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
