IFDHE Podcasts

00;53;36;28 - 00;54;03;12
Tom Haederle
Women's History Month here in March of 2023 includes an exciting new historical line, one that is still being written. And that is the very recent history of female led venture capital firms that are out to change women's lives for the better. One such firm is SteelSky. It invests in innovative companies working to improve health outcomes for women by focusing on improving health care, access, quality and affordability.

00;54;03;29 - 00;54;52;03
Tom Haederle
Raising capital for investment funds isn't easy, especially for historically marginalized groups. But SteelSky and a number of similar funds got a big boost last year when the American Hospital Association announced it was providing early financing. Welcome to Advancing Health, a podcast from the American Hospital Association. I'm Tom Haederle with AHA Communications. Financial support of investment funds that focus on addressing disparities in health outcomes and creating meaningful economic opportunity aligns with ASHA's strong commitment to these issues.

00;54;52;21 - 00;55;18;20
Tom Haederle
In this podcast, recorded in May of 2022, SteelSky Ventures founding partner Maria Velissaris talks about her goal of advancing women's health through an equity lens. Joining the discussion is Lara Khouri, executive vice president, chief strategy and transformation officer at Children's Hospital, Los Angeles. She's also a member and past chair of AHA’s Maternal and Child Health Council. Let's give a listen.

00;55;19;16 - 00;55;52;29
Lara Khouri
I'm so excited about this conversation today and thank the American Hospital Association for the opportunity to lead this important discussion on the connection between women's health and innovation with an equity lens. The AHA announced it's providing early financing for investment funds run by leaders focused on improving health care access, quality and affordability. The funds were selected because they financed historically marginalized entrepreneurs who have limited access to the capital needed to develop innovative solutions in health care.

00;55;53;23 - 00;56;21;22
Lara Khouri
I’m so excited because SteelSky Ventures is one of the funds receiving early AHA investment. It's a female led venture capital firm focused on companies working to improve health outcomes for women. SteelSky Ventures has invested in 14 women led and women oriented health care startups since 2017. And that's just so far. My conversation partner this afternoon is Maria Velissaris.

00;56;21;28 - 00;56;45;16
Lara Khouri
Maria is a venture capitalist and she's founding partner of SteelSky Ventures. She is passionate about developing a pipeline of female entrepreneurs, something we're going to talk about more in a moment. In March 2021, Maria was named by Forbes as one of eight female venture capitalists to watch. So, Maria, welcome again and thank you. Let's jump right in.

00;56;46;03 - 00;56;48;25
Maria Velissaris
Wonderful. Thanks for having me. I'm excited to chat today.

00;56;49;14 - 00;57;07;03
Lara Khouri
So I've got so many great questions I want to ask you. And I had to pick just a few. So I'm really excited to hear what you have to say. So first, I understand that SteelSky Ventures is among the largest, if not the largest, women led venture fund in health care today. Can you tell me a little bit about yourself?

00;57;07;04 - 00;57;09;12
Lara Khouri
SteelSky Ventures and how you got here?

00;57;09;25 - 00;57;31;08
Maria Velissaris
Yes, I'd be happy to. And it's been quite a journey to SteelSky, but have been really excited all the way. I started my journey as an entrepreneur. I'm a serial entrepreneur turned venture capitalist. So really always had a passion for building businesses, even from when I was a young girl starting lemonade stands, babysitting clubs, garage cleaning businesses.

00;57;31;08 - 00;57;53;23
Maria Velissaris
It's just always been in my DNA to be a builder. And since then, you know, 17 years of my career learning how to build companies and operate and then I jump to the other side of the table and learning how to invest. And I started investing in female led companies, typically. And then I just saw really a lack of dollars going into women's health companies because it's hard to navigate health care.

00;57;53;23 - 00;58;30;21
Maria Velissaris
And a lot of angel investors don't have that expertise. And so that's where I saw that I could really make a difference and carve out a market for myself in my fund. And so I started SteelSky Ventures Fund in 2020, and since launching, we've now invested in 17 companies and raised a platform of over $72 million. And so we're really excited about what the state of women's health care and being able to be a big part of pushing that forward and so happy that also having the partnership with the AHA and other women's health enthusiasts like yourself so that we can create better outcomes for women around the world.

00;58;31;13 - 00;58;55;05
Lara Khouri
Well, that's wonderful. It's so nice to hear your journey. And I'm sure that bringing that entrepreneurial and operating experience into the venture capital side has made you particularly well equipped to be able to identify opportunities that are going to be able to be successful and make the type of impact that you're looking for. And I'm curious about that impact and the big picture.

00;58;55;05 - 00;59;12;04
Lara Khouri
So you've made health equity a focus of your investment of your investing. Can you talk a little bit about why you see health equity as such an important feature of what you do and from your perspective, how do you see health equity connecting with health outcomes?

00;59;12;22 - 00;59;37;17
Maria Velissaris
Very good questions. I think post-COVID, it really illuminated for us the disparities in our health care system. And health equity has to be top of mind when we're making investments. We have to understand when we're investing in a company how it not only impacts women who have access to wiFi and cars and transportation and healthy food, but how does that affect the other half and how does the other half live and how can we better serve them?

00;59;37;23 - 00;59;55;21
Maria Velissaris
Because that is where the majority of health care spending is and that's where the majority of the progress needs to be made. And so we make sure that our investments all have a lens toward health equity so that we can make sure we are serving the most vulnerable populations, which also happen to be the most expensive populations for payers.

00;59;55;29 - 01;00;16;04
Maria Velissaris
And by investing in companies that can create better outcomes for them health wise, it also can create better outcomes for, you know, health care systems, for payers because they're saving money, they're having better outcomes, are getting better ratings, and in it's just a win-win for everyone. But I think it's definitely should be top of mind more than it is.

01;00;16;21 - 01;00;33;04
Maria Velissaris
It's a shame that I actually have to have a women's health fund because women's health has been overlooked. I should just be able to have a health care fund. But not all funds are focusing on women and the needs of other underserved communities. And so that was really important to us, and it's been a driving factor for our fund.

01;00;33;25 - 01;01;06;05
Lara Khouri
It's so wonderful to hear that intention that you're bringing to it. And it is always striking to think about how women are half the population, but we're disproportionately underinvesting in women's health. And so to imagine how you can accelerate that and make an impact through that intentionality is really wonderful. I'm curious for you, as you bring this lens and start to engage in companies and explore ideas for making a difference, what qualities are you looking for from the companies that you fund?

01;01;06;05 - 01;01;14;17
Lara Khouri
And especially curious about how you think about identifying companies that are run by founders that are going to be able to make a difference?

01;01;15;03 - 01;01;36;17
Maria Velissaris
Well, it's really hard decision making process. We get hundreds and actually thousands of portfolio companies coming to us every day. So it's a lot. It's a groundswell and it's been really tough to try to figure out which companies to invest in. But we are able to focus our efforts on a few key verticals that we think have the most need.

01;01;36;22 - 01;01;59;05
Maria Velissaris
And so when we're looking at entrepreneurs, we're looking at companies that are really solving big pain points, right? So there's a lot of reports around vitamin versus a painkiller. And we're trying to invest in companies that are pain killers that are solving the most challenging problems in healthcare. So that is one of our criteria for investment. Another one is inclusivity, like I mentioned before.

01;01;59;10 - 01;02;26;19
Maria Velissaris
Are you thinking about gender equality? Are you thinking about racial equality? Are you thinking about socioeconomic equality? Are you thinking about geographic diversity? Those are all components that we look at when we're evaluating companies and we want to make sure people are serving all of these markets. And for us, we really also want to make sure that things are covered by insurance and that people are taking Medicaid because we just do not want to continue to leave out whole bottom of the pyramid.

01;02;27;07 - 01;02;38;24
Maria Velissaris
And also, we're looking for passionate teams that want to make change in the world. We have an opportunity to invest in any companies that we want. We want to invest with like-minded individuals who have aligned missions.

01;02;39;12 - 01;03;05;27
Lara Khouri
That's wonderful. It's I liked your painkiller versus vitamin analogy. We probably need both of those. But as you think about big impact, that's a wonderful way to think about it. And it's also really neat to hear how much interest there is. Right? It's exciting. And I imagine that you all existing and coming to the table really clear about your goals motivates people to be interested in the work.

01;03;05;27 - 01;03;26;10
Lara Khouri
And so just by your existing, you're kind of building that and it's a wonderful way to imagine the impact that you're making going even beyond those companies that you're able to to fund and finance. So that's really wonderful to hear. So I've got one last question for you, although I could ask you many, many questions actually, I'll ask I'm going to ask you two more questions.

01;03;26;22 - 01;03;43;04
Lara Khouri
When you think about success and impact, how do you know whether you're achieving what you want to achieve? So what are some of the metrics or what do you look for to indicate that you're making the progress that you want to make, not just from a business perspective, but also from an impact perspective?

01;03;43;20 - 01;04;02;07
Maria Velissaris
We look at number of lives impacted. Our goal is to change and increase the health of women around the world. So how are we doing that? How many lives are we touching? How many people are living more pain free because of the companies that we've invested in? How are we creating better ways to access and engage the health care with the health care system?

01;04;02;07 - 01;04;25;19
Maria Velissaris
How are we helping marginalized communities feel safe when they go to the doctor? These are all different components that we look at to measure our outcomes and to measure if we are making the impact that we want to see and that we are intentional about trying to see in the world. And so we look for number of lives impact, we look for if people are healthier and safer and all of these things are measurable.

01;04;25;28 - 01;04;43;00
Maria Velissaris
So it's really important to us to keep track of those metrics so that we can make sure that we are actually doing what we say that we're doing. We're putting our money behind these companies to create better outcomes, and these can be measured, and we want to make sure that we continue to measure them and make sure that, you know, we're actually having outcomes.

01;04;43;00 - 01;04;51;15
Maria Velissaris
Right? There's a lot of people throwing money in a lot of places. But to truly make sure that you're being impactful, you have to be able to measure these outcomes.

01;04;52;13 - 01;05;14;14
Lara Khouri
You almost sound like you're talking about how hospitals think about what we do as well. It's really nice to hear somebody, you know, that the opportunity to have that perspective that you have driving where funding is going is going to make a big difference. And what you talk about is scale. And what you talk about is is impact.

01;05;14;14 - 01;05;34;04
Lara Khouri
And to talk about impact in scale in the populations that you're targeting is really exciting. And I think it really resonates for me as somebody who's been involved in the delivery side of health care for most of my career. It really is is nice alignment and I'll use that actually to segway to what I promise you will be my last question, although like I said, I could ask many, many more.

01;05;34;28 - 01;05;54;13
Lara Khouri
Part of what brings us together today is that engagement that the American Hospital Association has with SteelSky. And so I'm curious because I know that in addition to the AHA, you've got some other non kind of nontraditional investors in health care who've been engaged with you. And I'm not surprised because you're offering something really, really special here.

01;05;54;29 - 01;06;01;28
Lara Khouri
And you talk a little bit about how these partnerships come about, how you've been engaged with the AHA and where you see it going.

01;06;02;13 - 01;06;23;02
Maria Velissaris
Well, it feels good. We see ourselves as solution providers, right? We're solution providers for hospital systems, payers and women across the world. And so those are key stakeholders. So we talk and engage with health systems so that we can understand what are your biggest pain points, what are your gaps in care? And then we can go to the market and focus on finding solutions to those gaps.

01;06;23;07 - 01;06;45;24
Maria Velissaris
And so that we feel that partnering with the end customer really helps us drive great investment because we are focusing on the areas that are the greatest need for all of our key stakeholders. And that's why the partnership with the AHA is so important and so impactful for our fund is because we are hearing straight from the user community what they need and we can bring exactly what they need.  

01;06;45;24 - 01;07;05;00
Maria Velissaris
And sometimes we also have the ability to co-create together. A lot of the companies that we're looking at a very early stage and they're still in their foundational development until we're getting really unique insight from the hospital systems or the payers or the pharmaceutical companies about what they need to do to make their product offering more appealing to this community.

01;07;05;00 - 01;07;15;25
Maria Velissaris
We can do that early on, and so that's why it's such an interesting and important partnership so that we're building companies and solutions that actually can serve the needs of the end users.

01;07;16;14 - 01;07;39;08
Lara Khouri
It's such an effective approach, I expect, because you're thinking about your market in both your end user, the population you want to impact, as well as that entity and the stakeholders who are going to be involved in actually actualizing those opportunities. So it's a really, really smart and exciting way to think about how you advance some of these innovations.

01;07;39;08 - 01;07;57;05
Lara Khouri
So congratulations and thank you so much for your thoughtful answers. I know that this discussion is going to be a great resource for our AHA members and members of the public. I understand you have a few questions for me as well, and I'm very happy and honored to talk to you and answer any questions you might have for me, Maria.

01;07;57;28 - 01;08;19;02
Maria Velissaris
Yes. Laura Now it's time to turn the tables in your end. So I do have a lot of questions for you that I'm sure the audience will be really excited to hear. I know that innovation is really important at Children's Hospital Los Angeles and at SteelSky, one of our focus areas is maternal and child health, and we're constantly looking at new innovations in the space.

01;08;19;10 - 01;08;27;04
Maria Velissaris
Can you tell me about some recent innovations that you've been looking at from the hospital perspective? And what are some of your key focus areas of the year?

01;08;27;18 - 01;08;56;14
Lara Khouri
Sure. Thanks for that question. It's really timely. You know, mental and behavioral health conditions in children and youth is a growing crisis in our our country. And you've talked about disparity. And this is certainly something that's come up, especially on the heels of COVID, but certainly existed beforehand. And there is a dearth of resources and infrastructure for screening, for diagnosis, for treatment for a large number of patients, especially those who are in underserved communities.

01;08;56;28 - 01;09;33;04
Lara Khouri
When I was learning a little bit about you and SteelSky saw that you've invested in Bend Health, which is also focused on helping increase access to mental and behavioral health for women and families. We have an accelerator called Kids X, and we're supporting a few innovative startups that are working on products ranging from things like voice biomarkers that screen for depression while providers are talking to patients and families, to things like digital therapeutic that can use to can be used to treat depression through app based cognitive behavioral therapy.

01;09;33;22 - 01;10;07;06
Lara Khouri
Through our Office of Virtual Care, we've launched a virtual autism assessment program. And this is a really neat innovation that allows families to asynchronously submit videos for their children so they're able to, at their time in convenience, submit videos. And one of our autism specialists will provide an assessment. So it's a unique form of access. It's a really patient and family centered approach, and it offers something that's really underserved right now, especially in our populations, that we focus on serving.

01;10;07;23 - 01;10;38;19
Lara Khouri
So we're also working on supporting technologies that can help improve screening, diagnosis and treatment of a wide range of mental and behavioral health conditions. So there's definitely a lot going on and you've noticed it in your work. We've noticed it in our work. And it's something that, just like you were saying before, we have to decide that we're going to pay attention to it and through that intention and bringing innovation and expertise and that entrepreneurial spirit that you've described, we think there's a lot of impact that can be made. 

01;10;38;19 - 01;10;55;01
Maria Velissaris
Definitely. And it sounds like your hospital system is really on the forefront of innovation, technology and change. Sometimes we know that hospitals can get a bad rap for being slow to adopt. What are some of the components that make this so successful at Children's?

01;10;55;18 - 01;11;22;05
Lara Khouri
So one of the things that we've built here at Children's Hospital Los Angeles, which I alluded to, is an accelerator. So in 2019 we launched Kids X and it's actually a national consortium of 30 children's hospitals that are working together to accelerate pediatric digital innovation. You talked about the kind of lack of attention that's brought to women's health, and often women's health and children's health are kind of alongside each other.

01;11;22;17 - 01;11;45;26
Lara Khouri
And we see the same thing in pediatric challenges as well. So we brought together these 30 hospitals to understand the process by which they test and implement innovative new solutions. Through that understanding, we developed a toolkit that our kids across hospitals can use to accelerate the speed by which they can launch pilots and studies of digital innovation tools.

01;11;45;26 - 01;12;25;25
Lara Khouri
During the past two years, KidsX hospitals have launched more than 25 projects using this process. So it really takes innovation and moves it into an operationalization. That's often the challenge that we face in our provider settings. As you alluded to at Children's Hospital Los Angeles, we've used this process to test and evaluate an augmented reality-enabled gamified physical therapy app, and we've also used it to test a robot that can deliver medications to patients in the hospital and a clinical decision support tool that helps our emergency department physicians conveniently leverage clinical best practice to inform their decision making.

01;12;25;25 - 01;12;45;11
Lara Khouri
So one of the things that we've tried to do is demystify how you test innovation, create process and clarity around how you can do it successfully. And we've done it not only here at Children's Hospital Los Angeles, but in collaboration with many of our peer children's hospitals, because we, many of us face the same types of challenges.

01;12;45;11 - 01;12;50;15
Lara Khouri
And being able to accelerate that testing of innovation has been really, really effective.

01;12;50;24 - 01;13;14;20
Maria Velissaris
Amazing. It sounds like so many amazing things are going on over there, things that I should be probably getting involved with. As we wrap up, I could talk to you all day. I would love to just understand a little bit more and selfishly for input to my portfolio companies. What are some key characteristics that you see of companies that are creating successful digital applications for health systems?

01;13;14;20 - 01;13;38;03
Lara Khouri
So, you know, it's a lot of what you've talked about, Maria. For us in the provider environment, we are such a regulated environment. We're so focused on quality and safety that we do a lot of work to standardize practice, to put into place protocols to make sure that we're addressing risk of errors and hospital acquired conditions in so many different things.

01;13;38;16 - 01;14;14;21
Lara Khouri
So we can often identify problems and opportunities for improvement. But how we integrate change and how we change our processes is the place where the rubber hits the road. And so I actually will reflect back to you something you were saying, which is really understanding the market of the user, right? So for us having innovation and tools, digital solutions and otherwise that understand and anticipate our operating environments and are able to accommodate and flex for that is the best way for us to execute on innovation.

01;14;15;01 - 01;14;48;16
Lara Khouri
And so understanding not only your end user, so you've talked about wanting to make an impact for women. If you're thinking about women, if you're thinking about children, whoever your targeted population is, as providers having tools that can easily integrate into our electronic medical records, into our processes that anticipate some of the barriers and the regulatory and quality and safety realities that we're managing, I think is one of the most important things, because the worst thing is to have a great idea that can't be implemented and executed, right?

00:00:00:03 - 00:00:19:28
Tom Haederle
America is already running short on physicians and every health labor forecast projects it will only get worse in the next decade or so. Even more alarming, at a time when they are needed most. The percentage of black male physicians in the field has been basically unchanged for the past 80 years and isn't showing signs of growth even now.

00:00:20:15 - 00:01:10:19
Tom Haederle
What could be done to attract, recruit and train more talented young black men to the practice of medicine? And what implications would that have on the goal of health equity? Welcome to Advancing Health, a podcast from the American Hospital Association. I'm Tom Haederle with AHA Communications. In this podcast, Ogechi Emechebe, a senior communication specialist at AHA’s Institute for Diversity in Health Equity, and Dr. Leon Caldwell, senior director of health Equity Strategies, discuss ways to increase the number of black male physicians in the field and how that would lead to more equitable health outcomes for people of color.

00:01:11:04 - 00:01:27:14
Tom Haederle
They are joined by Dr. Owen Garrick, chief medical officer at CVS Health Clinical Trial Services, and Dr. Pierre Vigilance, senior partner at Korn Ferry, to explore how hospitals can create a pathway for black men into the health sector and provide a new vision for achieving health equity.

00:01:28:19 - 00:01:48:24
Ogechi Emechebe
Welcome, Dr. Garrick and Dr. Vigilance, thank you very much for taking the time today to speak with us for this very important conversation. So as you know, now it's February and it's also Black History Month. And today we wanted to discuss an interesting yet discouraging trend in America. And it's about the very small and stagnant number of black male physicians.

00:01:49:04 - 00:02:12:14
Ogechi Emechebe
According to the association of American Medical Colleges. Black men make up less than 3% of physicians nationwide. And a 2021 study by UCLA found that the percentage of black male doctors remained unchanged since 1940, which is around 2.6%. Meanwhile, the share of black female physicians and the doctors that are people of color have seen increases.

00:02:13:00 - 00:02:42:00
Leon Caldwell
So this is what we would call rather, if not disturbing trends. One problematic for our area of health equity. And as we talk about this topic and I thank you both again for your time and your work and your commitment to health in our country, one thing that's really of importance that we can lay out in the beginning of this conversation is data tells a story.

00:02:42:11 - 00:03:08:01
Leon Caldwell
And what I'd like to hear from it gets you first, Dr. Garrick, and then you, Dr. Vigilance, is when you hear this data and consider yourself within that 3% of physicians - what conjures up for you? Like what's the emotional space you're in when you hear those those numbers that represent your presence in the field? Dr. Garrick?

00:03:09:06 - 00:03:34:27
Owen Garrick
Sure. So so a few thoughts. One on the positive end, right? It seems like there's been the sisters are getting their act together, right? So it is much more an increase in presence and participation and numbers in terms of black female physicians. So positive trend there. So the thing I think through is what success, what is driving success there?

00:03:35:17 - 00:04:20:29
Owen Garrick
How can we mirror some of those strategies, alter some of those strategies for black men? And you know that statistic that in essence, it's been flat since 1940. I imagine there's been a little bit of movement, right? So they're probably some times when it's exceeded 3% and maybe retreated. So, you know, as a statistician, I fancy myself as a statistician, at least if I want to think through what are the some of the inflection points in, you know, a 40, 50 year history that we can point to or at least to look into the data, to share that, to see where there might be some successes and figure out how we amplify some of those.

00:04:20:29 - 00:04:22:28
Owen Garrick

00:04:23:00 - 00:04:23:13
Leon Caldwell
Great. Dr. Vigilance?

00:04:24:02 - 00:04:48:03
Pierre Vigilance
So the thing that makes me think about is we've not made significant strides with respect to health and wellness in the same communities that we were referring to having challenges with respect to physician populations or physician composition. Although we are seeing this increase, I've seen this increase in the number of black women who are entering the field of medicine.

00:04:48:03 - 00:05:22:18
Pierre Vigilance
And I think that that's fantastic. That the black male situation mirrors to me or for me a lot of the other sort of social determinants of health oriented considerations that we are also not seeing improvements or haven't seen improvements in. And it sort of relates to challenges around these systemic areas of concern outside of medical education itself. Back to K through 12, education and or support systems within communities and or the communities themselves and how well developed they are.

00:05:22:25 - 00:05:56:16
Pierre Vigilance
These socioeconomic driving factors of wellness in its entirety that include education, aspiration, income, etc. and all of these things being a set up for where individuals go and where communities go. So if communities of color were rising, if you will, then I would have expected for not just women of color to be increasing in their numbers, but also men of color to be increasing in the numbers in some of these fields.

00:05:57:01 - 00:06:26:13
Pierre Vigilance
And I think that that's a function of where we are with respect to some of those social determinants and the fact that those things haven't improved significantly enough for more people to be lifted out of or lifting out of existing circumstances to different circumstance to put them on a trajectory into medical school or elsewhere in the health care field I think is related to that.

00:06:27:06 - 00:06:58:29
Leon Caldwell
That's a really interesting concept. So here we have two physicians who have been in this space for quite some time. And going back to Dr. Garrett's point around looking at success, oftentimes we look at what why things fail. But if we sit and look at success with two successful black male physicians in our midst right now. Tell me a little more about what's your success story like?

00:06:58:29 - 00:07:00:14
Leon Caldwell
How did you get to where you are?

00:07:00:26 - 00:07:22:13
Owen Garrick
Sure. So I appreciate I'm going to take you're saying we've been in this space for a long time. You're calling us old ... Pierre is older than me. So I would say a few things. Well, first, you know, my motivation for becoming a doctor. I always wanted to be a doctor since I was a kid. Like, if you when I was three or four, that I have a faint memory of someone asking me what I wanted to be.

00:07:22:15 - 00:07:44:21
Owen Garrick
And with this, you know, to be a doctor, they weren't any physicians and the family - I have a brother in law now who's a hands surgeon, but no physician and certainly some nurses. And for me, it was I like the science. I want to make my grandparents proud. So I pursued the typical path of being pre-med. And obviously, go to medical school.

00:07:44:28 - 00:08:13:17
Owen Garrick
And I think back. I think there are a few things. One, parents that were both favorably supportive and laser focused on education. Right. We don't always think about Tiger parents in the African-American community. Right. But there are tons of them. And I certainly had them where, you know, I remember my dad being at literally every single parent teacher conference when I was, you know, growing up.

00:08:13:25 - 00:08:47:21
Owen Garrick
And I was like exceedingly well. So but there was just that support not just within the household, but also from without where whether it be mentors, teachers, professors that I built relationships with in college that continued to support me throughout. You know, that amplified some of my internal motivation and then don't in a peer network. Right? So as I mentioned, Pierre and I have known each other since medical school.

00:08:48:20 - 00:09:13:21
Owen Garrick
If I have any questions around from public health to policy. Greg, anything in health care, I might reach out to him. Right. So we have we've built this natural network. So I guess the constant theme is tons of support that I have had that is really amplified. I think my internal motivation because it's not it's not linear, right?

00:09:13:21 - 00:09:34:10
Owen Garrick
Med school ain't easy, as they say. Right? So you need to think through and have a system or a set of systems where you've got you have folks that hold you up and frankly, maybe even expand some of your thinking. Right. And I mean, in research. Right. And and more the the the business management side of research.

00:09:34:10 - 00:09:44:07
Owen Garrick
And 30 years ago, I would not have thought anything about this field. But there are many others. Many folks do it my path that exposed me to different aspects of health care.

00:09:44:07 - 00:09:53:23
Leon Caldwell
That's helpful. So I heard parental support, support in general and supportive networks as well. And exposure. Dr. Vigilance?

00:09:53:23 - 00:10:19:26
Pierre Vigilance
So I think that that network notion does start at home and being able to connect the dots to family members. Immediate and then more, more distal is is a very important part of things. So I grew up in a household where so my parents were immigrants from the West Indies to the UK and then were immigrants again from the UK, bringing us here to America.

00:10:19:26 - 00:10:46:11
Pierre Vigilance
When when I was in my late teens, that drive, seeing that understanding what that meant, understanding the sacrifices that they made and seeing the the way that they pushed themselves and the way that they pushed us was sort of a major piece of the initial part of how things got going. I don't have that same recollection of "wanting to be a doctor" in quotation marks.

00:10:46:11 - 00:11:08:17
Pierre Vigilance
When I was very young, my parents were both providers of some sort. My father was an optometrist, my mother was a social worker. And so that was an interesting set of conversations around access to care, care and that side of things from my father's side of things. And then the social spending, the social network part of things from my mother's side and social services.

00:11:08:24 - 00:11:32:23
Pierre Vigilance
So I've got a very interesting and different look at what health and wellness meant in a different country, different time, but still with people who were in that work with a particular set of focus, but like our own involvement and engagement, that sort of acts with our schools when things were good or when things weren't so good.

00:11:33:12 - 00:12:02:13
Ogechi Emechebe
Thank you so much for those answers, Dr. Vigilance and Dr. Garrick. So both of you mentioned that you know, it's really important to have a very strong support system. Something that we often hear from black men in medical school is that they see that they don't often feel support or they feel alone in their journey. So when men are in this on the school journey and they're talking about feeling isolated, feeling like no one understands them, how can we address this issue and what advice do you have for them?

00:12:02:22 - 00:12:04:05
Ogechi Emechebe
Dr. Vigilance, would you like to start?

00:12:04:29 - 00:12:31:24
Pierre Vigilance
Sure. So reflected on this before, and it was just quietly humbling to to recall that I was really blessed to have people at the schools that I went to for medical school and public health schools ... at Johns Hopkins in Baltimore. And there were a good number of there were a fair number of us in the I think we made up about 10% of our of our class.

00:12:31:24 - 00:13:00:22
Pierre Vigilance
So 12 or 13 of us in the class. But then there were a number of faculty members from the admissions office all the way through to cardiovascular surgery department. Dr. Levi Watkins, residents at the time, Dr. Malcolm Brock and others, internal medicine residents who were stars, I mean, they were well, well, well respected among their peers. And we'd hear about them from rotations and stuff like that.

00:13:00:22 - 00:13:42:10
Pierre Vigilance
And all these folks were ahead of us and they were available to us. They made themselves available to us. They engaged themselves with us, safe to say, years later, I'm able to pick up the phone and speak to any of them. A couple of them have unfortunately passed on. But certainly having those individuals there was hugely important. And I think that that's important for institutions now to make sure that there are those individuals who are not only present but also available to students for the type of support that we're talking about. Everybody who is of a particular skin color doesn't necessarily have the same lived experience.

00:13:42:20 - 00:14:21:29
Pierre Vigilance
And I think that from a culture perspective, from an institutional perspective, say, well, if we just have X number of students of color or students of African descent in the class, then they will naturally bond with each other and become one unit that will support each other may or may not be true, and the same can be said of faculty, etc. So having people who are able themselves to communicate regardless of even nuanced differences in background, but understanding some of the struggles based on race, ethnicity, etc. is very important, but something that institutions need to be mindful of.

00:14:21:29 - 00:14:34:18
Pierre Vigilance
The fact that simply having the numbers of a particular group doesn't necessarily mean that everybody in that group identifies the same way and means the same things.

00:14:35:17 - 00:14:55:11
Leon Caldwell
There's a part to this conversation, too, is like once you're out of medical school, right? Like once you're practicing, what I've always wanted to have conveyed is what difference does it make? Like why are having black male doctors even important to hospitals and health care systems?

00:14:55:29 - 00:15:20:06
Owen Garrick
And I'm having to take a credit that, you know, I want to come back to the original question and say, I think it's probably clear, but I want to make it obvious that these feelings, when we think about black male students or physicians and these feelings of isolation, I want to first acknowledge that your feelings are valid. Right?

00:15:20:06 - 00:16:01:09
Owen Garrick
So oftentimes we are, as black men, not allowed to feel angry, frustrated, scared. Right. And your feelings are valid. They are your own. They are acknowledged. So I think that is very, very important. And as Pierre mentioned, you know, there is this natural network you can build of African-American or like, you know, similarly cultured individuals. The other thing I think is important is accessing, especially if you're going to be in most of these professional settings, right.

00:16:01:09 - 00:16:37:04
Owen Garrick
They're going to be fewer numbers of people of color. So it will be, I think, important and critical to build relationships and be proactive about building relationships and looking for support with those that don't necessarily look like you. So I think it's critical that we look outside of sort of our cultural comfort to build these networks. And as to get to your your follow up question, you know, a few of us a few a couple of years ago published some research that looked at the importance.

00:16:37:17 - 00:17:07:25
Owen Garrick
And as Pierre mentioned, we want the real the real issue is health outcomes at the end of the day. So the importance of cultural congruence with that strong correlation and impact on health outcomes. Part of it is when you have people of color, physicians of color interacting with people of color, there is increased comfort, right? So there is an increase of exchange of information between provider and patient that leads to better insight.

00:17:08:05 - 00:17:39:16
Owen Garrick
It leads to I believe, though, that if we study this over the long term, earlier diagnoses and also more referrals to care options that you don't often see. Right. So better the increased ability to access the health care system facilitated by someone that looks like you, that has a frankly a born, inherited vested interest in your health and your health outcomes.

00:17:40:13 - 00:18:14:11
Leon Caldwell
So if you lean into the perspective that the presence of black male doctors will create, or at least afford the ability for a deeper knowledge, deeper relationships, kind of a joining, if you will, around health and particularly health outcomes. Would you conjecture that more black doctors would essentially decrease or if not eliminate, the disparities we see in black males health outcomes?

00:18:15:04 - 00:18:35:24
Pierre Vigilance
So as you both know, I have a...we're all raising children as we're raising kids at the moment. So and my little boy, I look at him and I think about what he's going to be dealing with going forward. Right. And we talk about why it's been a great boon that more African-American women are in medical school.

00:18:35:29 - 00:19:03:22
Pierre Vigilance
That's not to take away from the fact that they have climbed to those positions, working through a lot of sludge and mess, the kind of sludge and mess that impacts their ability to carry a child that has normal birth weight, for example. You know, an educated African-American woman ... actually, an uneducated white woman, is more likely to be able to carry a normal birth weight baby than an educated African-American woman.

00:19:03:22 - 00:19:29:22
Pierre Vigilance
And that's strange sounding statistic, but it's it's verifiable. And I think that we've got so far to go beyond just increasing the numbers of people, of "N." N equals a particular thing. It's almost like a particular approach to almost maybe even workplace or human resources. We say we've got X number of people doing that job now, so we're good.

00:19:30:13 - 00:19:57:14
Pierre Vigilance
The right people doing the work. And I think that that's important regardless of race, right? And if you're going to have people do certain work in certain communities, regardless of their race, regardless of the races of the community they're working in, if there isn't that desire to understand and to connect and to have dialog and to have the stories be told truthfully and there be this development of trust, then these outcomes don't change.

00:19:58:11 - 00:20:29:02
Owen Garrick
I would add. It's also getting individuals in leadership positions where they can control and directories sources. You know, if you think about the field that I'm in, ask more relevant research questions because a lot of this is nuanced. I think at the surface think, well, if if black women are having more success, why aren't just black men and women generally?

00:20:29:10 - 00:20:59:13
Owen Garrick
Right? So there's a nuance there you need to begin to think through. And if you have this, to to Dr. Vigilance point, this better connection, trusted relationship, you have the ability to hone in on what those distinctions are. If you control resources, you can leverage that analysis to direct resources in a more appropriate way. And we all invariably live in a resource constrained world, right?

00:20:59:13 - 00:21:21:29
Owen Garrick
So often times you need to have leaders decide where to put resources, which many times means not putting resources in other places. But I think that in addition to this connection that undergirds the leadership and the the control and the ability to direct resources would also be important.

00:21:22:18 - 00:21:45:08
Leon Caldwell
So, Dr. Garrett, here's a question I have for you. What do you see as the the role of hospice and health systems to advance equity for more black male physicians to take either leadership roles, practice roles, whatever roles they may take within health care in the United States?

00:21:45:28 - 00:22:13:03
Owen Garrick
I think there are a couple of opportunities here, right? So clearly, the ability to from a health system or hospital perspective to be part of that pipeline, that funnel. Right. So you are hiring, employing engaging black male physicians. You have it as a plan of yours not just to get them in, but to support them while they're there to advance their careers.

00:22:13:03 - 00:22:51:06
Owen Garrick
So they are you know, they grow into leadership positions and those positions could be clinical leadership, could be research leadership, but also the administrative or fiscal leadership of an institution. So that is broadly the opportunity. And as you think through one, this acknowledgment that there are smaller numbers having a commitment just like you would think about your nursing staff, right, your public administration staff, you build relationships with those institutions that educate and train that workforce.

00:22:51:24 - 00:23:18:23
Owen Garrick
The other part of this is thinking about what do you envision as the workforce of the future? So it's not just about bringing in individuals to fill a current role, but as you think about operating differently, you know, Dr. Vigilance mentioned these integrated care teams, but there are also these different settings, right? So it's not just hospitals are not just these inpatient entities, but are acquiring and building community presences.

00:23:19:05 - 00:23:27:13
Owen Garrick
So thinking through how black male physicians could and should have a role in the health care system of the future.

00:23:27:13 - 00:23:40:21
Ogechi Emechebe
I want to leave you both with one final question, and that is, what is your vision for health equity, given your experience and your knowledge and everything that you've dealt with so far up in your career, what would you hope? Where would you hope we are, you know, 50 years from now?

00:23:41:02 - 00:23:52:27
Owen Garrick
Yeah, I'll say that we put ourselves out of business, right? The entire apparatus of figuring out health equity, we figured it out in and we put ourselves out of business.

00:23:53:09 - 00:24:25:04
Pierre Vigilance
Yeah, I think we talk about this picture that we that we paint with the history that we were referring to before. And unfortunately, we're working on screens proverbially, that have many pixels missing. We've got only a partial picture of what entire communities look like because we've we've dug into certain spaces on those screens and we've got to define granular points of clarity with respect to some elements of it, but not others.

00:24:25:10 - 00:24:52:22
Pierre Vigilance
And none of us would buy a television screen that only showed half a picture. We'd take that back to the store immediately. But for some reason, to Doctor Caldwell's point about data, we've had data in to some extent. We have not necessarily chosen to go out and improve the collection of other data. And so we've got this partial fuzzy picture, but it's been okay and we've been able to we've just worked with it.

00:24:53:09 - 00:25:14:17
Pierre Vigilance
And I think that in 50 years time, hopefully much sooner than that, we will say, no, that screen is not sufficient for any of us and any part of an organization to be functioning to say that we're actually trying to improve outcomes and that we need to clarify this with adding to the data that's put into this picture so that it can be the high definition picture.

00:25:14:17 - 00:25:23:19
Pierre Vigilance
We need to be able to see exactly what's going on. And until you can see what's going on, you can't really address it.

00:25:24:03 - 00:25:59:29
Ogechi Emechebe
Well, thank you so much, Dr. Vigilance and Dr. Garrick for your time today and sharing with us this wealth of knowledge that essentially gives us and our members a call to action to tackle these issues. Thanks for listening. For more information from the Institute for Diversity in Health Equity, please visit our website at ifdhe.aha.org