While the focus recently has been on the twitter phrase, “black lives matter,” as a physician it is important to underscore the premise that all lives matter. Understandably, the amplitude of voices has increased over the past several months following the tragic deaths of unarmed black men – staunch reminders that implicit bias has had a role in shaping our country, our politics, and our hearts since the birth of our nation.
Academic medicine is certainly not exempt from such bias, with the recent perspective in the NEJM, Bias, Black Lives, and Academic Medicine, leaving the reader with an underlying sense of helplessness, considering the lack of diversity highlighted in the article.
In the article, the authors describe the staged “White Coats for Black Lives” die-ins that occurred this past December across 70 US medical schools, including the University of Pennsylvania, deliberately modeled after the recent nationwide protests. The authors highlighted the role that implicit bias serves in the care of patients and the education of our students. By understanding our own biases as it relates to others that have different perspectives, we become enlightened professionals who are better able to serve and understand the needs of others. So what is it that we as individuals can do to make a difference on a daily basis?
The underlying issues contributing to our current conversations about justice are decades old. I recall stories about my father, a Tuskegee Airman, coming home after serving in World War II not being able to enter certain businesses in New Orleans in places where German Prisoners of War were welcomed. Since the Civil Rights Act was passed in 1964, there has been greater attention paid to rectifying the inequities in our communities. Income inequality is a core contributor to this uneven playing field. Unfortunately, the socioeconomic gap among ethnic groups continues to deepen the chasm that separates segments of our society. While we are not in a position as individuals to rekindle and address the War on Poverty, we can do our part in our professional and personal lives to mitigate the socioeconomic gaps. In addition to ameliorating SES gaps, it is also important to consider the broader picture. For instance, the NEJM article highlights important data from the 2002 IOM report, which, concluded that for nearly every disease studied, black Americans received less effective care than white Americans, disparities that persisted even when matching SES and insurance status.
There has been significant effort mounted by many groups to address not only the socioeconomic challenges facing our society, but also within academic medicine there have been significant efforts to enhance diversity. Whether it is a focus on pipeline programs, targeted mentoring programs for faculty, or creating offices focused on inclusion and diversity having institutional level influence, there have been important strides to achieve even the level of diversity in academic medicine that we have today. We can do better, however, and it is now time to consider additional strategies.
Recognizing that we all have biases because of our life experiences, there are two tangible recommendations that I would like you to consider. One is to understand your contribution to an environment that is not completely inclusive. The implicit association test is one tool that is available on line that can assist you in your own journey of self-awareness. Once we know these biases then we can address them head on. Secondly, the Office of Inclusion and Diversity launched a diversity engagement survey that will determine where we are as a community in our journey toward a more inclusive environment. I encourage you to complete the survey and know that your input is critically important as we seek to understand how best to move forward. Nationally, attrition rates of faculty of color and women are higher than others. By addressing the environment in which we work, we can aim to mitigate the tension that unrecognized biases infuse into our lives. The challenges remain for us as a society but the first step is ours in making a difference.
Ansell D. A., & McDonald E. K. (2015). Bias, Black Lives, and Academic Medicine. New England Journal of Medicine. Retrieved from http://www.nejm.org/doi/pdf/10.1056/NEJMp1500832.
The Council of Economic Advisers, January 2014. The War On Poverty 50 Years Later: A Progress Report (2014). Retrieved from http://www.whitehouse.gov/sites/default/files/docs/50th_anniversary_cea_report_-_final_post_embargo.pdf