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Diversifying Clinical Research in the Deep South

Photograph of Dr. Belinda Savage-Edwards wearing a white coat, with arms crossed, smiling into the camera.

“I have never, and will never, be intimidated to be the only Black woman in any room.”  

Ten active. Three completed. Two observational.  

That’s how many clinical trials Dr. Belinda Savage-Edwards, a Huntsville, Alabama-based neurologist, specializing in headaches and neuromuscular disease is leading as a Principal Investigator (PI). Along with her research team which consists of a clinical research consultant, two research coordinators, and two research assistants, they are setting the bar high for clinical research.  

“There is a huge diversity gap in clinical trials for PIs of color,” she said, as she described her recent participation in National Medical Fellowships’ Diversity in Clinical Trial Research Program (NMF Dctr). With only 5% of physicians in the United States being black and less than 2.2% being Black women, Black PIs are significantly underrepresented. Equally alarming is that only 7% of clinical trial participants are Black people. Dr. Savage-Edwards said it’s programs like NMF Dctr that are crucial to addressing these issues – and offering hope for the future by developing more PIs of color.   

“To whom much is given, much is required and anything worth having, is worth working for. “

Dr. Belinda Savage-Edwards

“That is my mantra and what keeps me going. I did not expect the journey to medicine to be easy and from the start, was ready to put in the hard work required to become the best physician and researcher that I could be, she added. Being a physician was just too important to me.” 

Dr. Savage-Edwards grew accustomed to a lack of diversity when she chose to study physiology at Michigan State University, a predominately white institution, after attending predominantly Black schools all her life. 

“As a result of my upbringing, I have never, and will never, be intimidated to be the only Black woman in any room,” she said.  

Dr. Savage-Edwards earned her medical degree from the University of Pittsburgh School of Medicine. She then completed her neurology residency at Henry Ford Hospital – a specialty which continues to be male-dominated and with less than 100 Black women neurologists in the country.  

“I love the field of neurology because it is a cognitive specialty and one where I must listen to my patients because they have all the answers. I have to put the pieces of the puzzle together and come up with a diagnosis and treatment plan,” Dr. Savage-Edwards said. 

Upon completion of her residency and neuromuscular fellowship, Dr. Savage-Edwards went into private practice alongside her husband, Dr. Ted Edwards, a physiatrist specializing in interventional pain medicine. They have been in practice together for over 25 years. “I can’t imagine working any other way,” she said. Today, their company, Rehabilitation and Neurological Services, has more than 20 employees, including a physician assistant, a physical therapist, nurse practitioners, and a research team. 

Along her career journey, Dr. Savage-Edwards initially worked as a neurology consultant at East Carolina Neurology in Greenville, North Carolina, before moving to McAlester, OK where she was on staff at McAlester Regional Health Center. There, she was instrumental in implementing brain death and acute stroke protocols. She also played a key role in assisting the hospital gain continued medical education accreditation. Dr. Savage-Edwards and her husband eventually moved their practice to Huntsville, AL, where she has practiced for the past twenty years.  

In addition to patient care, Dr. Savage-Edwards is passionate about clinical research and recognizes how it has helped reinvent and sustain her private practice without the need to join a hospital system or lose ownership of her company to a private equity firm.  

“Yes – physicians are still one of the highest paying careers– but solely seeing patients does not fully pay the bills these days given declining reimbursements and the higher cost for goods and services,” she said. “Furthermore, neurology is a cognitive specialty, and we are reimbursed at a lower rate than procedure-oriented specialties.  

“For example, my husband, as an interventionalist, is reimbursed up to four-times the amount that I am for an injection that takes less than an hour versus the hour or more that I spend examining, diagnosing, and creating a treatment plan for a neurology patient.” 

“I had to look outside of traditional medicine to discover how to work smarter and not harder. In other words, I had to be innovative in bringing additional funds into my practice while continuing to follow my passion of service and being a servant leader.” 

Dr. Savage-Edwards was first introduced to clinical research by a fellow female neurologist of color who worked for a pharmaceutical company. “I was invited to review an industry sponsored clinical trial and a site visit was scheduled,” she said. “The monitor was pleasantly surprised at the amount of building space I had available, in addition to the ancillary services that were offered at my site.  Thankfully, as a result, we were selected for our first clinical trial. Since that initial trial, my site has received several accolades. For one, Rehabilitation and Neurological Services was recognized as being one of the highest enrolling sites for one of our pediatric clinical trials and was asked to share our best practices on an international call.” 

“Although I am an adult neurologist, I consistently am able to recruit pediatric subjects because of the pipeline I established early in my research journey with the pediatric neurologists and pediatricians in town,” Dr. Savage-Edwards said. “Being both a high enrolling site and a PI enrolling more subjects of color, put me on the radar of many more trial sponsors and ultimately, paved the way for more clinical trial opportunities to come my way.” 

Since Dr. Savage-Edwards did not have formal training as a PI. She wanted to increase her overall confidence and knowledge as a principal investigator.   

“Until that time, most of my clinical trial experience was in the form of on-the-job training. Through another female neurologist of color who had completed the NMF Dctr program, I learned about the National Medical Fellowships’ Diversity in Clinical Trial Research Program. This program is a high level, immersive program aimed at training physicians to become Principal Investigators. The program was invaluable and is sustainable, in that it did not end with just a certificate. It continues to offer mentorship, follow up routine Zoom meetings and a wealth of information to further my growth and development as an expert PI.   

Dr. Belinda Savage-Edwards

It is well known that medical mistrust exists, and patients are more comfortable with health care providers who look like them. Therefore, PIs of color are more likely to enroll a higher percentage of clinical trial participants of color which increases the likelihood that advertised efficacy and side effects of new medications include those experienced by all people, including those of color, thus the need for the NMF Dctr program. Finally, Dr. Savage-Edwards is giving back to the NMF Dctr program by serving as a Health Equity Ambassador which allows her to be a voice in raising awareness about health disparities and advance health equity.