Diversity, equity, and inclusion (DEI) was a key theme that helped to kick off the annual meeting, which was held virtually. During the Hale Lecture: Diversity and Equity in Obstetrics and Gynecology – The Patient and the Provider – Care Delivery to Employment, several ob/gyns provided their own perspectives, including sharing data on diversity in the specialty now and its implications for the future pipeline.
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Wanda Nicholson, MD, MPH, MBA, who is a professor of ob/gyn at the University of North Carolina and chair of the ACOG Workgroup on Advancing Diversity, Equity, and Inclusive Excellence, emphasized that having providers who represent the diversity of the patient population is crucial for the specialty.
“That is crucial to us being able to move forward in our specialty,” she said, calling for a fair, equitable and inclusive environment and emphasizing that cultural perspectives can improve and inspire diversity.
She addressed the impact of DEI on health equity. DEI in the provider workforce can impact health equity, she said. Diversity of providers in leadership need to reflect the patient population; that will lead to a richer understanding of patient needs and preferences. There is an opportunity to provide communication patients deserve and address the social determinants of health. Diversity in thoughts and perspectives are needed to solve current and future clinical challenges for patients. DEI can lead to reducing inequities in women’s health and health care.
She shared some sobering statistics affecting the pipeline of minorities in ob/gyn, even in medicine in general, including that fewer Black men applied to medical school in 2014 than in 1978. An audience member asked Nicholson for recommendations for how to nurture a pipeline of diverse talent for the future.
“The biggest part is expanding our footprint at high school and undergraduate levels so we’re able to compete with other career options,” she said. She also encouraged working in communities and combining efforts with ob/gyn practices and hospitals. Individuals can work through ACOG’s district and section levels, advocating to academic centers, and undergraduate students, to give them a better vision.
Jan van Dis, MD, medical director at the Maven Clinic in Los Angeles, said that we all live in a health care ecosystem and everyone should learn to be an effective upstander.
“When you see something or hear something, say something. We should be aiming for herd immunity in our workplace cultures,” she said. She presented research from the Association for Psychological Science that found that children show a gender gap in negotiation. Boys were more likely to ask for same amount of bonus from a male or a female evaluator whereas girls were to ask for lesser amounts from male versus female evaluators. There remains a remarkable disparity in pay in physician income by race and gender. Researchers from the State University of New York (SUNY) Albany looked at all residents and fellows from 1999-2008. They found a pay gap of $16,819 for newly trained physicians. The explanations for the gender gap remain elusive, according to van Dis and the research. “The researchers were really surprised,” she said. “They accounted for every confounder they could think of.” The researchers went on to collect more data up to 2017; the pay gap increased to $36,618. “There is no other explanation for this other than gender bias,” she said.
She made several recommendations for how an organization can begin to address its biases, including: improving hiring by blinding hiring; knowing the bias that exists; standardizing interviews and tracking outcomes. When it does come to gender equity within a workplace, male allies can have a significant impact. Gender equity programs are 96% effective when men are engaged, but only 30% when they are not, van Dis said. Also, male colleagues should not relegate or assign female colleagues to do housework at work. They also can ask female colleagues, “How can I amplify your work?”
Van Dis also covered maternity versus paternity leave in the workplace, noting that the United States is the only country among 41 that has no paid paternity leave; 48% of new mothers are overlooked for advancement; however, fathers are 1.83 times more likely to be promoted to management than childless men. Childless women are 8.2 times more likely to be recommended for management. But when it comes to the role of a father in the home, fathers that are more involved in feeding and diapering increases family stability and when a father does take paternity leave it improves women’s careers.
Michael C. Lu, MD, MS, MPH, serves as dean of the University of California Berkeley School of Public Health, said all levels must get involved with the push for equality in leadership and women’s health. That includes the national level of organizations, including the National Institutes of Health, and creating leadership and mentorship programs for this field.