Blog Viewer

INCC on DEI: A Look at the Inequities in Medicine First Requires a Good Look at Ourselves

By Currents Editor posted 01-24-2021 08:41

By Tommy T. Thomas, MD, PhD; Ebonye Green MNSc, ACNPC-AC, CNRN, SCRN, APRN; Deepa Malaiyandi, MD and Hana Nobleza, MD

Some of us watched the videos. A doctor’s cry for help from the very medical establishment to which she belongs. A CEO expresses contrition by saying that there were “good people” on both sides. A man cries out for his mother as he was robbed of breath.

We ask the question, “How we can avoid this situation?” The answers lie far beyond this isolated incident. They are buried in the awareness and analysis of a long history of inequity. To reconcile this, we must become aware of the biases that each of us holds. Regardless of our intent.

It’s not simply about what the team did in that one moment. it’s about every step that led to it. 

Nothing that has happened in the last year is new. We have lived in and supported a system that was built upon the back of inequality. 

DEI efforts through INCC can help to level the playing field. First and foremost, by opening our own eyes to the realities of injustice in which we have become unknowingly complicit. Such initiatives will need to focus on pushing the conversation further by asking bolder questions that require community dialogue to answer. Such questions include:

  • Why does one human determine the pain threshold of another?
  • Why haven’t we affected change? What about the system, the education, the personality of the individual?
  • Does a system that teaches empathy inherently teach compassion? Compassion especially for something or someone that you can’t identify with; you can’t mirror? A situation where you will never walk a mile in their shoes?

While empathy refers to our ability to take the perspective of and feel the emotions of another person, compassion is when those feelings and thoughts include the desire to help and the willingness to relieve the suffering of another without the necessity of complete understanding of it.

How do we uncover the biases within ourselves that lead to the discrepancy? Institutionalized or structural racism, personally mediated racism and internalized racism exist within us all. This along with social determinants of health lead to insidious and paroxysmal health effects.

When faced with a “sentinel moment to accelerate” their work, systems and leaders who truly take up the mantle of racial equity do not shift responsibility to the individual harmed or society at large, even in the context of a pandemic. They ask, “How could racism be operating here?” and explore, “Why was a Black woman and physician with valid concerns not heard and understood?”

Equity is both a process and an outcome. It is a measure by which we align our egalitarian values with our attitudes and behaviors, requiring us to stretch beyond ingrained and outdated notions of healthcare, which contribute to persistent inequities rooted in disparate access, quality and outcomes. True equity does not merely ask whether the people within a health system are well-intentioned but instead whether the policies, practices and institutional norms promote healthcare justice.

We encourage you to look within your organization and yourself, remove the blinders and begin asking the questions that will lead to long-term, sustainable change across institutions.  Let’s not simply talk about Dr. Moore’s tragic and unnecessary death, let’s do the work from the ground up so that we aren’t still asking the same question next year and the year after.

Right now, this is who we are. But it doesn’t have to be.

Lauren Koffman, DO, MS As a member of the Educational Products Committee, one of many committees within the Neurocritical Care Society, I was recently asked to review A Guide to Traumatic Brain Injury: The Intensive Care Unit . This guide was written several years ago by Dr. David Y. Hwang and ...
Jenna Gonillo Davis, MS, ACNPC-AG, CCRN Angie Murkins, FNP-BC Ana Kukulj, FNP-C, MSN, BSN, RN Advanced practice providers (APPs) have become the ever-present providers in critical care departments. They act as a stabilizing force for intensive care units (ICU) where residents and ...
Gantner D, Wiegers E, Bragge P, Finfer S, Delaney A, van Essen T, Peul W, Maas AIR, Cooper DJ. Decompressive Craniectomy Practice following Traumatic Brain Injury in Comparison with Randomized Trials: Harmonized, Multi-Center Cohort Studies in Europe, the United Kingdom, and Australia. J Neurotrauma. ...