Fostering a Diverse Faculty:Bridging the Divide

Ricardo Azziz, MD, MPH, MBAPresident, Medical College of GeorgiaCEO, MCG Health System, Inc.

Disclaimer• The talk today:–Offers a personal view, as a minority and as

an administrator– Is not meant to be politically correct

• Hence, MCG and the MCG Health System are not responsible for my comments

• I am an optimist problem solver by nature….

Di·ver·si·ty n. 1. The fact or quality of being diverse; difference. 2. Variety or multiformity:

• Overtly visible:–Gender–Race/ethnicity–Age/generation –Culture/foreign born status

• Less visible:– Sexual orientation– Socioeconomic strata–Religion–Culture/foreign born status

Georgia Tech and Diversity• A pioneer–Desegregated peacefully and without a

court order in 1961

• And a melting pot–Over 40 percent of student body is

minority–Nearly 20 percent is international

Why Should We Foster Diversity?• Increases the richness of ideas available• Improves focus on the needs of our diverse

communities• Increases access to and trust by the diverse

populations served• Maximizes the potential for translational

research & discovery• Enhances the value of strategic/scenario

planning

Diversity through Other Lenses• In nature–biodiversity is the basis for long-term

survival of all the species • In investing– a diverse portfolio is the pathway to financial

stability• But in the workplace and academia–Diversity is a harder sell

Interdisciplinary cultural competency course at MCG

The Case for Diversity and Culturally Competent Providers• General– Retention– Litigation savings– Greater market share-

relative profits– Individual performance

indices

• Health-Related– Lowers Hgb a1c– Lessens # ED visits– Improves medication

compliance– Reduces disparities– Fosters research relative to

societal needs– Enriches pool of managers

and policy makers

Diversity at MCG Health

Approaches to building a diverse faculty & student body• Equal opportunity vs. affirmative action?

• Setting the bar of excellence for UR vs. majority faculty?

• Formal vs. informal systems?

• UR vs. Young faculty?

Bridging the Divide

• The institution and faculty must both make a strong effort to reach out to each other, and to overcome each others shortcomings

• However, faculty should fully expect that their effort will be greater, as it is their career that is in the balance

Retaining and Maximizing the Success and Satisfaction of a Diverse Faculty• Accomplished by providing:–Opportunity– Training & insight–Acculturation–Mentoring, role modeling & guidance– Institutional education & sensitization – Support & a forum for conflict resolution,

focusing on the perception rather than the act of bias and prejudice

Providing Opportunity - Recruiting Diverse Candidates• Using the Search Committee as a tool• Widespread advertising of positions,

including in those publications focused on UR audiences

• Looking to alternative tracks in academic staffing

• The value of opportunity & chance • Caveat: Maintain fairness in recruiting–Value the faculty and not the label

Retaining and Maximizing the Success and Satisfaction of a Diverse Faculty

• Providing training & Insight–Regarding promotion and tenure processes• Recognize the additional efforts of UR in

mentoring & institutional service

–Regarding expectations• Of immediate supervisor(s), peers, students &

trainees, of the ‘institution’, of the community

• Provide leadership development

‘The Fourth Leg’ of Academics

• Academic faculty are the keepers – the stewards – of our future • Management and leadership– ‘The Fourth Leg’ of Academics

• Leadership is an aptitude, but leading requires training and education

A Moment of Perspective

Most professionals earn more than 90% of all Americans….

And more than 97.5% of all humans on the planet!

97.35% of tax returns report income less than $200,000

“The one quality that can develop by studious reflection and practice is the leadership of men.”

Dwight D. Eisenhower(1890-1969)

Retaining and Maximizing the Success and Satisfaction of a Diverse Faculty• Ac·cul·tur·a·tion

– n. 1. The modification of the culture of a group or an individual as a result of contact with a different culture. 2. The process by which the culture of a particular society is instilled in a human being from infancy onward

• Training in institutional and social culture– Should we train faculty towards a uniform ‘academic’

culture?or …– Should we change the underlying ‘academic culture’ to

accept diversity?

• Critical for leadership advancement– A matter of comfort, predictability, and ‘fit’

Ac·cul·tur·a·tion• Differences in perceptions of:–Respect: When to take offense? Is lack of perceived respect ones

personal failing or the offender’s failing? Age vs. hierarchy? Gender? How do we resolve conflicts?

–Communication: 10% is what we say, 20% how we say it, and 70% is body language

–Negotiation: Haggling vs. negotiating; back room politics vs. establishing agreements before meetings; personal gain vs. greater good

– Language: What does having an accent imply? What does the use of colloquialisms, local vernaculars, ebonics imply? What are the differences between the written and spoken word (on the one hand… and on the other; seeing vs. observing; showing vs. demonstrating)?

Ac·cul·tur·a·tion• Differences in perceptions of:–Politics: What is political capital? Who is really in charge? How

powerful (or not) are superiors?

–Civic duty: When is the greater good prevail? How is an individual’s needs modified by the greater good? What is Civic Duty and ‘Greater Good’?

– Socialization: Familiarity vs. friendship? how much and when is social discourse effective in the work place?

–Dress and hygiene: What’s appropriate, what’s not? What’s socially acceptable? What image do you want to convey?

What is Cultural Competency?• Culture refers to integrated patterns of human behavior that

include the language, thoughts, actions, customs, beliefs, and institutions of racial, ethnic, gender, sexual orientation, religions or social groups

• Competence implies being able to function effectively within the context of the cultural beliefs, practices, and needs presented by patients, families and their communities

• Cultural Competency the attitudes, knowledge, and skills that come together to integrate and apply knowledge of various cultures into healthcare

Whose Culture is it Anyway?

• Majority vs. Institutional (corporate) culture

• What is the majority culture in the US?

Retaining and Maximizing the Success and Satisfaction of a Diverse Faculty• Mentoring & role modeling– Critical for the success of all faculty, especially new

and UR faculty– Mentors vs. role models– Same group mentors vs. different group mentors• The paucity of same-group role models• Added burden to UR faculty

– Developing a structured/formal program– Participating in the mentoring process• However, many UR faculty themselves are poorly

trained to mentor and/or have limited time available for mentoring

The Chronicle of Higher Education Almanac 2010-11

U.S. Percentage of Faculty by Rank and Race/Ethnicity, Fall 2007

Retaining and Maximizing the Success and Satisfaction of a Diverse Faculty• Established senior leadership should:– Embrace, support and understand diversity scope,

values and goals– Communicate the importance of the diversity plan

to each unit and University goals– Encourage faculty, student and staff involvement

in and support of unit-level diversity programs/initiatives

– Raise institutional awareness concerning the value of diversity• Using objective (more or less) data• Using and comparing personal stories of development

Retaining and Maximizing the Success and Satisfaction of a Diverse Faculty

• However, established academic leadership may not:– Be willing to accept their own bias– Be aware of their own perceptions or prejudices– Be comfortable with fostering diversity or working

in a diverse environment – Be trained to lead– Be empowered

Professional Development of Faculty in Cultural Competency at MCG• Part of the MCG Quality Enhancement

Plan (QEP) for reaffirmation by the SACS Commission on Colleges (SACSCOC)

• Part of the requirements for Joint Commission accreditation of medical centers

• The right thing to do for faculty, staff, students and patients

Attitudes

• Recognize the importance of understanding self and personal biases, assumptions, and their own cultural backgrounds and practices

• Appreciate the differences that exist within and across cultural groups and the need to avoid overgeneralization and negative stereotyping

Knowledge• Demonstrate knowledge about varying cultural

beliefs about health, disease, and treatment that influence health care practice

• Explain changing demographics in the US and the presence of health disparities in health care and strategies to reduce disparities and improve quality of health care

• Identify and discuss relevant data sources and best practices in providing culturally competent care

Skills• Demonstrate verbal and non-verbal

communication in culturally competent practice that includes sensitivity to dimensions of diversity such as age, disability, gender, sexual orientation, socioeconomic status, race, ethnicity/nationality, and religion

• Collaborate with healthcare providers, patients and families to achieve a mutually acceptable, culturally responsive plan for individual patients

Dealing With the Perception of Discrimination

•Anger and conflict

•Understanding and strategy

Serenity PrayerGod, give us grace to accept with serenity the things that cannot be changed, courage to change the things that should be changed, and the wisdom to distinguish the one from the other.

Reinhold NiebuhrThe Serenity Prayer (1943)

Dealing With the Perception of Discrimination• A forum where the perception of discrimination

can be discussed frankly, privately, and in a non-threatening manner, is critical

• The goals of this forum should be to:– Provide for discussion and reflection regarding the

events/perceptions – Identify faculty/processes that may need addressing

in order to minimize the perception of discrimination

– Improving the present and future institutional environment

Dealing With the Perception of Discrimination• Moving forward in an institutional

climate that does not value diversity–May not be perceived that it is needed (e.g.,

already inherent in its structure)–May be perceived to be counter to the goal

of getting the ‘best’ faculty

• Are you fitting in?

Why Change Institutions?• Not ‘fitting in’: – May not fit in scientifically, politically, or

personally into the structure or priorities of Division Director/Chair/Institution

– Hard as it may be, do not take personally, as you gain nothing. • Understand that transitions do occur

– When considering changing or moving institutions, note:• Degree of current support and productivity• The short tenure of most Chairs/Deans

• Not ‘fitting in’ - Is it real or perceived?

Remember….

Positions of authority wax & wanePositions of authority wax & wane…No matter how bad it seems, it will eventually

get better!

Last Thoughts• Fostering faculty diversity – Should be carried out in a systematic, strategic,

organized, and measurable manner – Should involve formal and informal systems– Should focus on eliminating the perception of

discrimination• ‘Perception is reality’

– Should address the subtlety and nuances of communication

Last Thoughts• Fostering faculty diversity – Should involve the community, academic

leadership, and the UR faculty themselves• Need to avoid being a ‘one-issue’ ‘minority’ leader• Not all UR faculty understand the issues nor have a

sufficiently broad perspective• Avoid overtaxing UR faculty/students already in place,

and respect the need of UR faculty to decline

– Starts well before faculty positions are sought• In K thru 12• Parental education & income clearly play a role in

determining success

Last Thoughts• Challenges:– Value of diversity is under-recognized– Paucity of diverse leaders and mentors– Not all diversity groups, or even UR groups, are

equally discriminated against– There is a real need to maximize ‘fit’ and ‘comfort’• In Academics• In Healthcare• In Leadership

FOSTERING A DIVERSE FACULTY: BRIDGING THE DIVIDE