Diversity Community Conversation

Marc Nivet, Ed. D.
Chief Diversity Officer, AAMC
April 4, 2011

Now is a rare moment in time to think critically…adding inclusion piece instead of just tolerance…
Innovation in health care delivery

Diversity 3.0
Put diversity into the strategic plan…

• All diversity should mean is differences…define broadly
• Culture of inclusion
• Fuel that animates and makes use of diversity is organizational performance improvement.
• Have to be innovative
• Does diversity and inclusion accelerate the path to excellence? YES
• Previously we were limited to symbolic frame
• Social justice, the right thing to do was why we wanted diversity
• Now, can we ask a different question?
• Can we harness diversity to improve our work outcomes?
• Need metrics and capacity
• Leadership capacity

“Changing the face of medicine”…demographic changes only…not the outcome we really care about
Beyond race and ethnicity now

Lagging indicator…improving the health of the country

• Broad determinants of health
• Broadening what we think about as health
• Looking at the science of delivery and community engagement…the full spectrum

Scott Page…The Difference
An economist…research of putting different people in groups…leading to a better cognitive outcome despite initial troubles of engagement in small group

Symbolism is important – don’t ignore those prior goals – but do more

• What to do?
• Question why we are passive recipients of what comes to us….
• Think of the supply chain not just a pipeline…supply chain management
• (Importance of algebra in the 7th grade)
• Though we won’t be rewarded for that work directly, it will improve outcomes

Admissions work….there is a line whether written down or not…consider holistic interviews after the cut (for example, 24-34 on MCAT all become graduates – could we benefit from more 20s than 30’s?)

• Measure of an excellent institution to take lower and make great
• We fool ourselves into calling ourselves excellent when what enters is excellent…we are measuring the wrong thing
• We should try to recruit who has the capacity to be an excellent physician….not who can get out of our schools

• Meet our mission…customize who we take beyond scores
• Celebrate different successes – best in breed
• Meeting their mission should be viewed as fantastic (ex: Morehouse vs. Stanford, very different goals, both can be superb based on success achieving their goals)

• Processing is the goal of medical education…taking complex information
• Regurgitating information is not going to work
• Try to assess who can think

Problems posed to groups..teaming to solve a problem, invitational rhetoric

• Comparing to state population..is that a reasonable goal, too low, too high?
• Population parity doesn’t hold in supreme court decision with Michigan
• Not a goal
• Merely population parity is the mindset of racial concordance…AA patients need AA doctors….that doesn’t make sense
• Done with best intentions but doesn’t make sense
• Limits the argument of differences
• Team based sciences literature shows diversity helps

Qualitative difference we are trying to prove occurs….

Vibrancy is a goal

• Improve the atmosphere for faculty diversity
• Instead of recruitment and retention move to “attraction and thriving” – how do we attract people and make sure they thrive
• Gas mask phenomenon…we give people skills to function in a toxic environment. Instead, fix the toxicity so you don’t need a gas mask.
• Climate survey – usually shows minorities to be unhappy because they are not inoculated
• Should do a culture survey….why do you feel what you feel
• “You remind me of me 20 years ago”….leads to academic career…the importance of role models
• Think about it early in their career
• Problem of role models that say “don’t do what I do”
• Become more proactive in recruiting faculty earlier