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Anti-racism has become a hot topic, but also a needlessly confusing and even taboo one. Dr. Kozman and Dr. Gaines hear from internist Dr. Ryan Mire about what anti-racism means in healthcare education and how to bring about needed change in our learning and work environments.
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Show Notes
Learning Objectives:
Take-Home Point:
[00:00] Introduction- Intro to co-hosts and episode
[0:52] Introduction to Guest
- Internist Dr. Ryan Mire
[02:23] Step in Their Shoes Segment
- Flexing cultural humility muscles
- Ryan’s response regarding his love for music
[06:00] Anti-racism in Medicine
- Events in 2020 have made anti-racism a more known and discussed topic, especially anti-racism in medicine
[06:42] Definition of Anti-racism and Anti-racist, and applying those terms to healthcare and education
- Action-oriented (awareness and cultural humility) vs. being static
- Identifying and changing the values, structures, policies, and behaviors that foster racism
- Healthcare stakeholders actively acting to break down the walls and barriers that affect racial and ethnic populations and under-represented minority medical students and physicians in the workplace
[10:50] Examples of how healthcare has failed to address or even promoted racism in healthcare
- Race is not a biological construct, which is where medical education has failed
- Late 1800s, many false perceptions regarding race that were published in scientific journals even though there was no actual evidence backing the claims
- False perceptions still hold today
- Flexner Report and Tuskegee Syphilis Experiment
- GFR calculation different between white and black patients
[21:12] Current anti-racist changes in medical school curricula and healthcare centers
- Some individual institutions are removing race from GFR equation
- Medical institutions need to be comfortable being uncomfortable
- Commitment to Diversity, Equity, and Inclusion through leadership, implicit bias training, task force and mentorship programs.
- Shoutout to medical students and health professional students for leading these anti-racist changes in their institutions
- Institutions need to stop putting the burden on the underrepresented faculty member to eliminate racism in healthcare (minority tax); everyone must be engaged
[33:35] Advice to the individual for making their learning environment/work place more anti-racist
- Be self-aware, have cultural humility
- Try to learn from the other person's point of view through discussions and conversations
- Show your allyship through actions instead of words
- Call out anti-racist behavior, even though it can seem very daunting
[39:17] Things in healthcare that are giving Dr. Mire hope, and further changes he would like to see
- Younger generation of students and trainees who are proactively challenging racist concepts, creating conversations at the institutional level
- There has been resistance to change, but institutions and professional societies have to be bold and start to change medical algorithms. Some are starting to make nationwide changes instead of just individual institution-level changes.
- Incorporating social determinants of health into the medical curriculum cannot be a “one-and-done” process
- More people are speaking out; racism is everyone’s problem
[48:01] Resources listeners can check out
- Article in Journal of General Internal Medicine about the potential clinical implications of racism (see resource list)
[49:55] Closing remarks
[51:40] Continue conversation online
- Twitter and Instagram @TheDEIShift
- Check out our website at https://www.thedeishift.com/
[52:22] Blooper
Resources
In the order they are mentioned in the episode:
Credits:
Co-hosts/Producers: Dr. Maggie Kozman, Dr. DJ Gaines
Executive Producer: Dr. Tammy Lin
Co-Executive Producers: Dr. Pooja Jaeel, Dr. Tiffany Leung
Senior Producer: Dr. DJ Gaines, Dr. Maggie Kozman
Editor: Joanna Jain
Production Assistants: Ann Truong, Likitha Arudhyala
Website/Art design: Ann Truong
Music: Chris Dingman
Disclaimer: The DEI Shift podcast and its guest provide general information and entertainment, but not medical advice. Before making any changes to your medical treatment or execution of your treatment plan, please consult with your doctor or personal medical team. Reference to any specific product or entity does not constitute an endorsement or recommendation by The DEI Shift. The views expressed by guests are their own, and their appearance on the podcast does not imply an endorsement of them or any entity they represent. Views and opinions expressed by The DEI Shift team are those of each individual, and do not necessarily reflect the views or opinions of The DEI Shift team and its guests, employers, sponsors, or organizations we are affiliated with.
Season 2 of The DEI Shift podcast is proudly sponsored by the American Medical Association's Joan F. Giambalvo Fund for the Advancement of Women and the American College of Physicians Southern California Region III Chapter.
The DEI Shift theme music is by Chris Dingman. Learn more at www.chrisdingman.com.
Contact us: thedeishift@gmail.com, @thedeishift, thedeishift.com
- Define the terms anti-racism and anti-racist.
- Give 3 examples of how current healthcare training fails to address, or contributes to, racism and race-based medicine.
- List anti-racist changes being implemented in healthcare institutions.
- Adopt strategies for changing one’s learning/workplace environment to become more anti-racist.
Take-Home Point:
- Being anti-racist is not about who you are; it’s about what you do.
[00:00] Introduction- Intro to co-hosts and episode
[0:52] Introduction to Guest
- Internist Dr. Ryan Mire
[02:23] Step in Their Shoes Segment
- Flexing cultural humility muscles
- Ryan’s response regarding his love for music
[06:00] Anti-racism in Medicine
- Events in 2020 have made anti-racism a more known and discussed topic, especially anti-racism in medicine
[06:42] Definition of Anti-racism and Anti-racist, and applying those terms to healthcare and education
- Action-oriented (awareness and cultural humility) vs. being static
- Identifying and changing the values, structures, policies, and behaviors that foster racism
- Healthcare stakeholders actively acting to break down the walls and barriers that affect racial and ethnic populations and under-represented minority medical students and physicians in the workplace
[10:50] Examples of how healthcare has failed to address or even promoted racism in healthcare
- Race is not a biological construct, which is where medical education has failed
- Late 1800s, many false perceptions regarding race that were published in scientific journals even though there was no actual evidence backing the claims
- False perceptions still hold today
- Flexner Report and Tuskegee Syphilis Experiment
- GFR calculation different between white and black patients
[21:12] Current anti-racist changes in medical school curricula and healthcare centers
- Some individual institutions are removing race from GFR equation
- Medical institutions need to be comfortable being uncomfortable
- Commitment to Diversity, Equity, and Inclusion through leadership, implicit bias training, task force and mentorship programs.
- Shoutout to medical students and health professional students for leading these anti-racist changes in their institutions
- Institutions need to stop putting the burden on the underrepresented faculty member to eliminate racism in healthcare (minority tax); everyone must be engaged
[33:35] Advice to the individual for making their learning environment/work place more anti-racist
- Be self-aware, have cultural humility
- Try to learn from the other person's point of view through discussions and conversations
- Show your allyship through actions instead of words
- Call out anti-racist behavior, even though it can seem very daunting
[39:17] Things in healthcare that are giving Dr. Mire hope, and further changes he would like to see
- Younger generation of students and trainees who are proactively challenging racist concepts, creating conversations at the institutional level
- There has been resistance to change, but institutions and professional societies have to be bold and start to change medical algorithms. Some are starting to make nationwide changes instead of just individual institution-level changes.
- Incorporating social determinants of health into the medical curriculum cannot be a “one-and-done” process
- More people are speaking out; racism is everyone’s problem
[48:01] Resources listeners can check out
- Article in Journal of General Internal Medicine about the potential clinical implications of racism (see resource list)
[49:55] Closing remarks
[51:40] Continue conversation online
- Twitter and Instagram @TheDEIShift
- Check out our website at https://www.thedeishift.com/
[52:22] Blooper
Resources
In the order they are mentioned in the episode:
- Vyas DA, Eisenstein LG, Jones DS. Hidden in Plain Sight — Reconsidering the Use of Race Correction in Clinical Algorithms. New England Journal of Medicine. Aug 27, 2020.
- Cerdena JP, Plaisime MV, Tsai J. From race-based to race-conscious medicine: how anti-racist uprisings call us to act. The Lancet. Oct 10, 2020.
- Washington, HA. Medical Apartheid: The Dark History of Medical Experimentatin on Black Americans from Colonial Times to the Present.
- Modern-Day Hippocrates: Incoming School of Medicine Students Write Their Own Oath. University of Pittsburgh School of Medicine. Sept 2020.
- Mukwende M, Tamony P, Turner M. Mind the Gap - A Handbook of Clinical Signs in Black and Brown Skin. June 2020.
- Stone V. White Coats for Black Lives: The Time Has Come for Action | Annals of Internal Medicine. Opinion Piece. Oct 20, 2020.
- Cowan AN. Inappropriate Behavior by Patients Iand Their Families—Call It Out. JAMA Internal Medicine. Opinion Piece. Nov 2018. (Addressing Microaggressions)
- Ahmed S, Nutt CT, Eneanya ND, Reese PP, Sivashanker K, Morse M, Sequest T, Mendu ML. Examining the Potential Impact of Race Multiplier Utilization in Estimated Glomerular Filtration Rate Calculation on African-American Care Outcomes. Springer. Oct 15, 2020.
- Gutierrez, KJ. The Performance of “Antiracism” Curricula. New England Journal of Medicine. Opinion Piece. Sept 10, 2020.
Credits:
Co-hosts/Producers: Dr. Maggie Kozman, Dr. DJ Gaines
Executive Producer: Dr. Tammy Lin
Co-Executive Producers: Dr. Pooja Jaeel, Dr. Tiffany Leung
Senior Producer: Dr. DJ Gaines, Dr. Maggie Kozman
Editor: Joanna Jain
Production Assistants: Ann Truong, Likitha Arudhyala
Website/Art design: Ann Truong
Music: Chris Dingman
Disclaimer: The DEI Shift podcast and its guest provide general information and entertainment, but not medical advice. Before making any changes to your medical treatment or execution of your treatment plan, please consult with your doctor or personal medical team. Reference to any specific product or entity does not constitute an endorsement or recommendation by The DEI Shift. The views expressed by guests are their own, and their appearance on the podcast does not imply an endorsement of them or any entity they represent. Views and opinions expressed by The DEI Shift team are those of each individual, and do not necessarily reflect the views or opinions of The DEI Shift team and its guests, employers, sponsors, or organizations we are affiliated with.
Season 2 of The DEI Shift podcast is proudly sponsored by the American Medical Association's Joan F. Giambalvo Fund for the Advancement of Women and the American College of Physicians Southern California Region III Chapter.
The DEI Shift theme music is by Chris Dingman. Learn more at www.chrisdingman.com.
Contact us: thedeishift@gmail.com, @thedeishift, thedeishift.com
