Meet Dr. Monica Hahn, physician merging activism and medicine

Years ago, Dr. Monica Hahn thought she’d be more likely to end up protesting in the streets than seeing patients in an exam room. Now an assistant professor in the Department of Family & Community Medicine, Hahn is the daughter of Korean immigrants and the first person in her family to go to medical school. She grew up with a deep understanding of how factors like income, race and immigration status impact health equity. She pursued her education in Ethnic Studies and critical race theory and was active in the community, organizing around racial justice and criminal justice reform. She loved biology and thought about being a doctor, but just didn’t see how it fit her trajectory as an activist.

That changed when she started working as a sex educator and teen counselor at Asian Health Services Youth Program in Oakland. She learned more about how the Black power and civil rights movements led to the community health center movement. She understood their medical activism as part of movements toward liberation that she wanted to be a part of. “This all makes sense,” she recalls thinking. “My love for biology and my passion for social justice could actually be merged.”

Her habit of agitating against unjust power structures only grew. She went to public health school, studying reproductive justice in immigrant communities of color and learning more about HIV prevention and treatment. In medical school, she spoke up when she saw problematic aspects of what they were taught. As she gained more leverage moving up to resident and then faculty, she felt a responsibility to use that power to make change for her patients, colleagues and community.

To fight for equity on the structural level, Dr. Hahn collaborates with a group of other doctors to help root out centuries of racism that are baked into medical practice. “I’m trying to bring an anti-racist perspective into medicine, which is hard because medicine’s very roots are steeped in racism.” Certain practices within medicine are based on the flawed notion that there’s a genetic basis for race, despite all evidence to the contrary. One example is the estimated glomerular filtration rate (GFR) test that measures kidney function. It has traditionally been reported with two values, with the numbers “adjusted up” for Black patients. Supposedly race-based differences in this test can likely be attributed to higher muscle mass, yet labs use race as a proxy. Putting the focus on race rather than actual biological differences can have serious consequences for Black patients, like delaying referral to a kidney specialist or placement on a transplant list.

Changing the way people have been practicing medicine for decades isn’t easy, but the group scored their first big victory last year when Zuckerberg San Francisco General Hospital became only the 2^nd hospital system in the nation to stop reporting race in these kidney function tests. They’ve already heard from other hospitals inspired by the work they’re doing and eager to replicate it. That test is just one on a long list, but Dr. Hahn and her colleagues aren’t slowing down any time soon.

Where Dr. Hahn’s work feels most rewarding is the direct way she can impact her patients’ lives. She remembers in her early years as a trainee, meeting a patient from Ethiopia who came to the Family Health Center HIV Clinic; she and her husband were both living with HIV. Everywhere she went, she had been told that it was impossible to start a family, that she could never have a safe pregnancy and it would be selfish of her to have kids. “It gave me so much joy to be able to tell her that was all wrong, you absolutely can have children if that’s your dream. We can make that happen.” Dr. Hahn has cared for her through pregnancies at HIVE Clinic and now still sees them and their two healthy children when they come to the Family Health Center HIV Clinic, where she now serves as co-director and teaches Family Medicine residents to become family-oriented HIV primary care providers. The ability to counteract stigma and support her patients’ goals reaffirms why she became a family doctor.

What matters to Dr. Hahn is hearing from her mentees or patients that she made a difference in their development or health. Combining her clinical practice, mentoring and anti-racist organizing, her work touches a lot of people. She says, “I hope I’m remembered for the small things I did for a lot of people.” The impact of these efforts is hardly small. Transforming lives through compassionate HIV care and mentoring the next generation of anti-racist physicians will reverberate in years to come. Dr. Hahn is committed to honoring the resistance that birthed innovations like HIV medicine and using medicine as a vehicle for social justice. “In the spirit of advocates who have come before us, I feel it’s our duty to dismantle structurally oppressive policies in medicine and medical education. We owe it to the communities we provide care for, to honor and center their experiences and healing while striving for the goal of actualizing health equity.”