I’m a DEI educator at an academic medical center. Pull up a chair.
“This is Dr. Black — she’s a physician and does a lot of DEI work,” my colleague said, introducing me to a friend.
“Oops,” she said almost immediately afterward, dropping her voice to a hushed tone. “I guess we don’t say that anymore.”
I smiled. “That’s OK. I still say DEI.”
Aba Black
“Oh yes; just didn’t want to get you in trouble,” my well-meaning colleague said.
It’s interesting to have a routine aspect of your professional life become a national controversy.
I am a doctor at a large academic medical center. For more than a decade, I have practiced primary care and fostered the professional development of hundreds of medical trainees. I also mentor, teach, evaluate and help lead training programs.
No matter the hat I’m wearing, I strive to operate in ways that acknowledge different people have different lived experiences and carry different perspectives, strengths and needs. Making sure everyone gets a fair chance and creating places where people feel like they belong has been a focus for me long before diversity, equity and inclusion became a political flashpoint. No matter what we call it, this work matters for health care providers and patients — and it should continue.
Critics characterize DEI conversations as threatening and dogmatic. But it’s really about learning to listen to other people, including those you disagree with, sharing your own point of view, and embracing growth through discussion.
“I strive to operate in ways that acknowledge different people have different lived experiences.”
An inside look into one of my teaching sessions is unlikely to raise eyebrows, let alone make headlines. Here’s an example of the kind of controversial task I set for my groups: Draw a diagram of several identities you connect with. Talk with a partner about why they are important to you. Then share a time when you felt proud to be a member of a particular group, along with a time being part of a particular group brought pain.
Sometimes people talk about their so-called “woke” identities — race/ethnicity, gender, nationality. Just as often, other identities less in the spotlight become topics of conversation — being a working mom, being a doctor, being a Midwesterner, being an avid sports team fan. These are equally welcomed and embraced.
On one occasion, a resident talked about growing up both Catholic and Jewish, having a parent from each faith background. She talked about how childhood friends often didn’t know what to do with her and she didn’t know what to do with herself. Many people in the room, although they didn’t share those particular identities, connected with the experience of feeling tension in parts of who we are, and sometimes being left out of a group. The conversation naturally turned to the importance of embracing complexity and allowing people the space to figure out how they define their values and affiliations.
At other times, my learners talk about how uncomfortable it is when colleagues privately say derogatory things about patients (“I almost broke my back helping that patient get on the scale”) or when patients direct inappropriate comments toward providers (“Hi, sweetheart, you can examine me any day of the week”). We sit with that tension and talk about ways to set boundaries while still doing the things that led us all to medicine — to show up for our patients and colleagues and provide excellent clinical care.
These conversations matter, not just because they help people experience a sense of belonging and community (although that’s important, too). Through them, we learn more about what we believe and, just as importantly, why. We become less likely to rely on stereotypes or easy answers. We gain an appreciation for what it’s like to see a topic — or, indeed, the world — through someone else’s eyes, and we make space for everyone at the table.
And all this helps us become better doctors.
“All this helps us become better doctors.”
A large study involving more than 3,500 medical students found DEI education lessened their implicit biases — biases that we all have, regardless of background. This improves patient care. Peer-reviewed research has found medical providers with higher levels of implicit bias are more likely to provide substandard treatment recommendations and exhibit poorer interpersonal behaviors.
We also know diversity is good for institutions. A recent systematic synthesis of more than 100 studies investigating the economic outcomes of diversity concluded that having diverse groups of workers enhances innovation and productivity — elements essential to a thriving academic medical center — especially in organizations with inclusive leadership.
When people characterize those of us who support and promote diversity, equity and inclusion as nefarious or extreme, I wonder who they are talking about. If I am an ideologue about anything, it’s the concept of honing empathy for ourselves, one another and our patients.
Admittedly, DEI means different things to different people — and DEI educators, like all of humanity, come in all shapes and sizes. I’ve been in DEI sessions that have felt more abrasive than productive. And I recognize some have walked away from DEI trainings believing the goal was to make certain people feel guilty — a counterproductive outcome when it comes to grappling with social and structural inequities.
Yet to brand all DEI work as discriminatory and threatening is not just factually incorrect, it’s shortsighted. It denies us the beauty and tension that comes with honest conversation about parts of who we are. Dialogue about our diverse lived experiences and views is fundamental to human understanding, intellectual curiosity, respectful engagement and critical thinking. And these are skills that do us all good, especially in fields like medicine, which involves service to all humanity.
At times, these conversations can be uncomfortable. But when managed well, they always lead to growth.
Aba Black is an associate professor of medicine at Yale University School of Medicine and a Public Voices Fellow of The OpEd Project in partnership with Yale University. The opinions expressed in this piece are her own, and do not necessarily reflect the views of her employer.
Related articles:
The sacredness of DEI | Opinion by Ginny Brown Daniel
Why I’m glad DEI is being dismantled | Opinion by Catherine Meeks
In defense of DEI: 10 benefits of DEI in higher education | Opinion by Susan Shaw