Buchi Neita, PA-C, gives us tips from her lecture, The Art of Connection: Building Meaningful Rapport with Skin of Color Patients, at the 2nd Annual Elevate-Derm Alliance Summer Conference at the Grand Hyatt Deer Valley in Park City, Utah.

In this video

In conversation with Shannon Marante, PA-C, Neita traces the barriers that can stand between clinicians and their skin of color patients. She points to the historical mistrust rooted in the Tuskegee experiments and Holmesburg prison — events from just a generation ago that resurfaced during COVID vaccine hesitancy — and to patient experience, noting the data that patients of color are less likely to be offered isotretinoin for acne or biologics for atopic dermatitis and psoriasis. She also unpacks the difference between explicit bias ("overt racism") and the far more common implicit bias, which "we all have in some capacity" and which quietly shapes the care clinicians give. Rather than assigning guilt, she urges providers to "take a look in the mirror," dig deeper, and do better.

With dermatology being one of the least diverse specialties — Neita is among the roughly 1.6% of Black dermatology PAs — she stresses that patient-provider concordance improves outcomes, so every clinician of every background must learn to diagnose and treat skin of color well. She offers concrete ways to connect: make the effort to pronounce a patient's name (and type it phonetically in the chart), use virtual interpreters when language and dialect differ, find common ground, listen actively for what actually bothers the patient, show empathy, mind body language by sitting down and making eye contact, and always "ask before you touch," especially with textured hair. And because erythema may read as purple and findings can be subtle, a meticulous, detailed exam is essential.

  • Historical mistrust is real and current — the Tuskegee and Holmesburg experiments happened within the last 75 years and still shape how patients of color engage with the healthcare system.
  • Know the difference: explicit bias is overt racism, but implicit bias is more common, affects everyone, and changes the care you give — recognize yours without guilt and dig deeper.
  • Undertreatment is documented — patients of color are less likely to be offered isotretinoin for acne or biologics for atopic dermatitis and psoriasis.
  • Small gestures build rapport: learn to pronounce the patient's name, use virtual interpreters for language and dialect, find common ground, sit down, make eye contact, and ask before touching textured hair.
  • There's "no excuse" not to educate yourself — use skin of color textbooks (like Susan Taylor's), conferences, webinars, and podcasts to sharpen diagnosis of subtle findings, since erythema may look purple in darker skin.