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A Virtual Conversation with Harold P. Freeman, M.D. — The Origin and Effects of Patient Navigation
October 27, 2023
In part one of this series, Harold P. Freeman, M.D., is introduced by Massey's Sr. Director for Global Cancer Health Equity & Partnerships, Emmanuel A. Taylor, M.Sc., DrPH; and Massey director and Lipman Chair in Oncology, Robert A. Winn, M.D., who also serves as the Director of the Alliance (National Program Office). Stay tuned for more from Dr. Freeman as he discusses the disconnect between discovery and delivery, and putting navigation into practice.
Identifying a need for patient navigation
Largely known as the ‘father of patient navigation,’ Harold P. Freeman, M.D., has had a longstanding career advocating for and advancing access to equitable health care. In the late 1960s, Freeman was beginning his career as a surgical oncologist at Harlem Hospital in New York City following his residency at Memorial Sloan Kettering Cancer Center. Despite his training and expert skills, Freeman quickly realized that he could not just cut cancer out of Harlem – a foreign concept to a surgeon. Throughout this series, Freeman shares his first-hand experience as a pioneer in patient navigation and an advocate for those facing a late-stage diagnosis.
As skilled as I was, I couldn't cut cancer out of the poor black community because another invasion had taken place – an invasion of poverty and racism, which displayed itself in that community highly. – Harold P. Freeman, M.D.
During the 1960’s poverty and racism were part of the societal landscape across the country, including Harlem. Freeman details his own experience growing up in segregation, which informed his desire to better understand and to serve others experiencing inequities, particularly when accessing timely care. As head of the breast cancer clinic at the Harlem Hospital, Freeman recognized a number of the women who were coming to his clinic had visible lumps in their breasts, tumors large enough to see with his own eyes. He later became the Director of Surgery at the Harlem Hospital. Freeman took it upon himself to not only understand why these patients were coming in so late, but to learn from the people themselves. He listened – and learned – what was preventing his patients from getting the care they needed, regardless of their race or socioeconomic status.
While the term ‘social drivers of health’ wasn’t introduced until much later, many of the challenges faced by Freeman’s patients in Harlem are still true today – economic instability, lack of insurance, living conditions. In the late 1970’s, Freeman had set up a free clinic in Harlem, offering no-cost cancer screenings every Saturday morning. The clinic served as a springboard for what would later become Freeman’s patient navigation framework, which is still used today in hospitals and cancer centers across the U.S. and through national initiatives like the Alliance.
Explore part 2 of this series as Dr. Freeman discusses the disconnect between discovery and delivery, and putting navigation into practice.
Written by: Jennifer Drummond