Attacking racism from the inside out

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How one large institution is addressing workplace inequities

As part of our ongoing series “A View from the Top, CEO’s and DEI” this week we sat down with Dr. Marc Gorelick of Children’s Minnesota. The series seeks to follow up with Twin Cities metro area CEOs who signed onto pledges to step up their commitment to diversity, equity and inclusion. The idea is to give our readers better insight into the companies, understand their struggles, and get updated on their progress in efforts to make their workplaces inclusive, diverse and equitable.

Submitted photo Dr. Marc Gorelick

MSR: Tell us about yourself and how you got to the Twin Cities.

Gorelick: I grew up in New York City in Queens and then Long Island. Moved to Milwaukee in 2000 and was there for 17 years before coming to the Twin Cities in 2017. Pediatric emergency medicine was my specialty for a long time.

MSR: How did you come to lead this large organization?

Gorelick: My goal was always to see how I could have a bigger impact. As a physician I help people one at a time, very intense but satisfying. But it’s slow work and takes a long time to impact a lot of people. If I can get a system of care, I can impact a whole lot of people at the same time.

MSR: How did you decide you wanted to be a doctor?

Gorelick: I grew up in and around health care. My mother was a nurse. As far back as I can remember I wanted to be a doctor. It was a way of combining my interest in science and my desire to help people.

MSR: What is Children’s Minnesota?

Gorelick: Children’s is a pediatric health system. It’s one of only 35 health systems in the country that are 100% pediatric. We are not a part of an adult system.

Our mission is to champion the health needs of kids. We do that by providing outstanding clinical care as well as education, research and advocacy. We are the largest pediatric provider in the state.

MSR: You signed on to a document with other health care providers to promote more diversity, equity and inclusion, which is now popularly referred to as DEI. Tell us why you signed on.

Gorelick: Shortly after I became CEO of Children’s Minnesota beginning 2018, I signed on to the CEO Action Pledge on Diversity and Inclusion, a national effort started in 2017 by a number of companies, I believe in New York. It was a way to get leaders of organizations, for profit and not for profit, to get those leaders to commit to actions that would increase the diversity and inclusiveness in the workplace.

It’s something I have been passionate about for a long time. At the time we were only one of about 100 organizations that signed on to that pledge; it’s now well over a thousand. We committed to promoting honest and difficult conversations in our workplace around equity and diversity and inclusion, to provide implicit bias training in our organization so people could understand how that contributes to issues around lack of diversity and lack of inclusiveness.

 And we share with each other best and worst practices. We ask, “What are we doing? What works and what doesn’t work?” We were one of the early organizations to sign on to that [pledge], so it’s been a part of our work at Children’s Minnesota for a long time.

The statement you are referring to was an effort for us as health care providers, health care insurers, to understand how we could work together to address long known and now become obvious issues of health disparities and inequities within health care.

MSR: For some, committing to DEI is a matter of doing the right thing. Explain why this seems to be personal to you.

Gorelick: As a physician in the emergency department, you develop a very intense short connection with [patients] and you get to see what their lives are like. And having a front-row seat to the ways the disparity in our society affect the health of people and the way it operates within the health care system.

I think people who come through that experience either get jaded or become more empathetic. For me it led to greater empathy and a greater desire to want to do something to fix it. It’s hard to spend time talking with people who are suffering from these inequities and not be moved by it.

Early on in my career I was treating a little girl in the emergency department about five years old. Nowadays we try to do things to make it a more pleasant experience; back then we just muscled through it.

This five-year-old girl had put something in her ear and I was trying to get it out of her ear, and I got  a couple of the nurses to help hold her down—naturally she’s five years old so she’s wiggling and struggling. She is yelling, “Get off me, get off me,” and then she yells, “Get off me you White people.”

I thought to myself, here is a five-year-old girl. What kind of experiences has she had in her life that the worst thing she can imagine is not being held down by somebody, but being held down by a White person.

That was more than 30 years ago in Washington, D.C., and it has stuck with me. There was something there that was deep and has affected her experience. I thought I need to learn more about that. It was very powerful. It was troubling to me, and it spurred me to think differently about kids like her and her family.

MSR: What are your thoughts about Dr. Susan Moore, a Black physician who died recently from COVID-19 and complained of receiving biased and inadequate care at an Indiana University hospital?

Gorelick: It is sad. It is shocking, but not necessarily surprising. We hear from People of Color and Blacks about their experience with different treatment from health care professionals. The fact that it takes a peer, one of our own, to draw attention to it, that alone is troubling.

We see this all the time. We hear stories about this. There are studies that show there are racial differences in receiving pain medication for the same conditions. There are racial differences in access to certain procedures. There are differences in prescribing certain medications.

The evidence is overwhelming. People are treated differently by the health care system based on their race. It’s true even when it’s somebody within the health care system.

For a long time we [Children’s] had a focus on improving patient safety. What we recognized is if there are disparities in treatment and if people are not treated with dignity and respect, that is another form of unsafe care.

As part of our safety monitoring system we started in January, we implemented a new kind of report that people can file. Safety learning reports we call them. We encourage people to report errors or when things go wrong or almost go wrong. We ask, how did that happen? Why did the wrong medication get sent? What can we do to prevent that from happening in the future?

We started a new kind of safety and learning report, a dignity and respect safety learning report. So if someone, either themselves or they witnesses someone being treated in a way that is not consistent with dignity and respect, they can report that.

If someone is a recipient of a racist comment or hears a racist comment, they can report that. We can investigate and ask what are the contributing factors. It has become a very powerful way for us to address some of these unfortunately deeply ingrained practices.

MSR: What is Children’s doing to make it a welcoming environment for Black people in particular and other People of Color?

Gorelick: We talk about diversity and inclusion. We have set goals to try to be more diverse in our hiring. We still have higher turnover rates for Blacks than we do for Whites.

We implemented implicit bias training throughout the organization. We try to understand all of the implicit bias that we bring to all of our interactions, starting with the senior leadership team. We want to know how we can be more appreciative of the value of diversity in our organization, not just as something we can say we have done.

We have done diversity and inclusiveness coaching. Organization-wise we have rolled out implicit bias training. We have six employee resource groups. It allows people to find solidarity and support as well as being a place for the rest of the organization to understand the issues that are preventing us from being more welcoming of Blacks, Latinos, or whatever group that employee group represents.

We have set targets for getting results. We have a target for diversity in hiring. We have a target for decreasing our turnover rate among Black employees. We are setting targets so we can hold ourselves accountable.

We are being intentional. We want to change not just the rhetoric, but the results. We have to do some intentional things to drive those results.

MSR: You helped craft a document calling for more diversity and inclusion, which 50 Twin Cities metro area CEO’s signed onto in the wake of the murder of George Floyd by Minneapolis police. Realistically what can corporations do to make sure we don’t have any more George Floyd’s?

Gorelick: There are a few things. Corporations are one element of the community. I think we need to take seriously our role as community members. That includes being willing to speak up when there are issues that are affecting our community.

Business leaders have not always been comfortable with that, but more business leaders are willing to stand up and speak out about issues supporting policies that drive change. For example, many of the corporations that signed on to legislative reforms.

MSR: How do we ensure that the next pandemic does not hit the Black community so disproportionately?

Gorelick: Access to resources. Access to everything from personal protective equipment to vaccines to being able to work remotely and take other efforts to protect themselves…

I hope that one thing we learn from this pandemic is that we need to prepare for the next one so we are not caught off guard as we were with this one. And in the course of preparing for the next one, we learn from the lessons from this one, in particular the disproportionate impact that a pandemic can have on different populations and communities, and incorporate that into the planning work.

MSR: The Black community historically has been the victim of lots of broken promises. How will people know that Dr. Gorelick is not just saying what people want to hear?

Gorelick: We need to be able to go out and say we used to have 25% of our workforce People of Color, now its 35%. We need to be able to say we use to have a 50% higher turnover rate [for BIPOC], now it’s only 10% higher. And we are working to get it to be equal.

To share our progress with the community is probably the best way. As the saying goes, action speaks louder than words.

MSR: What do you do best at Children’s? Or to borrow your expression, what does Children’s do that you would consider a “hit out of the park?”

Gorelick: We are committed to treating allchildren andfamilies. When we say our vision is to be every family’s essential partner in raising healthier children, we put the emphasis on every. I think we do that very well.

We do not turn anyone away based on their ability to pay. This year we provided over $100 million in uncompensated care. We interpret over 70 languages of people who come to our facilities. Now what we need to do better is make sure the care we provide is equitable.

MSR: Tell us about the community organizations with which you are working/partnering.

Gorelick: Every few years we are required to do a community health needs assessment. We bring together about 45 community organizations that we engage with to help us understand what are the most important issues affecting the health of kids in this community.

What we have started to do is not only partner with them to identify the problem; now we are actually engaged with them to help us figure out how to address this problem.

As a result we have been working with the African American Leadership Forum, which has been holding [virtual] town halls that we have been sponsoring. One of our clinicians, Adrien Thornton, has been a guest on that town hall often.

MSR: How do folks keep from being overwhelmed and help them concentrate on the things that are important so we don’t wind up doing nothing?

Gorelick: Knowing that there are so many terrific community partnerships that we can engage with is a helpful way of thinking about what we can do. Racism has been around for centuries. Racism is not going to go away tomorrow, and one organization will not get rid of it.

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