Cross-Cultural Health Care Conference

Are you really listening? Multicultural issues for a community-based medical school

October 8, 2011

Jerris R. Hedges, MD, MS, MMM Professor & Dean John A. Burns School of Medicine

My goals for this talk

Share my multi-cultural journey Share some of the many multicultural areas

within a medical school from the perspective of the dean

Summarize our shared responsibilities

My journey

Raised on farm in Pacific NW– Ancestors crossed great plains/Rocky Mountains

in covered wagon - ox carts– Attended public schools from grade school

through medical school– Only ethnic diversity I saw as child were NA

classmates and my Spanish Teacher– Pacific NW still about 80% Caucasian

Which surfer doesn’t belong?

My journey

Brother – LGTB Brother-in-law – Hispanic Practice – emergency medicine

– Limited use by Caucasians, unless poor or injured Residency – urban Philadelphia: 75% AA Faculty position – urban Cincinnati: 65% AA As OHSU medical center leader – promoted

diversity in recruitment – all levels

OHSU – research team

Departmental - Recognition

Governor John Burns championed education- vehicle for opportunity

Chosen from and for Hawai’i

1,500 applicants, 66 chosen

90% Hawai′i residents

One of most diverse ethnic student bodies

What is diversity at JABSOM?

Ethnic Cultural Socio-economic Geographic

– urban vs rural in-state medical students – international in regards to graduate students

Sexual/Gender Role - responsibilities

HR Issues

Hiring - EO/AA– Protected classes

Dispute resolution– Fact finding– Team composition

Disciplining– Grievances

Student issues

Selection– Pipeline - opportunity– Screening criteria– Interview and selection process– Notice, balance, communication

Evaluation – Disciplining– Process, process, process - documentation– Faculty mentoring

Clinical faculty & patients

Diversity – squared Interwoven ties to community, hospital(s) &

family All are aware of and concerned regarding

opportunity– Social justice – Equitable opportunity in inequitable world

Research

Health Disparities Especially Native Hawaiians & other Pacific

Islanders– Department of Native Hawaiian Health – Center

of Excellence– RMATRIX – Clinical translational research grant

Research initiatives

Na Po’o No’o - thinkers

Global health

Okinawa – Chubu Hospital

Student – eyes on Samoa

My goals at UH-M JABSOM

Create the culture that will succeed in…– our locale, – our cultural/economic environment, and – our place in time

Build the programs that will enhance this culture and leverage what the school can bring to our community and the world

Have our employees choose to be involved because they are making a difference for the world through their job

Traditional academia

Focused on individual Unforgiving of errors Fragile egos

– Grudges & suspicions– Feuds & cliques

New academia

Pono – ethical balance Light shined on bad behavior Reward for individual and team work Mutual support and recognition Shared vision & community connection Understanding through communication

– Tolerance is not enough

Organizational culture

Always there implicitly or explicitly If misbehavior tolerated, climate changes

– Fear, intimidation– Demoralization– Inequities of opportunity result

Awareness & communication are needed

Remember

No amount of money can take the place for not having to work for a living…

Hedges 1969

Building on Culture Tribal Leadership:

Leveraging Natural Groups to Build a Thriving Organization

Dave Logan, John King & Halee Fischer-Wright

Summary of stages

Stage Mood Theme

5 Innocent wonderment Life is great

4 Tribal pride We’re great – and they’re not

3 Lone warrior I’m great – and you’re not

2 Apathetic victim My life sucks

1 Despairing hostility Life sucks

Shared responsibilities

Adopt healthy organizational culture Foster inclusive groups Communicate, communicate, communicate– Ask & listen– Test assumptions– Explain concepts, processes, decisions– Seek transparency – encourage others

JABSOM vision

Attain Lasting Optimal Health for All

ALOHA

JABSOM Core Values

Collaboration: Shared accomplishments in the spirit of partnership

Diversity and Inclusion: Respect for the entire spectrum of human experience

Excellence: Guiding all of our efforts in research, education, and service

Innovation and Discovery: The generation, application, and transmission of new knowledge

Pono: Balance – with integrity, morality, & equity– e.g., taking action to eliminate health disparities in the spirit

of social justice

Mahalo nui loa