Department of Pathology Updates - Vol 2.1

Teammates,

Welcome to a new edition of DOP Updates (PDF Version), an email that I haven’t sent in nearly 6 months.  Not sure why I stopped.  Mostly self-talk convincing myself that lack of time driven by competing demands was explanation enough.  And yet people far busier than I always find the time to do the things that matter most, whether it be exercise, time with friends and family, or sharing information with teammates (none of which anyone would characterize as my strengths).

In the end I stopped because I was uncertain the problem that writing it solved.

Last week I was privileged to participate in a series of conversations and experiences that allowed me to reflect more deeply on the gap between our current state and who we aspire to be when it comes to diversity, equity and inclusion (DEI).  It followed closely on the heels of a two and a half day intensive training seminar in which members of our Patients and Families Advisory Council (PFAC) were riveted by opportunities to build mutually beneficial, collaborative partnerships with patients and families who look to us for answers.  These experiences served to balm the ennui that has settled into our national – and my personal – psyche following an election that divided rather than united us, with plenty of blame to go around whether you celebrate or grieve the outcome.

This weekend I paused to reflect on previous editions of Updates and pondered whether it could serve as a vehicle to spark substantive conversations that might otherwise go untended.   Conversation that unite rather than divide us.  I started by reading the last edition sent on June 24, 2016 (see attached, DOPUpdatesVol1.10_2016.06.24.pdf), 12 days after Omar Mateen killed 49 people and wounded 53 others in an attack on a gay nightclub in Orlando, FL.  Since sending it I have focused too much on the discomfort it caused for some, and too little on the emails sent by others who spoke to the importance of the conversation. Emails like the following.

“I hope another hippie movement will arise with love for all etc. What else could counteract so much violence that has built for so long except a voice that speaks against it?”

“This is of great importance to me personally as I am raising three multi-racial children in a world that is becoming, unfortunately, less tolerant of those deemed not like the rest.“

“everyone deserves to be treated fairly, no one is better or worse than anyone else. “

“I appreciate you opening our eyes and making us think about difficult things we tend to forget in our safe little worlds where we only think of ourselves.”

“As a member of the Department of Pathology and the LGBT community.  Thank you!”

“‘Today I fear we’ve made little progress and instead are at risk of losing what little ground we may have gained.’ Truer words have not been spoken.”

“It brings to mind the conversation we had regarding Carl Sagan’s ‘The Pale Blue Dot’ and realizing that the Earth is where we make our stand and that it is our responsibility to deal more kindly with one another. But what kind of stand will we make?”

“What can any one person do to affect the kind of change to live in a world where ‘we’ live together devoid of ‘them’? What can I do to help the world see that it is ‘us’ and not ‘us and them’?”

“It is such a disgrace that hate is being carried on in a new ways even though our society has been removing the layers for generations.”

“It is definitely a  good feeling  to know that the Leadership Team here at University of Michigan Hospital and Health Systems cares about different  social issues.”

“. . . would you mind if I shared this with my brother?”

“Living in Ann Arbor, we are often shielded from the reality of how far our nation (and world) has to come in reaching equality in the way we think about, and treat, the LGBT community. Though we have a long road ahead, I’m glad that Ann Arbor and UMHS allows a platform to express support for the LGBT community and to educate people who, for whatever the reason, are uncomfortable with the notion of love in all forms.”

“thank you for addressing this topic head on”

THANK YOU to all who joined the conversation, whether in emails, in hallways, at water coolers and coffee pots, with co-workers and colleagues, or with significant others, sisters, brothers, mothers, fathers, daughters, sons, and cousins whether once, twice or three times removed.  Perhaps the time is right to return to Updates with the hope that it sparks conversations important to our common welfare.  It is time to feed the better wolf of Native American lore; the Good wolf who lives in each of us modeling peace, serenity, kindness, generosity and compassion.

Diversity, equity and inclusion (DEI)

As many (all?) of you may know, in October President Schlissel launched a 5-year strategic plan to create a more vibrant, diverse and inclusive campus based on the conviction that excellence – making the leap from the merely good to truly GREAT – is not possible without diversity in all of its dimensions.

We often speak about diversity and equity in the very important dimensions of gender, race, ethnicity, religion and sexuality/gender identity, but as important as these are they are not the whole story when it comes to the power of diversity, equity and inclusion as an overarching strategy.  This also extends to those who may have traveled a road foreign to those of us from privileged backgrounds; scrappers who forge personal journeys to success despite the barriers that confront them.  Scrappers achieve their goals despite the barriers through resilience, tenacity, and creativity of the sort never demanded from the rest of us.  Embracing diversity means challenging our own comfort zones when we recruit new staff, trainees, faculty and leaders confident in the incontrovertible evidence that diversity is fundamental to achieving our greatest capacity for creativity and innovation.

Learning to work with those who are different from us while holding firm on those things that define our values at our core is key to doing better tomorrow what we may already do well today.  Diversity is defined differently by each of us; one speaker in a short (just over a minute) UMich YouTube clip described it as, “different ways of seeing and understanding and different ways of thinking.”  A commitment to diversity, equity and inclusion is not some sort of “feel good” strategy du jour – it is a strategy fundamental to the survival of our brand as the place that others look to when imagining excellence in the care we provide to others, in educating those who will care for us, and in the discoveries that will shape our future!

Angela Wu leads our own departmental DEI committee comprising 13 staff and faculty from CP, AP and research who are dedicated to understanding the sorts of countermeasures that might bridge the gap between where we stand today and where we wish to be when it comes to diversity, equity and inclusion.  Their charge is to determine our current state including any challenges to DEI in our department, and to brainstorm innovative ways to address our challenges. In the language of Lean principles, job #1 is to deeply understand the problem that they/we are trying to solve and only then to respond with iterative experiments in the spirit of P-D-C-A recognizing that, “plans are useless, but planning is indispensable” (Dwight D. Eisenhower on preparing for battle).

Last week Angela met with our Chair, Chuck Parkos, and our two Vice Chairs, Kathy Cho and me, to share excerpts of a survey intended to help us understand our current state.  The results were interesting and included some things to celebrate and others that require more inquiry and attention.  What is clear is that we have work to do to get to a place in which all feel welcome, valued, and heard when it comes to the ways in which we realize the rewards from working together to achieve excellence in all that we do.

In conversations that followed I learned a lot about opportunities that I myself have missed when it comes to raising the bar on issues of diversity, equity and inclusion.  To some extent these missed opportunities reflect my own naïve assumptions about what it means to be different in our work place.  I reflected on just over a decade of recruiting to anatomic pathology and overlapping divisions, a decade in which we recruited 44 faculty to 29 incremental positions.  Half (22) were graduates of our own training program.  Under half (19 or 43%) were women.  Eight (62%) of those recruited to leadership roles (i.e. section/service chiefs, laboratory and program directors, or above) were women, and of those half (4) were from our training programs.  Out of these conversations and reflections have percolated ideas regarding the ways in which we recruit to all levels of our organization whether they be high level leadership roles or the technologists and administrative assistants who more than any others tend to the needs of those who look to us as providers, educators and scientists.

We also had conversations regarding ideas bubbling through our DEI Committee about ways in which to share and hear the stories of those who are different from ourselves, stories to help us better understand things that we might otherwise miss from our positions and perspectives of privilege. I was shocked at some of what I learned last week.  Collectively we need to know – all of us really need to understand – those things to which we’ve not yet been sensitized when it comes to the work that remains in getting us to our vision of diversity, equity and inclusion.

Our DEI committee is also working with our web team to have a dedicated web page to keep all of us in the loop when it comes to our DEI strategy and what it will require from YOU.  And participation is not optional!  Like quality and safety, DEI is the way in which we work and is an expectation for all who have a place on this team.  Opting out doesn’t make you a bad person, but it may mean you are in the wrong place.

So stay tuned to announcements and communications coming from our DEI committee and others.  At the end of the day we will not be judged by what we say but what we do.  And should we do nothing we will never achieve our full capacity for creativity and innovation to transform the experience of those for whom we care and those who offer it.  In a quote traditionally attributed to Mayo Angelou by some and Carl Buehner by others, “They may forget what you said – but they will never forget how you made them feel.”

Thanks for tuning in.  Next week we’ll tackle that inspirational seminar I mentioned in the intro.  Until then please send me a note if you have something to share.  In the meantime, let’s continue to be careful out there . . .

— Jeff