| Daily Briefing

Why racism is a health care issue—and how to address it

On the Radio Advisory podcast, host Rachel Woods spoke with Micha'le Simmons, research lead with Advisory Board's HR Advancement Center and leader of the firm's People of Color Affinity Group, and Darby Sullivan, a consultant with Advisory Board's Health Care Advisory Board who focuses on health equity, about how health care executives can help address systemic racism not only in their communities, but in their own organizations as well.

Addressing racism: Resources for health care leaders

Read a lightly edited excerpt from the interview below, and download the episode for the full conversation.

Rachel (Rae) Woods: What can health care leaders do to directly support the efforts of their community? Maybe particularly, if they are in one of the communities that has seen a surge of protests right now.

Micha'le Simmons: Health care organizations right now need to be part of the conversation. Your community, your employees, are looking for you to make an explicit stand against racism. If you do not, they are going to view your silence as complicity with all of the things that are happen in our society today.

Darby Sullivan: Well, notably the [American Medical Association] made a statement recently that specifically called out the need to end police brutality as a public health mandate and also embedded it within the historical context of American racism. This is not the third rail anymore. You can also be part of this conversation.

Simmons: And one thing I'll note as health care organizations make statements is to not rely on the Chief Human Resource Officer or the Chief Diversity Officer as the one to make the statement. This should be coming from the CEO. I'd also encourage white leaders to make their voices heard and say that they stand against racism. If the messages continue to just come from people of color, we won't be able to make progress on racism.

Woods: And I think it is really important to push all health care leaders to be an active part of the conversation. Like you said Darby, it's not the third rail anymore. It's time to step in. I'm wondering if you could tell me a little bit more about what leaders can do to actually improve things moving forward.

Sullivan: When I think about moves a provider organization can make right now, number one I think about: supporting your patients who are choosing to protest. So, what this looks like is making sure they can make these choices safely. If you have extra PPE, masks, hand sanitizer, donate them to activist organizations who are organizing these protests. This is actually something that is really crucial for provider organizations to do to prevent the further spread of Covid-19 in communities of color, specifically in black communities, which we know are more at risk. Some of your staff also may be interested in participating, so sending clinical support on the front lines to help people who maybe have respiratory problems that have been exacerbated because of pepper spray, for instance.

Woods: I don't know about the two of you, but I'm certainly getting questions from executives right now who are not just asking about how they can support their community, but also how they can support their own people, right? Their own employees, physicians, and staff. I'm curious, what else can leaders do to support their physicians, their employees, and their staff right now?

Simmons: That's incredibly important. You really don't want to be investing all of this in the community and then not be doing the work internally for your own staff at a time when they are already pretty burnt out from the pandemic. So, a few things I'd highlight would be, one: be courageous enough to have internal conversations about what is going on. I think the worse thing we can do is ignore it and not create a space for people to either grieve if they need to grieve, or to talk about, "What are the actions that we want to take as allies that are going to help us combat racism in our communities?"

Secondly, if you happen to have employee resource groups and you have one that is dedicated to people of color or to black employees, ask them, "What is the support that you need from us right now?" Whether that is a day off or freeing up some of their time so they can focus on processing things emotionally. I would note, please do not ask for those staff to be leaders of the solution in dismantling the racism that they face. That is a really tall order and is not their responsibility.

Woods: And, I'm very mindful of the fact that there is a spotlight on racial injustice right now, but I am curious, what are some of the long-term steps that organizations can take to dismantle some of this structural racism, maybe even after the protests have stopped?

Sullivan: There are a number of antiracist actions that provider organizations have already been taking. The first one is providing the relevant anchor institution in your community. So, when I say anchor institution, I am referring to organizations that have realized they are the major employer in their community and that they can take real steps, make real business decisions, to uplift the economic outcomes that they see.

That encompasses things like paying all of your staff a living wage, making sure you create career pathways for local students to enter your organization, also, to provide entry level staff a pathway to become clinical staff. It also looks like being really strategic about the business investments you are making and who you partner with for your supply chain needs and contracting with local women of color and businesses whenever possible. And also, we are seeing a number of social impact loan efforts to support community-led investments. So, that is the anchor role.

Organizations can also play the advocate role. And this looks like using your traditional, governmental, or policies affairs arm, and instead of using it just for reimbursement rates, looking at how you can advocate for policies or legislation that impacts the health of your local community and health equity.

Simmons: I want to add health care organizations also should be investing in the leadership in people of color. A lot of times, we don't see enough people of color serving as leaders within health care organizations, and this is going to require us to look at our own internal policies around promotion, around how we evaluate talent, how we invest in talent, and whether or not we actually have succession management in place. It's a long road ahead, but so that overtime, we can see more representation in our senior leadership ranks.

Woods: I mentioned at the outset that we would be leaning into conversations that would be keeping executives up at night. And, in an honest moment, I think there are a lot of leaders, in particular white leaders, who are feeling uncomfortable right now. Micha'le, can you give some advice directly to them and help them avoid the ways that this could go potentially wrong.

Simmons: I am not a white person, so I can't imagine the discomfort of being white in this moment and not having all of the right words to talk about race and racism. But I'd assure leaders that your employees, your community, would rather you be humble, be vulnerable, and realize, you don't have all of the answers, but to hear you make a statement anyway.

And, I think in terms of your question about where this could go wrong, do not just send an email and expect that to be your action. That is the first step that you are taking in a series of actions to help address racism in your community, whether that is donating to local organizations that are doing antiracist work, volunteering your time, or educating yourself. There are a lot of other steps you can take, and you should be vocal with your organization about some of the things you are doing.

Sullivan: And as a white person, maybe it's appropriate for me to offer some advice, which is, we are going to make mistakes. This is not going to be easy for us. We don't know everything about this. So, what we need to do is take the lens of cultural humility and understand that we are not going to have all the answers, but we are going to have this growth mindset. We are going to enter knowing that we are not going to be perfect, and we have to continuously reassess our intentions, the impact of our work, and keep trying to be better.

Simmons: I think as leaders, we would be calling on all of you to not prioritize your own comfort over black lives. And also, the national attention is on this issue right now. What are you going to do when the national attention moves on to the next issue? To the next tragedy? Are you going to continue the work and are you going to hold the rest of the executive team and your senior leadership accountable to doing it on an ongoing basis?

Woods: Well, Micha'le, Darby, I want to thank you so much for coming on Radio Advisory, particularly in kind of a tough moment with literally helicopters flying overhead here in the District of Columbia. I want to offer you each a couple of final moments to give some advice to the health care leaders right now. Those ones who are wondering, what can I do and how do I know if I am doing enough. Micha'le, why don't we start with you?

Simmons: I would ask that we all question some misconceptions that we might have about, "What does it mean to me to be an inclusive leader?" Because many of us have this belief that, "I'm not biased, I'm not racist." We don't want to be labeled that way because we feel like we are good people. We get defensive when people say that we are racist. We don't want people to perceive us as discriminatory. And the truth is, for the most part, I believe that we are all intending to be good people and that we are not intending to do harm to anyone.

But if we are honest with ourselves, our intentions do not matter as much as the impact of our actions. And so, realize that this belief that, "I'm not biased, I'm not racist" is an excuse that we can hide behind. And when we do that, we are not taking responsibility for our actions. So, to move past that, we need to accept that being biased does not make you a bad person, it means that you are a human. And what makes us great people is not about being right or being free of bias, it's having the humility to own that you are biased and looking for ways to interrupt those biases.

Woods: Darby, what about you?

Sullivan: I think my message would be that this is the time for white people to step up. As Micha'le mentioned, we are not going to end racism or police violence without white people standing in solidarity with people of color who are leading this movement. I think we have to say that Black Lives Matter, explicitly. We have to take a lot of time to educate ourselves, to read materials, really foundational materials. It's time for us, once we feel equipped with an understanding of institutional racism, with an understanding of police violence, to bring our information and our knowledge to our communities because we are the communities that need education.

Simmons: Rae, can I add one more thing?

Woods: Go for it.

Simmons: If your mission as a health care organization is to deliver patient-centered, high-quality care, we cannot deliver on this mission unless we address racism.






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