WEBVTT - It’s Not Just Business: Healthcare Equity & leadership with Dr. Errol Pierre 0:00:00.120 --> 0:00:04.440 I can count endless stories of people who were sick 0:00:04.960 --> 0:00:09.680 and forego for when care because they knew the system 0:00:09.800 --> 0:00:12.160 was bad. They knew they were going to be on 0:00:12.200 --> 0:00:15.040 a waiting line for four hours. They knew they were 0:00:15.080 --> 0:00:17.280 going to wait a line just to get a script 0:00:17.280 --> 0:00:19.480 to go see another doctor. They knew they were going 0:00:19.520 --> 0:00:21.480 to get a bill in the mail for four bucks, 0:00:21.520 --> 0:00:22.840 and they have no idea how they're going to pay 0:00:22.880 --> 0:00:27.640 for it. This is Here After, and I'm your host, 0:00:27.680 --> 0:00:30.440 Megan Divine, author of the best selling book It's Okay 0:00:30.520 --> 0:00:34.400 that You're Not Okay. This week on Hereafter, business leader 0:00:34.440 --> 0:00:37.880 and mentor and author and corporate exact doctor Errol Pierre 0:00:37.960 --> 0:00:40.800 joins us to talk about the hardships inherent in climbing 0:00:40.840 --> 0:00:45.559 the corporate ladder, systemic equity, and why all advocacy at 0:00:45.560 --> 0:00:49.120 its root is really grief work. I know that's a 0:00:49.159 --> 0:00:53.479 hodgepodge of things everybody, but the conversation we're about to 0:00:53.520 --> 0:00:56.480 have is going to bring all that stuff together. So 0:00:56.480 --> 0:00:59.280 settle in. We'll be right back after this first break. 0:01:08.040 --> 0:01:10.479 Before we get started, one quick note. While we cover 0:01:10.600 --> 0:01:14.680 a lot of emotional relational territory in each and every episode, 0:01:14.920 --> 0:01:17.640 this show is not a substitute for skilled support with 0:01:17.680 --> 0:01:21.200 a license mental health provider, or for professional supervision related 0:01:21.240 --> 0:01:30.040 to your work. Hey friends, So, on the surface, today's 0:01:30.120 --> 0:01:33.240 guest might seem like an odd match for this show. 0:01:33.520 --> 0:01:37.039 I mean, okay, listen to the description of his new 0:01:37.080 --> 0:01:40.440 book in the Way Up, Climbing the Corporate Mountain. As 0:01:40.440 --> 0:01:44.720 a professional color accomplished executive, Dr Errol Prierre delivers a 0:01:44.760 --> 0:01:48.800 pragmatic and actionable guide to help underrepresented individuals from all 0:01:48.840 --> 0:01:52.600 ethnic backgrounds achieve their professional goals and elevate their careers 0:01:52.640 --> 0:01:57.800 in today's modern workplace. And here's his bio. Dr Errol 0:01:57.840 --> 0:02:01.440 Pierre provides leadership, mentorship and ideans to professionals of color 0:02:01.480 --> 0:02:05.440 across various industries, ensuring the advancement of diverse professionals into 0:02:05.520 --> 0:02:12.040 leadership positions. Okay, all of that sounds amazing and awesome 0:02:12.320 --> 0:02:16.840 and it is. But I mean, the tagline of Hereafter 0:02:17.000 --> 0:02:20.119 is conversations with interesting people about difficult things. So why 0:02:20.240 --> 0:02:26.639 exactly is a corporate executive, mentor leadership author a guest 0:02:26.800 --> 0:02:34.760 on the show. Well, as you will hear in today's conversation, grief, love, suffering, 0:02:35.000 --> 0:02:37.440 and a dream for a better world is at the 0:02:37.520 --> 0:02:42.040 root of everything Dr Errol Pierre does. We kind of 0:02:42.080 --> 0:02:45.760 came to that realization together in the course of our conversation, 0:02:45.760 --> 0:02:49.160 which is also really cool. So on one hand, yes, 0:02:49.360 --> 0:02:53.240 he is an amazing mentor and leader and guide, particularly 0:02:53.280 --> 0:02:56.760 for people of color looking to advance their careers. But 0:02:56.880 --> 0:03:01.480 he's also an advocate for equity and x sessibility in healthcare, which, 0:03:01.520 --> 0:03:04.120 when you think about it, is actually a ferocious, deeply 0:03:04.240 --> 0:03:07.600 embodied care for the well being of individuals and families 0:03:07.600 --> 0:03:12.080 and communities. The work of leadership, whether on a corporate 0:03:12.160 --> 0:03:16.240 level or an advocacy, isn't like to erase pain, the 0:03:16.280 --> 0:03:18.240 pain that is such a large part of being human. 0:03:19.080 --> 0:03:21.440 But the real work is to decrease the odds of 0:03:21.440 --> 0:03:24.760 that pain showing up on your doorstep, and to reduce 0:03:25.160 --> 0:03:29.480 suffering when that kind of pain can't be avoided. This 0:03:29.600 --> 0:03:33.520 conversation is really special, So I don't want you to 0:03:33.600 --> 0:03:36.520 listen to his accolades and think that doesn't sound like me. 0:03:36.600 --> 0:03:40.880 There is so much in this conversation for everybody. Now. 0:03:41.080 --> 0:03:44.240 When I first started talking to him, I kind of frontloaded, though. 0:03:44.320 --> 0:03:46.640 Let's go over your bio and why you being here 0:03:46.720 --> 0:03:49.360 is a topic of discussion before I even actually kind 0:03:49.360 --> 0:03:53.200 of properly welcomed him to the show, sort of a 0:03:53.280 --> 0:03:57.320 host faux pop. But you know whatever, I'm jumping in 0:03:57.360 --> 0:04:02.000 with my own over zealous awkward. Welcome to the awkward 0:04:02.000 --> 0:04:04.320 party is also a tagline for the show, so you know, 0:04:04.400 --> 0:04:08.240 I'm I'm just breaking it anyway, here you go, jumping 0:04:08.360 --> 0:04:11.160 right in with the over zealous awkward. My conversation with 0:04:11.320 --> 0:04:17.919 Dr Errol Pierre. So in the intro, I was telling 0:04:17.920 --> 0:04:21.640 people that you provide leadership, mentorship and guidance to professionals 0:04:21.640 --> 0:04:25.760 of color across various industries, ensuring the advancement of diverse 0:04:25.760 --> 0:04:30.080 professionals into leadership positions, which is a lot of business 0:04:30.120 --> 0:04:34.800 talk that I lifted from your books press release, but 0:04:35.880 --> 0:04:40.000 I want to get behind that. So first of all, 0:04:40.480 --> 0:04:44.320 welcome to the show, Errol. Thank you for having me pleasure. 0:04:44.720 --> 0:04:47.320 We were chatting before we got rolling about like the 0:04:47.320 --> 0:04:50.039 the work of bringing a book out into the world, 0:04:50.240 --> 0:04:52.880 and I think that's part of it too, that like 0:04:53.360 --> 0:04:56.200 there's this book about business that you have out in 0:04:56.240 --> 0:04:59.800 the world, but it's really more than a book about business. 0:05:00.720 --> 0:05:03.320 Can you tell me a little bit about that? Sure? Sure? 0:05:03.520 --> 0:05:07.520 So the culmination of the book The Way Up was 0:05:08.080 --> 0:05:11.480 after the murder of George Floyd and during the pandemic 0:05:11.680 --> 0:05:15.880 that disproportionately impacted communities of color, black and brown populations. 0:05:16.760 --> 0:05:19.839 I was stuck in a nine square foot apartment in 0:05:19.839 --> 0:05:23.360 the Bronx with too much time in my hands and 0:05:23.880 --> 0:05:26.560 was just retrospective on how I ended up being where 0:05:26.560 --> 0:05:29.400 I was at that point in time, and putting pen 0:05:29.480 --> 0:05:34.480 to paper, I really wanted to describe my journey from 0:05:34.600 --> 0:05:39.120 working in the beauty supply store warehouse to becoming chief 0:05:39.160 --> 0:05:41.800 operating officer of a large insurance company in New York 0:05:42.200 --> 0:05:45.200 and then still feeling some emptiness. And so the book 0:05:45.240 --> 0:05:47.600 is a culmination of, Hey, I got to where you're 0:05:47.600 --> 0:05:49.440 supposed to get to. You got to the top, but 0:05:49.600 --> 0:05:54.040 I wasn't happy. And I also interviewed eleven other executives 0:05:54.040 --> 0:05:56.599 of color as well, which are infused to the books. 0:05:56.640 --> 0:06:01.400 Their quotes are through there because unfortunately, under represented people 0:06:01.600 --> 0:06:05.080 like myself, we're not believed. So you need other people 0:06:05.160 --> 0:06:07.920 to have the same story so that you're validated. So 0:06:08.000 --> 0:06:11.960 I also wanted to infuse their input and their insights 0:06:12.040 --> 0:06:15.000 and their experiences, and then lastly back it up with 0:06:15.080 --> 0:06:18.320 data and statistics, so that again it's not just an 0:06:18.320 --> 0:06:22.040 anecdotal story, but that that's really the culmination of it. 0:06:22.360 --> 0:06:24.880 And the goal is twofold one. If you are a 0:06:24.920 --> 0:06:28.440 person of color, hey, here's a nice little rubric of 0:06:28.640 --> 0:06:30.960 tips and tricks that you can learn. That's great. But 0:06:31.040 --> 0:06:34.279 then I think the other major important piece is if 0:06:34.320 --> 0:06:37.840 anyone reads this book, especially someone in leadership at corporation, 0:06:38.240 --> 0:06:42.320 will realize like, wow, I didn't know my employees are 0:06:42.360 --> 0:06:45.640 going through this just to tread in place, and that's 0:06:45.680 --> 0:06:48.760 really the bigger unset story. Yeah, there's sort of this 0:06:48.839 --> 0:06:53.599 like lip service around caring about employees mental health, and 0:06:53.720 --> 0:06:55.360 I love that you bring that up, like you want 0:06:55.400 --> 0:06:59.760 some real stories about what your employees are bringing to 0:07:00.000 --> 0:07:02.680 our lives on the job, Like can we have that 0:07:02.760 --> 0:07:05.960 conversation instead of that sort of you know, pop psychology 0:07:06.080 --> 0:07:08.480 lip service will give you a gift basket for all 0:07:08.480 --> 0:07:11.440 of your hard work, but not address the real systemic 0:07:11.440 --> 0:07:16.120 issues inside corporate structure. Now you mentor professionals of color 0:07:16.120 --> 0:07:18.960 who work in the health care industry, and I imagine 0:07:19.000 --> 0:07:23.040 that there are conversations about really difficult things inside that 0:07:23.160 --> 0:07:27.240 work that you do. It's not just career strategy so 0:07:27.360 --> 0:07:28.760 you know my question was going to be can we 0:07:28.760 --> 0:07:31.160 talk a little bit about the grief spoken and unspoken 0:07:31.320 --> 0:07:33.760 for people of color inside the corporate climb? But I 0:07:33.800 --> 0:07:36.800 think I want to ask a question before that, which is, 0:07:37.680 --> 0:07:42.240 how does grief intersect with this work for you? If 0:07:42.280 --> 0:07:45.920 it does, yeah, it's a great question. It does intersect 0:07:46.280 --> 0:07:49.920 because I say this a bunch of times and throughout 0:07:49.960 --> 0:07:54.200 the chapters, the way society is is going to show 0:07:54.280 --> 0:07:57.920 up inside the office. And for some strange reason, we 0:07:58.040 --> 0:07:59.960 have this belief that when you show up to work 0:08:00.280 --> 0:08:02.720 like this different person, you're not bringing the baggage that 0:08:02.760 --> 0:08:06.240 you have in and so in society, if I go 0:08:06.360 --> 0:08:09.480 to a grocery store and someone follows me around because 0:08:09.480 --> 0:08:11.960 they think I'm going to take something, that sort of 0:08:12.000 --> 0:08:15.440 chip on my shoulder, that paranoia, that feeling is going 0:08:15.480 --> 0:08:18.000 to show up in the workplace when I don't get 0:08:18.040 --> 0:08:21.240 a promotion or I get passed on for a job, 0:08:21.760 --> 0:08:25.240 and delinking the two you do a disservice to your employees. 0:08:25.480 --> 0:08:29.280 So grief is absolutely throughout. Some of the chapters talk 0:08:29.360 --> 0:08:35.280 about traumatic experiences I've been through and how to harness them. First, 0:08:35.280 --> 0:08:38.320 you have to be aware of them and acknowledge them 0:08:38.559 --> 0:08:42.760 so that you can like distress and it doesn't create anxiety. 0:08:42.840 --> 0:08:44.840 And then once you get to that point, which can 0:08:44.880 --> 0:08:48.640 take a while, then harness them as you continue your climb. 0:08:49.080 --> 0:08:52.160 So grief runs throughout it greet not just my grief, 0:08:52.200 --> 0:08:54.240 also brief of my parents. Because I talk about my 0:08:54.360 --> 0:08:58.560 parents that came from Haiti and how they're America was 0:08:58.600 --> 0:09:02.280 different than my America, but yet they're America totally influenced 0:09:02.280 --> 0:09:05.160 how I operate in my America. Yeah, and your parents 0:09:05.200 --> 0:09:07.920 came to America from Haiti in the seventies, right, as 0:09:07.920 --> 0:09:11.240 you said, completely different world. And you write that while 0:09:11.280 --> 0:09:13.280 your father worked really hard and was in a union, 0:09:13.520 --> 0:09:16.240 health care was out of reach for your family, right, Like, 0:09:16.280 --> 0:09:21.040 that's just one example of challenges that people face. You 0:09:21.120 --> 0:09:23.000 talked about it a little bit, But what role does 0:09:23.120 --> 0:09:25.720 that experience play in the life that you've built for 0:09:25.760 --> 0:09:27.880 yourself and the life that you hope to help others 0:09:27.880 --> 0:09:30.480 build for themselves. I talked about in the book It's 0:09:30.520 --> 0:09:33.360 it's a I see it right now vividly. I had 0:09:33.360 --> 0:09:35.080 to get a hut canal when I was a kid, 0:09:35.640 --> 0:09:37.880 and I went to the dentist, and the dentist told 0:09:37.880 --> 0:09:39.520 my dad, and these are grown ups talking, so like 0:09:39.559 --> 0:09:41.360 you're off to the side, you don't know it's right. 0:09:42.440 --> 0:09:44.839 And it's interesting what kids remember right when they're older, 0:09:45.080 --> 0:09:47.960 and the dentist center tolding my dad we can't complete 0:09:47.960 --> 0:09:51.760 the work until January one of next year, so even 0:09:51.800 --> 0:09:53.760 though you started, it was like September, like he has 0:09:53.840 --> 0:09:55.720 to come back in January. I had no idea what 0:09:55.760 --> 0:09:58.280 this smet, and so they sort of like closed my 0:09:58.360 --> 0:10:01.560 tooth that was unfinished and we left, and I remember 0:10:01.800 --> 0:10:06.000 having this feeling of an unfinished mouth walking around, not 0:10:06.080 --> 0:10:08.880 realizing why I had to wait till January. Later on 0:10:08.920 --> 0:10:12.480 in life, I learned, oh, dental plans for union workers 0:10:12.520 --> 0:10:15.480 who have worked menial jobs my dad was dishwasher at 0:10:15.480 --> 0:10:18.400 a nursing home are not comprehensive. So we had an 0:10:18.440 --> 0:10:21.560 out of pocket max, which meant the root canal. The 0:10:21.600 --> 0:10:24.079 whole cost of root canal was more than the benefit 0:10:24.120 --> 0:10:27.959 I had per year, and so I end up ironically 0:10:28.160 --> 0:10:32.000 working in health insurance and that became my passion. It's like, 0:10:32.080 --> 0:10:35.520 this is crazy that in the country that is spends 0:10:35.679 --> 0:10:39.520 more money than any country in the world on healthcare, 0:10:40.160 --> 0:10:44.480 doesn't provide adequate comprehensive, high quality care to all of 0:10:44.480 --> 0:10:48.560 its citizens with dignity and respect. There's so much of 0:10:48.600 --> 0:10:51.160 a lack of dignity and respect when a father has 0:10:51.200 --> 0:10:53.199 to tell their son, I'm going to bring you back 0:10:53.240 --> 0:10:56.120 to finish your tooth next year. So I know he 0:10:56.160 --> 0:10:58.040 felt that as a hard hit, and I could see 0:10:58.040 --> 0:10:59.320 it as a kid that he was kind of like, 0:10:59.480 --> 0:11:02.480 I'm not doing enough, and I thinking, my passion. That's 0:11:02.480 --> 0:11:05.440 why I'm into health equity space today. Of no one, 0:11:05.559 --> 0:11:08.520 no one, no one should not get comprehensive care that 0:11:08.559 --> 0:11:12.360 they deserved that's culturally sensitive and high quality. Yeah. I 0:11:12.360 --> 0:11:14.440 mean again, we go back to sort of these are 0:11:14.800 --> 0:11:19.280 headlines and buzz words, right. The lack of comprehensive health 0:11:19.280 --> 0:11:21.840 care has real world impact, like all of these things, 0:11:21.840 --> 0:11:25.520 but until you live it, until you really understand the 0:11:25.559 --> 0:11:29.280 personal impact of that, it's just a headline. It's just 0:11:29.400 --> 0:11:32.720 something to be mad about. It's just something to say 0:11:32.760 --> 0:11:34.560 we should all move to Canada or you know whatever, 0:11:34.640 --> 0:11:37.960 the things that we do that are not in the 0:11:38.040 --> 0:11:42.640 muck of the real human toll of that. Yeah. The 0:11:42.720 --> 0:11:45.920 one thing I'd add to is we shouldn't wait until 0:11:45.920 --> 0:11:49.280 it happens to us for it to be validated. So 0:11:49.840 --> 0:11:53.800 I don't need to have someone else experience lack of 0:11:53.840 --> 0:11:56.120 health care for me to say, oh, it happened to 0:11:56.200 --> 0:12:00.280 my mother, so now I believe in it and unfortunate. Really, 0:12:00.360 --> 0:12:02.160 it happens a lot in America where it's like, well, 0:12:02.200 --> 0:12:04.319 I don't experience it, so it's not real until it 0:12:04.320 --> 0:12:06.760 happens to you. Then you're like, well, I'm speaking from 0:12:06.920 --> 0:12:09.640 you know, experience, just so real. It shouldn't be that way. 0:12:09.640 --> 0:12:12.839 If if one human experienced it, then it's valid. Yeah, 0:12:12.920 --> 0:12:14.920 and I would love that. I would love if if 0:12:15.000 --> 0:12:17.360 human brains work that way. But it does seem like 0:12:17.880 --> 0:12:22.360 there's something important that has to happen to sort of 0:12:22.400 --> 0:12:26.319 open those doors in the brain to recognize somebody else 0:12:26.480 --> 0:12:32.800 as deserving of support and access and care and all 0:12:32.840 --> 0:12:34.319 of those things. There's this great I'm not going to 0:12:34.360 --> 0:12:36.160 go on this tangent for too long, but there's this 0:12:36.240 --> 0:12:40.559 great book called General Theory of Love written by three psychiatrists. 0:12:40.840 --> 0:12:43.559 It's an older book now, but they talk about how 0:12:43.760 --> 0:12:47.079 there were experiments done on the limbic part of the 0:12:47.120 --> 0:12:50.960 brain in mammals. I promise this is related to what 0:12:51.000 --> 0:12:54.240 you were just saying, But what they found and sorry, 0:12:54.240 --> 0:12:57.160 this is an animal study, everybody, not my study, don't 0:12:57.240 --> 0:12:59.319 yell at me. But what they found was that if 0:12:59.360 --> 0:13:01.720 they damn of just the limbic part of the brain 0:13:02.000 --> 0:13:07.600 of female hamsters, that those female hamsters wouldn't recognize their 0:13:07.600 --> 0:13:10.760 own offspring, they would basically treat them as furniture, and 0:13:11.280 --> 0:13:13.800 that if they stimulated the limbic part of the brain, 0:13:14.200 --> 0:13:18.000 then everybody was family and they cared for each other. 0:13:18.040 --> 0:13:20.959 And they're like, so, so of course me. I'm like, so, 0:13:21.000 --> 0:13:24.440 what we're saying is that for the people who enact 0:13:24.559 --> 0:13:27.679 policies that do actual damage to real, actual people, they 0:13:27.720 --> 0:13:30.880 have limbic deficits, and there's some limbic damage in there, 0:13:30.880 --> 0:13:32.680 and what we need to do is find some way 0:13:33.160 --> 0:13:37.360 to help them reconnect with the part of their brains 0:13:37.400 --> 0:13:41.200 that sees every life as valid and deserving of care. 0:13:41.280 --> 0:13:43.480 And how the heck do we do that, I don't know, 0:13:43.800 --> 0:13:46.679 but I do know that some of that work is 0:13:46.679 --> 0:13:48.920 advocacy work. I told you I could bring this back 0:13:49.080 --> 0:13:54.840 right a lot of so some of the ways that 0:13:54.880 --> 0:13:58.920 we do that that we help people understand that things 0:13:59.040 --> 0:14:01.319 need to happen to make things better for others, even 0:14:01.360 --> 0:14:03.840 if it's not your own shared experience. Like, that's advocacy 0:14:03.880 --> 0:14:05.960 work in a nutshell, and a lot of your public 0:14:05.960 --> 0:14:10.520 advocacy work is in health equity. That phrase health equity 0:14:10.600 --> 0:14:12.560 is something that we sometimes see in headlines. So can 0:14:12.600 --> 0:14:15.280 you tell me, first of all, what that means in 0:14:15.400 --> 0:14:18.360 a business and policy sense, and then what it means 0:14:18.360 --> 0:14:20.120 for you personally. We touched on that a bit, but 0:14:20.160 --> 0:14:23.200 I like the two parter here. Yeah. Sure, So health 0:14:23.200 --> 0:14:27.880 equity the intent is it's different than equality health Health 0:14:27.920 --> 0:14:34.600 equality equal would mean everyone gets a visit to a physician. 0:14:35.160 --> 0:14:38.840 One visit to a physician, that's equal, But some patients 0:14:38.880 --> 0:14:41.760 may need six visits, and some may patients may be 0:14:41.880 --> 0:14:45.280 so healthy they need zero. So health equity looks from 0:14:45.320 --> 0:14:49.400 an economic lens, how to take limited resources and make 0:14:49.440 --> 0:14:54.640 sure that they're used in the most equitable efficient way 0:14:54.680 --> 0:14:56.640 based on the needs of the people. And so the 0:14:56.680 --> 0:14:59.640 example you know you can use is like one patient 0:14:59.720 --> 0:15:03.000 maybe a wheelchair. Doesn't mean everyone needs a wheelchair for 0:15:03.000 --> 0:15:05.280 it to be equal, But from an equino perspective, say 0:15:05.400 --> 0:15:07.760 give this person a wheelchair, this other person may need 0:15:07.800 --> 0:15:10.680 something else. And so we spend two point five times 0:15:10.680 --> 0:15:12.880 more than any other country in the nation. We don't 0:15:12.880 --> 0:15:17.680 need more money, we need better bureaucratic systems to make 0:15:17.720 --> 0:15:20.520 sure that the money flows to the right places. And 0:15:20.560 --> 0:15:23.680 so what health Equity fights for is today there is 0:15:23.760 --> 0:15:27.560 somewhere in New York City a mom who's a single 0:15:27.600 --> 0:15:31.160 mom with a child who won't go to the doctor 0:15:31.200 --> 0:15:34.520 because by taking off work means they won't make money, 0:15:34.640 --> 0:15:37.800 and so they stay at work and their sickness gets 0:15:37.840 --> 0:15:40.480 worse and they end up in the emergency room at 0:15:40.640 --> 0:15:43.600 the worst point, and then on the same vein. And 0:15:43.600 --> 0:15:47.440 there's another mom who can take off work because their 0:15:47.480 --> 0:15:50.440 salaried and they decide to bring their child to the 0:15:50.680 --> 0:15:54.760 off the doctor's office twenty times for stifools, earaches anything, 0:15:55.240 --> 0:15:58.200 And that person who's going twenty times can probably go 0:15:58.280 --> 0:16:01.360 four times. And then the mom who never went once 0:16:01.680 --> 0:16:04.080 should probably go twice at least for preventive care of 0:16:04.120 --> 0:16:06.480 visits in the follow up. And what Health Equity trying 0:16:06.520 --> 0:16:11.080 to do is shake that. It turns into sometimes controversial 0:16:11.440 --> 0:16:16.520 because it's like you're taking something from someone, you're rationing care. Ironically, 0:16:16.680 --> 0:16:20.520 every developed nation on the planet besides us, that's health 0:16:20.520 --> 0:16:24.680 care that way, United Kingdom, France, Germany, Norway, Sweden. That's 0:16:24.680 --> 0:16:26.440 how they do care. They say, the people who need 0:16:26.480 --> 0:16:28.120 it get it. The people who don't need it, they 0:16:28.120 --> 0:16:30.080 will be a little bit longer. That's just how it 0:16:30.120 --> 0:16:32.440 works when you have limited resources. So that that's really help. 0:16:32.480 --> 0:16:36.120 Equity you layer on to it as well cultural competency. 0:16:36.240 --> 0:16:39.040 We happen to be some of the most diverse citizens 0:16:39.200 --> 0:16:42.440 in the world in America, and so you're thinking through 0:16:42.880 --> 0:16:46.480 English is not the first language. What happens when someone's 0:16:46.520 --> 0:16:49.120 telling you, you know, discharge information on how to leave 0:16:49.120 --> 0:16:51.360 a hospital. So if someone is saying to you you 0:16:51.400 --> 0:16:54.280 need to have a meal with these medications that you 0:16:54.320 --> 0:16:57.840 take twice a day, and it's not in their native language, 0:16:57.840 --> 0:17:01.000 do they understand those instructions that will be abide by it. 0:17:01.360 --> 0:17:03.760 The example I always used to is some only with 0:17:03.760 --> 0:17:06.640 pneumonia shows up to the emergency room. You stabilize them, 0:17:06.680 --> 0:17:08.959 you give the medication, you send them home. They end 0:17:09.040 --> 0:17:11.679 up going back to a nitia house building public housing 0:17:11.760 --> 0:17:14.040 that doesn't have heat. We didn't solve the issue. So 0:17:14.080 --> 0:17:17.000 how that But he also thinks about the other determinants 0:17:17.000 --> 0:17:19.120 of health that's outside of just getting access to care, 0:17:19.200 --> 0:17:22.160 but other things that also lead to health outcomes. Yeah, 0:17:22.200 --> 0:17:25.440 it's really looking at the whole complex picture of things 0:17:25.480 --> 0:17:28.199 and understanding that we don't operate in a vacuum. And 0:17:28.240 --> 0:17:32.159 I think that industry and corporate levels often think just 0:17:32.240 --> 0:17:35.879 in one channel, right, yeah, just one channel and not 0:17:35.960 --> 0:17:37.960 in systems. And it's like, you know, I'm listening to 0:17:38.000 --> 0:17:41.000 you say the you know, the economic benefit of equitable 0:17:41.040 --> 0:17:44.560 care like it, we have to actually make it fit 0:17:44.720 --> 0:17:49.960 into the language that industry speaks, which is economics. Right, 0:17:50.040 --> 0:17:53.600 it's it's r O I And that actually caring for 0:17:53.640 --> 0:17:55.760 people in the ways that they need to be cared 0:17:55.800 --> 0:18:00.639 for is to your economic benefit. Is that a hard sell? Now, 0:18:00.680 --> 0:18:02.919 I'm just now, I'm just indulging my curiosity, But is 0:18:02.920 --> 0:18:05.320 that a hard sell inside the health care industry for you? 0:18:05.520 --> 0:18:07.600 I don't think it's a hard sell. I think the 0:18:07.720 --> 0:18:10.960 work needed to get done to make it happen is 0:18:11.000 --> 0:18:14.240 the hard sell. So the example we can show is 0:18:14.480 --> 0:18:18.400 other developed nations like Norway, Sweden. They do lots of 0:18:18.640 --> 0:18:23.280 social programs for their citizens, stick paid leave, child care, 0:18:23.720 --> 0:18:27.440 free healthcare, and what they find is their healthcare costs 0:18:27.440 --> 0:18:32.000 are reduced because they're investing in things that keep people healthy. Right. 0:18:32.640 --> 0:18:36.280 People believe that in concept. Now in America, when you say, okay, 0:18:36.359 --> 0:18:39.960 we agree with the concept, let's make it happen. Songbody 0:18:40.000 --> 0:18:42.199 has to change, and that's what the rubb is. No 0:18:42.200 --> 0:18:44.800 one wants to change. Like I agree, eral health equity, 0:18:44.840 --> 0:18:47.240 let's do it. But can you leave me alone and 0:18:47.280 --> 0:18:52.080 start with them? Right? I mean, I think this is 0:18:52.119 --> 0:18:55.080 this is probably you know, the response to a lot 0:18:55.200 --> 0:19:00.680 of behavioral and worldview changes, right like, yeah, yeah, yeah, 0:19:00.680 --> 0:19:02.399 that sounds great. I'm on board as long as I 0:19:02.400 --> 0:19:04.080 don't have to do anything different, as long as I 0:19:04.119 --> 0:19:06.320 don't have to feel any discomfort, as long as nothing 0:19:06.359 --> 0:19:08.840 in my world needs to change. And of course there's 0:19:08.840 --> 0:19:14.280 a direct bridge here to addressing systemic racism in the 0:19:14.320 --> 0:19:17.760 medical industry, right like, oh yeah, I'm totally on board 0:19:17.760 --> 0:19:19.840 with you. I get this. That's a terrible outcome. But 0:19:19.880 --> 0:19:22.320 I like, I've got managed care, and I've got this, 0:19:22.400 --> 0:19:26.240 and I've got that. Like, so we think about the 0:19:26.240 --> 0:19:29.400 health care industry, insurance especially as this like anti human 0:19:30.080 --> 0:19:34.040 monolith from a consumer that that is definitely how I 0:19:34.040 --> 0:19:36.360 feel about it. But I was listening to an interview 0:19:36.359 --> 0:19:38.679 with you the other day as I was preparing for 0:19:38.720 --> 0:19:43.280 our time here together, and you were talking about systemic 0:19:43.400 --> 0:19:47.200 racism and what we call poor medical outcomes for people 0:19:47.200 --> 0:19:51.600 of color. And you used a term of systemic equity 0:19:51.960 --> 0:19:55.160 as a counterpoint to systemic racism. Can we talk about 0:19:55.200 --> 0:19:57.240 that for a minute, and then I then I do 0:19:57.320 --> 0:20:00.640 want to get into like the reality of health outcomes 0:20:00.680 --> 0:20:05.280 for communities of color. So systemic equity, what does that mean? 0:20:07.760 --> 0:20:10.120 So I'll say that we're trying to fix the issues. 0:20:10.520 --> 0:20:13.760 And so when you think from a perspective of solving things, 0:20:14.000 --> 0:20:17.200 you hear the term that people use a systemic racism 0:20:17.240 --> 0:20:21.720 and systemic inequality because it's embedded into systems that we have. 0:20:22.480 --> 0:20:25.560 I like to say, let's start from scratch. Let's have 0:20:25.680 --> 0:20:29.200 a clean piece of paper. What would be the world 0:20:29.280 --> 0:20:32.959 we would imagine. So you start with systemic equity, and 0:20:33.000 --> 0:20:36.120 from that perspective, you're like, here's all the dollars, now, 0:20:36.240 --> 0:20:39.119 let's rationally think about how to get it federated to 0:20:39.160 --> 0:20:44.399 the right places. Systemic equity would then say, okay, the 0:20:44.520 --> 0:20:48.240 best most efficient way to deliver care is to preventive 0:20:48.240 --> 0:20:52.280 care visits. Awesome. Here are a group of people who 0:20:52.520 --> 0:20:56.720 are unable to show up to the doctor because transportation 0:20:56.800 --> 0:20:59.520 is an issue, because there are a senior who lives 0:20:59.520 --> 0:21:01.199 on a shift or walk up that doesn't have an 0:21:01.200 --> 0:21:06.000 elevator because they are salaried, and any time that they 0:21:06.040 --> 0:21:08.040 take off work, they're not putting money in their pocket. 0:21:08.400 --> 0:21:11.480 They can't find a doctor speaks their language. Of the 0:21:11.560 --> 0:21:14.800 vaccination websites were only in English, so if they speak 0:21:14.920 --> 0:21:18.159 or do Chinese Asian creole, they won't even know how 0:21:18.160 --> 0:21:20.840 to book an employment. So we would make sure there 0:21:20.920 --> 0:21:24.959 was more funds for those to get their preventive care visits, 0:21:25.359 --> 0:21:29.480 and then folks that can navigate the healthcare arena would 0:21:29.520 --> 0:21:32.879 eventually get their care as well because they have health literacy, 0:21:32.920 --> 0:21:36.240 they have the capabilities, they have transportation and things of 0:21:36.280 --> 0:21:39.680 that nature. And so instead of speaking of a deficit 0:21:39.800 --> 0:21:43.359 like oh my gosh, that's systemic inequity and it's so bad, Like, well, 0:21:43.560 --> 0:21:46.760 how would we create the perfect model where we start 0:21:46.840 --> 0:21:50.920 with systemic equity. It's embedded in the system. An example 0:21:51.560 --> 0:21:54.639 is when they created those vaccination websites for everyone to 0:21:54.680 --> 0:21:58.639 get vaccinated. Obviously, the people who were around the table, 0:21:58.920 --> 0:22:01.359 we're thinking through the lens themselves, but like I use 0:22:01.400 --> 0:22:05.280 a desktop and it's English, not realizing that the people 0:22:05.320 --> 0:22:09.000 who had the highest hesitancy don't use desktop as their 0:22:09.040 --> 0:22:11.359 formal way to get into that access to use a 0:22:11.400 --> 0:22:14.439 mobile phone, and English is not their first language, so 0:22:14.480 --> 0:22:18.240 systemic equity would have built a mobile app in Spanish 0:22:18.240 --> 0:22:21.760 and Chinese first, So that that's the type of thing 0:22:21.800 --> 0:22:24.240 that I like to solve publes with. From that perspective, 0:22:24.280 --> 0:22:26.639 it's like, let's look at it from a systetic equity lens. 0:22:26.720 --> 0:22:28.640 Start with the way you want to create it, as 0:22:28.640 --> 0:22:31.000 opposed to trying to move the deck chairs on something 0:22:31.040 --> 0:22:35.360 that's broken. That is brilliant. It really is, because it's 0:22:35.440 --> 0:22:39.879 like I think, when you start talking about systemic racism 0:22:40.000 --> 0:22:43.919 systemic inequity, people get their hackles up. Just is what 0:22:43.960 --> 0:22:45.800 you describe, Like that sounds great, but don't make me 0:22:45.880 --> 0:22:49.960 change anything. But I think if you present things as 0:22:50.040 --> 0:22:52.359 let's start from scratch and what dream can we build, 0:22:53.359 --> 0:22:57.119