White Coats: Yvette Miller, MD, ABIHM: Improving Access to Health Care for All

“White Coats” is an AABB News series that interviews the experts that are transforming the fields of transfusion medicine and biotherapies. Join AABB today to read the rest of this month’s issue.

Yvette Miller, MD, ABIHM, is the American Red Cross executive medical officer for the Donor and Client Support Center, headquartered in Charlotte, N.C., where she oversees the organization’s donor eligibility determination, blood product management and donor management. Her areas of expertise include donor recruitment and retention in the Black community and meeting the transfusion needs of patients with sickle cell disease (SCD).

She is board-certified in clinical pathology and is a diplomate of the American Board of Integrative Holistic Medicine. Miller volunteered as a blood donor and CPR instructor with the American Red Cross while preparing for medical school. She has worked for the American Red Cross for more than 25 years, serving in various leadership capacities, including regional medical director and director of apheresis donor collections and clinical services for the Arizona Region. She has training in leading critical conversations on structural racism and bias, diversity, equity and inclusion and community resilience development. Her other areas of interest include donor recruitment and education in the African American community and underrepresented communities, equitable access to health care in underserved communities, and use of integrative medicine modalities in community health and wellness and for self-care.

Miller is co-chair of the Academy of Integrative Health and Medicine (AIHM) Board BIPOC Committee, which was created in June 2020 to serve as a catalyst for meaningful transformation toward racial equity in integrative health. She is also a member of the AABB Donor History Task Force and the AABB Diversity, Equity, Inclusion and Access (DEIA) Task Force.

AABB News spoke to Miller about her long-distinguished career at the American Red Cross, as well as her efforts to reduce health disparities for patients with sickle cell disease and to improve access to health care for underserved and vulnerable populations.

AABB News: What inspired you to study medicine and pursue a career in blood banking?

Miller: From an early age, I wanted to be a doctor because my mother was interested in attending nursing school. When I was thirteen, my father died of cancer. This was a painful life-changing event for me. I made the commitment then to go to medical school and perhaps do cancer research. I actually did cancer research for a year after medical school, but I quickly realized I need interaction with people.

AABB News: You have led critical conversations on health inequities and structural racism and its impact on the social determinants of health, particularly for patients with sickle cell disease (SCD). Can you talk about your efforts to reduce racial disparities in transfusion medicine and increase blood donations in the African American community?

Miller: I worked in the blood bank when I was a resident. There were two patients with SCD, a set of African American twin boys. They both had developed multiple antibodies, and it was difficult to find optimal blood products for them. I was deeply affected by that experience. From that point on, it became my mission to focus on recruitment in the African American community and advocate on behalf of patients and communities affected by SCD. SCD is the most common inherited blood disease in the United States. Although the condition affects individuals of any race, the population most affected in the U.S. are African Americans and people of African descent. Yet, until the last few years, research funding, drug treatment development and addressing health disparities and inequities affecting this population have been trailing behind other conditions that affect smaller and less diverse patient populations. The work I am most proud of is elevating the voices of Sickle Cell Warriors. Although I speak on behalf of these patients in some cases, I try to create space for Sickle Cell Warriors to speak for themselves.

AABB News: The American Red Cross launched the national sickle cell initiative in 2021 to increase blood donors in the African American community and support patients with SCD. What is the most successful strategy you have employed to recruit more donors of color?

Miller: The most successful strategy that we have employed has been engaging and partnering with respected African American organizations. These trusted organizations became our voice in the community. Organizations have seen the excellent work we have done in the community and have reached out to partner with the American Red Cross.

AABB News: Building and cultivating an inclusive blood donor pool remains a priority. How can donor recruiters diversify blood donations and engage donors from underrepresented communities?

Miller: The most important thing that recruiters can do is listen to the voices of their partners rather than approach the partner with a predetermined plan. They will tell you their needs and how to work with them to have a successful blood drive. The most valuable lesson for recruiters to learn is that if a blood drive does not meet the goal, don’t blame the partner. Many partners from underrepresented communities have not had experience hosting a blood drive, and they will likely need significant support to execute the blood drive successfully.

AABB News: Much of your work focuses on patients with SCD. What are some common misconceptions about this patient population? What barriers prevent sickle cell warriors from receiving proper treatment and quality care?

Miller: One of the most common damaging and stigmatizing misconceptions about patients with SCD is that they are just seeking drugs when they present to the ER for pain control. These patients have a disease in which the primary symptom is intense pain. When they present to the ER, they are absolutely seeking treatment for devastating pain that most of us could never imagine having. To have health care providers who are supposed to help relieve the pain and suffering of patients, to refuse to provide timely, and adequate pain control in some cases, is unconscionable.

There are many barriers to sickle cell warriors receiving proper treatment, quality care and support, including shortage of compatible blood products, lack of access to health care providers familiar with treatment protocols for SCD, shortage of health care providers to treat adult patients with SCD and difficulty accessing non-medical support services, such as transportation, childcare and in-school educational support.

AABB News: You have been with the red cross for more than 25 years. What do you find most rewarding about your work? What is your greatest accomplishment thus far?

Miller: The most rewarding part of my job is that the work that I do every day – determining donor eligibility and supporting the sickle cell initiative – saves lives. My greatest accomplishment so far is being a member of the Sickle Cell Initiative team and developing educational content for staff, donors and partners.

AABB News: As a member of the AABB Donor History Task Force, can you tell us how the changes to the donor history questionnaire and the updated FDA guidance will impact the blood community moving forward?

Miller: I believe that the FDA draft guidance, which proposes new blood donor eligibility criteria using a gender-inclusive, individual donor assessment, is a critical step toward the goal of achieving an inclusive blood donation process. The proposed changes treat all donors with respect and continue to support a safe blood supply that is readily available for patients in need. As blood collection organizations strive to be more inclusive of all communities to diversify the blood donor pool, the proposed FDA change to donor eligibility is a move in the right direction.

AABB News: What changes have surprised you the most about the field?

Miller: How quickly the FDA has made changes to donor eligibility criteria over the past five years.

AABB News: What are some common obstacles or challenges you face in your work?

Miller: Honestly, I work with a great team. If there are challenges, we work together to solve problems.

AABB News: What’s one thing most people don’t know about you?

Miller: I was an extra on the TV shows Homeland and Outcast.

AABB News: What are your favorite leisure activities outside of work?

Miller: Dancing, travel, acting and hiking.