each patient’s journey and story is so unique. I have been privileged enough to treat wealthy patients, patients who have been incarcerated, athletes, young adults, the elderly, babies, and so many others.
Every time I get to learn more about someone, it further educates me on how best to help others in the community around me, and even myself.
While this profession can be taxing a lot of the time, I still believe that at the end of the day, I chose the most satisfying career field for me; I love that every day is a unique experience and I cannot imagine living any other way.
Find More From Dr. Smith:
In the Washington Post talking on how to improve seasonal affective disorder
Speaking on how to prevent premature againg on Yahoo
Feature in Eat This, Not That taking about cautions when using asprin pre-emptively
Everything you need to know about asthma via Parade magazine
The 4 Stages Of A Cold & What To Expect From Each via Mind Body Green
