Beating burnout has been a long-time battle for many people in the workforce. Whether you are running your own business or belonging in the corporate world, there are times you will be challenged by stress and overwhelm. Burnout is always seen as a personal, internal battle, but Paula Davis, JD, MAPP aims to change this perspective. Joining Dr. Diane Hamilton, she discusses how this topic must be looked at on a larger scale, particularly with the way leaders manage their teams. Paula also talks about motivating yourself into loving your work even more and, if it comes to it, when is the right time to jump into a brand new career.
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The COVID-19 pandemic has tested the capabilities and limitations of the healthcare industry. As the vaccination program for this disease rolls out, one unabated challenge of this sector takes the spotlight once more: health equity. Dr. Diane Hamilton sits down with Duane Elliott Reynolds of Just Health Collective to talk about their mission of making the COVID-19 vaccination a lot easier to access for everyone, regardless of age, race, or gender. He explains how the medical solutions for this world-scale problem must never be politicized; instead, they must be focused on the proper education of the public. Duane also shares how they promote diversity in healthcare leadership to increase the representation of minorities and people of color.
I’m glad you joined us because we have Paula Davis and Duane Elliott Reynolds here. Paula is the Founder and CEO of The Stress & Resilience Institute and author of Beating Burnout at Work. Duane is the Founder and CEO of Just Health Collective. He’s a diversity and health equity expert. We’re going to be talking about burnout, diversity, and equity. It’s going to be interesting.
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Beating Burnout With Paula Davis, JD, MAPP
I am here with Paula Davis who is the Founder and CEO of The Stress & Resilience Institute. A training and consulting firm that partners with organizations to help them reduce burnout and build resistance as a team leader and organizational level. You’ve probably seen her featured in The New York Times, O, The Oprah Magazine, and The Washington Post, you name it. She also contributes to Forbes, Fast Company, and Psychology Today. I’m excited to have her here. Welcome, Paula.
Thank you, Diane. I’m glad to be here.
I’m looking forward to this. I know you have a new book, Beating Burnout at Work: Why Teams Hold the Secret to Well-Being and Resilience. I love that. Everybody is burned out. Before we get into that, I want to know a little bit more about you. You’re everywhere. I was looking at your bio. It was impressive. We can get a little bit into that. How did you reach this level? What’s your backstory?
I practiced law for seven years. I burned out during what became the last year of my law practice. Honestly, I didn’t know what it was that I was experiencing. I went through the whole progression of burnout. When I entered burnout I was rolling into work, 10, 15, 20 minutes later than I would and up later on Sunday night, staring at the clock and hoping I could freeze time because I didn’t want to go into work the next day. That’s how it started. It lasted about a year or so. By the time it finished, I was in bad shape. I was getting panic attacks almost every day. I was having a lot of issues with anxiety. I was in the emergency room twice because I had bad stomach aches from the stress that I was experiencing.
It took a while for me to put the puzzle pieces together but all of that led me to decide to leave my law practice. I went and got a Master’s Degree in Applied Positive Psychology at the University of Pennsylvania. I thought, “I don’t know what this was but I want to help other people not to experience it.” I want to start studying well–being and what are the sources of that for individuals, organizations, and leaders and how can I bring that back to organizations to help educate people about burnout, stress, and resilience.
You’re flashing back to my twenty years I was at work at AstraZeneca and the last fifteen, I was in the pharmaceutical division. I loved working at AstraZeneca. It was a great company. I didn’t like being a pharmaceutical rep in the end. I don’t like to drive. It’s not my job. I’m administrative. It was a misalignment to me. How much does your well–being tie in? Is it that you were burned out as a lawyer or you shouldn’t have been a lawyer? It’s not your passion.
We often don't listen to learn. That's an underdeveloped aspect of leadership that plays into the burnout conversation. Click To TweetIt’s both, strongly. When anyone asks me, “Why did you go to law school?” It was the thing for me to do, quite honestly. There was no huge compelling draw or passion for it. My undergrad is in psychology. When I graduated, there wasn’t yet the formed or named science for positive psychology. I didn’t want to pursue a PhD in the mental illness side of psychology. I thought, “I want to continue with my education. What can I do? I’ll go to law school.” I had taken some constitutional law classes and other things in my undergrad and I loved them. I thought that would be a great thing to pursue. Honestly, I never liked law school all that much. The first week of law school, I remember being in the dean’s office in tears and telling him, “I don’t know that this is for me.” I had these inklings even in the early stages of law school. I ignored them and kept going.
They’re bringing back memories. I used to remember sleeping and throwing up in the toilet from going through the training in pharmaceutical sales because I was like, “I hate this.” They would videotape us giving these fake sales presentations and it was stressful. That’s in my early twenties. I was young. Going away for six weeks of training and different things, it wasn’t me. You end up in these golden handcuffs and everybody keeps telling you, “You’re a pharmaceutical rep. You’re a lawyer. You’re lucky.” You go, “What’s wrong with me that I’m in this job?”
The golden handcuff is powerful because I work with a lot of people in that position, especially if you’re good at it. Even though I didn’t have a strong passion for being a lawyer, there were many aspects of lawyering that I was good at. It was seen as a star and labeled that way within the firm that I was at. You start to buy into the fact that you’re doing something lofty and important and it seems to the outside world as something prestigious. If you don’t like it but the money then starts rolling in. It can be hard to get out of when you hit that point because it’s hard to let a six–figure salary go by the wayside to do something different. It can be hard. It’s funny because if you had asked me when I was a lot younger what did I want to do in college or what did I see myself doing, I would have said immediately that I wanted to be a teacher. It’s funny how I’ve come back around with my work. I do so much teaching and training. I’m like, “That’s where I started.”
I wouldn’t have said that if they’d asked me. In my family, everybody went into sales. I won the President’s Award doing all that stuff. You can be great at it but that doesn’t mean you love it. Is Beating Burnout at Work part of it leaving work? What are you trying to help people come to from reading this?
First of all, it’s a little bit of what we’re talking about in terms of understanding our individual wiring, understanding what we love to do, where we feel a sense of meaning and impact. Are we feeling a sense of meaning and impact in our work? It is some of those building blocks but it’s also starting to expand the conversation because so much of what we talk about when it comes to burnout stops with individual conversations, individual factors, and it’s a syndrome of exhaustion. We apply self–management or self–care strategies and stress management strategies, which are good and we need them. That’s not to be excluded from the conversation but we have to start thinking a little bit more broadly when it comes to burnout.
If we’re burning out and if people in organizations are burning out, it is somewhat influenced by their individual wiring and personality traits and things like that. It’s much more heavily influenced by the deeper causes of it how leaders lead, organizational policies, culture, and how teams are oriented. We need to expand the conversation into more of a systemic focus so that we see and not put the burden on individuals to say, “Fix this.” You have to do your part but then you also have to draw in the rest of the folks within an organization to have the right conversation.
That’s important because people leave bosses and not companies. I leave for lack of respect. If somebody is not respecting me, that’s going to be a tough one for me. It led to my interest in studying curiosity because I thought many people are complaining about engagement. Everybody wants innovation and all of the things. I was researching the things that I thought were key to improving those things. For me, a lot of it is curiosity and the ability for people to ask questions and feel like what they say means something. What are we doing to cultivate a sense of engagement at work? Are we giving them a sense of well–being? Are we listening to them? As leaders, is it happening?
There’s a lot of education that has to happen around the burnout conversation, particularly at the leader level. One of the big words you’re hearing is empathy, how leaders need to cultivate a skillset around empathy. I think of empath, I use a phrase that a colleague of mine coined as a humble curiosity. It’s aligned with what you’re talking about. As leaders, we oftentimes listen to fix. In the legal profession with the lawyers who I work with, we listen to win but we don’t oftentimes listen to learn. That’s an underdeveloped aspect of leadership that plays into the burnout conversation because it makes us less likely to have the right conversations around stress with people and with our teams. We don’t feel comfortable necessarily asking 1 or 2 more questions to dig in a little bit more deeply to understand a person’s situation and perspective in terms of what’s contributing potentially to the stress and causing the burnout. There’s a lot that still has to be done and talked about at that level as a start.
That’s interesting because I wrote my dissertation on emotional intelligence. Your empathy is such a big part of that. When I had Daniel Goleman on, I asked him about curiosity. I hadn’t heard that term humble curiosity. I love that. When I wrote it, I thought, “This is an interesting subject.” I was figuring I got on this thing and it’ll pass. Years later, it’s this huge thing that people are still trying to figure out. Travis Bradberry had some research and he was quoting about how CEOs have some of the lowest levels of emotional intelligence. They were insinuating that maybe it’s because we’re in these meaningful conversations when we’re at the level of going up the ladder. Eventually, we get to this point where we’re at the top, and then you’re surrounded by people who are saying yes to everything. You may not get real conversations where you can develop that sense of emotional intelligence. Do you think that’s happening? The CEOs and the higher levels are saying yes and we’re not developing that sense.
That’s certainly part of it. If I can think of a silver lining from the pandemic, what I’m hoping is that because we’ve all lived it. We can’t say, “It’s somebody else’s issue. They’re experiencing stress and that’s not something that I experienced.” I’m hoping that it’s opening up CEO and senior leaders‘ eyes to the fact that we’ve all, pre–pandemic, have been experiencing a whole host of challenges. I feel like the pandemic ripped the band–aid off and exposed the fact that we’re all challenged, even to the next level for a lot of people. What you’re describing is true. I’m also cautiously optimistic that some perspectives might be changed and some minds might be open because of what folks have had to live through and what they’ve seen their teams go through as well.
If you’re not on the front lines dealing with people’s perspectives and in a position to ask some of these questions, it’s a skill. It’s a muscle like anything else if you don’t use it. It’s going to atrophy a little bit. I work with a lot of advice–givers. I work with people who are paid lots of money to give their advice in professional services organizations. They also forget to ask their clients. You mentioned innovation in design thinking models. The first step is empathy. It’s this humble curiosity piece and asking people to explain the breadth of their challenges. It’s generally a mindset that needs to be rewired or practice to help.
Originally, my goal was to study curiosity and I started to think, “What does curiosity mean to me?” It’s about empathy but also getting out of status quo thinking and getting out of this rut. A lot of people feel like they’re in this burnout, as you call it or whatever you want to call it. You can’t just go to yoga, get a retreat, and do one thing to get out of this. How do you get out of it?
First of all, understand is what you’re experiencing even burnout. Because we use the term interchangeably with general stress, it becomes self–help and applied in a lot of different respects. We’ve lost the essence of what burnout is. That’s always a starting point that I tell people. We all experienced stress daily. Some stress is good. We need to have it to focus and be productive and things like that. Chronic stress is what doesn’t serve us. We know we’re getting closer to something that looks like burnout when we experience these three dimensions. The first one is chronic, physical, and emotional exhaustion. We’re all feeling tired. We all have busy days, weeks, and months where we feel like we’re slacking a little bit. Over time, it’s chronic that whatever you’re doing isn’t replenishing your tank, especially if you’re trying to do the same things that had always worked in the past and they’re not working now. That’s something to pay attention to.
It’s also a sense of chronic cynicism. People are annoying you. People are bugging you. I remember going to work and thinking, “Hi, everybody.” I then darted right for my office because they didn’t want to interact with anybody, and that wasn’t my personality, especially with my clients. I started to think, “Can you figure this out on your own? Do we have to have this conversation?” That wasn’t good. The result is that sense of lost impact. You start to think, “Why bother and who cares more?” You start to ask yourself, “Am I getting the sense of meaning from my work that I thought I should? Am I making an impact?” That opens up those questions. Burnout is more a constellation of those three pieces that you’re experiencing more consistently over time. First of all, that’s what it looks like. We have to start using the terms precisely.
I’m a sponge. I take everything I can take out of a situation. I’m like, “The sponge is full. I want to go on to something else.” How do you know if this is the time to reinvent yourself or if it’s something else?
When everything shifts back into normalcy, let us preserve the sense of autonomy and flexibility brought by the pandemic. Click To TweetA lot of people ask me that question and there’s no one answer to it because it depends on everybody’s specific situation. If you’ve been having these little whispers, they’re turning into a louder conversation, and you can’t let go of the fact that you feel like you’re either on the wrong path, there’s something else that you’re meant to do, or something else is pulling you in a different direction, pay attention to those whispers. Pay attention to those louder conversations because it means something and it’s something that you should be paying attention to.
If you’re thinking about either changing careers or changing organizations or even changing teams within your organization, be intentional about it and give it some thought. When I was going through this process, I hired a coach to bounce ideas off and say, “Help me figure this out.” There’s a lot of work that goes into making the ultimate decision to decide, “This isn’t for me.” It starts and we oftentimes suppress it. We don’t pay attention to those little whispers and conversations that come up about, “I don’t think this is something that I love.”
I’m hearing more of that because of COVID. Everybody is zoomed out. They’re trying to raise kids while working. It’s such a hard time to know whether you’re bummed from work or whatever. Do you make any decisions in the middle of COVID?
No. Whenever you’re in a place of exhaustion and frustration and everything you described, I think of it as the swirl. That’s generally not a good place to come to these big decisions. If you’re starting to see or tell yourself more and more during the time that we’ve been in a pandemic, “I’m not sure if this is what I want to do.” That’s also important to pay attention to. One of the things that the pandemic has taught me and a lot of people have shared with me too is that life is short. We’ve had a front–row seat to the hundreds of thousands of people’s lives being taken and millions across the world because of this pandemic. That left an impression on a lot of people and it’s caused a lot of people to take a step back and say, “If the time is not now, what am I waiting for?” Life could be short in a way that we hadn’t intuited consciously before. Paying attention to those moments is important. Let’s get on the other side of this for a little bit and see if you’re still having those same feelings months after the pandemic is done.
Sometimes, you know right away when you’re in a job but then again, it takes six months or more for a job to make people feel comfortable. It’s tough to know which one you’re feeling if you’re in something new and this all happened. A lot of people are switching and having to get to new things. A lot of people aren’t used to working virtually and that’s been a challenge for a lot of them. I had people on the show from Harvard who said they were seeing more productivity from people working at home. When I talk to people, they don’t feel like they’re productive and have that same desire. I’ve seen a few people switch jobs to get a new burst of energy. Do you think people are hopping around because they want to feel better?
I haven’t seen as much of the trend of hopping around. I’ve talked to a lot of people who have said, “I’m staying put in the immediate short term.” As soon as things get lifted a little bit more or as soon as we’re transitioning back into whatever work is going to look like, I’m going to put my resume out there. I’ve got the headhunter on speed dial, especially for working parents and people who have needed a lot of flexibility during this time. If you’ve been a valued member of the team, your organization cared about you and helped you through this crisis. That registers with people. To me, I’m treading water until things open up a little bit more. I’m going to see what else might be out there. Part of it is because I don’t know that they have felt entirely supported by their organization.
I see two things when I’m talking to people. I had a company where I worked and we were all working. We probably start around 5:00 in the morning and we stop about 7:00 PM. We might come back at 9:00 PM to work some more. We work Saturdays and Sundays and we don’t take vacations. All of a sudden, you get the sense that it’s over the top and you’re never going to have a life again or you have these other ones that we want to be a work–life balance. What are you seeing more of working people to death or some of that supportive thing?
Anecdotally, most of what I’m hearing from people is more like the first situation you described. It’s hard to avoid it in part because we don’t have the natural boundaries and breaks in our day in this format. Computers are there, so they might as well hop on, start working, and then we keep going. We don’t have to commute home. We’ve got the kids dinner and other things have been settled as they are. I might as well patch in again and see what’s going on. There was a study published somewhat early in the pandemic showing that we’re working about 10% to 20% longer in a day and that’s on top of already long days that we were working prior to this thing even starting. I’m not sure if this is a direct connection to what you were asking but I hope that we preserve a couple of things as we shift back into what is work going to look like. I hope we preserve this sense of autonomy and flexibility.
There’s so much research, especially from the burnout literature, showing that having that sense of choice, voice, flexibility, and autonomy over our days is a huge job resource that can slow burnout down even in and of itself. Helping people keep some of that flexibility is important. I also hope we don’t engineer our connection. Another thing I’m hearing consistently from people is the physical structure of the workplace was my connection point. It was where I could walk to the meeting with three other people and we can bounce ideas off of each other. Onboarding is better and easier in an in–person environment and mentorship, feedback, and all of those things. We need that connection. I hope that we think intentionally about that piece of the puzzle too.
The part I liked about pharmaceutical sales is that I was working out of my home most of the time but they did several meetings throughout the year where everybody got together and everybody got to know each other. You had that sense of knowing everybody. When I’ve taught in online education, I didn’t know who my bosses were. I didn’t know who anybody was until I had a full–time job with them. It helps to have a little bit. I keep hearing that when you talk to real estate experts, whether they’re going to need buildings or not need buildings, it’s going to be a combination. A lot of it is about building habits around this flexibility. What habits do you have that help you? Is there something you can share?
I am a newly single parent, running my business, having come out of writing a book, and all of that. I try to be strict about how I compartmentalize my time. If I am in the office, then I’m focused on being in the office. If I have noticed that I have been in the office for way too many days. Sometimes, I forget that I’m the CEO of a company and it’s like, “I can leave at 2:00. I can take Saturday off.” That can happen. It’s taking advantage of those opportunities. Most of us will find that work will take as much from us as we are willing to give. Unless we put the brakes on and push back against that a little bit, it can overtake us. I’m thinking and taking advantage of those times and compartmentalizing. When I’m with my daughter, my phone goes away. I’m focused and intentional about being with her. I think about it in terms of boxes and that’s the box that I’m in at the time. That helps me.
I have a friend and sometimes I’ll go, “I’ve worked twelve hours this day.” Since I’m the CEO of my company, she’ll go, “You need to complain to your boss. Your boss is scheduling you stupid hours.” Sometimes, you have to think like that.
It’s like, “Here’s your mirror. Talk to the boss.”
If anybody is reading this, is there one major takeaway that you’d like them to get from your book or something you’d like to end with that is important to you that they get from it and be curious?
It’s starting to expand our conversation around burnout from one that looks at or through the lens of being an individual issue or problem and expanding out our conversation to understand and realize that it’s about the system. We have to start looking at how leaders lead and how teams function in all things within the organization if we’re going to make some meaningful maneuvering when it comes to this topic. Hopefully, as I explained in the book, it’s not as daunting as it might sound. There’s a lot of tiny noticeable things or TNTs that leaders and teams can start to incorporate to make this process moving in the right direction. That’s the biggest takeaway.
Unless we put brakes on our work and push back against that a little bit, it can overtake us. Click To TweetIt’s perfect timing. You can’t think of a better time for a book like this. A lot of people are going to want to read it and find you and learn more. Is there some site or something you’d like to share?
Folks can go to BeatBurnoutNow.com, which will take them directly to my website, where they will find how to order the book and more information about it.
That’s great. I hope everybody takes the time to check it out. It was fun having you on the show. Paula, this was so much fun.
Thank you, Diane. I enjoyed our conversation.
You’re welcome.
Health Equity During Pandemic With Duane Elliott Reynolds
I am here with Duane Elliott Reynolds, who is the Founder and CEO of Just Health Collective. Recognized by countless organizations as a change–maker within his field, he’s helped to lead the national conversation around belonging to the intersection of diversity, inclusion, and health equity. It’s nice to have you here, Duane.
It’s great to be with you, Diane. I appreciate you having me on the show.
I was looking forward to this. You’ve been doing some amazing things. You’ve been written up by some great magazines. You’re the President and CEO of the American Hospital Associations Institute for Diversity and Health Equity. That’s a pretty big deal. You’ve held leadership positions in Johns Hopkins. You have done a lot in the healthcare field. I want to get a backstory on you, so we know what led to this position.
I always start with the Ohio State University. I got my Master’s in Healthcare Administration from Ohio State. I’ve spent the majority of my career in healthcare administration, starting in organizational development and then moving into operations for academic medical centers and into consulting. Consulting is also where I started leading inclusion and diversity for the entire consulting organization. That married my interest and passion in healthcare administration. I developed a practice called The Inclusion and Health Equity practice that was meant to help healthcare organizations think about the strategy around health equity, diversity, and inclusion for their organizations.
From there, I was recruited to the Institute for Diversity and Health Equity and develop their strategy around both internal diversity inclusion and health equity for member organizations, hospitals, and health systems across the country. I have developed Just Health Collective, which is a consulting and advisory services firm that is out helping healthcare organizations figure out how to do health equity, figure out how to change their culture so that people feel that they belong, valued, and can contribute to how that healthcare organization serves this community.
That’s interesting because I’ve worked in health care and my husband is a physician. With that background, tying into my research on curiosity and how it helps with engagement and many other things, where do you see curiosity plays a role? In the healthcare field, are you finding that they’re allowing a lot of questions and people providing insights? It’s a unique area in business compared to some of the others.
That’s true. Healthcare is going on a transformation. We are the biggest portion of gross domestic product and spend. Our costs are out of control when we look at other developed countries and what they spend and what our outcomes are. Along with that, when we begin to think about health equity and diversity and inclusion, they are different fields but they’re interrelated. We help organizations think about both. When we’re looking inside the organization, we want to make sure that the diversity of the organization, particularly at the leadership and board levels, is representative of the community that they serve. We can have multiple lens and perspectives that help to think through what the operation looks like, what strategy looks like, how you’re serving patients from diverse demographics and ensuring that you’re providing quality care.
One thing that we all have seen since the pandemic is that there are underlying social and economic conditions that are leading certain populations to experience disparate outcomes. That has been there for many years. It relates to systemic racism, other laws and regulations that have set up the perfect storm for poor health for certain communities. Healthcare organizations are thinking about this in a much broader way because they understand the implications of not doing so.
I’m trying to remember back to my days in pharmaceutical sales. I sold blood pressure medicines. I remember African–Americans had a higher incidence of high blood pressure and different things. Looking back to the past of how others have been treated that didn’t feel was equitable or they felt tested in that type of thing, how are you getting the message across about how to handle this COVID situation? That’s got to be a big challenge.
There has been a lot of what is called vaccine hesitancy. It’s less about hesitancy and more about trust and understanding what the process was to develop. There’s a natural anxiety that’s produced when you’re thinking about putting something in your body that you know nothing about particularly when you think about the African–American community, other communities of color, the experience that they’ve had with the United States government, and some of the atrocities that have occurred. What we’re trying to do is to help to get information out there. At the end of the day, it is the consumer who has the right to make decisions about their own. We want to make sure that people are well–educated and understand the benefits and risks of not getting the vaccine. It matters in communities of color where we’ve been hit hardest by the actual pandemic.
Are they getting the ability to get the vaccine if they want it as much as other areas?
I would say that is a mixed bag. Some hospital health care systems and public health agencies do understand that health equity has to be a part of how the vaccine is rolled out. Others are not as well versed and may not put a priority on the health equity component, thinking about populations that have experienced the most impact getting the vaccine out to those populations first. What I have seen, particularly here in Georgia and other states, is that we’re basing off on age, which certainly is one level of health equity that you can look at. Given that communities of color are hit the hardest, it probably makes sense to be looking at age and race in that equation. Some are doing good jobs at that and others are not.
Here in Arizona, we have a large Hispanic community. They get a lot of the jobs that you have to continue going to during the pandemic. They’re getting a lot of the COVID. They aren’t over 70 years old, necessarily. How would you handle that? How do you decide who gets it?
The reality is we have to look at underlying conditions. We have to look at the impact. We have to look at age. We have to follow what the statistics are and what the science is telling us. The reality is, by taking care of the most impacted populations, we all win. If anything we’ve learned with COVID-19 is that we’re all in this together. If there are communities that are impacted, aren’t being taken care of appropriately, those communities continue to spread and perpetuate COVID-19, we’re all at risk. It makes sense to make sure that we are getting out to the appropriate communities first so that we’re stopping the spread there. We’re preventing deaths from occurring. We all win because we’re taking care of the communities that are being hit the hardest that impact all of us.
There was one person who mentioned that the mask–wearing situation in each country is interesting to look at. Here, it’s politically divided. When you go to other countries, they have different reasons and not necessarily political. How is that impacting health in general?
At the end of the day, it's the consumer who has the right to make decisions on what they want to buy. Click To TweetI would say it is unfortunate that politics has played into our public health strategy here. It put us behind in terms of the things that we know to be proven to help prevent the spread of the disease. Mask-wearing somehow moved into the political realm. In reality, it’s our best measure to take absent the vaccine. Even with the vaccine, still wearing a mask is going to help the situation. I do think politics have played a role in public health and access to care. It’s pretty unfortunate because, at the end of the day, our lives are not about politics and shouldn’t be dictated by one political party or the other.
On the show, she was saying that it was interesting to her because it wasn’t necessarily politically based in other countries but people put their heels strongly against, for whatever reason, in different areas. You had mentioned earlier about science and we got to follow the science. You only know what you know right then. We thought Pluto was a planet and then we don’t. It’s interesting to me because you’re taking a vaccine that can impact your RNA and people might find that scary. They don’t know the science behind things. How do you know where to get your information?
You’re right, we don’t know all of the downstream impacts. There’s a certain level of trust that has to be built for people to feel comfortable embarking upon something new and somewhat unknown. We do have lots of data through clinical trials. We will continue to have data that may change the course of what we’re doing relative to the treatment of COVID-19. You have to have trust. Part of the situation when we think about health equity is about how health systems, physicians, and public health agencies develop trust within their communities.
Are there any other social determinants of health that we didn’t talk about because it’s interesting to look at that?
Social determinants of health are what ultimately impact health equity. When we are solving for social determinants of health, we’re trying to alleviate and prevent health inequity and disparities that occur. The social determinants of health are a huge factor in why certain communities experience poorer health outcomes. In certain zip codes, we know that you may not have access to healthy food options. You may not have public transportation that can effectively get you to doctor’s appointments.
There’s a multitude of things that are about where we live, where we grow, and where we play that impact our health more than the care that we receive inside of healthcare organizations. There are movement and understanding that we not only need to solve the problems inside the healthcare system but we need to be thinking outside of the four walls about the social determinants of health. That requires community partnerships, interventions, and policies that are much bigger than the health care provider system itself.
The health care provider system is interesting to me in general from the fifteen years when I was calling on the doctors in what they know and what people think doctors know. They’re advertising directly to the patient. How do you feel about advertising directly to people? Is it good giving them information? Is that making it harder?
It makes some sense to provide the information and to try to educate folks. I also think there’s an element of health literacy that comes into play and understanding the pros and cons and whether a particular drug may make sense for a person in their plan of care. It’s fine to educate and market to consumers but there have to be advocates either with the inside of the healthcare system or within your own family that help individuals make good decisions about the advertisement that is happening and how it influences the provision of the care that someone receives.
With your work at Just Health Collective with companies, what would they have you do specifically?
We provide consulting services. We may come in and do health equity, diversity, and inclusion assessments, looking throughout the organization, and interviewing individuals. Ultimately figuring out where their gaps are, creating strategic priorities, and a roadmap that will help them move in the first year to maybe even three years down the road. We also support the implementation of that roadmap. The other thing that we do is training and education around specific aspects of health equity around anti–racism and how that needs to show up in the healthcare space. We also provide data and analytics in this particular space to be able to help organizations identify where their disparities are. We propose interventions that ultimately close disparities that exist in clinical outcomes, disparities that may exist inexperience, and certainly disparities that cause cost in the system that can be avoided.
Can you give some examples?
If we think about, for instance, diabetes, we know that African–Americans have higher rates of diabetes and complications from diabetes than the white population. We know that a disparity exists and that disparity itself then causes certain outcomes to be worse. Patients may show up in the emergency department, which is a high–cost part of the healthcare system or they may have to be admitted to the hospital again, which is higher costs. If we were to get ahead of that, do prevention, and take care of some of the social determinants of health, that person may be showing up to the healthcare organization as a social need. We then have the opportunity to close those gaps or those disparities and that can improve experience outcomes and costs.
It’s interesting to look at companies and the blind spots they have. I wrote about perception and researched some of that. The culture was such a big part of perception. In your experience growing up and the different things, what are the biggest cultural blind spots you’re seeing?
In healthcare, in particular, we have a diversity issue amongst the leadership. When we think about the leadership of hospitals, health systems, and health plans, it is predominantly white males. While that has worked and been somewhat effective over the years, what it leaves out is the perspective of women who are decision–makers in healthcare and their families. It leaves out minority populations who may speak a different language, who have different cultural nuances that haven’t been built into our healthcare system. It’s leaving behind demographics of individuals that, quite frankly, continue to shift in our demographics of the United States. We’re going to, at some point, become a majority and minority country.
If we have not deconstructed and reconstructed a healthcare system that works for that minority and majority, we’re going to have major issues. For instance, if a person does not speak English as their primary language but yet they’re trying to move through a healthcare system that is predominantly set up for an English–speaking patient, they’re going to have challenges within the system that can lead to disparities. We have a major blind spot as it comes to diversity in these organizations. I would even say the skillset of some of our leaders, understanding how social determinants of health connect how the internal workings and operations of the health care system have to change to ensure that we are driving towards health equity.
I’m curious. There’s always going to be people, white, black, or whatever color, that are going to take advantage if you have these programs to help them. I’ve seen in some companies, they’ve promoted people not because of their qualifications but because they met a certain group that was underrepresented. They would be able to get away with murder because nobody wants to do that. How do you get away from that where people take advantage of these great opportunities that should be allowed to people who are the best? Hopefully, people of color can get those opportunities because they’re the best but sometimes, they’re not the best. How do you avoid that situation?
Our lives are not about politics and shouldn't be dictated by one political party. Click To TweetThat’s a great question and one that I would turn around because what we have done is create a system where predominantly white males have been privileged and advantaged. There are a lot of white males that aren’t the best and weren’t the best to be. The women are the minorities. That is the system that is at play. Thinking about how we interrupt that system on the flip side means that we first have to take care of the system as it’s set up to advantaged folks.
I’ve had people on in the show talk about putting women on boards, for example. One guy who was the CEO of a major insurance company was saying that he works as a board of directors and all these different boards. He tells them to not even put anything but women in the pool when people are looking for the next board member. Otherwise, you’ll never get enough women on the board to make it equitable. Do you think it’s fair to do that? Do you think that’s the way we need to go?
It makes sense in terms of trying to balance out. If we looked at how long it would take us to get an appropriate representation of women, these are their representation and the overall population. If we don’t make decisions to stack the field, we’re not going ever to reach a point of equality and equity. Unfortunately, that may feel bad to some individuals. There’s a win–lose situation. The reality is we’re already in a win–lose situation.
We know that women make up 80% of healthcare decisions for their families. To not have them over–represented does us a disservice. It doesn’t allow that perspective to be at the table. A perspective that’s important in thinking about how people access the healthcare system and the decisions that they make that will help move towards preventive care versus downstream acute care. We are doing ourselves a disservice by not having the representation fairly. Other communities that need to be supported within the healthcare system are growing in the United States.
Between COVID, Black Lives Matter, Me Too, you’re right in the middle of this storm of everything that we all need to address. I’m imagining that you’re getting a lot of people who need your help. I’m sure a lot of people are going to want to know how they can find you. How can they learn more about Just Health Collective? Is there any site or anything you’d like to share?
Our website is JustHealthCollective.com. We also have a digital engagement community, which can be found on our website called The Just Health Collective Village. Professionals, people who are champions of diversity, equity, inclusion, and health equity, come to our digital engagement community, which is a private community to be able to network, learn, and participate in different programmatic activities. I would say head to JustHealthCollective.com and you can find The Just Health Collective Village and also our other social media handles.
That’s awesome, Duane. Thank you so much. This is interesting. You’re doing some great things that we need more focus on. Thank you so much for being on the show.
If we don't make decisions to stack the healthcare sector, we're not going to reach the point of equality and equity. Click To TweetI have been delighted to be on the show. Thank you so much, Diane, for having me and posing some great questions.
You’re welcome.
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I’d like to thank both Paula and Duane for being my guests. We get many great guests on the show. If you’ve missed any past episodes, you can catch them at DrDianeHamilton.com. There’s so much information on the site about The Power of Perception, Cracking the Curiosity Code, Perception Power Index, The Curiosity Code Index, you name it, it’s all on the site. If you’re looking for more information about speaking, consulting, and all that I do, that’s all there. I hope you enjoyed this episode. I hope you join us for the next episode of Take The Lead Radio.
Important links:
- The Stress & Resilience Institute
- Just Health Collective
- Beating Burnout at Work: Why Teams Hold the Secret to Well-Being and Resilience
- Daniel Goleman – Previous episode
- American Hospital Associations Institute for Diversity and Health Equity
- The Just Health Collective Village
- The Power of Perception
- Cracking the Curiosity Code
About Paula Davis, JD, MAPP
Paula Davis JD, MAPP, is the Founder and CEO of the Stress & Resilience Institute, a training and consulting firm that partners with organizations to help them reduce burnout and build resilience at the team, leader, and organizational level. Paula left her law practice after seven years and earned a master’s degree in applied positive psychology from the University of Pennsylvania. As part of her post-graduate training, Paula was selected to be part of the University of Pennsylvania faculty teaching and training resilience skills to soldiers as part of the Army’s Comprehensive Soldier and Family Fitness program. The Penn team trained resilience skills to more than 40,000 soldiers and their family members. In addition to her work with the military, she has worked with thousands of professionals, leaders, and teams in many industries, including many of the world’s largest law firms. Her expertise has been featured in and on The New York Times, O, The Oprah Magazine, The Washington Post, and in many other publications. Paula is also a contributor to Forbes, Fast Company and Psychology Today. Paula is a two-time recipient of the distinguished teaching award from the Medical College of Wisconsin. In addition, she will be co-teaching a new reading seminar about resilience and leadership at Harvard Law School starting in February 2021.
About Duane Elliott Reynolds
Duane Elliott Reynolds is the Founder and CEO of Just Health Collective. Recognized by countless organizations as a change maker within his field, Duane has helped to lead the national conversation around belonging – the intersection of diversity, inclusion, and health equity. His work is illuminating new perspectives and helping others connect the dots between value transformation and belonging. As a health care consulting leader for The Advisory Board Company, Reynolds developed the division’s first inclusion and diversity department — and served as its inaugural chief executive. His work earned the organization recognition as a 2017 and 2018 “Best Place to Work for LGBTQ Equality” by the Human Rights Campaign. Reynolds was most recently the president and CEO of the American Hospital Association’s Institute for Diversity and Health Equity and has held operational leadership positions at other prominent organizations including Johns Hopkins Medicine, Emory Healthcare, OhioHealth and Optum, a United Health Group company.
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