Where is there opposition to DEI roles?
The main pushback to DEI practices has come from Republican-led legislatures across nine states. In Florida, Gov. Ron DeSantis’ (R) Stop WOKE Act — which bans diversity, equity and inclusion efforts in higher education and public offices — forced health systems to alter their professional development curriculum and trainings on unconscious bias and cultural competency.
Additionally, medical boards in states including Louisiana and California have faced lawsuits over requirements to hire people of color and mandates for physicians to study implicit bias and health inequities as part of their continuing medical education. Last year, attorneys general in seven states sued the Health and Human Services Department over its allowance of anti-racism plans as eligible improvement activities for the Centers for Medicare and Medicaid Services’ Merit-based Incentive Payment System.
How are health systems responding to pushback?
Some facilities’ DEI offices have been disbanded as a result of backlash — in Florida and Texas in particular—and others have toned down messaging around diversity-focused roles, said Kathryn Sugerman, leader of the global healthcare services practice at Spencer Stuart, an executive search firm.
“There’s a lot of concern from coast to coast about how to frame [these roles] in a way that doesn't lose the importance of the work, but also meets the changing legislative requirements that are coming out now,” Sugerman said.
The backlash, coupled with a lack of long-term funding for DEI work, has caused chief diversity officers nationwide to lose their jobs, said Dru Bhattacharya, the former chief diversity, equity and inclusion officer at Banner Health, based in Phoenix.
“I’ve had colleagues across the nation who have reached out to me for support and guidance as they consider whether to stay in the DEI space or pivot,” he said.
Health systems with long-standing, established DEI programs are continuing their work. In some cases, diversity leaders are working under new titles or department names, said Carlos Cubia, executive vice president and chief inclusion, equity, diversity and sustainability officer for Corewell Health.
“I don’t think the work is ever going to go away,” Cubia said. “But how we talk about the work needs to evolve, because there’s advocates for this work and there’s critics of this work.”
Are health systems still hiring for these roles?
While there are still job postings for roles like chief diversity officer, many health systems are shifting their focus to recruiting those with experience in health equity work.
The industry’s demand for health equity workers has been on the rise since CMS, the National Committee for Quality Assurance and the Joint Commission required providers to stratify certain quality data by race and ethnicity and implement strategies to improve community well-being, Lewis said.
Some former DEI leaders shifted to take on roles in the health equity space, Bhattacharya said.
“We’re starting to see more of that movement in recognizing that DEI and health equity are intertwined,” he said. “There’s not just one home that a future leader can lead from in this space anymore.”
What makes for a successful DEI program?
Health systems with support from executives and board members have generally held onto their diversity leaders and made progress on initiatives promoting inclusivity and respect.
DEI programs and employees need to work collaboratively with all departments, said Dr. David Ansell, senior vice president for community health equity at Rush University Medical Center in Chicago. This takes significant investment from senior leaders and prioritization of the work, he said.
Diversity leaders should sit on teams with other senior executives and be involved with other areas of operation at their health system like patient safety and quality, Ansell said.
DEI teams also need enough staff, especially at larger organizations, said Arianne Dowdell, vice president and chief diversity equity and inclusion officer for Houston Methodist.
“Burnout is something that DEI folks don't talk about enough,” Dowdell said. “That’s where the issue is, more than anything, just underestimating how much manpower it takes to do good work.”
Houston Methodist has a 10-person DEI team that spearheads education and recruitment subcommittees, oversees grant funding and conducts data analyses of demographic trends in hiring, she said. The team is responsible for managing health equity grant funding as well.
Above all, leaders in the DEI space must have a clear vision of what they want to do for an organization and how to get there, Cubia said.
“DEI really thrives within organizations that have educated the workforce on what it is they’re trying to accomplish and are reporting on the progress made,” he said.
