INTERVIEW TRANSCRIPT

The following transcript is provided for the sole purpose of accessibility per the Americans with Disabilities Act (ADA). The content herein is an abridged transcription of a radio interview featuring Robert Phillips, CEO of West Oakland Health. Editing was done to shorten sections of the transcript for readability and clarity with no impact on the context of the interview. We do not claim ownership of the original content, including but not limited to any intellectual property rights. All rights, including copyright, remain with 94.1 KPFA and Hard Knock Radio.

DAVEY D / HOST:

Davey D, Hard Knock Radio, hanging out with you this afternoon. I started off the show with a news clip from a local TV station highlighting a problem that many of us have known to have long existed, but we didn’t think it existed to that extent. Quite often on the show, we’ve had discussions with physicians and health care advocates and social justice warriors to talk about disparaging health treatment that Black folks generally have to deal with when they go into hospitals. And we’ve heard all the horror stories and we know that many people have long fought to find solutions. In the newscast, as you were able to gather, we did not realize that that same discrimination was extended to doctors, themselves, physicians. And so the question comes to mind, what’s the solution? Well, here in the city of Oakland, we’ve had a solution that’s been around for almost 60 years. It is West Oakland Health. And joining us is somebody who has gone through the challenge of trying to find good health care, one that would be responsive to him as a Black man. His name is, I was going to say, Justice, but it’s Robert Phillips. I don’t know why Justice came to my mind. Justice Phillips is Robert Phillips, and he’s the new CEO. Robert, before we delve into the legacy of West Oakland Health and a new documentary that’s come out to celebrate the accomplishments of that institution, let’s dig a little bit deeper into what we just heard. In the clip, they were focusing on Sutter Health. In the conversations we’ve had on either waves, you know, you can put Kaiser in there and a bunch of other places where folks have said, I’ve gone into the doctor. I had a complaint, either one, they didn’t take me seriously. So you hear that with a lot of Black folks, you hear that with a lot of women. We’ve heard stories of people going in there with ailments and being told, well, how old are you? Well, I’m 30 years old. Well, you know, as you get older, your knees are going to start to hurt. As you get older, your breath is going to get shorter. And meanwhile, it’s really something much more serious. So the obvious question is, what is this about? Is this about money? Is this about racial animosity? Is there something else we’re missing in the equation? 

ROBERT PHILLIPS:

Well, good morning, and thank you for having me on. You know, it’s a bit about money, some not necessarily like open animosity, but, you know, some assumptions. But all that really boils down to kind of one core thing, which is, you know, culture, I would say, it doesn’t matter if it’s for profit-driven medicine, or just conventional medicine at nonprofits like Kaiser, etc., or the Stanford sort of world. It’s that, you know, these institutions, you know, really focus on medical authority and professionalization, it’s an industrial complex in and of itself. And so the practice there is one that has distance from the belief, you know, that the Black community has value and worth. And so it has, you know, a mismatch both in its cultural consistency, but also its preference for who it sees. And it doesn’t matter if you’re a patient or a professional in that institution, that institution does not see it as a practical matter for our desires, our needs, our wants, to be approached and tailored to who and what we are. And we know that that type of one-size-fits-all approach, doesn’t matter if it’s on the workforce side, or if it matters on the care side, doesn’t work. And a tailored approach is actually essential.

DAVEY D / HOST:

You said something I don’t want to go over people’s heads, which is it doesn’t really matter who you are. You know, you just said, you know, if you’re on the professional side of the doctor, if you’re on the patient side, you’re still facing these challenges of discrimination. The recent scenario involving tennis star Serena Williams shed light on the fact that you can have lots of money. You know, she has more money than any of us can dream about. And yet she almost lost her life in a hospital where the pain that she talked about with not listening to people just discriminated and dismissed. And so I guess it goes to your point about culture. And I guess the question becomes, is the culture just one that is Black people aren’t human? Is the culture just one that I guess up until the Serena Williams thing, we believe that Black people don’t so they’re not going to really be able to really pay for the care. Is it an act of folks infiltrating the medical system and as a way to attack people in a different type of way? We often heard of races joining the police force. Do we have a lot of races that get involved in the medical field where we’re at our most vulnerable and arguably our most, I won’t use ignorant, but not knowing all the ins and outs of what to expect when you go into a physician’s office? 

ROBERT PHILLIPS:

You know, it’s a couple of different factors. So one is, I’m going to say, you know, it’s the approach. There is an approach to our community that’s a one-size-fits-all approach, like I just said. So let me give you an example of what I mean. The example of, you know, a celebrity going in to get healthcare and getting treated poorly. You know, there’s an underlying approach to that, to our community that assumes that there is a monolith around who and what we are. And so I’ll give you an example of what I mean. You know, Serena Williams is a very wealthy person as well as a very well-known person. But I guarantee you that the way she is looked at when walks through that door, because of who and what she is, she is treated the same way as any other Black woman that walks through that door, simply because of what she looks like. The assumptions that are actually built in. The things that we have experienced over time, that legacy of medical discrimination, ranging from, you know, disrespectful and incompetent treatment and ethical experimentation have always been embedded in the system. And there haven’t been alternatives to that, that, you know, have really pushed on this idea that, you know, we as a community have always, always been a diversity of anyone else who makes up humanity. But the strategies that are taken towards addressing those are really about one size fits all. Usually, the strategies are about poverty, not about race. Usually, the strategies aren’t about the woman sitting in front of them, the man sitting in front of them. It’s about the assumptions that they make about them. It’s, you know, akin to the if Black corrections in medicine, like you see in EGFR, that they’ve been fighting in nephrology for a long time. So that’s one. The second is that this notion that cultural consistency is the only kind of conventional thing for folks who don’t actually look like our community is a mismatch to the approach. So we know that being culturally consistent, you know, in the medical field is called cultural concordance. And we know that community preferences are essential to improving health outcomes. And we know that the overriding concern, right, of most of the strategies regarding us don’t actually have that embedded. And so we get the treatment, the response to us that is wholly inconsistent with who and what we are and wholly inconsistent with our preference. 

DAVEY D / HOST:

That’s the voice of Robert Phillips. He’s the CEO of West Oakland Health and talking about the disparaging treatment that many of us as Black folks experience when we go into, you know, healthcare facilities in so many ways. And I think over the years, as I mentioned, we all have these stories, we all have some of them anecdotal, some of them are patterned. We could see this happening over and over again. So the question becomes, what’s the solution? And I started off by saying, well, there’s West Oakland Health. You know, there are a number of clinics that sit here in the Bay Area that have really been responsive, you know, big shout out to Emoja, you know, big shout out to, oh gosh, Dr. Noha Roots, thank you, Dr. Noha would have ran up and threw me down the stairs. Yeah, we have Roots and then of course we have West Oakland Health. Many of us when we talk about these types of clinics, we harken back to the days of the Black Panthers, who you have actually in your background if you’re on Zoom, and then starting healthcare clinics in the 60s and 70s. Let’s talk about the legacy of West Oakland Health, which has been around here 60 years. So were they born out of, you know, the Panthers desire or were they an inspiration because, you know, 60 years, so the years are give or take a few, you know, who inspired who and who was around when?

ROBERT PHILLIPS:

Yeah, so it all grew out of the same ethos. You know, we were started in 1966, officially incorporated in 1967 by four Black moms who saw themselves as the health need and 25 volunteer Black ducks, a lot of them who worked in the Panther free clinics, and came out of the same ethos says there need to be something that was organized as an alternative health care facility. And just like when you would see the Panthers talk about this or you see other, you know, Black physicians back in the day talk about this, you know, the creation of us, we weren’t a radically new idea, but we were a radical act. The idea of West Oakland, you know, came out of the same idea of the free clinics and still exists to this day out of this idea that, you know, we were crafted out a whole called by a group of West Oakland residents who decided that, you know, the West Oakland Health Center should exist to meet the health needs of the Black community. Instead, we were formed to reflect the tradition of Black institution building as a form of recourse against health inequity. And then we were matched with the Black political perspective that was emerging back then that sought to remedy the lack of good, affordable, respectable health care services for Black folks who are often relegated to unreliable health care alternatives like teaching hospitals in places that had really inexperienced staff to use us as a way to learn. And so we exist because, you know, we wanted to provide trustworthy options for the Black community, and particularly those who are at risk for the thing that we were just talking about. All that medical discrimination, all that disrespectful incompetent treatment, all that unethical experimentation, we were organized to deal with that. But the other reason why we were organized is we were imagined as an alternative to for-profit driven health care, that we were created to embody the Black community’s larger critique of medical authority and professionalization and the medical industrial complex while seeking to provide a place where we could respectfully and reliably demonstrate how you practice medicine. And we were like an experiment with a different type of health care, one where medical authority was demystified by making just regular folks, moms, pastors, folks that are Black, panoply, vital to this operation. That’s still key to what we do today. This idea where non-expert wisdom from the community was validated by medical professionals who train communities as health workers to be core parts of providing primary health care. And then the third thing is we were founded by those women and those docs as an attempt to serve as a broad base of operations just for the community. So we weren’t founded as a health care institution. We’re founded as a community institution that also provided health care. And what I mean by that is they wanted to be an organizational and administrative infrastructure for the Black community’s platform health initiatives. It was designed to serve as the hub for the community’s attention to what we now call social determinants of health, but back then we called the circumstances surrounding illness and becoming this ecumenical brick-and-mortar representation of the community social health prerogative. So we were supposed to be a space where the central, but not the sole aim was medical care. Like whatever you needed to be healthy, whatever assistance you needed socially, economically, spiritually, physically, that’s what we were supposed to be.

DAVEY D / HOST:

And that kind of answers my next question, which was looking at some of the unique challenges we face. I mean, primarily we have discrimination and the stress that it causes. And then it’s compounded by, you know, workplace conditions, you know, the real-life obstacles. You know, if you’ve all been around 60 years, you went to the heroin epidemic, you went to the crack epidemic. We now have an opioid epidemic, right? So we see the disparaging treatment with the opioid epidemic. It’s like, this is a healthcare emergency. Let’s help these poor people because a lot of it is white folks that’s been on it. But during the crack epidemic, which is actually much smaller than the opioid epidemic, it was like criminalization. And if you walked in there with a problem, you know, you didn’t get the sympathy or empathy, I should say, that is needed as I’m sure the West Oakland folks were able to kind of look deeper. Well, why do you have this in the place? What are the circumstances surrounding you having to take a substance? And then you can start dealing with it from there. Whereas, you know, that sort of questioning would be out the window, at least in many of the thoughts of us who experience walking into a hospital and they’re saying take a pill, you know, and stop drinking or stop smoking and get better. Well, that doesn’t cut it. With that being said, 2023, and you being the CEO, do you see any sort of patterns that exist, at least locally? Or do you see anything on the horizon that emerges nationally? I know, for the work that I’ve been doing, long COVID is a big issue. But I don’t know if it’s a main conversation because of all the disinformation that has gone on in our community, which kind of, you know, had people believing that this disease doesn’t even exist in some circles. So what are some of the patterns you’re seeing health-wise or challenges that we face? 

DAVEY D / HOST:

You know, it’s the patterns we’ve been seeing, not just over the last, you know, three years, right, or even 10 or 15 years. But, you know, the patterns that we’ve been seeing that have been driving this since we got here are still persistent. And so what I mean by that, I’m saying the etiology, the cause of the causes of the trends that drove the heroin epidemic, and then the crack epidemic, then the HIV AIDS epidemic, then that exacerbated what happened during COVID, and that is exacerbating that’s happening with the opioid crisis today, which still disproportionately affects the Black community. All that stuff has been existing and continues to exist today. And so here’s what I mean. The same factors that, because folks got to remember back today, you know, West Oakland was Black Oakland. And so the same displacement factors that we are experiencing today started then. Those factors are the same things that exacerbated the health inequities that we’re seeing because they also exacerbated the institutional inequities that didn’t allow us to invest in the things that would be responses to those things, right? So an example would be during the heroin epidemic, that’s when we also saw disinvestment in a lot of the institutions in the community, that they got exacerbated, the same thing happened during the crack. And the most recent example is now during COVID. So the trends we’re beginning to see are people taking a long view of understanding that one, not only is long COVID an issue, but long COVID now becomes part of the litany of chronic diseases that our community faces just over time.

DAVEY D / HOST:

Wow. 

ROBERT PHILLIPS:

And so if you look at the disparities, let’s just take Alameda County, and you look at the health conditions, and the disparities between communities in terms of who has the worst outcomes across the top 10 chronic diseases, eight of the 10 are led by the Black community. That’s an institutional structural question. And now long COVID is added to that. The other thing that is getting added to it that’s getting exacerbated just by the time is mental health and behavioral health. That is an epidemic that has always been with us, but is now exacerbated by the isolation that we experienced. So we had these things happen to us that, you know, they get compounded by history and then moments, these moments of punctuated equilibrium where they really hit us, and then we add another thing to the pile. And so there are trends coming out of it. One is, you know, realizing that at least in our community, the market models that we have haven’t really responded to. So while there’s a wonderful Kaiser and the Stanford UCSF, that’s not a market model that gets at our issues, because it really treats us like it’s a poverty issue, not a race issue. And I’m not saying the two don’t connect. I’m just saying that if you don’t recognize what’s happening to Black folks as a race issue, then you can’t ever get at anything else that you’re talking about. And we’ve seen that come out of, you know, the health issues that we’re facing around COVID. And, you know, the beginning to see maternal health rates get worse again around what we’re seeing around, you know, mental health and behavioral health, around what we’re seeing around substance abuse. The other thing we’re beginning to see out of that is, you know, a real kind of understanding that you have to have something that responds to us, that isn’t just about a healthcare intervention. Because the thing we’re talking about is, yes, there’s great healthcare institutions around here, but we still have these health inequities. And healthcare interventions alone will not improve our health outcomes if our social and political determinants of health aren’t being addressed concurrently. That’s the experience we were just talking about. 

DAVEY D / HOST:

Real talk. West Oakland Health, in many ways, fills the void. And I would imagine in some places, it’s a reimagining of healthcare in a way that we say we want, because it flies in sharp contradiction to the for-profit model, which exists, where everybody’s trying to cut corners versus getting us healthy. After being here for 60 years, are we finding that powerful entities are looking and saying, we need more of West Oakland Health, or do they see you as a threat, a reminder of what healthcare could be, and so therefore, either want to ignore you, make it very difficult, or outright shut you down? And when I, and I’m asking that question very seriously, because some people would say, well, why would anybody want to find this to be a problem? Well, let’s look at what happened when folks were walking around trying to feed the homeless. Remember how all of a sudden people came up and they were like, we’ll take you to jail. I remember it’s the name of the organization that was going around to the parks and making sure that folks who didn’t have food got food. All of a sudden, they were being hit and being arrested and the whole nine, not just here, but around the country. So it’s like, do you want these people who are starving to not starve or what’s the issue here? And so now you have these health clinics when people are like, we need to get our dividends up and all the other thing, and here you are. Not only that, you may bring to the forefront, quote unquote, I hate to use the word nontraditional medicines for us to consider. You might emphasize on prevention more than reacting and tell me how to eat differently versus giving me a pill for the ailment, those types of things. Maybe looking into traditions that are practiced by our ancestors or indigenous folks and using that as a step towards curing what we are. Well, that becomes a problem if I’m up the street trying to make money selling pills and needles and everything else. So how has the reaction been to West Oakland Health? 

ROBERT PHILLIPS:

That’s a fantastic question because it hasn’t necessarily been a disability. It has been benign neglect. So now I’ll just tell you an example of West Oakland. Our history has traced the ebbs and flows of the history of the community when there was investment and a contiguous focus from the community and then disbursement from the community and not as much interest. And then an ability to learn from those lessons to research. So West Oakland is following all that. And the focus on it is split. So the community is very, very, very clear that it wants an institution like West Oakland. And what I mean by that is, so there was a study done by the California Health Care Foundation earlier this year called Listening to Black Californians and really asked them, not only what are your experiences, what do you want? And so one of the things they asked is, given all of the institutional racism that we are facing, all of the health inequities that we’re facing, what do you think are the core responses to it as the community that would get at these questions? Over 80% of the folks said three things. They need more Black doctors and health professionals. They need more Black health leaders. They need Black health institutions that are intentionally focused on serving the Black community. So Black is very, very, very clear that it requires something that is responsive to it. Now, on the other hand, the market has an attitude. And when I say the market, I mean that broadly. Big health institutions, county health institutions, and those who are in the for-profit business have a different attitude, which is, there’s about, if you look at the nine-count barrier. So let’s just split the difference and say there are about 475,000 Black folks who reside in the nine-county Bay Area. There is a perspective that, in spite of all the legacy issues affecting the community and how prominent they are, our community is too small to matter. And we’re too small to have a market approach to what we’re doing. We’re too small, other than the special initiative approach, to actually intentionally focus on and invest in institutions that would intentionally, unapologetically, focus on not just collaborating with them, but coordinating efforts to improve the delivery of health services to the community. And that having Black-led, Black-focused, Black-serving institutions as hubs and conveners isn’t necessarily what’s needed because, you know, other folks face inequities too. Why can’t we just put you in other institutions that are trying to deal with this, that, you know, are dealing with other communities? Why do you need a singular focus on your community? So we have this, you know, these, I won’t say diametrically opposed, but I’ll say differing opinions. Where the community says one thing, but the market says another. And so what we’re finding is, you know, we’re having to, you know, take a Huey approach to what we’re doing. You know, where Huey said that, and it’s a, you know, another critique of, you know, mainstream kind of social programs in the medical care system, where, you know, there’s a contradiction between what the Black community wants and could accomplish with will and fewer resources versus what larger institutions with much are doing much less. So we’re taking this approach and really leaning into intentionally a focus on what the community has said that it wants and needs and is relying upon and is desperate for, which is an institution where it doesn’t have to search for somebody who actually understands who and what we are. Somebody who’s standing in the culture and is providing health care that actually feels like home. And I don’t mean like home, like walking to your house. I mean, home, like it wants you there and will fight for you and advocate for you.

DAVEY D / HOST:

Right. And loves you. Yes. You know, they see their family members in you as a patient, you know? And so there’s an empathy that oftentimes doesn’t exist in many places where I think they see a stereotype before they see a human being, you know? That’s right. That’s right. Robert, as we close out, West Oakland Health is being celebrated with a new documentary that’s going to be released on Giving Tuesday, the 28th of November. Talk a little bit about that. How can people see it and what does it entail? 

ROBERT PHILLIPS (37:55):

So the documentary really is, you know, a love letter to the four women who founded us and, you know, our reason for existing. So, and it is literally called a legacy of love because that’s what we are and that’s what we’re leaning into. And so they can find it on our website as well as on, and our website is WestOaklandHealth.org. And they can also find it at our YouTube channel, which you can link to through our website. And it really is a celebration of, you know, the last 60 years of who we are and really understanding what that radical act has resulted in over the last 60 years. But, you know, what, you know, four moms who had over 20 kids between them and these 25 black dogs, most of them who weren’t over 30 at the time, did, just with sheer will. Right. Who are four moms? So the four moms and I will make sure that folks see them on our website, are Cloteal Davis, and I always, I don’t want to get their names wrong, but it’s Miss Cloteal Davis, Mrs. Jessie Hamilton, Mrs. Edith Brown, and Mrs. Olivia Parks. 

DAVEY D / HOST:

There you go. Say those names again. Say their name again. 

ROBERT PHILLIPS:

Mrs. Cloteal Davis, Mrs. Jessie Hamilton, Mrs. Edith Brown, and Mrs. Olivia Parks. 

DAVEY D / HOST:

You mentioned the 25 doctors who came and helped. One of the challenges facing us right now is student debt. And for people who don’t know, let’s kind of paint a picture. So, arguably, when the 25 doctors were going to school, if they were going to the California state, California school system, you know, whether with UC or Cal State, etc., etc., they probably got to go for free or didn’t have a crazy student loan… So, you know, in those 30 years, you coming out of school and not being, as I’ve seen some colleagues, $200,000, $300,000 in debt after they got a master’s or a PhD or some sort of law degree or anything like that, means that to your point about professionalization, Robert, you know, that’s cool. You know, you want to go help at the clinic, you could do that. But I need these loans that you went to, you know, Stanford Medical School, and you owe the bank, you know, $250,000. And we need that paid back. We give you six months to get your act together, which means that you got to find an institution that can match, you know, the crazy amount of money that you’ve got to start paying back, which might be a couple of thousand dollars a month. And, you know, you might not be able to do that by volunteering or working at West Oakland Health, which means that some of the best and brightest aren’t always able to show up. Is that a challenge that you have now? 

ROBERT PHILLIPS:

So, you know, that’s a fantastic question because, you know, we are what is called a federally qualified health center, which means that given our focus on the Black community, we do have the ability to tap into a number of resources that our community usually can’t leverage. And, you know, the toughest part is just getting known by those who actually want to be a health professional, practice medicine, you know, become a public health professional, even just become an administrator professional in health. And that, you know, we have been trying to make sure that people know that, you know, we are a valuable training ground for them. It doesn’t matter if you’re a new doc, a new professional, whatever, there’s a unique opportunity to not only gain experience but get financially and professionally supported in that way. And there are just three ways. One is we do offer loan repayment assistance. That is backed by the federal government. And that, you know, as long as you commit for a certain term to serve our community, we will pay off your debts for as long as you’re here. And so we’re here to offset the school debt. And we offer that to a range of professionals that we have the ability through our partnership with our network, the Community Health Center Network, and also through the Alameda Alliance here to offer performance-based and center programs. So new docs can get, you know, support for becoming good docs. We have mentorship programs and preceptor programs, continuing education, and training opportunities. So for those who want to go on and do more than just, you know, come out of residency and just kind of jump into it, they want to go further. So there are a number of things we can offer here. You know, the hardest part has actually been educating folks that we got a lot of things you can offer here. But the most important thing we offer you that folks get, particularly if you want to rock with your community, is we offer a place for you to come here and learn how to provide care to your community in the way that you imagine. 

DAVEY D / HOST:

And that’s important. That’s real important. You know, hopefully, and hopefully people find that as an incentive. Robert Phillips, thank you for joining us. Tell everybody how they can see the documentary on West Oakland Health.

ROBERT PHILLIPS:

Yes, come to our site, WestOaklandHealth.org. The documentary is tied to the top of the website. Just click on the link. You can watch the full thing. 

DAVEY D / HOST:

There you have it. And where’s West Oakland Health again? 

ROBERT PHILLIPS:

We’re down here at 7th and Adeline. So come on, if you’re on your way to the West Oakland Bart, just stop on by and come in and see it. Come in and say hello. 

DAVEY D  / HOST:

Robert Phillips, thank you so much. We’re going to take a break on Hard Knock Radio. We’ll be right back.