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Learn how Dr. Harold Freeman’s personal experiences have shaped his remarkable career in medicine—and find out how his tennis game is these days.
You played tennis as a youth. How did this shape the person you are today?
Freeman: I started playing tennis at the age of five. Actually, my parents met on the tennis court—so I owe a lot to tennis.
The discipline that came with trying to perfect tennis strokes as a little boy has been lifelong for me, and spread to many other areas of my life. I learned the idea of fairness and good sportsmanship—doing what you can to win without taking anything from others.
How did growing up in segregated Washington, D.C. shape your personal and professional interests?
Freeman: It led me to become a person who did not accept social injustice, no matter how it was being applied—race, sex or anything else.
It was because of my personal background that I concentrated on cancer in the poor. After training to a very high level as a cancer surgeon, I selected to work in Harlem.
What was different about the situations of the cancer patients you were seeing in Harlem?
Freeman: I found that many of the women with breast cancer that I was treating in Harlem were coming in very, very late. Sometimes coming in with ulcerated masses for the first visit.
This was a turning point for me. I had trained at a high level and thought I could come into Harlem and make a real difference—to symbolically cut cancer out of Harlem.
Yet when I faced this population, I knew that the technology know-how that I had developed as a well-trained surgeon was often not the answer there.
How did this interest in the influence of race and poverty on cancer care drive your career?
Freeman: Before I became president of the American Cancer Society, I led a study that focused on cancer and the poor. The real question was, what was driving high cancer death rates? Is it poverty or race? We found that divergent outcomes between black and white cancer patients were driven by economic status and poverty.
The report research and findings crystalized what I had learned in Harlem about the existence of barriers in the healthcare system and led to the concept of patient navigation, which I launched in Harlem in 1990.
What is one of the biggest challenges facing cancer care today?
Freeman: It is wonderful that we have put so much funding and research into the discovery process—and I’m glad to have been a part of that.
But discovery is not a magic bullet. Delivery is crucial too. Not everyone has access to what’s being discovered. There are so many complex racial, economic and cultural influences on the “why’s” behind this, but we have to think about this too.
What role does technology play for the population you have served—and in the future of medicine?
Freeman: I have a great belief in technology. The frustration is that technology is too late for some populations. In order to solve healthcare problems in America, we need to increase our technology, and we are doing that.
What insights led to the development of patient navigation?
Freeman: I learned that you have to deal with the world as it is. You have to ask yourself what’s the best thing you can do under the circumstances you are in. Patient navigation developed from this way of thinking. Without saying you have to change the whole health care system, we first had to find a way to get women access to mammography as both a screening and diagnostic tool.
We also had to find a better way for patients to move through from abnormal findings to resolution in a very complex healthcare system. So the patient navigator is a relatively simple, low-cost way of doing this—to rapidly move from abnormal findings to diagnosis and treatment. It was about rethinking the delivery of care knowing that we could not change the whole system.
I think of the movement through the continuum of care as a mile relay. The navigators are the team of runners, and the baton is the patient. You can’t drop the baton. And the race is not over until the patient is done with treatment.
What is the best advice you have ever gotten?
Freeman: Be true to yourself and you can’t be untrue to any others. Be honest in how you see things. Stay your course and be true to what you believe in.
Who are your personal heroes and what influence have they had on you?
Freeman: Albert Einstein is definitely a hero of mine. I have spent a lot of time reading about him.
He taught us that: “What you see depends on where you stand.” He was talking about cosmology, but this is such a profound statement. If you see things through a different lens, you may see things differently. That is a powerful perspective that I try to apply to my own life.
To learn more about how patient navigators help patients through financial, logistical, emotional, cultural and communications barriers, read Simple Solutions to Complex Problems: How Patient Navigation Brings the Human Touch to Healthcare.
April 9, 2014
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