The Sekhmet Writing Project 3/12
Persistence leads 3 physicians to found Equity Quotient. Read about Drs. Van Dis, Choo and Blackstock, who individually and collectively ARE true "Sekhmets."
The other day while working in the quiet space of my bedroom, I heard a repetitive (and quite distractive) sound coming from my youngest daughter’s room. It was rhythmical. Thump. Five seconds later... thump. Five seconds more, thump. Over and over it continued. As I moved down the hall to get a better listen, I heard another sound to this rhythm. Oomph… Thump. “What was I hearing?” I asked myself. I drew closer. Then a third sound. Oomph… Thump… Exasperate. Over and over again. When I turned the corner I found my five year-old daughter in her room, repeatedly jumping off a small tea table chair while reaching high in the air (though falling drastically short of the mark each time) for a stuffy that laid perfectly draped across the ceiling fan above her. With each Oomph a display of effort. With each Thump an experience of failure. With each Exasperation a sign of resilience. When I saw the picture in its totality I recognized what I was hearing:
I was listening to the sounds of my daughter’s persistence.
About ten minutes earlier, my oldest son (her twin brother) flung a soft, grey penguin stuffy into the air and it lodged on the ceiling fan. After many failed attempts at retrieving this stuffy, there my daughter stood, frozen, with her hands on her thighs and waist bent at the hips, patiently waiting until another idea popped in her head. She stood up, proceeded to move the chair back to its home, walked towards the wall, reached for the switch and turned on the fan; there she patiently waited for the fan to create enough momentum to fling the penguin back to ground level. She then picked it up and handed the stuffy to its owner, her younger brother (my three-year-old son) who sat on the other side of her bed, waiting for his favorite stuffy to be rescued. To him, this stuffy is everything. To her, it is just a plush penguin. But that didn’t matter. What mattered was her fortitude and persistence in solving what my three-year-old saw as an impossible problem. But my daughter knew that if she kept trying, she would find a solution.
In healthcare, for women and individuals of color, equity in the workplace can be found in predicaments similar to my son’s penguin: stuck in places low enough to see, yet high enough to be just out of arm’s reach and seemingly impossible to retrieve. Though very rarely discussed, there is a reason for this perception. Looming in the past of America’s healthcare system lies a deep and dark history full of forgotten racial and misogynistic transgressions. Many that have left the male and white dominated space of healthcare void of equitable opportunities for people of color and women. Often times these inequities are minimized, blown off, viewed as nothing more than minute problems easily remedied by annual Diversity in the Workplace training sessions. Furthermore, the inequities are justified by those in power through the use of gas-lighting. Instead of recognizing these transgressions to belong to inherent systemic issues, they are often viewed as isolated events. This act is intentional so that patterns of behavior can be more easily safeguarded. Though this would make change in a large system seem impossible, every now and then, along comes a certain type of individual, like my daughter, who refuses to give up and instead tackles problems with persistence. Those who see the switch on the wall. Those who recognize that even the smallest shift in momentum can have profound positive effects. Those who just might be able to find a way for equity to fall into the arm’s reach of those who deserve it.
Enter The Founding Physician Women of Equity Quotient: Drs. Uché Blackstock, Esther Choo and Jane Van Dis.
Healthcare has an incredibly checkered past filled with unjust transgressions. Included in this is the unauthorized use of deceased enslaved Black individuals for the education of anatomy to physicians and medical students in the eighteenth and nineteenth centuries. In fact most recently in 2013, the bones belonging to an enslaved Black man named Fortunate, were finally given a proper burial in Waterbury CT. They were previously taken without consent by the white physician who owned him so he may teach anatomy to others.
Only after TWO- HUNDRED and SIXTY years following this man’s death was he finally laid to rest. My God not even after death would the white race grant freedom to those enslaved. Forced into servitude postmortem, Fortunate was left to serve the white race and the privilege the white race saw fit.
Our history also includes unethical studies on minority races. There are many well documented scientific investigations where specific diseases were not only forced into a minority host but then it’s known treatment was purposefully withheld so scientists (and in many cases physicians) could observe the progression of that disease in the human body. In some cases this even meant allowing a disease to lead to the host’s death.
In addition to this, documentation exists of pervasive and inhumane treatment towards women as well. This was commonly the case so that surgical and non-surgical procedures could be developed and then perfected (even procedures for ailments as common as pregnancy). These were often at the detriment to the female, causing immense pain and causing chronic effects such as infertility. It is also important to note that many of those individuals used for such studies were Black enslaved women. The opinion that women are less-than can even be seen today. It’s been over three-hundred years since the birth of medicine in the United States and still the ownership of a woman’s body and her autonomy to make individual reproductive decisions is largely dictated by white males.
To date, nearly 45% of Black individuals working within the healthcare system have experienced some form of racial bias. In addition to this, over 65% of women have had a similar experience with gender bias. How is it that the greatest healthcare system in the world is failing it’s workers? Is it because if the system as a whole acknowledged such data, it would require an outward recognition that the foundation of America’s medical system was built upon racism and misogyny?
As a nation, we rely heavily on data collection and educated interpretation to aid in healthcare advancements. Especially those pertaining to how social determinants of health affect individual disease states on the human body as well as how their associated therapeutic interventions do as well. Why is it then that these same processes are not used to objectively observe social flaws such as racism and misogyny within the system itself? What better way to advance science and strengthen its arguments than to elicit the help of none other than science itself. Since the healthcare system is historically resistant to introspection, the only conclusion I can draw to the lack of effort in the collection of such data (in both large medical and hospital systems) is the result of willful ignorance. In other words, if it is simply not collected, the system can proceed as if it does not exist, allowing the status quo to remain intact. This is where Equity Quotient and the persistence of its founders, will single handedly change the inner structure of the American healthcare system, indefinitely.
EQ is a physician-led company which strives to help healthcare organizations and academic institutions create equity for all its associated members. The foundation of its work is driven by data collection, the discussion of members’ unique experiences with bias and qualitative measures to identify the pervasiveness of both racial and gender inequalities existing in that specific system. Because healthcare was founded on racial and gender biases centuries ago, they have been given ample space and time to flourish. And because these biases are so deeply embedded in it, it has become nearly impossible to identify the extent of their reach without the aid of objective, quantitative and qualitative measures.
Equity Quotient, like so many other American businesses, was born out of need. In the wake of the #MeToo and the #BlackLivesMatter movements exist palpable energy necessitating the urgency for introspection and change within our healthcare system. Because equity is so scarce, there is a need to dismantle and rebuild the only system we have ever known. The change will be uncomfortable. The change will demand that the voices of those oppressed and marginalized be heard. Our hope is that, this time, it will be everlasting. Equity Quotient and the persistence of Drs. Blackstock, Choo, and Van Dis are the difference.
If you are a physician or member of the healthcare community, or are a professor or member of an academic institution who has experienced either gender or racial biases, I urge you to reach out to your leadership team to consider the use of Equity Quotient’s services.
Dr. Esther Choo, MD, MPH
Associate Professor, Emergency Medicine
Dr. Choo is a nationally recognized expert in gender bias in medicine, lecturing frequently on this topic and writing on discrimination and women’s careers for both the popular press and the scientific community. She is a funded researcher and brings significant experience in quantitative and qualitative research methods and analysis. She has served as President of the Academy of Women in Academic Emergency Medicine and a Senior Advisory Board member for FeminEM.org.
Jane Van Dis, MD
Ob Hospitalist Group, USC-Keck Verdugo Hills Hospital
Dr. Van Dis is an expert in gender equity in the workplace. She established the Working Group on Gender in the Physician Workplace, a national network which amasses data on gender-based disparities in healthcare and solutions to these disparities. She is currently Medical Adviser to three technology-based women’s health start-up companies, as well as Co-Founder of OB Best Practice. She is currently volunteer clinical faculty at USC Keck SOM; works at Verdugo Hills Hospital, and serves on the USC Gender Equity in Medicine Advisory Council. She speaks nationally on gender equity in medicine.
Uché Blackstock, MD
Founder & CEO, Advancing Health Equity
Dr. Uché Blackstock is the Founder and CEO of Advancing Health Equity, which partners with healthcare organizations to address the critical factors contributing to health inequity, through talks, educational trainings and consulting services.
She is a former Associate Professor in the Department of Emergency Medicine and the former Faculty Director for Recruitment, Retention and Inclusion in the Office of Diversity Affairs at NYU School of Medicine. She left NYU School of Medicine in December 2019 after almost 10 years on faculty to focus on her company.
Dr. Blackstock received both her undergraduate and medical degrees from Harvard University.