WELCOME TO THE CLINICAL CENTER GRAND ROUNDS,
A WEEKLY SERIES OF EDUCATIONAL LECTURES FOR PHYSICIANS AND
HEALTH CARE PROFESSIONALS BROADCAST FROM THE CLINICAL
CENTER AT THE NATIONAL INSTITUTES OF HEALTH IN
BETHESDA, MD.
THE NIH CLINICAL CENTER IS THE WORLD'S LARGEST HOSPITAL TOTALLY
DEDICATED TO INVESTIGATIONAL RESEARCH AND LEADS THE GLOBAL
EFFORT IN TRAINING TODAY'S INVESTIGATORS AND DISCOVERING
TOMORROW'S CURES.
LEARN MORE BY VISITING US ONLINE AT HTTP://CLINICALCENTER.NIH.GOV
GOOD AFTERNOON.
WELCOME TO TODAY'S CLINICAL
CENTER GRADUATE MEDICAL
EDUCATION GRAND ROUNDS.
I WANT TO FIRST START WITH THE
CME INFORMATION, THE HOPKINS
CLOUD CME ACTIVITY CODE FOR
TODAY'S GRAND ROUNDS IS 50567.
SO PLEASE TEXT THIS CODE TO THE
JOHNS HOPKINS CME PHONE NUMBER
ON THE SLIDE TO RECEIVE CME
CREDIT FOR THIS LECTURE.
WE ALSO KINDLY INVITE YOU TO
PROVIDE FEEDBACK ON
LECTURE BY SCANNING THE QR CODE
SHOWN ON THE CME SLIDE AND IF
YOU ARE APPLYING FOR CME, YOU
WILL PROVIDE THE SURVEY LINK VIA
EMAIL.
THE SURVEY WILL BE USED TO
PROVIDE US WITH IMPORTANT
FEEDBACK ABOUT THIS PRESENTATION
AND ALLOW YOU TO SUBMIT ANY
SUGGESTIONS FOR FUTURE GRAND
ROUND TOPICS.
FOLLOWING DR. CAPERS'
PRESENTATION, I'M ABOUT TO
INTRODUCE HIM, THE QUESTIONS
WILL BE TAKEN FROM THE
MICROPHONES IN THE AISLES FOR
THOSE OF YOU IN PERSON.
ADDITIONALLY, VIDEOCAST VIEWERS
MAY SUBMIT QUESTIONS AT ANY TIME
DURING THE LECTURE BY SCROLLING
DOWN AND CLICKING THE LIVE
FEEDBACK BUTTON LOCATED ON THE
VIDEOCAST WEBSITE.
QUESTIONS FROM THE VIDEOCAST
WILL BE ANSWERED AS TIME PERMITS
AT THE END OF THE PRESENTATION.
SO I'M VERY EXCITED TODAY TO
INTRODUCE OUR GRAND ROUNDS
SPEAKER, DR. QUINN CAPERS.
DR. CAPERS HAS BEEN WIDELY
RECOGNIZED AS AN EDUCATOR,
CLINICIAN, AND CHAMPION OF
DIVERSITY ENHANCEMENT IN
MEDICINE.
HE'S A GRADUATE OF THE HOWARD
UNIVERSITY COLLEGE OF ARTS AND
SCIENCES AND THEN THE OHIO STATE
UNIVERSITY COLLEGE OF MEDICINE,
AND THEN HE TRAINED IN INTERNAL
MEDICINE, CARDIOVASCULAR
DISEASES AND INTERVENTIONAL
CARDIOLOGY AT EMORY UNIVERSITY.
HE SPENT TIME IN PRIVATE
PRACTICE AND THEN HAD HELD
FACULTY APPOINTMENTS AT
VANDERBILT, MEHARRY MEDICAL
COLLEGE, THE OHIO STATE
UNIVERSITY AND UNIVERSITY OF
TEXAS SOUTHWESTERN MEDICAL
CENTER.
BEFORE JOINING HOWARD AS CHAIR
OF THE DEPARTMENT OF MEDICINE IN
JANUARY OF 2024.
SO JUST WITHIN THE LAST SIX
MONTHS.
AS AN INTERVENTIONAL
CARDIOLOGIST, HE HAS AN INTEREST
IN THE TRANS RADIAL APPROACH TO
CORONARY STENTING AND THE
TREATMENT OF PATIENTS WITH ACUTE
MYOCARDIAL INFARCTION.
HE HAS PERFORM MOED MORE THAN 40
CORONARY ARTERY STENTING
PROCEDURES AND HIS PHYSICIAN
PEERS HAVE NAMED HIM ONE OF
AMERICA'S BEST DOCTORS 10 YEARS
IN A ROW.
IMPORTANTLY HIS PATIENT
SATISFACTION SCORES HAVE ALSO
PLACED IN THE 90TH PERCENTILE
NATIONALLY FOR SIX YEARS IN A
ROW, AND IN 2019, HE WAS ELECTED
TO THE OHIO STATE UNIVERSITY
SOCIETY OF MASTER CLINICIANS.
AS AN EDUCATOR, HE HAS RECEIVED
NUMEROUS TEACHING AND MENTORING
AWARDS.
HE RECEIVED THE AMERICAN HEART
ASSOCIATION'S NATIONAL CLINICIAN
EDUCATOR AWARD IN 2018, AND THE
OHIO STATE UNIVERSITY COLLEGE OF
MEDICINE'S GRADUATING CLASS OF
2019 NAMED HIM THE PROFESSOR OF
THE YEAR.
WHICH IS AN AWARD RESERVED FOR
THE MOST IMPACTFUL EDUCATOR IN
THEIR FOUR YEARS OF MEDICAL
SCHOOL.
AT OHIO STATE, HE SERVED AS THE
ASSOCIATE DEAN FOR ADMISSIONS
FROM 2009 TO 2019, LEADING
STRATEGIES TO RECRUIT, INTERVIEW
AND SELECT OVER 2,000 FUTURE
PHYSICIANS.
AND THEN AT THE UNIVERSITY OF
TEXAS SOUTHWESTERN, HE RECEIVED
SEVERAL TEACHING AWARDS AND LED
EFFORTS TO APPOINT AND MENTOR
VICE CHAIRS AND LEADERS OF
DIVERSITY IN ALL THREE BASIC
SCIENCE AND CLINICAL
DEPARTMENTS.
DR. CAPERS IS A THOUGHT LEADER
IN THE AREAS OF DIVERSE IN
MEDICINE, RACIAL HET HEALTHCARE
DISPARITIES AND HAS TRAINED
THOUSANDS OF PHYSICIANS AND
SCIENTISTS IN STRATEGIES TO
REDUCE IMPLICIT RACIAL BIAS IN
PATIENT CARE AND THE SELECTION
OF STUDENTS, TRAINEES AND
FACULTY.
HE CURRENTLY SERVES AS INAUGURAL
CHAIR OF THE AMERICAN COLLEGE OF
CARDIOLOGY' DIVISION AND
INCLUSION COMMITTEE.
IN THAT ROLE, HE LEADS NATIONAL
EFFORTS TO DIVERSIFY THE
SPECIALTY OF CARDIOLOGY.
SO WE ARE HONORED TODAY TO HAVE
DR. CAPERS SPEAK TO US.
THE TITLE OF HIS PRESENTATION IS
"THE EVIDENCE-BASED ARGUMENT FOR
A DIVERSE PHYSICIAN WORKFORCE."
PLEASE JOIN ME IN WELCOMING
DR. CAPERS.
[APPLAUSE]
>> THANK YOU SO MUCH.
THANK YOU FOR INVITING ME.
THANK YOU, EVERYBODY, FOR COMING
OUT.
HELLO!
SO THIS IS MY FIRST VISIT TO NIH
AND I'M VERY PLEASED TO BE HERE.
AND I'M GRATEFUL THAT I WAS
ASKED TO COME HERE AND
SPECIFICALLY TO TALK ABOUT
DIVERSITY AND DIVERSITY, EQUITY
AND INCLUSION.
YOU KNOW, THIS IS -- THESE ARE
INTERESTING TIMES TO TALK ABOUT
DIVERSITY, EQUITY AND INCLUSION,
RIGHT?
WE'VE GOT PRESIDENTIAL
CANDIDATES BEING LABELED DEI
CANDIDATE AND SOME HAVE TRIED TO
MAKE THE CONCEPT OF DIVERSITY,
EQUITY AND INCLUSION, WHICH IS
EXTENDING OPPORTUNITIES TO
GROUPS WHO ARE TRADITIONALLY
SHUT OUT OF OPPORTUNITIES.
BUT THERE'S BEEN SOME MOVEMENT
AFOOT TO TRY TO MAKE JUST DEI A
BAD WORD, A BAD PHRASE, AND MAKE
IT HAVE A NEGATIVE CONNOTATION.
SO I THOUGHT -- IT WOULD BE NIE
TO, SINCE YOUR WHOLE CAREER HERE
IS ABOUT MAKING AND PRODUCING
THE EVIDENCE THAT REALLY GUIDES
WHAT WE DO IN MEDICINE, TO TALK
ABOUT THE EVIDENCE THAT
DIVERSITY ACTUALLY IS A POSITIVE
FORCE IN THE WORLD AND DOES A
LOT OF GOOD THINGS.
I THOUGHT IT WOULD BE FUN TO DO
THAT IN THE FORM OF A QUIZ, SO I
HOPE YOU'RE READY.
WE WANT TO GIVE YOU A QUIZ ON
DIVERSITY.
WHAT I MEAN BY THAT IS, IF YOU
WERE IN, LET'S SAY, THE DOCTOR'S
LOUNGE AND SOMEONE CHALLENGED
YOU AND WHY YOU'RE USING DRUG A
VERSUS DRUG B, I WOULD BET YOU
COULD PROBABLY VERY RAPIDLY
QUOTE STUDIES SHOWING WHY YOU DO
WHAT YOU DO.
ON THE OTHER HAND, IF IN THAT
SAME LOUNGE SOMEBODY CHALLENGED
YOU AND SAID WHY ARE YOU ALWAYS
TALKING ABOUT DIVERSITY, WHY ARE
YOU ALWAYS PUSHING DIVERSITY?
MY QUESTION TO YOU IS, WOULD YOU
BE ABLE TO, IN THE SAME MANNER,
DEFEND YOURSELF BY QUOTING STUDY
AFTER STUDY?
AND IF THE ANSWER TO THAT IS NO,
WELL, HOPEFULLY IT WILL BE YES
BY THE END OF THIS TALK.
SO THIS TALK WILL REVIEW
EVIDENCE THAT DIVERSITY WILL
IMPROVE HEALTHCARE OUTCOMES.
WE'LL TALK ABOUT SOME OF THE
BARRIERS, WHY WE'RE NOT THERE
YET, AND THEN FINALLY, WE'LL
TALK ABOUT STRATEGIES TO ENHANCE
DIVERSITY IN MEDICINE.
SO HERE WE ARE, MULTIPLE CHOICE
QUESTION.
THIS IS A QUIZ.
THE QUESTION IS, WHY DO WE SEEK
DIVERSITY IN MEDICINE?
THIS IS A SINGLE-BEST ANSWER
TYPE MULTIPLE CHOICE QUESTION,
AND AS YOU KNOW, I'M SURE
EVERYONE IN HERE, YOU'RE ALL
GOOD TEST-TAKERS.
THE BEST WAY TO APPROACH A
MULTIPLE-CHOICE QUESTION IS TO
CROSS OUT THE STATEMENTS THAT
YOU KNOW ARE INCORRECT UNTIL
YOU'RE LEFT WITH THE ONES, MAYBE
TWO, MAYBE, AND THEN YOU'VE GOT
TO USE YOUR NOGGIN TO FIGURE IT
OUT.
SO THE QUESTION IS, WHY DO WE
SEEK DIVERSITY IN MEDICINE?
AND I'M ON YOUR SIDE.
I WANT YOU TO DO WELL ON THIS.
WHY DO WE SEEK DIVERSITY IN
MEDICINE?
IS IT A?
BECAUSE UNDERREPRESENTED
MINORITY PHYSICIANS ARE MORE
LIKELY TO SERVE THE UNDERSERVED?
IS IT B, BECAUSE MINORITY
PATIENTS ARE MORE LIKELY TO
FOLLOW THE RECOMMENDATIONS OF
MINORITY PHYSICIANS?
MAYBE IT'S C, THAT DIVERSITY ON
RESEARCH TEAMS ENHANCES THE
IMPACT OF RESEARCH, OR MAYBE
IT'S D, THAT A DIVERSE PHYSICIAN
WORKFORCE WILL REDUCE THE
INEQUITIES, DISPARITIES, RACIAL
HEALTHCARE DISPARITIES.
REMEMBER, THIS IS SINGLE-BEST
ANSWER.
SO YOUR JOB IS TO CROSS OUT THE
THREE INCORRECT ANSWERS, SO
LET'S GET STARTED WITH ME GIVEIG
YOU SOME BACKGROUND INFORMATION.
THIS IS AN ANALYSIS AND BRIEF
FROM THE AAMC.
IF YOU ARE A GRADUATE OF A AAMC
M.D. SCHOOL, YOU MIGHT NOT
REMEMBER IT BUT YOUR FIRST WEEK
OF SCHOOL WITH THE POMP AND
CIRCUMSTANCE OF ORIENTATION, YOU
SAT DOWN YOU AND TOOK A SURVEY
FROM THE AAMC.
AND YOU ALSO MIGHT NOT REMEMBER
THAT IN YOUR LAST WEEK OF
SCHOOL, YOUR FOURTH YEAR, YOU
TOOK ANOTHER AAMC SURVEY.
SOME OF THE QUESTIONS, THEY ASK
THE SAME QUESTION TO SEE HOW YOU
CHANGED FROM YOUR FIRST YEAR OF
MEDICAL SCHOOL TO YOUR LAST
YEAR.
THIS ANALYSIS LOOKS AT, ANALYZES
ANSWERS FOR 80,000 MEDICAL
STUDENTS.
THE QUESTION WAS, DO YOU PLAN TO
LOCATE YOUR PRACTICE IN AN
UNDERSERVED AREA?
THERE WERE THREE POSSIBLE
ANSWERS, YES, NO OR MAYBE.
ONE OF THE FIRST THINGS THEY
FOUND IS THAT BLACK AND HISPANIC
STUDENTS WERE MORE LIKELY TO
ANSWER YES.
WHITE AND ASIAN STUDENTS WERE
MORE LIKELY TO ANSWER NO.
BUT THEY WERE PARTICULARLY
INTERESTED IN THOSE WHO WERE
INITIALLY UNDECIDED, SO THOSE
WHO SAID MAYBE IN THEIR FIRST
WEEK OF MEDICAL SCHOOL.
AND IT TURNS OUT THAT BLACK AND
HISPANIC STUDENTS THAT WERE
INITIALLY UNDECIDED WERE MORE
LIKELY TO ANSWER YES BY
GRADUATION, WHITE AND ASIAN
STUDENTS THAT WERE INITIALLY
UNDECIDED WERE MORE LIKELY TO
ANSWER THAT QUESTION NO BY
GRADUATION, WHICH MAKES ME WANT
TO TALK TO OUR CURRICULAR
PEOPLE, WHAT ARE WE DOING DURING
MEDICAL SCHOOL THAT'S TURNING
PEOPLE OFF TO THE IDEA OF
SERVING THE UNDERSERVED?
BUT THAT IS MEDICAL SCHOOL, AND
THESE ARE STUDENTS UPON ENTRY.
ON THIS NEXT SLIDE, I FELL SHORT
OF MY GOAL TO PUT ON ONE SLIDE
EVERY STUDY THAT HAS EVER SHOWN
THAT PHYSICIANS OF BLACK,
HISPANIC AND NATIVE AMERICAN
DESCENT ARE MORE LIKELY THAN
DOCTORS OF OTHER GROUPS TO
LOCATE THEIR PRACTICE IN
UNDERSERVED COMMUNITIES.
AND I FELL SHORT OF THAT GOAL
BECAUSE THE SLIDE WASN'T BIG
ENOUGH.
SO YOU'LL HAVE TO SETTLE FOR 10
STUDIES FROM FOUR DIFFERENT
DECADES THAT ALL REMARKABLY SHOW
THE SAME THING, IT'S NOT EVEN
CLOSE.
DOCTORS FROM UNDERREPRESENTED
AND UNDERSERVED RACIAL
BACKGROUNDS ARE MORE LIKELY THAN
OTHERS TO GO RIGHT BACK TO
COMMUNITIES LIKE THE ONES THAT
THEY CAME FROM.
SO YOU MIGHT FEEL GOOD ABOUT A
AS THE ANSWER.
BUT WAIT, THERE'S MORE.
AS THEY SAY.
HERE'S A STUDY BY SAHA AND
COLLEAGUES, SAHA IS AN
INVESTIGATOR I TRULY ADMIRE,
HE'S DONE A LOT OF INKRED BIBL
WORK.
IN THIS STUDY, WE ALL KNOW WHAT
STANDARDIZED PATIENTS ARE,
ACTORS PLAYING THE ROLES OF
PATIENTS.
THEY USE STANDARDIZED
PHYSICIANS.
SO ACTORS PLAYING THE ROLE OF
PHYSICIANS, AND IN THIS STUDY,
THESE ACTORS WERE PLAYING THE
ROLE OF CARDIOLOGISTS, AND SO
YOU SEE A PICTURE OF THE
CARDIOLOGISTS THERE USED IN THE
STUDY.
ALL OF THESE ACTORS IN THE WHITE
COATS READ AN IDENTICAL SCRIPT,
AND THE SCRIPT SAID, I HAVE
LOOKED AT YOUR TEST RESULTS, I
RECOMMEND OPEN HEART SURGERY.
THE VIEWERS OF THE VIDEOS WERE
ACTUAL PATIENTS, SO THEY
ACTUALLY WENT OUT AND HAD HEART
PATIENTS, PATIENTS WITH HEART
DISEASE, VIEW THESE VIDEOS, AND
EACH PATIENT ONLY SAW ONE VIDEO.
BUT AT THE END, THEY ASKED THE
PATIENTS, WELL, WHAT DO YOU
THINK?
WILL YOU HAVE THE HEART SURGERY
BASED ON WHAT YOU HEARD THE
DOCTOR SAY?
AND IT TURNS OUT THAT THE BLACK
PATIENTS WERE MORE LIKELY TO
AGREE TO OPEN HEART SURGERY IF
IT WAS RECOMMENDED BY A BLACK
DOCTOR.
SO THAT IS A SIMULATION.
LET'S GO TO REAL LIFE.
HOPEFULLY YOU'VE HEARD OF
MARCELLA AWSAN'S STUDY FROM
2014.
THEY DID A STUDY, THIS IS NOW
REAL LIFE IN SOME OAKLAND
PRIMARY CARE CLINICS WHERE THEY
RANDOMIZED BLACK MALE PATIENTS,
THE PATIENTS WERE ALL BLACK
MALES, TO BEING SEEN IN THIS
PRIMARY CARE CLINIC BY EITHER A
WHITE MALE PHYSICIAN, A BLACK
MALE PHYSICIAN OR AN ASIAN MALE
PHYSICIAN.
THOSE PHYSICIANS ALL AS A PART
OF THE STUDY HAD THE SAME
PROTOCOL AND DID THE SAME THING
WHERE THEY RECOMMENDED THAT THE
PATIENT GET A FINGER STICK FOR
BLOOD GLUCOSE CHECK, A FINGER
STICK FOR CHOLESTEROL AND GET A
FLU SHOT.
THE RESULTS SHOWED THAT THE
BLACK MEN WERE MORE LIKELY TO
FOLLOW THE RECOMMENDATIONS OF
THE BLACK MALE DOCTORS THAN THEY
WERE THE WHITE AND ASIAN DOCTORS
BUT I'M REALLY GLAD THAT THE
INVESTIGATORS DIDN'T STOP THERE.
THEY WENT INTO THE PROGRESS
NOTES.
YOU KNOW, YOU AND I SEE A
PATIENT, WE'VE GOT TO WRITE A
NOTE ABOUT IT.
AND THEY SAW A THEME.
REMEMBER ALL OF THE PATIENTS
WERE BLACK MALES.
WHAT THEY SAW IS THAT THE WHITE
PHYSICIANS AND THE ASIAN
PHYSICIANS, THEIR PROGRESS NOTES
WERE VERY SHORT.
THEY WERE ABRUPT, THEY WERE
FACT-BASED, AND VERY OBJECTIVE.
JUST THE FACTS.
JUST THE FACTS, MA'AM.
I'LL GIVE YOU AN EXAMPLE.
HERE ARE SOME ILLUSTRATIVE
EXAMPLES OF SOME PROGRESS NOTES
WRITTEN BY THE WHITE AND ASIAN
PHYSICIANS.
WEIGHT LOSS.
THAT'S IT.
THAT'S THE ENTIRE PROGRESS NOTE.
TB TEST.
THAT'S ANOTHER ONE.
AND HERE'S A ONE-WORDER FOR YOU.
ANXIETY.
I DON'T KNOW ABOUT YOU, BUT IN
MY CLINIC, IF THAT WAS MY
PROGRESS NOTE, MY CODERS WOULD
BE ON MY CASE.
THEY'D SAY QUINN, THAT'S NOT A
LEVEL III VISIT.
YOU'VE GOT TO WRITE MORE THAN
THAT.
AND LET'S LOOK AT SOME
ILLUSTRATIVE EXAMPLES OF
PROGRESS NOTES THE BLACK DOCTORS
WROTE ABOUT THEIR BLACK PATIENT.
NEEDS FOOD, SHELTER, CLOTHING
AND A JOB.
SUBJECT YELLED AT ME, HE'S
TALKING ABOUT THE PATIENT HERE,
BUT THEN AGREED TO GET THE FLU
SHOT BECAUSE I RECOMMENDED IT.
MADE PATIENT LAUGH.
DO YOU FEEL A DIFFERENCE BETWEEN
THOSE GROUPS OF PROGRESS NOTES?
AND POSSIBLY, BECAUSE OF THAT
DIFFERENCE, MORE OF A CONCERN
FOR THE ECOLOGY OF THE PATIENT,
THE SOCIAL DETERMINANTS OF
HEALTH THAT SURROUND THE
PATIENT, PERHAPS THAT HAD
SOMETHING TO DO WITH THE
PATIENTS BEING MORE LIKELY TO
AGREE TO THE BLOOD TEST AND THE
FLU SHOT.
SO THIS NOW IS NOT A SIMULATION
BUT REAL LIFE.
AND SO I MIGHT HAVE CONVINCED
YOU THAT B IS THE ANSWER,
BECAUSE MINORITY PATIENTS ARE
MORE LIKELY TO FOLLOW THE
RECOMMENDATIONS OF MINORITY
PHYSICIANS.
BUT THERE'S MORE.
HERE IS A VERY INTERESTING STUDY
DONE PUBLISHED IN 2018.
THEY HAD A HYPOTHESIS AND THAT
WAS THAT RACIAL DIVERSITY ON THE
RESEARCH TEAM, ON THE TEAM DOING
THE RESEARCH AND WRITING THE
PAPER, ACTUALLY IMPACTS THE
QUALITY OF THE RESEARCH AND THE
IMPACT OF THE RESEARCH, AND HERE
THEY DEFINED IMPACT BY THE
NUMBER OF TIMES THE RESEARCH
PAPER WAS CITED.
SO THEY ANALYZED OVER 9 MILLION
PAPERS, AND THEY STUDY THE
RELATIONSHIP OF SEVERAL TYPES OF
DIVERSITY, DIVERSITY OF RACE AND
ETHNICITY, DISCIPLINE,
AFFILIATION, ACADEMIC AGE, AND
THEY TRIED TO RELATE TO NUMBER
OF CITATIONS OF THE RESEARCH
PAPER.
BY FAR, THE STRONGEST
CORRELATION WITH IMPACT, IE,
NUMBER OF CITATIONS, WAS THE
RACIAL AND ETHNIC DIVERSITY OF
THE RESEARCH TEAM.
SO THAT MEANS IT'S LIKELY THAT
IF YOU WANT YOUR RESEARCH TO BE
HIGHLY CITED AND IMPORTANT, TAKE
A LOOK AT YOUR RESEARCH TEAM.
YOU WANT TO HAVE SOME RACIAL
DIVERSITY ON YOUR RESEARCH TEAM.
THERE ARE OTHER STUDIES THAT
SHOW THE SAME THING.
I THOUGHT THIS ONE WOULD SUFFICE
AND MAKE YOU FEEL GOOD ABOUT C
AS THE ANSWER.
DIVERSITY ON RESEARCH TEAM
ENHANCES THE IMPACT OF RESEARCH.
I WANT TO -- IF YOU DON'T MIND,
GET KIND OF CARDIOLOGY-CENTRIC
FOR A MINUTE AS I TALK ABOUT
RACIAL HEALTHCARE DISPARITIES.
WE AS CARDIOLOGISTS HAVE
WONDERFUL TOOLS AND TECHNOLOGY
TO IMPROVE THE LIVES OF OUR
PATIENTS.
AND IMPROVE THE QUALITY OF LIFE
OF OUR PATIENTS.
WE HAVE DEFIBRILLATORS TO
INSTALL ON OUR PATIENTS WHO ARE
AT RISK OF CARDIAC ARREST.
WE HAVE WONDERFUL WAYS IN A CATH
LAB TO REA ST RESTORE BLOOD FLON
PATIENTS HAVING A HEART ATTACK
AND WE HAVE WAYS TO TREAT POOR
CIRCULATION.
EACH OF THOSE AREAS CAN ENHANCE
AND PROLONG THE LIVES OF OUR
PATIENTS, AND WHILE YOU MIGHT
ALREADY BE FAMILIAR WITH IT, I'M
SAD TO REINFORCE TO YOU THAT
THERE ARE RACIAL DISPARITIES
RIGHT ALONG RACIAL LINES IN EACH
OF THOSE MODALITIES.
LET'S TALK SPECIFICALLY ABOUT
RESTORING BLOOD FLOW TO BLOCKED
LEG ARTERIES.
WHAT HAPPENS ACROSS THIS NATION
WHEN SOMEONE PRESENTS WITH
CRITICAL LOWER EXTREMITY
ISCHEMIA?
DATA HAS BEEN SHOWING THIS FOR A
LONG TIME, WHAT HAPPENS.
HERE IS A STUDY PUBLISHED
ACTUALLY JUST LAST YEAR WHERE
THEY LOOKED AT A LARGE NATIONAL
DATABASE OF PATIENTS WHO
PRESENTED TO THE EMERGENCY ROOM
WITH AN ACUTELY ISCHEMIC LIMB,
SO BLUE FOOT WITH NO PULSE.
YOU'VE GOT TO DO SOMETHING OR
ELSE THIS PERSON MIGHT LOSE
THEIR LIMB.
WHAT THIS SHOWS IS -- LET ME SEE
IF I CAN -- THIS IS PRETTY COOL.
I LIKE THIS.
SO THIS SHOWS YOU THE HAZARD
RATIO OF RECEIVING AN AM EU AN N
AS COMPARED TO WHITE PATIENTS.
SO BLACK PATIENTS WERE 30% MORE
LIKELY, HISPANIC PATIENTS, 59%
MORE LIKELY THAN WHITE TO
RECEIVE A LIMB AMPUTATION.
WHERE THE WHITES WERE MORE
LIKELY TO GET A PROCEDURE TO
RESTORE BLOOD FLOW TO THE LEGS.
THIS IS ALL-COMERS, THIS IS
TAKING EVERYBODY.
SO THOSE OF YOU WHO -- WHICH IS
ALL OF YOU WHO THINK LIKE A
SCIENTIST, YOU SAY HOLD ON, WAIT
A MINUTE, WE'VE GOT TO CONTROL
FOR CERTAIN THINGS.
WE'VE GOT TO CONTROL FOR THE
EXTENT OF DISEASE AT
PRESENTATION, THE SEVERITY OF
THE DISEASE AT PRESENTATION,
BECAUSE IF IT'S TRUE AND DATA
SHOWS THAT IT IS, THAT OFTEN
PEOPLE FROM UNDERREPRESENTED AND
UNDERSERVED BACKGROUNDS WAIT
VERY LONG IN THE COURSE OF THEIR
DISEASE BEFORE PRESENTING.
SO IF YOU SHOW UP IN THE
EMERGENCY ROOM WITH AN ISCHEMIC
FOOT AND EVERY BLOOD VESSEL FROM
YOUR FEMORAL ARTERY TO YOUR TOE
IS OCCLUDED, THERE'S NOTHING FOR
A SURGEON TO BYPASS INTO.
AND THERE'S NOTHING FOR A
BALLOON OR A STENT TO OPEN.
SO IF YOU PRESENT VERY LATE,
THEN YOU WILL SEE THESE KIND OF
DISPARITIES.
SO THEY CONTROLLED FOR THAT.
THEY SAID LET'S CONTROL FOR THE
EXTENT AND SEVERITY OF DISEASE.
AND I'D LIKE YOU TO LOOK AT THE
HAZARD RATIOS AND SEE WHAT
HAPPENS TO THEM WHEN WE
CONTROLLED FOR EXTENT AND
SEVERITY OF DISEASE.
DID YOU SEE THAT?
THEN IT SEEMED LIKE THE
INVESTIGATORS SAID WAIT A
MINUTE, WE'VE GOT TO MAKE THESE
DISPARITIES GO AWAY.
LET'S CROW FOR PAYOR MIX, LET'S
CONTROL FOR SOUTH VERSUS THE
NORTH, LET'S CONTROL FOR PUBLIC
VERSUS PRIVATE HOSPITAL, LET'S
CONTROL FOR PRIVATE INSURANCE
VERSUS PUBLIC INSURANCE.
LET'S CONTROL FOR EVERYTHING YOU
CAN THINK.
AND WHEN THEY DID THAT, THEN IT
DID AFFECT THOSE HAZARD RATIOS A
LITTLE BIT, THEN AFTER
CONTROLLING FOR EVERY SINGLE
THING YOU CAN THINK OF, THEN
BLACKS WERE ONLY 12% MORE LIKELY
AND HISPANICS ONLY 34% MORE
LIKELY TO HAVE AN AMPUTATION
COMPARED TO WHITE PATIENTS.
THEY COULDN'T MAKE THE DISPARITY
GO AWAY.
NO STATISTICAL MANIPULATION
WOULD T DO THAT.
SO THIS IS THE CURRENT STATE OF
TREATING ISCHEMIA, THIS IS LIKE
LOOKING AT ART.
WE LOVE LOOKING AT AN ARTERY,
THIS IS THE RIGHT CORONARY
ARTERY, IT'S OCCLUDED BEFORE AND
THEN AFTER OPENING IT UP WITH
BALLOONS AND STENTS.
HOW ARE WE DOING WITH TREATING
PATIENTS WITH ACUTE CORONARY
SYNDROMES?
THIS STUDY PUBLISHED AGAIN JUST
LAST YEAR LOOKED AT A NATIONAL
DATABASE OF PATIENTS PRESENTING
WITH A NON-ST SEGMENT MYOCARDIAL
INFARCTION WHICH IS A TYPE OF
HEART ATTACK YOU CAN HAVE.
AS WE ALL KNOW A HEART ATTACK
MEANS THE CORONARY ARTERY IS
SEVERELY BLOCKED OR CLOSED.
THE BEST WAY TO TREAT IT IS TO
OPEN THAT CORONARY ARTERY
MECHANICALLY AND THE FIRST STEP
IS DOING A HEART CATH, DOING A
CORONARY ANGIOGRAM.
SO WHAT THEY LOOKED AT WAS WERE
THERE RACIAL DIFFERENCES IN
PERFORMING CORONARY ANGIOGRAM IN
PATIENTS WHO PRESENT TO THE
HOSPITAL WITH A HEART ATTACK AT
FOUR DIFFERENT TIME POINTS.
AND THIS SLIDE COMPARES WHITE
PATIENTS, THAT'S THE CIRCLE, AND
BLACK PATIENTS, AND AT FOUR
DIFFERENT TIME POINTS.
THE WHITE HEART ATTACK PATIENT
WAS SIGNIFICANTLY MORE LIKELY
DURING THE ENTIRE
HOSPITALIZATION TO HAVE A HEART
CATH THAN THE BLACK PATIENT.
LET'S MOVE ON TO A DIFFERENT
GROUP.
THIS IS WHITE'S VERSUS ASIANS
AND FA CIVIC ISLANDER.
THEY DEFINE IT BOTH AS EAST
ASIANS AND SOUTH ASIANS YOU AND
SEE ONCE AGAIN AT EACH TIME
POINT WHEN YOU'RE PRESENTED WITH
A HEART ATTACK THE WHITE PATIENT
WAS MORE LIKELY TO HAVE THE
CORONARY ANGIOGRAM THAN WAS THE
ASIAN PATIENT WHO PRESENTED WITH
A HEART ATTACK.
THIS IS NATIONAL DATA NOW, NOT
JUST ONE REASON.
THE LAST ONE LOOKS AT
DISPARITIES AMONG THOSE WHO ARE
HISPANIC.
THE FIRST TWO TIME POINTS, WE
ACTUALLY WERE PRETTY CLOSE, SO
THOSE WERE GOOD TIMES BUT THEN
THERE WAS A SPLAY AS YOU WENT
OUT.
SO THAT MEANS IN THIS COUNTRY,
IF YOU PRESENT TO THE HOSPITAL
WITH A HEART ATTACK, THE BEST
WAY TO MAKE SURE YOU RECEIVE A
HEART CATHETERIZATION IS TO BE
WHITE.
I KNOW THAT'S PAINFUL FOR YOU TO
HEAR, IT'S PAINFUL FOR ME TO
SAY, BUT I'M JUST QUOTING THE
STUDIES.
AND I KNOW THAT YOU FIND THIS AS
SHOCKING AND UNACCEPTABLE AS I
DO.
IN 2014, WE DID A REVIEW OF
PAPERS JUST LIKE THE ONES I JUST
SHOWED YOU, THE ONES SHOWING
RACIAL DISPARITIES IN
CARDIOVASCULAR CARE, AND WE
FOUND OUT SOMETHING THAT -- WE
FOUND THAT IN A 20-YEAR PERIOD,
THERE WERE MORE THAN 300 STUDIES
LIKE THE ONES I JUST SHOWED YOU,
300, SHOWING DISPARITIES ALONG
RACIAL LINES.
AND THE SOBERING THING WE FOUND
IS THAT THINGS WERE NO BETTER AT
THE END OF THAT 20-YEAR PERIOD
AND DOCUMENTING THE PROBLEM 300
TIMES AS THEY WERE AT THE
BEGINNING OF THAT PERIOD.
SO THE ONE THING WE'VE LEARNED
IS DOCUMENTING THE PROBLEM,
WHILE IMPORTANT, IS NOT ENOUGH
TO CHANGE.
WE ALSO NOTED WHILE WE WERE
LOOKING AT THIS, CARDIOLOGY HAS
ANOTHER PROBLEM, A DIVERSITY
PROBLEM.
THESE ARE CURRENT STATS FROM THE
AAMC COMPARED TO THE U.S.
CENSUS, WE HAVE A SEVERE
DIVERSITY PROBLEM IN THE
SPECIALTY OF CARDIOLOGY.
THE LAST U.S. CENSUS SHOWS THAT
51% OF AMERICANS IDENTIFY AS
WOMEN YET ONLY 13% OF
CARDIOLOGISTS ARE WOMEN.
17% OF AMERICANS IDENTIFY AS
HISPANIC, ONLY 5% OF
CARDIOLOGISTS ARE HISPANIC, AND
WHILE 13% OF AMERICANS IDENTIFY
AS BLACK OR AFRICAN AMERICAN,
NOT EVEN 3% OF CARDIOLOGISTS ARE
BLACK AND AFRICAN AMERICAN.
MANY OF US, CAN YOU COUNT ME INN
THIS NUMBER, THINK WE WON'T FIX
THOSE OTHER PROBLEMS I SHOWED
YOU UNTIL WE FIX THIS PROBLEM.
NOW HOW DO I KNOW THAT?
THAT'S SOMETHING THAT YOU'VE GOT
TO BACK UP WITH DATA AND WE'RE
STARTING TO GET THAT KIND OF
DATA.
THIS STUDY BY SNYDER AND
ASSOCIATES NOT NECESSARILY
CARDIOLOGY, LOOKED AT EVERY
COUNTY IN THE UNITED STATES OF
AMERICA.
AND THEY LOOKED AT THE NUMBER OF
BLACK PRIMARY CARE PHYSICIANS IN
THAT COUNTY.
AND THEY FOUND AN ASTOUNDING
STATISTIC.
THE MORE BLACK PHYSICIANS THAT
JUST LIVED AND WORKED IN THAT
COUNTY, THE LONGER THE LIFE
EXPECTANCY OF BLACK PATIENTS WHO
LIVED IN THAT COUNTY.
AND THE MORE BLACK DOCTORS IN
THAT COUNTY, THE LOWER WAS THE
BLACK-WHITE MORTALITY GAP IN
THAT COUNTY.
SUGGESTING THAT JUST HAVING MORE
DIVERSE DOCTORS AROUND IMPACTS
THE LIVES OF THOSE MINORITY
PATIENTS.
AND SO TO SUMMARIZE A PORTION OF
WHAT I'VE BEEN SAYING, BLACK AND
HISPANIC STUDENTS ENTER MED
SCHOOL, THEY COME IN WITH A
DESIRE TO SERVE THE UNDERSERVED.
IT'S NOT JUST TALK.
WHEN THEY COMPLETE THEIR
TRAINING, THEY GO OUT AND DO
JUST THAT.
AND WE'RE NOW STARTING TO GET
THE DATA THAT THE PATIENTS
BENEFIT.
AND SO I HOPE THAT I'VE
CONVINCED SOME OF YOU THAT THE
ANSWER IS THAT A DIVERSE
PHYSICIAN WORKFORCE WILL REDUCE
RACIAL HEALTHCARE DISPARITIES.
SO OKAY, NIH, IT'S TIME.
SO YOU NEED TO ELIMINATE THREE
ANSWERS AND COME UP WITH THE
RIGHT ANSWER.
SO WHAT'S THE ANSWER?
ANYBODY?
ALL OF THE ABOVE?
[LAUGHTER]
YOU MEAN YOU THINK IT'S A TRICK
QUESTION AND THE ANSWER IS
REALLY ALL OF THE ABOVE?
YOU'RE ABSOLUTELY RIGHT.
THE ANSWER IS ALL OF THE ABOVE.
AND SO WHAT I HOPE IS THAT NOW,
IF YOU ARE IN A DEBATE, WHETHER
IT'S THE FRIENDLY DEBATE OR NOT
SO FRIENDLY, AND SOMEONE PRESSES
YOU ABOUT EVIDENCE OR DATA THAT
DIVERSITY WILL IMPROVE WHAT WE
DO, THAT IT WILL IMPROVE
HEALTHCARE, THAT IT WILL IMPROVE
SCIENCE.
I HOPE THAT NOW YOU FEEL
SOMEWHAT ARMED TO HAVE THAT
DEBATE.
SO IF WE KNOW THESE THINGS, THEN
WHY AREN'T WE THERE?
WHAT ARE SOME OF THE BARRIERS TO
ACHIEVING A DIVERSE WORKFORCE?
WELL, ONE IS, SOME LEADERS DON'T
BELIEVE IT'S NECESSARY.
OR DON'T BELIEVE THAT IT IS THE
RIGHT THING TO DO TO TRY TO
DIVERSIFY OUR PHYSICIAN
WORKFORCE.
NUMBER TWO, WE'RE ALSO BATTLING
SOME JUDICIAL RULINGS FROM THE
SUPREME COURT OF THE UNITED
STATES, AND ALSO SOME
LEGISLATION AT THE STATE LEVEL
AND MAYBE EVEN BEYOND THE STATE
LEVEL THAT SEVERELY RESTRICT
EFFORTS TO ENHANCE DIVERSITY IN
MEDICINE.
NOW HERE IS MY EVIDENCE THAT
SOME LEADERS, AND SOME DOCTORS
EVEN, AND SOME SCIENTISTS DON'T
NECESSARILY BELIEVE IT'S THE
NECESSARY OR RIGHT THING TO DO.
THIS IS A SURVEY STUDY PUBLISHED
IN THE ANNALS OF THORACIC
SURGERY.
THE SOCIETY OF THORACIC
SURGEONS, A NATIONAL
ORGANIZATION OF CARDIOTHORACIC
SURGEONS, THEY RECOGNIZE THAT
LIKE CARDIOLOGY, THEY'RE NOT
VERY DIVERSE, SO THEY DID A
SURVEY TO SURVEY THEIR MEMBERS
TO SEE HOW THEY FEEL ABOUT THE
LACK OF DIVERSITY AND WHAT CAN
BE DONE ABOUT IT.
LIKE SO MANY SURVEYS JUST LIKE
THIS, THE REAL GOALS, THE REAL
GOOD PART OF THE SURVEY WAS WHEN
YOU GOT TO THE LAST QUESTION,
WAS JUST AN OPEN-ENDED QUESTION
THAT SAID TELL US WHATEVER YOU
WANT TO ABOUT THIS TOPIC.
AND HERE ARE SOME OF THOSE
RESPONSES.
SO ONE RESPONDENT SAID, WHITE
MALES ARE CURRENTLY BEING
DISCRIMINATED AGAINST IN
ADMISSION TO COLLEGE, MED SCHOOL
AND RESIDENCY PROGRAMS.
CT SURGERY SHOULD BE A
MERITOCRACY.
ANOTHER PERSON SAID I DO NOT
BELIEVE BARRIERS EXIST.
THIS MYTH OF THE NECESSITY OF
DIVERSITY AND INCLUSIVENESS IS
POLITICAL CORRECTNESS ON
STEROIDS.
WE NEED TO WORRY ABOUT TURNING
OUT WELL-TRAINED RESIDENTS.
FINALLY, SOMEBODY SAID THE STS
DOESN'T NEED TO ADDRESS
DIVERSITY AND IN FACT THIS
SHOULDN'T EVEN BE ON THE RADAR
OF THINGS FOR OUR ORGANIZATION
TO DO.
SO THAT'S CARDIOTHORACIC
SURGEONS.
WE'VE GOT -- CARDIOLOGISTS,
WE'VE GOT A VERY CLOSE
RELATIONSHIP WITH CARDIAC
SURGEONS SO I DON'T WANT TO FEEL
LIKE I'M JUST PICKING ON THEM SO
WE'VE GOT TO GET OUR OWN HOUSE
IN ORDER.
SO WE DID A SURVEY IN 2020 OF
CARDIOLOGY FELLOWSHIP PROGRAM
DIRECTORS.
THEY ARE IN A SENSE THE
GATEKEEPERS TO THE PROFESSION OF
CARDIOLOGY.
YOU DON'T GET TO BECOME A
CARDIOLOGIST UNLESS YOU GET
PAST, SO TO SPEAK, THE
CARDIOLOGY FELLOWSHIP PROGRAM
DIRECTOR AND THEIR FELLOWSHIP
COMMITTEE.
SO WE SURVEYED THOSE PROGRAM
DIRECTORS TO SEE HOW THEY FEEL
ABOUT DIVERSITY AND THE LACK OF
DIVERSITY IN CARDIOLOGY AND
CARDIOLOGY FELLOWSHIPS.
ONE OF THE FIRST QUESTIONS WE
ASKED WAS THIS: DIVERSITY IS A
DRIVER OF EXCELLENCE IN
HEALTHCARE DELIVERY, IN OTHER
WORDS, THE MORE DIVERSITY
REPRESENTED AMONGST YOUR
PROVIDERS, THE BETTER THE CARE
DELIVERED.
DO YOU BELIEVE THIS?
FORTUNATELY ALMOST 70% SAID YES.
BUT 5% SAID NO, I DON'T BELIEVE
THAT, AND 25% SAID MAYBE.
SO THAT'S 30%, 3 OUT OF 10,
FELLOWSHIP PROGRAM DIRECTORS
AREN'T SURE IF DIVERSITY IS
SOMETHING THAT SHOULD BE SOUGHT,
IF DIVERSITY ENHANCES QUALITY.
SO NOT EVERYBODY BELIEVES IT,
AND NOT ONLY -- THAT'S ONE
THING.
NOT EVERYBODY BELIEVES IT.
BUT SOME PEOPLE ARE MAKING
ACTIVE MOVES AGAINST IT.
YOU HEARD IN MY RESUME THAT I
SPENT A WONDERFUL THREE YEARS IN
DALLAS, TEXAS AT UT
SOUTHWESTERN, VERY GRATEFUL FOR
MY TIME THERE AND REALLY ENJOYED
MY COLLEAGUES THERE.
TEXAS WAS ONE OF THE FIRST
STATES TO ACTUALLY PASS AN
ANTIDIVERSITY, EQUITY AND
INCLUSION BILL.
IT'S NOT A BILL ANYMORE, IT'S A
LAW, SINCE JANUARY.
AND IT BANS CERTAIN THINGS AND
IT HAS HERE -- I SHOW YOU THE
DIFFERENT THINGS THAT IT BANDS.
WE'LL GET BACK TO THOSE DETAILS
BUT WHAT I'LL TELL YOU IS THAT
IT TRULY RESTRICT THE ABILITY TO
TRY TO ENHANCE DIVERSITY IN
PUBLIC INSTITUTIONS, WHICH
INCLUDES UNIVERSITIES, WHICH
INCLUDES UT SOUTHWESTERN MEDICAL
SCHOOL.
FLORIDA WAS THE FIRST STATE,
TEXAS WAS SECOND, AND NOW THERE
ARE 7 OR 8 STATES THAT HAVE
PASSED ANTI-D EI BILLS INTO LAW.
WHAT ABOUT MARYLAND?
DO YOU KNOW ABOUT MARYLAND?
THE QUESTION PEOPLE WILL START
TO TALK ABOUT IS, WELL, YOU
KNOW, MY STATE, WE'RE A LITTLE
BIT DIFFERENT, I THINK WE'RE
GOING TO BE OKAY.
IS YOUR STATE SAFE IS THE
QUESTION THAT I ASK, AND THE
ANSWER THAT I GIVE IS GUESS
AGAIN, BECAUSE A U.S. CONGRESS
PERSON, GREG MURPHY, HAS
INTRODUCED A BILL IN CONGRESS TO
BAN WHAT HE CALLS RACE-BASED
MANDATES AT MEDICAL SCHOOLS.
SO ESSENTIALLY A NATIONAL
ANTI-DEI BILL AND THIS ONE IS
NOT JUST PUBLIC UNIVERSITIES,
IT'S NOT LIBRARIES, NOT
COLLEGES.
THIS IS COMING FOR US.
THIS IS MEDICAL SCHOOLS.
SPECIFICALLY ABOUT MEDICAL
SCHOOLS.
THAT NATIONAL LAW WOULD BAN
DIVERSITY OFFICES AT MEDICAL
SCHOOLS.
AND TO SHOW THAT THE PEOPLE
MAKING LEGISLATION TO RESTRICT
THESE EFFORTS DON'T REALLY
UNDERSTAND WHAT DIVERSITY
OFFICES DO.
ONE OF THE AT THE NETS OF THIS
BILL IS YOU MAY NOT COMPEL
FACULTY TO AFFIRM THAT AMERICA
IS SYSTEMICALLY RACIST.
WHICH I DON'T KNOW ABOUT YOU,
BUT THAT'S USUALLY THE FIRST
THING I DO WHEN I WALK INTO A
ROOM.
I TELL EVERYBODY TO PLEASE STAND
UP, RAISE YOUR HAND AND REPEAT
AFTER ME.
AMERICA IS SYSTEMICALLY RACIST.
RIGHT?
SO WHO'S DOING THAT?
NOBODY'S DOING THAT.
BUT THE PEOPLE WRITING THESE
BILLS, THEY'RE SMART ENOUGH TO
KNOW THAT IT REALLY DOESN'T
MATTER WHAT YOU PUT IN THE BILL.
BECAUSE PEOPLE WON'T READ THE
DETAILS, THEY'LL JUST KNOW IT'S
AN ANTI-DIVERSITY BILL.
SO WHAT CAN WE DO, YOU AND I?
LET'S GET ON TO THE MORE
POSITIVE PART OF THE TALK.
WHAT CAN WE DO TO ENHANCE
DIVERSITY IN MEDICINE?
AND IF THIS LAW COMES TO
MARYLAND, IF IT PASSES IN THE
U.S. CONGRESS, WHAT CAN WE DO?
ONE THING THAT'S REALLY
IMPORTANT IS THAT YOU'VE GOT TO
CONSULT WITH YOUR LAWYERS.
YOU YOU HAVE TO COMPLY, BUT YOU
DON'T HAVE TO OVERCOMPLY.
AND I TRULY THINK THAT SOME OF
THE PEOPLE, THEY'RE BETTING ON
YOU TO OVERCOMPLY.
LET ME TELL YOU WHAT I MEAN.
IN THAT BILL WHICH IS NOW A LAW
IN TEXAS, ONE OF THE TENETS IS
THAT YOU SHALL NOT REQUIRE OR
MAKE MANDATORY DEI TRAINING.
AND WHAT I'D LIKE TO ASK YOU IS,
HOW DOES THAT HIT YOUR BRAIN?
YOU SHALL NOT REQUIRE OR MAKE
MANDATORY DEI TRAINING.
I'M KIND OF A NATURAL-BORN
REBEL, SO I READ THAT AND THAT
HITS MY BRAIN AS, OKAY, SO
YOU'RE SAYING WE CAN HAVE DEI
TRAINING, IT JUST CAN'T BE
MANDATORY.
SO WE'LL JUST MAKE IT ALL
OPTIONAL.
THAT'S ONE WAY THAT THAT MIGHT
HIT YOUR BRAIN.
KEEP YOUR TRAINING, MAKE IT
OPTIONAL.
THAT'S COMPLYING.
OVERCOMPLYING WOULD BE SAYING
YOU KNOW WHAT, JUST SHUT IT ALL
DOWN.
BECAUSE WE DON'T WANT TO TAKE A
CHANCE.
WE DON'T WANT TO TAKE A CHANCE,
THE LAST THING WE WANT IS THE
STATE LEGISLATURE COMING IN HERE
ASKING FOR MINUTES OF MEETINGS,
AND JUST TO BE ON THE SAFE SIDE,
LET'S JUST SHUT IT ALL DOWN.
WHICH IS WHAT MANY OF THE
MEDICAL SCHOOLS IN TEXAS DID
BEGINNING JANUARY 2024.
ANOTHER EXAMPLE WOULD BE FROM
THAT LAW IN TEXAS, ANOTHER TENET
WAS THAT YOU SHALL NOT GRANT
PREFERENCE ON THE BASIS OF RACE,
SEX, AND SOME OTHER CATEGORIES
FOR EMPLOYMENT, PROMOTION OR
TENURE.
AND HOW DOES THAT HIT YOUR
BRAIN?
YOU KNOW, IT HITS MY BRAIN THIS
WAY, I SAY OH, OKAY, SO WHAT
YOU'RE REALLY SAYING IS I CAN
KEEP DOING EVERYTHING I'VE BEEN
DOING.
BECAUSE I HAVE NEVER HIRED
SOMEBODY JUST BECAUSE THEY'RE A
WOMAN OR PROMOTED SOMEBODY JUST
BECAUSE THEY'RE HISPANIC, OR
GRANTED TENURE TO SOMEBODY JUST
BECAUSE THEY'RE BLACK.
TO ME, TO LOOK AT THAT TENET AND
KEEP DOING WHAT WE'RE DOING, BUT
PUT THE EMPHASIS ON RECRUITING,
THERE'S NOTHING HERE THAT SAYS
YOU CAN'T DO EVERYTHING YOU CAN
TO ENRICH DIVERSITY IN YOUR
PIPELINE.
THAT WOULD BE COMPLYING WITH THE
LAW.
OVERCOMPLYING WOULD BE TO SAY,
YOU KNOW WHAT, LET'S GO FROM
WEBSITE TO WEBSITE ON OUR
WEBPAGES, AND SCRUB OUT THE
WORDS DIVERSITY, EQUITY OR
INCLUSION ON ALL OF THE
WEBSITES.
THAT'S OVERCOMPLYING.
WE HAVE TO COMPLY WITH THE LAW
BUT YOU DON'T HAVE TO
OVERCOMPLY.
WHAT I JUST SAID TO YOU IS WHAT
MANY OF THE MEDICAL SCHOOLS IN
TEXAS DID.
AND AGAIN, I THINK THE PEOPLE
WHO ARE WRITING THESE LAWS,
THAT'S WHAT THEY'RE BANKING ON.
THEY'RE BANKING ON THAT YOU WILL
BE SO RISK-AVERSE THAT YOU WILL
OVERCOMPLY.
SO GETTING BACK ON TRACK, WHAT
CAN YOU AND I DO TO ENHANCE
DIVERSITY IN MEDICINE, AGAIN
RECRUITING ESPECIALLY IN THE
U.S. PRY CHAIN SO THAT WE HAVE
MORE AND MORE AND MORE QUALIFIED
PEOPLE FROM DIVERSE BACKGROUNDS
ENTERING COLLEGE, ENTERING
MEDICAL SCHOOL, ET CETERA.
THE IMMEDIATE SUPPLY CHAIN,
COLLEGE STUDENTS, PRE-MED
STUDENTS, PEOPLE WHO ARE RIGHT
AROUND THE CORNER, AND I MEAN
ACTIVE RECRUITING.
IT'S NOT JUST ENOUGH TO HAVE A
NICE WEBSITE, BUT ARE YOU GOING
TO COLLEGE CAMPUSES, ARE YOU
GOING TO HIGH SCHOOLS?
NUMBER THREE, THERE'S A LOT OF
BIAS.
THERE'S A LOT OF BIAS IN THE
DECISION-MAKING PROCESS, THE
ADMISSIONS COMMITTEES FOR
COLLEGE, THE ADMISSION
COMMITTEES FOR MEDICAL SCHOOL,
RESIDENCY, FELLOWSHIP, AND EVEN
THE SEARCH COMMITTEES TO BE ON
THE FACULTY.
NUMBER FOUR, WHAT IF WE DID
THIS, WHAT IF IN OUR SELECTION
CRITERIA, WHETHER IT'S MEDICAL
SCHOOL, MEDICAL SCHOOL, FACULTY,
WHAT IF WE MADE THE COMPETENCY,
THE HEALTH EQUITY COMPETENCY, A
VALUABLE TRAIT AND A METRIC THAT
WE LACK FOR?
AND SAID DIFFERENTLY, THE LIKELY
LIKELIHOOD THAT THIS PERSON IS
GOING TO BE A CHAMPION OF HEALTH
EQUITY IN THIS SPECIALTY,
WHETHER IT'S ALLERGY,
CARDIOLOGY, CANCER, ORTHOPEDIC
SURGERY, WHAT WOULD THAT LOOK
LIKE?
AND THEN FINALLY, WE'VE GOT TO
GET ACTIVE.
OUR STUDENTS ARE WATCHING US.
THIS IS THE TIME IN THE WORLD TO
BE AN ACTIVIST.
IT IS NO LONGER ENOUGH,
UNFORTUNATELY, TO IMPROVE THE
HUMAN CONDITION BY PRACTICING
MEDICINE AND HELPING EVERY
PATIENT THAT YOU PHYSICALLY GET
YOUR HANDS ON.
AND BY DOING EXCELLENT RESEARCH
THAT SHOWS THE BEST WAY TO TREAT
DISEASES.
YOU ALMOST HAVE TO GO A LITTLE
BIT BEYOND THAT, DO SOME THINGS
TO BE AN ACT VIT, TO TRULY
IMPROVE THE LIVES OF OUR
PATIENTS.
EXAMPLES, RECRUIT DEEP INTO THE
SUPPLY CHAIN.
I'M GOING TO BET THAT THIS IS
THE CUTEST SLIDE YOU'LL SEE ALL
DAY.
THESE ARE KINDERGARTNERS AT
THEIR WHITE COAT CEREMONY AT A
K-12 HEALTH SCIENCES ACADEMY IN
COLUMBUS, OHIO.
A JOINT VENTURE BETWEEN THE OHIO
STATE UNIVERSITY MEDICAL CENTER
AND COLUMBUS CITY SCHOOLS.
FROM KINDERGARTEN THROUGH 12TH
GRADE, THESE KIDS WILL ACTUALLY
HAVE THE HEALTH SCIENCES
INTRODUCED INTO THE CURRICULUM.
MOST IMPORTANTLY, THREE TIMES A
YEAR STARTING IN KINDERGARTEN,
THEY ARE GOING TO HAVE VISITS
FROM DENTAL STUDENTS, MEDICAL
STUDENTS, PHARMACY STUDENTS,
NURSING STUDENTS, ET CETERA, SO
THAT YOU CAN IMAGINE, BY THE
TIME THEY GRADUATE FROM HIGH
SCHOOL, THE IDEA OF BEING A
DOCTOR IS GOING TO FEEL LIKE
THAT'S NO BIG DEAL.
I'VE BEEN SEEING DOCTORS MY
WHOLE LIFE.
SO THIS IS FOUR YEARS ON AND WE
DON'T HAVE DATA YET BUT WE HOPE
TO HAVE SOME DATA SOON DEEP IN
THE SUPPLY CHAIN.
EVEN THE IMMEDIATE SUPPLY CHAIN.
SO I'LL GET CARDIOLOGY-CENTRIC
FOR A MINUTE, BUT WE CERTAINLY
HOPE OTHERS WILL COPY THIS
WONDERFUL INITIATIVE.
SO MY TERM AS THE INAUGURAL
CHAIR HAS COME TO AN END, BUT
ONE OF MY FAVORITE PROJECTS WITH
THAT WAS OUR INTERNAL MEDICINE
MENTORING PROGRAM.
SO WE REACHED OUT TO THE
IMMEDIATE SUPPLY CHAIN, INTERNAL
MEDICINE RESIDENTS, AND WE HAVE
COHORTS OF RESIDENTS THAT WE
MENTOR, THEY ENTER INTO A
PROGRAM, IT'S COMPETITIVE, THEY
HAVE A MONTHLY WEBINAR ABOUT
CARDIOLOGY, THEY HAVE PANEL
DISCUSSIONS WITH CARDIOLOGY
FELLOWSHIP PROGRAM DIRECTORS,
AND YES, WE PICK UP THE TAB AND
BRING ALL OF THEM TO THE ACC
MEETING ONCE A YEAR.
WE WANT TO DEMYSTIFY CARDIOLOGY
AS A SPECIALTY FOR THESE GROUPS
THAT ARE SEVERELY
UNDERREPRESENTED IN CARDIOLOGY,
AND WHAT WE HOPE IS TO IMPACT
THE DIVERSITY IN THE FIELD.
WE START OFF EACH OF THOSE
COHORTS WITH A ZOOM MEETING, SO
THIS IS THE KICKOFF FOR OUR
AFRICAN AMERICAN COHORT.
THESE ARE AFRICAN AMERICAN
RESIDENTS WHO ASPIRE TO BE
CARDIOLOGISTS.
THIS IS A GROUP OF INTERNAL
MEDICINE RESIDENTS WHO IDENTIFY
AS MEMBERS OF THE LGBTQ+
COMMUNITY, ANOTHER VERY
UNDERREPRESENTED GROUP IN
CARDIOLOGY.
THIS IS A GROUP OF INTERNAL
MEDICINE RESIDENTS WHO ASPIRE TO
BE CARDIOLOGISTS WHO ARE OF
NATIVE AND INDIGENOUS
BACKGROUNDS AND THIS IS OUR
HISPANIC COHORT.
IF JUST ALL OF THOSE PEOPLE GOT
INTO A CARDIOLOGY FELLOWSHIP,
THAT WOULD MAKE A SIZABLE
UPSWING IN DIVERSITY IN
CARDIOLOGY AND THIS IS US AT
ACC, THEY'VE CALLED ME -- I'VE
BEEN CALLED BEFORE THE SELFIE
KING, AND THIS IS NOW ONE OF MY
FAVORITE SELFIES.
YOU SEE STANDING BEHIND ME 400
INTERNAL MEDICINE RESIDENTS WHO
ARE WOMEN, HISPANIC, BLACK,
NATIVE AMERICAN, LGBTQ+, WHO
ASPIRE TO BE CARDIOLOGISTS.
IT IS OUR GOAL TO MENTOR THEM
UNTIL THEY ARE VERY COMPETITIVE
CARDIOLOGY FELLOWSHIP
APPLICANTS.
THAT IS REACHING BACK TO THE
IMMEDIATE SUPPLY CHAIN MED
MITIGATING BIAS IN THE SELECTION
PROCESS.
WHEN I WAS DEAN OF ADMISSIONS AT
THE OHIO STATE UNIVERSITY
ADMISSIONS -- WE HAD A BIG
GROUP, 140 PEOPLE.
THOSE OF YOU WHO KNOW THE OHIO
STATE UNIVERSITY KNOW WE DO
THINGS BIG.
SO THERE WERE 140 PEOPLE ON THE
ADMISSIONS COMMITTEE.
WE HAD ALL OF THEM TAKE THESE
ONLINE IMPLICIT ASSOCIATION
TESTS TO UNCOVER HIDDEN UNKNOWN,
UNCONSCIOUS BIASES, IF THEY WERE
THERE, AND TO IDENTIFY THEM, AND
TO QUANTIFY THEM.
ONE TEST THAT YOU CAN DO IS THE
BLACK WHITE IMPLICIT ASSOCIATION
TEST, AND IT HAS THREE OUTCOMES.
ONE, IT CAN SHOW THAT YOU HAVE
WHAT'S CALLED IMPLICIT WHITE
RACE PREFERENCE.
IF I HAVE THAT, WHAT THAT MEANS
IS THAT WHEN I SEE A WHITE
PERSON'S FACE, I AUTOMATICALLY
UNCONSCIOUSLY ASSOCIATE THAT
WHITE PERSON'S FACE WITH GOOD
THINGS, LIKE FAMILY, HOME, LOVE,
JOY, WARMTH, ET CETERA.
AND IF I SEE BLACK PERSON'S
FACE, I AUTOMATICALLY,
UNCONSCIOUSLY, NOW THIS IS
BEYOND YOUR CONSCIOUS CONTROL,
IDENTIFY THAT BLACK PERSON'S
FACE WITH NEGATIVE THINGS LIKE
VIOLENCE, FEAR, MISERY, DANGER,
ET CETERA.
SO THAT'S ONE RESULT.
IF I HAVE IMPLICIT WHITE RACE
PREFERENCE, CAN YOU HAVE THE
OPPOSITE, IMPLICIT BLACK RACE
PREFERENCE, OR YOU COULD BE
NEUTRAL.
WHAT WE FOUND IS THAT ON OUR
ADMISSIONS COMMITTEE, IT DIDN'T
MATTER IF YOU WERE A MAN, A
WOMAN, A MEDICAL STUDENT WHOSE
AVERAGE AGE WAS 23 OR FACULTY,
ALL OF THOSE GROUPS DISPLAYED
SIGNIFICANT LEVELS OF IMPLICIT
WHITE RACE PREFERENCE.
WE IMMEDIATELY WENT INTO AN
IMPLICIT BIAS MITIGATION
WORKSHOP, SOMETHING I SPEND A
LOT OF TIME DOING, BECAUSE IT
TURNS OUT THERE ARE ACTUALLY
SOME VERY EASY TO USE TOOLS WHEN
YOU'RE CONVERSING WITH SOMEONE
THAT YOU CAN USE TO HELP
OVERRIGHT ANY UNCONSCIOUS BIASES
THAT YOU MAY NOT EVEN KNOW ARE
THERE.
WE WENT INTO AN IMPLICIT BIAS
MITIGATION WORKSHOP, AND
PARTIALLY WE THINK AS A RESULT,
THE NEXT CLASS THAT WE ADMITTED
WAS THE MOST DIVERSE CLASS IN
THE HISTORY OF THE OHIO STATE
UNIVERSITY COLLEGE OF MEDICINE.
SO WE IMMEDIATELY MADE ANNUAL
IMPLICIT BIAS MITIGATION
TRAINING A REQUIREMENT FOR BEING
ON THE ADMISSIONS COMMITTEE.
I'VE BEEN ALL OVER THE COUNTRY
FROM EAST COAST TO WEST COAST,
TRAINING ADMISSIONS COMMITTEES,
TRAINING PHYSICIANS, TRAINING
SCIENTISTS, AND SOM, IN SOME OFE
WAYS TO OVERRIDE, OVERCOME OUR
UNCONSCIOUS BIASES THAT ARE
REALLY BEYOND OUR CONSCIOUS
CONTROL BUT THERE ARE SOME
THINGS WE CAN DO.
SO WE'VE GOT TO GET THE BIAS OUT
OF THE SELECTION PROCESS.
NUMBER FOUR, WHAT IF YOU
ELEVATED HEALTH EQUITY
COMPETENCY TO A TOP
CONSIDERATION?
WELL, THAT'S WHAT WE DID WHEN I
WAS AT OHIO STATE AND I WAS FOR
A SHORT TIME THE FELLOWSHIP
PROGRAM DIRECTOR OF THE
INTERVENTIONAL CARDIOLOGY
FELLOWSHIP.
IN THIS EDITORIAL PIECE THAT WE
CALL BLACK LIVES MATTER IN THE
CATH LAB TOO, WE TALKED ABOUT
WHAT WE DID AT OHIO STATE
UNIVERSITY.
WE HAD A POINT SCORE SYSTEM TO
SELECT FELLOWS.
YOU RECEIVED POINTS FOR EACH ONE
OF THESE: CLINICAL SKILLS,
COLLEGIALITY, ACADEMIC
CURIOSITY, LEADERSHIP POTENTIAL,
AND LIKELIHOOD OF PROMOTING
HEALTH EQUITY IN THE FIELD.
THAT'S REALLY IMPORTANT IN
INTERVENTIONAL CARDIOLOGY
BECAUSE SOME OF THE NEW
ADVANCES, THE NEW MEDICATED
STEPTS, MEDICATED BALLOONS,
TAVERS, BEING ABLE TO REPAIR AN
AORTIC VALVE WITHOUT OPEN HEART
SURGERY BUT DOING IT THROUGH A
PUNCTURE IN THE GROIN AND THESE
DAYS SOME PEOPLE ARE GOING HOME
THE NEXT DAY, FIXING MITRAL
VALVES.
WE KNOW THAT THE DATA SHOWS THAT
THOSE ARE VERY UNDERUTILIZED IN
MINORITY COMMUNITIES.
AND SO IF IN OUR FELLOWSHIP WE
REASONED ALL WE DID WAS IN THAT
YEAR WAS SHOW FELLOWS HOW TO DO
THE PROCEDURES, HOW TO BECOME AN
EXPERT AT PUNCTURING THE ARTERY,
ADVANCING A WIRE DOWN THE LAD,
OPENING THE LAD, IF THAT'S ALL
WE SHOWED THEM, THEN THEY WERE
GOING TO GRADUATE AND PROBABLY
GO OUT THERE AND CONTINUE TO ADD
TO THIS DISPARITY.
SO WHAT IF WE TRY TO SELECT
PEOPLE WHO HAVE THINGS ON THE
BALL, THOSE THESE OTHER THINGS
BUT ALSO SHOWN A PROPENSITY TO
BE AN ADVOCATE FOR HEALTH
EQUITY?
LET'S GIVE IT A TRY.
NOW HOW DO YOU SCREEN FOR THAT?
WELL, SOME OF IT IS YOU JUST ASK
THE QUESTION.
SO THIS ACTUALLY COMES FROM THAT
PAPER, NUMBER ONE, WHAT WE DO IS
WE GIVE A SCORE FOR COMMUNITY
OUTREACH.
HAVE THEY PARTICIPATED IN
COMMUNITY OUTREACH SINCE MEDICAL
SCHOOL, AND WE QUANTIFY IT.
HAVE THEY BEEN IMMERSED IN A
CULTURE OTHER THAN THEIR OWN?
AND WE QUANTIFY THAT.
HAVE THEY TRAINED AT A HOSPITAL
THAT SERVES UNDERSERVED OR
DISADVANTAGED POPULATIONS, AND
WE QUANTIFY THAT.
DO THEY HAVE EXPERIENCE WORKING
ON OR INVESTIGATING PROBLEMS OF
DISPARITIES, WE QUANTIFY THAT,
THEN WE SEE HOW THEY DO ON A
QUESTION RELATED TO THEIR
UNDERSTANDING OF HEALTHCARE
DISPARITIES.
AND WHAT I'D LIKE TO SAY, IT WAS
A VERY COMPETITIVE FELLOWSHIP,
AND I CAN PROUDLY SAY THIS, IF
YOU DID VERY WELL ON THESE FIRST
FOUR THINGS BUT YOU COMPLETELY
BOMBED NUMBER FIVE, YOU WEREN'T
GETTING INTO OHIO STATE'S
CARDIOLOGY FELLOWSHIP PROGRAM.
I ALSO WANT TO POINT OUT TO YOU
THAT NOTHING ABOUT THOSE
QUESTIONS I JUST SHOWED YOU HAD
ANYTHING TO DO WITH YOUR RACE.
THE RACE OF THE PERSON.
SO YOU COULD BE -- YOU COULD
HAVE THE WHITEST SKIN AND THE
BLONDEST HAIR AND THE BLUEST
EYE, BUT STILL BE SOMEONE WHO
SCORED VERY HIGH ON ALL OF THOSE
THINGS.
AND SO WHAT DOES IT LOOK LIKE IF
YOU MAKE THIS A PART OF YOUR
DECISION-MAKING PROCESS?
HERE'S WHAT IT LOOKS LIKE.
EIGHT YEARS IN A ROW WE HAD
EIGHT INTERVENTIONAL CARDIOLOGY
FELLOWS, AT LEAST ONE OF THOSE
THREE CAME FROM A BACKGROUND
THAT WAS UNDERREPRESENTED IN
MEDICINE.
BECAUSE WE HAD SELECTED THEM
THUSLY, WE WERE CONFIDENT THAT
THEY GO OUT INTO THE COMMUNITY
OR OUT INTO ACADEMIA BUT IT IS
IN THEIR HEART, IT'S IN THEIR
DNA TO DO SOMETHING TO PROMOTE
HEALTH EQUITY.
FINALLY, WE'VE GOT TO BE AN
ACTIVIST.
THEY'RE WATCHING US.
OUR STUDENTS ARE WATCHING US,
OUR RESIDENTS ARE WATCHING US,
OUR FELLOWS ARE WATCHING US, SO
MAKE A STAND, TAKE SOME ACTION
FOR HEALTH EQUITY BECAUSE IT
SAVES LIVES.
SO WHETHER THAT'S TAKING THE
KNEE TO PROTEST POLICE BRUTALITY
OR MARCHING IN THE STREET TO
HAVE RACISM DECLARED A PUBLIC
HEALTH ISSUE, THE REASON FOR
THAT IS THAT THEN THERE CAN BE
FUNDS FUNNELED INTO THE HEALTH
OUTCOMES OF RACISM, OR LIKE
THESE MEDICAL STUDENTS AT UT
SOUTHWESTERN, YOU CAN DO WHAT
THEY'RE DOING.
YOU KNOW WHAT THEY'RE DOING IN
THE LOBBY OF PARTHON HOSPITAL?
THEY'RE REGISTERING VOTERS.
SO CAN YOU IMAGINE GOING TO YOUR
DOCTOR TO GET A REA FILL ON YOUR
PRESCRIPTION AND WHILE YOU'RE
THERE, SOMEBODY SAYS OH, BY THE
WAY, ARE YOU REGISTERED TO VOTE?
PLEASE STEP RIGHT OVER HERE TO
THIS TABLE AND WE CAN HELP YOU
GET REGISTERED.
NOW OF COURSE WHAT WE'RE VERY
CAREFUL ABOUT IS WE CAN'T TELL
YOU WHO TO VOTE FOR, BUT WE CAN
GET YOU REGISTERED TO VOTE.
THIS IS OF COURSE BEING
REGISTERED TO VOTE AND VOTING IS
A NEW SOCIAL DETERMINANT OF
HEALTH.
SO IN CONCLUSION, DIVERSITY IN
MEDICINE WILL SAVE LIVES AND
REDUCE HEALTHCARE DISPARITIES.
LEGISLATION THAT RESTRICTS OUR
EFFORTS TO DO SO WILL ULTIMATELY
EXACERBATE RACIAL HEALTHCARE
DISPARITIES.
THERE ARE MANY EFFECTIVE
STRATEGIES TO ENHANCE DIVERSITY
THAT ARE NOT IMPACTED BY THE NEW
AND PROPOSED LEGISLATION, SO DO
NOT OVERCOMPLY.
AND JUST WANT TO SAY IN THE
CURRENT CLIMATE, ENHANCING
DIVERSITY REQUIRES COURAGE.
YOU HAVE THAT.
THAT'S ONE OF THE REASONS THAT
YOU INVITED ME TO COME HERE AND
SPEAK TO YOU AND SHARE SOME
THOUGHTS.
AND SO CONTINUE TO PURSUE
JUSTICE, CONTINUE TO BE
COURAGEOUS BECAUSE OUR PATIENTS
DESERVE THIS, AND I'LL END WITH
THIS PICTURE FROM A NIGHT ON
CALL WHEN I WAS AT UT
SOUTHWESTERN, AND WE REALLY PUT
A VALUE ON DIVERSITY IN
CARDIOLOGY.
AND SO THIS WAS A RANDOM
OCCURRENCE.
ONE NIGHT OF STEMI CALL AT
PARKLAND HOSPITAL FROM LEFT TO
RIGHT, YOU SEE THE
INTERVENTIONAL CARDIOLOGY
FELLOW, THE GENERAL CARDIOLOGY
ATTENDING, THE INTERVENTIONAL
CARDIOLOGY ATTENDING AND THE
GENERAL CARDIOLOGY FELLOW.
WE PUT OUT THIS TWEET AND SAID
TONIGHT IS A GOOD NIGHT TO HAVE
A HEART ATTACK IN DALLAS, TEXAS.
[LAUGHTER]
I WANT TO THANK YOU FOR INVITING
ME, AND I HOPE NOW YOU ARE ARMED
TO HAVE THIS DEBATE.
THANK YOU SO VERY MUCH.
[APPLAUSE]
>> I'D LIKE TO INVITE PEOPLE IN
THE AUDIENCE TO COME UP TO THE
MICROPHONES AND ASK QUESTIONS
AND THEN WE ALSO HAVE THE
OPPORTUNITY FOR THOSE ON
VIDEOCAST IF THEY HAVE ANY
QUESTIONS.
SO FEEL FREE TO COME UP.
THAT WAS AN EXCELLENT TALK, VERY
THOUGHTFUL TALK.
I'M SURE THERE'S SOME DISCUSSION
TO BE HAD.
>> THANK YOU FOR THE EXCELLENT
PRESENTATION.
>> THANK YOU.
>> PROBABLY WOULD BE ACCUSED OF
SOMEONE WHO SAYS I WANT TO
MINIMALLY COMPLY, AND SO I
WONDER WITH ALL THE DATA THAT
YOU'VE SHOWN, COULD YOU SIMPLY
REBRAND, AS OPTIMIZING
HEALTHCARE OUTCOMES, AND TEACH
EVERY SINGLE LECTURE THAT YOU
WOULD HAVE UNDER THE BANNER OF
DEI, EVEN IN THE STATE OF TEXAS
SINCE YOU'RE NOT TEACHING DEI
LECTURES ANYMORE, YOU'RE TELLING
PEOPLE HOW TO OPTIMIZE OUTCOMES?
>> SO I REALLY LIKE THAT
QUESTION.
IT'S A VERY INTELLIGENT
QUESTION.
AND THAT CAN BE SOME GOOD ADVICE
FOR US IN THAT.
UNFORTUNATELY, AT SOME OF THE
STATE MEDICAL SCHOOLS IN TEXAS,
THE WAY THEY INTERPRETED SOME OF
THE ASPECTS OF THIS LAW WAS THAT
YOU SHOULDN'T TALK ABOUT EVEN
RACISM.
AND THE IMPACT OF RACISM ON
HEALTH.
THAT THAT'S -- SHHH, DON'T TALK
ABOUT THAT.
WHICH IS VERY UNFORTUNATE.
AND IT'S A LITTLE BIT ODD THAT
AT SOME OF THESE TEXAS MEDICAL
SCHOOLS, IF YOU'RE ON THE
FACULTY, IF YOU WORK THERE, YOU
CAN'T DO IT, BUT IF THEY INVITE
AN OUTSIDE SPEAKER TO COME IN,
THAT OUTSIDE SPEAKER CAN TALK
ABOUT BUT YOU AS AN EMPLOYEE OF
THE STATE AND IF YOU WORK AT ONE
OF THESE STATE MEDICAL SCHOOLS,
YOU'RE A STATE EMPLOYEE, IT'S
NOW AGAINST THE LAW FOR YOU TO
TALK ABOUT THAT.
SO WE HAVE TO BE -- AND I THINK
WHAT YOU'RE SUGGESTING IS, BE
CREATIVE.
BE CREATIVE IN HOW YOU DO THIS.
>> HI.
THANKS FOR THE GREAT TALK.
>> THANK YOU.
>> IT'S VERY INSPIRING.
I HAVE A QUESTION FROM A
PERSONAL EXPERIENCE.
AT ONE POINT BACK IN THE DARK
AGES OF MY LIFE, I WAS AT THE
NEW JERSEY MEDICAL SCHOOL, AND
WE TOOK CARE OF PATIENTS AT
UNIVERSITY HOSPITAL, WHICH WAS
THE ONLY HOSPITAL IN NEW JERSEY
THAT REALLY TOOK CARE OF THE
POOR SPECIFICALLY.
AND I WAS DOING CLINICAL
RESEARCH, AND LEARNED THAT I WAS
QUITE IGNORANT ABOUT THE
TUSKEGEE EXPERIMENT, WHICH WAS
SURPRISINGLY TO ME CARRIED FORTH
IN GENERATION AFTER GENERATION
OF AFRICAN-AMERICANS IN NEWARK.
AND EVEN THOUGH WE MAY NOT WANT
TO SYSTEMATICALLY EDUCATE
ACCORDING TO SOME OF OUR
POLITICIANS NOW, DO YOU THINK
THAT EDUCATING MEDICAL STUDENTS
ABOUT DISASTERS LIKE THAT WOULD
BE HELPFUL AND SORT OF WAKE
PEOPLE UP A BIT?
>> YES, THANK YOU VERY MUCH FOR
THAT QUESTION.
ABSOLUTELY.
I THINK PHYSICIANS NEED TO KNOW
ABOUT SOME OF THESE HISTORICAL
ATROCITIES AND THE FACT THAT
THEY DO HAVE A LINGERING EFFECT,
AND I PERSONALLY HAVE -- YOU
KNOW, FOR MORE THAN A DECADE
NOW, GIVEN A LECTURE ON RACIAL
HEALTHCARE DISPARITIES IN
MEDICAL SCHOOL AND WE TALK ABOUT
THE TUSKEGEE EXPERIMENT.
IF YOU'VE HEARD OF IT BUT YOU
DON'T KNOW THE DETAILS, YOU
REALLY SHOULD READ ABOUT IT, BUT
HERE'S THE 15-SECOND PRIMER.
IT WAS A 40-YEAR STUDY FUNDED BY
THE U.S. GOVERNMENT WHERE ABOUT
400 MEN IN ALABAMA WHO HAD
SYPHILIS WERE ENTERED INTO A
STUDY, THE PURPOSE OF WHICH WAS
TO SEE WHAT IS THE LONG-TERM
CONSEQUENCE OF NOT TREATING THAT
SYPHILIS, LIKE IF WE JUST
WATCHED THESE PEOPLE YEAR AFTER
YEAR, WHAT RAVAGES WILL HAPPEN
TO THEM.
AND THEY WERE LIED TO.
SO THESE WERE MEN WITH VERY
LITTLE FORMAL EDUCATION SO THEY
WERE BEING TOLD THAT THEY WERE
BEING TREATED.
AND WHAT THEY WERE BEING GIVEN
WAS COCA-COLA, AND THEY WERE
TOLD THAT THE SPINAL TAPS THAT
THEY HAD EVERY YEAR WAS ACTUALLY
A TREATMENT.
WHAT WE FOUND OUT FROM THE
TUSKEGEE STUDY IS THAT UNTREATED
SYPHILIS LEADS TO AORTIC
ANEURYSMS AND DEMENTIA AMONGST
OTHER THINGS.
SO THAT'S YOUR 15-SECOND PRIMER
ON THE TUSKEGEE EXPERIMENT.
ABSOLUTELY, I THINK MEDICAL
STUDENTS, NURSING STUDENTS,
PHARMACY STUDENTS NEED TO KNOW
THAT AND OTHER SUCH HISTORICAL
ATROCITIES.
>> THANK YOU, DR. CAPERS, FOR
YOUR INCREDIBLE TALK.
I REALLY APPRECIATED THE
SPECIFICITY AND THE BREADTH OF
WHAT YOU PRESENTED.
>> THANK YOU.
>> I'M JUST CURIOUS ABOUT YOU'RE
NEWLY AT HOWARD.
>> YES.
>> AND WE KNOW HOWARD TO BE AN
INCREDIBLE HISTORICALLY BLACK --
PART OF THE HBCU GROUP KIND OF A
LEADER IN THAT ACADEMIC
INSTITUTIONS, AND I'M WONDERING
WHAT DREW YOU TO COMING TO
HOWARD.
I KNOW YOU WENT TO COLLEGE AT
HOWARD, AND SO GOING FROM SOME
OF THESE MORE MAJORITY WHITE
INSTITUTIONS TO ONE LIKE HOWARD,
WHAT IS YOUR VISION, WHAT IS
YOUR REASON FOR COMING -- GOING
THERE AND HOW DO YOU THINK THAT
CAN HELP YOUR PLATFORM, WHICH IS
INCREDIBLY IMPORTANT?
>> WELL, THANK YOU VERY MUCH FOR
YOUR KIND COMMENTS.
SO THE MOVE BACK TO HOWARD WAS
FOR BOTH PERSONAL AND
PROFESSIONAL REASONS, NUMBER
ONE, BECAUSE I STARTED OFF THERE
IN COLLEGE, IT REALLY FEELS LIKE
A WONDERFUL FULL CIRCLE MOMENT
IN MY CAREER.
BUT I PREVIOUSLY WAS AT UT
SOUTHWESTERN, THAT WAS MY MOST
PREVIOUS STOP, AND I CAN TELL
YOU WHAT HAPPENED THERE, I LOVE
THAT INSTITUTION AND I LOVE
THOSE PEOPLE THERE AND I DON'T
WANT TO -- I WANT TO MAKE IT
CLEAR, MY PROBLEM WAS NOT WITH
UT SOUTHWESTERN.
THEY WERE JUST OBEYING THE LAW.
THIS LAW HAD BEEN PASSED.
BUT KIND OF A FINAL STRAW FOR ME
WAS WHEN I WAS PREPARING A
WORKSHOP ON IMPLICIT BIAS, AND
SOME SENIOR LEADERSHIP SAID
WELL, YOU CAN TALK ABOUT
IMPLICIT WEIGHT BUY A WHICH IS A
THING BECAUSE PEOPLE WHO ARE
OBESE DO SUFFER FROM BIASES AND
CAN YOU TALK ABOUT IMPLICIT BIAS
AGAINST PEOPLE WITH
DISABILITIES, WHICH IS A THING,
BUT NOT RACE BIAS.
YOU CAN'T TALK ABOUT RACE BIAS
IN YOUR WORKSHOP.
AND THAT MADE ME PULL OUT THE CV
AND START JOB HUNTING.
AND SO BEING BACK AT HOWARD
REALLY ALLOWS ME THE ABILITY TO
DO WHAT I'VE DONE AT ALL OF MY
STOPS, WHICH IS TEACH, PRACTICE,
SUPPORT RESEARCHERS, DO MY OWN
RESEARCH, BUT DO IT IN A PLACE
WHERE I'M EEN MORE AMPLIFYING
WHAT I LIKE TO DO, WHICH IS
PRODUCE MINORITY PHYSICIANS WHO
ARE ARMED AS TRIPLE THREATS.
>> DR. CAPERS, FIRST I WANT TO
SAY THANK YOU FOR OFFERING THE
EVIDENCE AND CAUSING US TO
REFLECT DEEPLY IN THE NEED FOR
CALL FOR ACTION, SO THANK YOU
FOR BEING HERE WITH SHARING ALL
THAT.
>> THANK YOU.
>> WE DO HAVE A FEW QUESTIONS
COME IN FROM VIDEOCAST VIEWERS.
SEVERAL THINGS ACTUALLY.
BUT ONE IS, THE DAY YOU
PRESENTED, CLEARLY CONVEYED THAT
DIVERSITY IS NOT SOLELY ABOUT
DIVERSITY IN THE WORKFORCE BUT
IMPROVING HEALTH OUTCOMES.
WHEN IT COMES FROM DIVERSITY IN
THE SCIENTIFIC WORKFORCE, IS
THERE THE DATA AND IS IT STRONG
THAT DIVERSITY ULTIMATELY
IMPROVES OUTCOMES IN TERMS OF
HEALTH?
SO THIS IS INSTEAD OF THE
CLINICAL WORKFORCE, WE'RE
TALKING ABOUT SCIENTIFIC
WORKFORCE AND BIOMEDICAL
WORKFORCE COMMUNITY.
>> SO THANK YOU FOR THAT
QUESTION, AND I DID SHOW YOU
SOME DATA THAT DIVERSITY IN THE
SCIENTIFIC WORKFORCE IMPROVES
THE IMPACT OF THE RESEARCH, THE
MORE PEOPLE ARE READING THE
PAPER.
I'VE NOT YET SEEN A PAPER THAT
CONNECTS THE TWO, THE RESEARCH
IS MORE IMPACTFUL WITH
ULTIMATELY IMPROVING HEALTH
OUTCOMES.
I HAVE TO IMAGINE THAT IT WOULD
IN THE SAME WAY THAT A DIVERSE
PHYSICIAN WORKFORCE WOULD.
BUT WE'RE WAITING ON THAT DATA.
AND MAYBE THE PEOPLE IN THIS
AUDIENCE WILL WRITE THAT PAPER.
>> HI.
THANK YOU SO MUCH FOR YOUR TALK.
SO I REALIZE THAT MOST OF THE
PEOPLE HERE ARE FURTHER ALONG IN
THEIR CAREERS THAN ME AND YOU'RE
MOSTLY TALKING TO THEM --
>> OH, NO, WE'RE TALKING TO YOU
TOO.
>> I'M A MED SCHOOL APPLICANT,
I'M REALLY EXCITED ABOUT
CARDIOLOGY, AND I WAS WONDERING
IF YOU HAVE ANY ADVICE FOR ME ON
WHAT SPECIFIC THINGS I SHOULD
LOOK FOR IN A MED SCHOOL AND HOW
DO I TELL IF THEY'RE FOR REAL
WHEN THEY TALK ABOUT HEALTH
EQUITY BECAUSE EVERYONE TALKS
ABOUT IT ON THEIR WEBSITE BUT
WHO'S FOR REAL?
>> WHAT A WONDERFUL QUESTION
BECAUSE YOU WANT TO BE -- OH,
YEAH, PLEASE, WE'VE GOT TO
APPLAUD THAT.
BECAUSE YOU WANT TO BE AN
INFORMED CONSUMER.
AND YOU'RE RIGHT, MANY PEOPLE
WILL HAVE WEBSITES THAT REALLY
SOUND ATTRACTIVE REGARDING
HEALTH EQUITY.
BUT I WOULD TAKE A LOOK AT --
SEE IS IT BEYOND THAT, BEYOND
HAVING A STATEMENT, YOU ALSO BE
ABLE TO FIND ON THE WEBSITE SOME
ACTUAL PROGRAMS, LIKE WHAT ARE
THEY DOING?
ARE THEY DOING SOMETHING LIKE
WORK IN THE COMMUNITY TO
IDENTIFY PEOPLE WHO ARE AT RISK
FOR CERTAIN THINGS, ARE THEY
DOING THINGS TO HELP WITH FOOD
DESERTS IN THE COMMUNITY,
BECAUSE IF MEDICAL SCHOOLS ARE
DOING THAT, THEY'RE USUALLY
PROUD OF IT AND THEY HAVE THAT
ON THEIR WEBSITE AS WELL.
SO GO BEYOND THE STATEMENT AND
LOOK AND SEE ARE THERE ACTUAL
PROJECTS OR PROGRAMS THAT YOU
CAN GET INVOLVED IN.
>> THANK YOU.
>> OKAY.
YEP.
THEY'LL BE LUCKY TO HAVE YOU.
>> I'LL JUST MAKE ONE COMMENT,
WE HAVE HERE AT THE NIH PROGRAM
CALLED THE MEDICAL RESEARCH
SCHOLARS PROGRAM, WHICH HAS --
>> WOO!
>> THANK YOU.
>> SHOUT OUT FOR THAT.
>> MEDICAL STUDENTS, DENTAL
STUDENTS, VET STUDENTS LOOKING
TO TAKE A YEAR OFF TO DO
RESEARCH, RESEARCH TRAINING, WE
ACTUALLY HAVE SEVERAL STUDENTS
FROM HOWARD UNIVERSITY.
>> YES.
>> AND EVERY YEAR -- I WILL SAY
THAT'S ONE OF THE PROGRAMS IN
OUR PORTFOLIO.
I MEET WITH THESE STUDENTS AND I
JUST WANT TO SAY, I AM VERY
OPTIMISTIC ABOUT OUR FUTURE
BECAUSE WE HAVE SO MANY STUDENTS
WHO ARE COMING IN REGARDLESS OF
THEIR OWN BACKGROUND REALIZING
THE INHERENT PROBLEMS WE'VE HAD
IN TERMS OF DIVERSITY IN
OUTCOMES AND THEIR FOCUS ON
THAT, SO I DO THINK THE FUTURE
IS GOOD FOR US BUT IT DOESN'T
MEAN TAKE THE FOOT OFF THE
ACCELERATOR EA EITHER.
HOW CAN YOU FIND DOCTORS THAT
SUPPORT DEI?
IF I WANT TO FIND A PROVIDER,
HOW WOULD I KNOW, HOW COULD I
KNOW?
>> THAT'S A GOOD QUESTION.
I WOULD START BY LOOKING AT
INSTITUTIONS THAT EMPLOY THE
PHYSICIANS, AND GENERALLY IF THE
INSTITUTION CARES ABOUT
DIVERSITY, HEALTH EQUITY AND
INCLUSION, THE FACULTY THAT THEY
EMPLOY ALSO CARE ABOUT
DIVERSITY, HEALTH IK W EQUITY AD
INCLUSION SO THAT WOULD BE A
GOOD PLACE TO START.
>> HI.
THANK YOU SO MUCH FOR YOUR TALK.
IT'S REALLY INTERESTING.
>> YOU'RE WELCOME.
>> I'M WONDERING IF YOU HAVE ANY
ADVICE FOR MEDICAL STUDENTS IN
STATES WHERE DEI INITIATIVES ARE
LIMITED.
I'M A MEDICAL STUDENT, I GO TO
SCHOOL IN NEW YORK STATE AND I
KIND OF WANT TO KNOW IF I CAN
SHARE ANY OF THE RESOURCES THAT
I'VE HAD WITH THESE STUDENTS.
I HAVE FRIENDS WHO GO TO SCHOOL
IN THE SOUTH AND I WOULD JUST
LIKE WANT THEM TO HAVE THE SAME
OPPORTUNITIES THAT I DO.
>> OH, ABSOLUTELY.
SO -- AND THAT'S KIND OF WHAT WE
NEED TO DO.
SO WHAT ARE WE EACH DOING THAT'S
INNOVATIVE THAT CAN HELP OUT
ANOTHER INSTITUTION OR EVEN
OTHER INDIVIDUALS?
THE AAMC IS A GREAT WAY TO DO
THAT, IF YOU GOT SOME INNOVATIVE
PROGRAM PRESENTING THAT AT THE
AAMC OR SOME OTHER LOCAL
MEETING, OR OF COURSE, YOU KNOW,
WRITING IT UP INTO A PAPER IF
YOU HAVE SOMETHING THAT'S ONE OF
THE MOST EFFECTIVE WAYS TO SHARE
SOMETHING BECAUSE THEN IT'S WITH
US FOREVER.
BUT THESE DAYS, SOCIAL MEDIA,
PODCASTS, I'M STILL -- I THINK
WE'RE SUPPOSED TO CALL IT X, I
STILL CALL IT TWITTER.
I'M ACTIVE ON TWITTER AND ONE OF
THE REASONS THAT I'M ACTIVE ON
TWITTER EVEN THOUGH I'LL SAY
SOCIAL MEDIA CAN BE USED FOR
GOOD PURPOSES OR EVIL PURPOSES.
I USE IT FOR GOOD PURPOSES, IS
TO GET THE WORD OUT QUICKLY.
SO IF YOU HAVE SOME RESOURCES
THAT CAN BE HELPFUL TO
INSTITUTIONS THAT WANT TO TACKLE
THIS PROBLEM OR TO INDIVIDUALS,
I WOULD SAY YOU'RE PROBABLY MORE
SAVVY IN SOCIAL MEDIA THAN I AM.
I'M ONLY ON TWITTER AND A LITTLE
BIT ON INSTAGRAM AND I JUST
CAN'T FIGURE THE OTHER ONES OUT,
BUT SOCIAL MEDIA IS A GOOD WAY
TO GET THOSE IDEAS OUT.
>> THANK YOU.
>> THANK YOU FOR THAT.
THAT WAS GREAT.
MY QUESTION IS LOOKING WHEN YOU
WERE DISCUSSING THE CONTROL
AFTER DISCUSSING THE AMPUTATIONS
AND THAT THEY WERE HIRING
AFRICAN-AMERICANS AND HISPANICS,
AND JUST FOR THOSE WHO ARE KAUR
JUST ABOUT THE PRESENTATION WHEN
THEY CAME TO THE HOSPITAL, WHAT
STAGE OF DISEASE THEY WERE AT.
I JUST WANTED TO KNOW WHAT ROLE
AS FAR AS PATIENT EDUCATION
ABILITY TO DETECT THAT YOU'RE
SICK PLAYS IN THE -- BETTER IN
IMPROVING HEALTH OUTCOMES FOR
THOSE PATIENTS.
>> THANK YOU FOR THE QUESTION.
VERY GOOD QUESTION.
SO I'LL CALL WHAT YOU'RE ASKING
ABOUT HEALTH LITERACY, SO ARE
PATIENTS INFORMED ABOUT THEIR
OPTIONS.
AND WE KNOW THAT THERE ARE
INEQUITIES IN HEALTH LITERACY
JUST AT BASELINE, JUST AS KIND
OF A RESIDUAL EFFECT OF RACISM
IN THIS COUNTRY, STRUCTURAL
RACISM.
BUT ALSO YOU KNOW, THERE ARE
SOME STUDIES THAT SHOW THAT
DOCTORS, SOME DOCTORS SHARE
INFORMATION WITH SOME GROUPS AND
NOT OTHER GROUPS.
SO IF YOU COME IN KNOWING THAT
LISTEN, I KNOW I'VE GOT A
PROBLEM, AND I'VE READ ABOUT IT,
SO I KNOW THERE ARE THREE
OPTIONS TO TREAT MY PROBLEM,
WHEN A DOCTOR SAYS THERE'S ONLY
ONE OPTION, THEN YOU ARE ARMED
TO SAY WAIT A MINUTE, DOCTOR,
WHAT ABOUT OTHER THING I READ
ABOUT?
AND PEOPLE FROM DISADVANTAGED
AND VULNERABLE COMMUNITIES ARE
LESS LIKELY TO BE ARMED WITH
THAT KIND OF INFORMATION.
SO THAT'S SOMETHING THAT WE HAVE
TO FIX AS WELL.
>> DR. CAPERS, WE NEVER GOT TO
MEET, BUT I AM ACTUALLY ONE OF
THE MRSP FELLOWS THAT
DR. BERKELEY WAS TALKING ABOUT
AND I'M AN OHIO STATE MEDICAL
STUDENT, SO --
>> OH!
>> IO.
>> THERE YOU GO.
>> THANK YOU FOR ONE OF THE BEST
LECTURES I HAD IN MEDICAL SCHOOL
ON ACS SO THANK YOU VERY MUCH
FOR THAT IN ADDITION TO YOUR
LECTURE TODAY.
>> THANK YOU.
>> SO AT OHIO STATE, WE HAVE A
LOT OF FREE CLINICS, WHICH IS
ONE OF THE -- ONE OF THE BEST
OPPORTUNITIES TO HELP KIND OF
RECTIFY SOME OF THE DISPARITIES
AS A ME MEDICAL STUDENT STARTS E
CAN.
>> I AGREE.
>> BUT ONE OF THE KIND OF
CHALLENGES THAT WE FACE A LOT IS
NOT ONLY GETTING THE
FINANCIAL -- OR NOT ONLY GETTING
THE FINANCIAL RESOURCES BUT ALSO
THE PEOPLE TO HELP TREAT THE
VAST NEED THAT'S THERE.
DO YOU HAVE ANY RECOMMENDATIONS
FOR HOW WE CAN GET MORE PEOPLE
INTERESTED IN ENGAGING IN THAT
DIRECT CARE BUT THEN ALSO HOW WE
CAN GET MAYBE SOME MORE
RESOURCES IN ORDER TO HELP THOSE
PEOPLE WHO ARE IN THE GREATEST
NEED?
>> YEAH, THE RESOURCES ARE
TOUGH, AND IT COMES BACK -- ONE
OF THE MOST EFFECTIVE WAYS THAT
I CAN THINK OF FOR THAT IS
VOTING WITH YOUR FEET.
SO AGAIN, THAT SLIDE WITH THOSE
PEOPLE REGISTERING VOTERS, WE
ALL NEED TO BE WRECK SISTERED TO
VOTE, AND VOTE FOR HEALTH
EQUITY.
WHEN YOU'RE AT THE POLLING
PLACE, VOTE FOR HEALTH EQUITY
AND ONE THING I'LL JUST PUT IN A
PLUG TO SAY, IT'S SO IMPORTANT,
AND YOU KNOW, YOU ALL KNOW THIS,
TO NOT ONLY GET REALLY FIRED UP
ABOUT VOTING EVERY FOUR YEARS
FOR THE PRESIDENTIAL ELECTION,
BUT THOSE SMALLER ELECTIONS IN
BETWEEN, THOSE ARE THE ONES THAT
HAVE A REAL IMPACT ON OUR DAY TO
DAY LIVES.
SO VOTE FOR HEALTH EQUITY IN
TERMS OF GETTING MORE RESOURCES
FOR HEALTH AND THE WAY OUR
NEIGHBORHOODS ARE STRUCTURED, ET
CETERA.
IN TERMS OF GETTING MORE PEOPLE
INVOLVED IN THE FREE CLINICS,
PARTICULARLY AT OHIO STATE, I
THINK IT'S JUST A MATTER OF
HOPEFULLY JUST A MATTER OF
GETTING THE WORD OUT.
I RECALL THAT THERE WERE A SMALL
GROUP OF ATTENDING PHYSICIANS
WHO LOVED BACKING UP TO STUDENTS
AT THOSE FREE CLINICS, BUT I
REMEMBER WHEN I WAS THERE THAT I
JUST HAPPENED TO KNOW ABOUT IT,
AND I WAS THE DEAN OF
ADMISSIONS, BUT THERE WERE -- IT
DIDN'T SEEM TO ME LIKE THERE WAS
A GOOD PR TO LET ALL THE FACULTY
KNOW.
AND THAT WOULD COME FROM YOUR
FACULTY PARTNERS.
LET ALL THE FACULTY KNOW ABOUT
THIS.
TALK ABOUT YOUR SUCCESSES.
AND AGAIN, USE SOCIAL MEDIA TO
LET PEOPLE KNOW WHAT YOU'RE
DOING.
HIPAA, YOU'VE GOT TO FOLLOW THE
GUIDELINES OF HIPAA.
DON'T HAVE A PICTURE OF THE
PATIENT BUT JUST TALK ABOUT
GREAT THINGS YOU'VE
ACCOMPLISHED.
IT'S GOOD TO SEE YOU.
SO YOU'RE A MEDICAL STUDENT HERE
DOING RESEARCH?
>> YES.
>> ALL RIGHT.
MY MAN.
[LAUGHTER]
>> THANK YOU SO MUCH,
DR. CAPERS, AND THANK YOU,
EVERYBODY.
[APPLAUSE]