A black female medical professional and a black female adult patient discuss medical information in a health-care setting

“A little bit of background about myself,” begins Diana Cejas, M.D., MPH: “I am a cancer survivor and a stroke survivor. It took me five years before I was able to get a correct diagnosis.”

Diana is an assistant professor of neurology at the University of North Carolina School of Medicine, and co-chair of the PCORI Advisory Panel on Healthcare Delivery and Disparities Research (HDDR). She is a clinician, a researcher, an educator — and also, of course, a patient.

Before her cancer diagnosis, Diana had known for a long time that she was in need of care but had trouble finding a healthcare team who would listen to her. “It was always talked up to me being anxious, or it was nothing to worry about; it's just a little infection, you're going to be fine.”

               Diana Cejas, M.D., MPH

After quite a bit of convincing from Diana, one of her physicians agreed to do an additional scan. This finally resulted in Diana’s cancer diagnosis.

Diana had a full cancer workup and several surgeries, and during the course of her treatment she experienced a stroke. Two years later, after finishing her pediatric training and her Master of Public Health degree, she returned to work as a neurology trainee.

While working on the consult service for adult medicine, Diana met a patient who, like herself, was a young Black woman and had also made multiple trips to multiple physician's offices trying to get care. And much like Diana, this patient had been consistently told: it was nothing to worry about. She was just a little anxious. “You could tell that she was really trying to advocate for herself,” says Diana, “but not getting very far.”

The patient was a bit distressed when Diana did her physical exam. “I really, genuinely thought that there was something that was going on and we just weren't finding it,” says Diana. Finally, due to a lot of persuasion from Diana, the team brought in the patient for evaluation. They found that she had a neurological condition beyond her symptoms of anxiety.

“I just kept thinking after that moment,” Diana shares, “How many times did this woman have to try to get care for herself? What would her care be like if someone had listened to her in the first place?” Diana felt a link between this patient’s story and her own. “How many times did I have to go to the physician before someone started to take me seriously?”

The interaction with this patient and the way it echoed Diana’s own story fueled her interest in patient experience. Today, Diana’s research focuses on improving quality of care for young disabled and chronically ill people, particularly Black and Latino/a individuals, and improving their physicians’ communication with them. She is faculty at the Carolina Institute for Developmental Disabilities and is a tireless advocate for patients. PCORI’s focus on patient inclusion and empowerment inspired Diana to apply to become an HDDR Advisory Panel member in 2022, after being nominated by a mentor, and in 2023 she was nominated co-chair of the panel.

“There has been a little bit more acknowledgment and realization about how the historical influences of racism, ableism and other forms of discrimination are embedded into our healthcare system and the way we practice,” Diana says. But still, she is resolute: “We could be doing a lot better in our healthcare system to support people.” Her work in patient-centered care is an important step along the way.

Diana Cejas’ remarks were given during a breakout session at the 2022 PCORI Annual Meeting.

Posted: October 2, 2023

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