One of my most interesting, recurring roles as a healthcare CEO is to lead physicians, APPs, care teams and executives in a webinar series on implicit/unconscious bias under the umbrella focus of diversity, equity and inclusion. I initially developed an implicit/unconscious bias learning activity for Practice Transformation Institute and the Michigan Osteopathic Association and was recently asked by Blue Cross Blue Shield of Michigan to expand the curriculum. I am grateful for the opportunity to engage in meaningful dialogue on a subject I am passionate about.
One of my main goals in this series is to expand considerations of DEI and implicit/unconscious bias beyond race, gender and sexual orientation to include immigrants and non-native English speakers. Many readers may know of my Polish heritage (my surname provides a clue), but I am also an immigrant – albeit one who arrived as a babe in arms. Born in Mannheim, Germany to Polish parents, my father, mother, brother and I immigrated to the U.S. after World War II and made frequent trips back to Poland when the opportunity arose. My father, a captain in the Polish Army, had been a prisoner of war for five years. My Catholic mother had been a laborer in a Nazi concentration camp in Poland. She was only 13 when captured by the Hitler Youth.
That background may help you understand that because I am bi/lingual and bi-cultural, in my heart I am both an American and a Pole. Growing up with parents unaccustomed to – and often non-conforming to – American life, I was often viewed as an outsider as well, frequently subjected to taunts, sneering, bullying by neighborhood kids for being different. I carry that (and, perhaps surprisingly, a very slight accent) with me, yet aim to conquer such biases in the professional and neighborhood communities where I serve. As a matter of fact, my own organization was founded in part to fill a need for foreign-born private practice primary care physicians who couldn’t easily access traditional Physician Organizations.
Through my webinar series, it is not unusual for me to hear from foreign-born and even U.S. born physicians of immigrant parents like mine who say it is assumed that their English and writing skills are not on-par with native English speakers. This unconscious bias makes no consideration for the focus on education, both in the sciences and liberal arts, that guided these physicians to their current success. There may also be a tendency to speak down to healthcare consumers who have an accent (or a handicap), again presuming they can’t understand a diagnosis or treatment plan shared in plain English.
By including cultural sensitivity on ethnicity and religion into the DEI conversation, we create opportunities for dialogue and understanding that can take us closer to health equity. Indeed, the pandemic showed us how important outreach is not only to urban centers but also faith communities of ethnics who look to each other for support in troubled times and may be more trusting of their own community leaders in encouraging, for example, the COVID-19 vaccine.
Ever since the vaccine has been available, our pop-up vaccination clinics have taken us into diverse communities, including areas not only majority populated by African Americans and Hispanics, but also community and faith-based organizations that serve Arabic, Korean, Chinese, and Philippine and LGBTQ+ populations.
We’ve learned so much through our efforts. We routinely develop, test, and incorporate communication strategies that work within culturally and linguistically diverse communities – even within physician practices. We also shifted beyond disseminating written information to designing tailored solutions for the community we plan on targeting. The vaccination team
members were always reminded there were diverse needs and experiences of the people we were vaccinating, and we had to be prepared for “conversations.” They were also asked to refresh their motivational interviewing techniques, so their efforts would be aligned with behavior change methods.
While my personal history and curriculum development and training roles don’t make me immune from carrying unconscious and implicit biases, it certainly heightens my awareness of my own shortcomings in this area – and makes me more open to broader acceptance. Will you join me on that journey?