Cedars-Sinai Leaders Speak Candidly About Racism, Health Equity

It was an extraordinary communal conversation: a racially and ethnically diverse collection of physicians, scientists and administrators speaking simply and honestly about racism and what they hope will be a national awakening to the ills of systemic discrimination – even as many were skeptical about achieving lasting change.

The unusual online session at Cedars-Sinai this week, titled "Introspection and Healing for STEM in Academia," attracted about 130 faculty and trainees from a broad cross section of the institution. More than a dozen speakers recounted personal stories and experiences with racial injustice, health inequities and associated pressing subjects.

The goal was to enhance a culture of inclusion at Cedars-Sinai and to recommit to values of respect, compassion and diversity by asking all involved to listen and learn as the nation undergoes a painful reckoning about its complex experience with race.

Several panel participants expressed a common hope that the death of George Floyd would lead finally to progress in racial understanding in the U.S. and to greater sensitivity among their colleagues, even as they expressed doubt about an improving racial landscape. They lamented persistent disparities they and others see in healthcare and education – and the economic gap between racial groups.

"I'm excited by the sheer number of people unwilling to make excuses for what's been happening in our country for a long time," said Pulmonary Medicine physician Angelena Lopez, MD. "I'm hopeful it will lead to societal change, but I'm also worried it's not going to translate and this will lose momentum."

That sentiment was echoed by Milton Little, MD, director of the Orthopaedic Trauma Fellowship and an Orthopaedic Trauma attending physician. Despite the greater sensitivity he perceives, he said he feels deeply concerned about the prospect of real social progress.

"I hope we continue to see a wide swath of people protest and express interest in change," he said. "But I find it challenging that my 7- and 8-year-old children can name Tamir Rice, Philando Castile, George Floyd and Breonna Taylor, and name the situations that led to these people dying. When I told them about this current situation [involving George Floyd], their response was, 'Again' – not incredulousness. It was sadness and understanding that this probably will happen again."

The 90-minute session followed a recent message from Cedars-Sinai President and CEO Thomas M. Priselac, who called on Cedars-Sinai and its employees to "redouble our efforts at equity, justice and respect." 

Nicole Mitchell, director of Diversity and Inclusion at Cedars-Sinai, built on that message as she planned and moderated the session. "I'm excited that we're able to have this dialogue about bias," Mitchell told the online gathering. "This isn't something we've just started and are reacting to. We've already laid the foundational work. I want to hear the voices of our employees. Tonight is only the next step in this journey."

During the online conversation, some participants spoke about their discomfort at fielding a sudden surge of questions from well-meaning colleagues about racism, even as they appreciate inquiries from those who want to understand experiences of inequality.

White participants expressed concerns as well about saying the "wrong" thing or not sufficiently understanding the experiences of colleagues of different races.

Christine Albert, MD, chair of the Department of Cardiology in the Smidt Heart Institute, expressed her desire for education on how leaders might foster change. She wondered aloud how she can play a constructive role as the chair of a department at Cedars-Sinai and as the newly elected President of the Heart Rhythm Society. "I want to know how I can help," she said.

Nicole Leonard, JD, vice president and associate dean of Research, offered this solution: "Hold ourselves and others accountable – check our own privilege and assumptions, and in a respectful way call out micro-aggressions or other insensitive interactions."

The panel participants offered a variety of prescriptions:

• Let staff know that it is OK to feel uncomfortable.
• Create a culture in which each person is held accountable for their actions and words and that allows the calling out of aggressive and insensitive behaviors.
• Ask staff to listen, read, research and study – be informed and open the door for discussion and understanding. 
• Bring to physician meetings experts who study and publish in this field and can offer advice on policy and best practices.
• Teach hospital staff the distinction between inclusiveness and anti-racism.
• Build a pipeline of diverse talent, diverse recruitment and career advancement opportunities.
• Require implicit-bias training.
• Continue similar conversations and forums.

"We have to redouble our efforts to move forward and make society color blind and just," said Keith L. Black, MD, chair of the Department of Neurosurgery. "I would have hoped by now that we would have made a lot more progress."

Still, Black said he's hopeful for what the current focus on race will mean for generations that follow.  "Making that effort as an institution and as citizens of Los Angeles and the country will require work," he said. "It's not an easy journey, but it will be worthwhile."

Read more on the Cedars-Sinai Blog: Faces of Cedars-Sinai: Neurosurgeon Keith Black