It is a natural tendency to veer away from
confrontation or diversity of ideas because
sometimes people believe that makes decision making more complex and difficult. How
do you overcome this challenge and encourage
Most people think it’s difficult to be inclusive and
diverse, and that challenge arises when people who
have different beliefs enter into a conflict. Some
people aren’t as fair as you would like them to be.
I am somebody who loves everything to be fair.
I think once you realize that your decision will
be better if you take time to listen and bring in
diverse views, you will find that you can’t even
imagine making a decision without that diversity
I will give you one example. I have been practicing for 30 years as a vascular surgeon. Just in the
last five years, I have taken the opportunity to listen
to a better way to take care of patients, which is by
giving the patient a voice, too. I used to say, “You
need to have a femoral popliteal bypass,” or “Your
aneurysm just hit six centimeters, and I need to fix
it.” In the past, I would just say, “We’re going to go
do this procedure, and what date would you like the
surgery?” I’ve grown as a surgeon, and now I have
learned instead to ask the patient, “Do you want
your aneurysm fixed?” or “Do you want a bypass?”
You listen to what they have to say. This approach
is patient-centered, and it’s actually better for the
patient. You can adapt to it. It does take a new mindset that you’re going to focus on the patient—his or
her desires and wants. Then you alter your behavior
and availability appropriately.
If you take clinical inclusion of the patient’s voice,
and you can then take it to your office and other
places to be more inclusive, I think that can help
people decide that listening and inclusivity aren’t
that hard. Actually, it takes a bit more time, but you
make better decisions.
What are specific steps you can take as a leader to
foster and implement a diversity initiative so that
it doesn’t feel like a directive?
An example is when I started as chair of surgery at
Hopkins. Initially, we interviewed resident candidates from five to eight schools, and we received a
few hundred applications, mainly because people
thought we only looked at a few schools to fuel our
residency. The residency program director and I
expanded the pool and interviewed students from
different schools. As we did that, the diversity of the
pool increased because people started to apply to our
program from multiple states. We then set two more
goals: to increase the number of women and international graduates. We added looking at gender because
only 10 percent of our applicants were women. International graduates, who were amazing candidates,
allowed us to appreciate how difficult it is to be born
and raised in a foreign country and want to train in
the U.S. The diversity of our residency expanded.
When I was at the University of California (UC)
Davis as dean and vice-chancellor, we really were trying
to increase our faculty diversity. We found that it was
very hard. We decided we needed to tell our residents
that we wanted them to stay. Only about 17 percent
of all our residents stayed at UC Davis. We worked
hard to let them know that they could fit in and that
they could stay. This extended our diversity initiative
to our medical students. For our student applicants, we
implemented a second-look opportunity and looked
to our more diverse faculty who could talk to them,
interview them, and represent where they came from.
It takes a long time to change the culture, especially if
you’re lagging behind. Those initiatives are still a work
in progress. Trying to get more diverse students, and
then more diverse students to stay on as residents and
faculty, builds the pipeline through a domino effect.
Culture change requires patience. You allow things
to happen over time and it can take many years to see
changes in diversity and inclusion take shape.
As you sit at a table or you sit with your team, you
want to see a mosaic—you want to see different
people with whom you interact each day.