INTRO COMMENTS: Hello, this is Modern Healthcare’s Next Up, a podcast for emerging healthcare leaders. I’m your host, Kadesha Smith, CEO of CareContent, a digital content strategy agency for healthcare organizations.
It has been a tough week. We are in the midst of two crises — the COVID-19 pandemic and the civil unrest stemming from the deaths of Ahmaud Arbery, Breonna Taylor, and most recently, George Floyd. The civil unrest in recent weeks has led to thousands of arrests and continued anger and frustrations over systemic racism seemingly embedded into our nation. Both of these crises highlight the need to address disparities in healthcare and throughout our society.
So, how can emerging leaders equip themselves to fix problems that have gone on for centuries? Veteran healthcare strategist, Dr. Carladenise Edwards, has some ideas. She’s Henry Ford healthcare’s new senior vice president and chief strategy officer. She’s coming from 4 and ½ years as executive vice president and chief strategy officer at Providence St. Joseph Health system, one of the nation’s largest health systems. Now, let’s hear Dr. Carladenise Edwards' thoughts on how emerging leaders can lead during two crises.
MODERN HEALTHCARE: Hello, Dr. Carladenise Edwards. Thank you so much for joining us. How are you?
DR. CARLADESNISE EDWARDS: I am well, thank you.
MODERN HEALTHCARE: It has been a tough last couple of weeks, to say the least. Before we get into our discussion, I just want to highlight a couple of key data points about what we know regarding these two concurrent crises.
One, is that nationally, we know that the COVID-19 pandemic has disproportionately affected Black Americans. You’re going to Detroit soon — in July, I believe. So, I found some data about Detroit that about 40% of the people who’ve been killed by coronavirus in Michigan so far are Black — even though they're only 14% of the population.
EDWARDS: Correct. Those numbers are consistent in the cities across the United States — an overrepresentation of African Americans and Hispanics.
MODERN HEALTHCARE: And some of the reasoning being offered for this is that many Black Americans are essential workers. So, they’re at more risk because they’re going out of their house every day and interfacing with other people and potentially bringing the virus back home where they’re more likely to live in multigenerational households. There might be a senior person living with that essential worker that is also more at risk. And then there’s also a higher prevalence of chronic conditions, which make you even more susceptible to complications from the COVID-19 virus. That’s what we know about one crisis.
Then, on the other hand, we have this crisis that has resulted in civil unrest regarding law enforcement practices against Black Americans. We know that of the 1,098 people killed by police in 2019, Black people were 24% — despite being only about 13% of the population. And so, our goal today is to really help leaders navigate these two concurrent crises, especially those who have large Black patient populations and are looking at their own institution saying, “Okay, what can I do?” What are the three conversations that you think senior leaders should be initiating with their teams, with their communities right now? And who should they be talking to?
EDWARDS:The very first thing that comes to mind is for the leadership to be courageous. And to actually ask individuals how they’re doing and how they’re feeling, and sit around and wait for the answer. And to be prepared for the answer not to be the typical, “I’m fine.” And the person receiving the question to be courageous enough to answer it authentically. It takes a lot of energy and intentionality to actually ask the question and wait for an authentic answer, and then to be willing to give it.
Given all of that, what do you need? What resources are needed in order to support you during this feeling of angst, anxiety, turmoil, maybe even depression? I don’t want to go to fixing it, I want to go to addressing it — because it’s part of a natural process of healing, which is to actually feel and experience the pain. I think what we typically do as leaders is we want to jump to the solution. And so my recommendation is first, identify that there’s a problem. Second, is to acknowledge that there is a problem and to work with one another to kind of ease through the pain. Not mask it, not hide it, not try to fix it, but allow a time and space for that grief. If it’s a leader saying, “Hey, do you want to take some time off? I know it seems weird to take time off in the middle of a pandemic.” Or is it, you know, can we talk about — is there some way we can create a support group or way in which we’re talking to one another more frequently on a social basis?
So, to summarize, one, ask the question. Two is, listen to the answer, and acknowledge the pain. And then three, move into action. I think that number two step is often missed.
MODERN HEALTHCARE: Yeah. Have a conversation and listen. That seems so simple, but I think with the current climate, it may be hard to hear some of the answers they get back.
EDWARDS: People don’t want to hear that their colleague, their friend is having some issues or concerns, or is in pain. And as an African American leader, I know. I mask it every day. That’s the only reason they let me in the boardroom!
MODERN HEALTHCARE: Wow. So, I’m on LinkedIn a lot because that’s where — that’s about as close as we can all get to happy hour, sometimes. And I’ve seen others in this space — in the healthcare space — say, “Yeah, you know, I really appreciate that my CEO did this,” or “I really appreciate this gesture.” What have been some of the more impressive steps that you’ve seen senior leaders in healthcare take to show genuine support?
EDWARDS: I have been incredibly impressed by the leaders — White and Black — who have been authentic in their experience and how they’re feeling. It’s going to be difficult for me to say this and people believe it’s actually true, but I think Wright Lassiter’s statement was probably one of the best that I read. It was authentic, it was his voice, it was his experience, and it ended with a true commitment to ensure he addressed — the thing I just talked about — was the pain. He actually acknowledged that they were not perfect in his organization. None of the other statements did that. All of the other statements touted all the great things they were doing. If they were doing all those great things, we wouldn’t be in this crisis.
MODERN HEALTHCARE: You know, we’re seeing companies release statements, healthcare organizations talk about their commitment to diversity, but here’s some very sobering information about the state of diversity in healthcare leadership. This data is from 2015, which is the most recent that’s available, from a June 6th Modern Healthcare story written by Steven Ross Johnson. And he reported that minority groups combined made up to approximately 37% percent of the US population, that they account for just 14% of hospital board members in 2015. And about 11% of executive leadership and most of those executive leaders are diversity officers. Now, we hope that, that has changed when new data comes out, hopefully soon. But, as you talk about how, you know, you’ve seen people take action steps to make those changes, what can healthcare organizations do to make good on these statements about diversity? So, you’ve done the asking the question, you’ve listened, clearly leadership is an important part of this. What should healthcare organizations do if they look around their board and their executive leadership, and say, “We don’t have people that reflect our community?”
EDWARDS: I have mixed feelings about this. I have witnessed organizations that have done a phenomenal job of hand-picking the rainbow and ensuring that they fill in the diversity grid. And you can do that, I think that’s one step. I think that’s necessary, is to be intentional about making sure that the individuals on the board and the executive team are representative of diverse opinions, viewpoints, and experiences. And they also represent the people in the communities that you serve — or want to serve — and should want to do that at a global level. Which means you need to be exceptionally diverse in how your leadership is represented. My concern is that some organizations think once they’ve filled in the grid, they’re done. So, that’s the diversity step.
The next step is actual inclusion, where now that you’ve brought the people into the organization or you’ve given them a seat at the table, are you taking the right steps for them to be included and to actually feel included? Because your perception as the Other of someone being included might be, “Well, we gave them a seat at the table.” The person at the table may not feel welcome or in a position where they can be their authentic self. Or can speak up for the issues that are important to drive the diverse dialogue that’s needed. Because they're afraid that if they say that, they may not be invited back. Yes, do the grid, and be very intentional in making sure that you have the representative voices at the board level and the executive level. But step two is making sure that now you’ve invited them, you’ve welcomed them, and they feel included.
And the way that works is by engaging, going back to my very first statement. Asking the question — knowing that something traumatic happened in the community, let’s say the night before — and not starting the board meeting or the executive meeting without acknowledging that traumatic event. It doesn’t have to take over the entire business of the day. But, there should be a certain level of sensitivity to what happened and not assume that the only person who’s concerned about it is the African American person sitting at the table. You could have a Caucasian person who’s in an interracial relationship or has biracial children. You could have somebody who came from a war-torn country or society or civilization who has post-traumatic stress from their experience back home. And so I think it’s not assuming it’s just a Black person's problem or issue. So now, “Oh well, we have a Black person at the table — check the box.” Or, “Okay, I asked the Black person how they’re feeling — check the box.” It is actually wanting to include in your dialogue the conversations about race, inequity, violence, injustice. So that the decisions that you make at that table can actually be part of the solution as opposed to exacerbating the problem.
MODERN HEALTHCARE: Couple more questions just to wrap up. You’re transitioning to Henry Ford Health System in a few weeks. I’m sure that whenever you go into an organization, you'll notice some blind spots that the leadership has. What heads up would you give healthcare leaders about their blind spots around diversity, inclusion, and equity, and then just supporting their current team members?
EDWARDS: As an African American, I have been the token Black person, the person in the corner office, the person who needed to be in the meeting or in the room. Sometimes, people are imminently clear and they tell me, “I just needed a Black person, so I called you.” And other times, they try to convince you they really want you for your skills and your experience, what you bring, and they really weren’t integrous. So, my advice to my folks — to people who look like me, who are descendants of slavery in America, or who have brown or black skin — is be cautious. Don’t always trust. Verify their authenticity. If they are very authentic and very clear that they — I’m using air quotes, you can’t see me — “just want a Black person,” don’t say no. Decide what the value will be to you and what you should get in return for being that Black person at the table.
On the other side, my advice is, come on, folks. You don’t need just a Black person so you can fill the quota. What you need is diversity of thought and opinion, so that you can make business decisions, clinical decisions, scientific decisions, based on the knowledge that that person is bringing to the conversation. That’s my advice to the Other. What I really want you to do is get beyond the check the box, and actually include people who have different experiences and worldviews in the conversation. So that you can perfect your product, your business, but most importantly, improve the outcomes of those who are receiving care. Because you really understand how racism — institutional racism — changes not only the psyche, but the physiology of somebody who has to live with that stress day in and day out.
MODERN HEALTHCARE: And that’s sort of one of the core principles of team building, right? Find people who fill in your blanks. Find people who can be your other set of eyes and ears for things that may not be clear to you. That is excellent insight. Last question. You kind of already answered this, but let us know because we’re taking all offers for advice from people who have been there and done that, and can share this expertise. Any other sage advice, words of wisdom that you would give to emerging healthcare executives who may not be happy with how their healthcare organizations have handled both of these crises, but they are still aspiring to be in leadership, so they can one day make that change? What advice would you give them on their path toward senior leadership?
EDWARDS: I think you have to be bold, and I think you have to be willing to take risks. I don’t want everybody, you know, dropping the mic and walking out the door. I don’t think that’s in our best interest collectively. But, what I do want is whatever the gift is that God gave you, whether it’s a healthcare executive, a nurse, a doctor, a phlebotomist, or an educator, you know, or a mechanic, or an engineer. I mean healthcare — every possible job there is, exists in our ecosystem. Whatever that gift is that God gave you and what inspires you, do that to the best of your ability. And knock it out of the park. Be visible. So, what you should be vigilant about is excellence.
But, also, the risk comes in being vocal and being clear when you see discrimination happening, when you see disparities and inequity occurring, be willing to speak up. Not just for yourself, but for the Other. And not only do the Black professionals who are aspiring to move up the ladder need to do that, their White peers need to do it, too. Don’t be stupid! [Laughs.] Don’t curse people out, but be clear. Be very clear that you see the inequity. And then, have a solution to go with it. Or be willing to participate in the dialogue that enables that community of leaders to come up with a collective solution.
If you are in an organization that is not willing to look in the mirror or to engage in that dialogue, you may want to think about if that’s the organization that you want to stay with. But, I am not encouraging everybody to drop the mic, you know, go pick up their Black Lives Matter t-shirt, which I wore everyday last week — I just put it in the washer. But, please be bold. And be fearless when you need to speak up about inequity.
MODERN HEALTHCARE: I’m one hundred percent convinced that these are words you live by because you are transitioning to a COVID-19 hotspot, a hotspot for law enforcement issues among Black Americans, and this is where you are walking right into the middle of to start a new role.
EDWARDS: I’m being called. I’m being called. I feel like I don’t need more of things. I would love a new pair of Ferragamos for my first day at work. [Laughs.] I do need to know that I’m doing my best work and that the generation behind me has a door open. That they can actually live through the next virus infiltration — I’m being very intentional with my words because I don’t want another pandemic. But, there will be other viruses that infiltrate our ecosystem, and we cannot afford to have a pandemic and shut everything down everytime that happens. And for us — the Black folks — to be at the losing end of that. So, my hope and prayer is that I’m with an organization in a community, such as Detroit and Henry Ford, where I can actually help strategize and participate in building some of the solutions that will have a direct impact, really globally, on the community I care about but even beyond that.
MODERN HEALTHCARE: Thank you — this was therapeutic for me!
EDWARDS: Oh, I am so humbled and so honored that you asked me to do this. Thank you.
MODERN HEALTHCARE: Thank you, Dr. Carladenise Edwards, for that amazing wisdom. Again, I’m your host, Kadesha Smith, CEO of CareContent. We help health systems reach their growth goals through digital strategy and content. To connect with other women leaders who have that kind of wisdom, please attend the Women Leaders in Healthcare conference on August 13th and 14th. This is an ideal time for women in healthcare to connect and talk about how to do things differently for the next generation. To register, visit modernhealthcare.com/WomenLeaders. Look for more episodes of Next Up at modernhealthcare.com/podcasts or subscribe at your preferred podcatcher. Thanks again for listening.
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