2022-23 Distinguished Scholar Series Concludes with Focus on Equity and Diversity

The 2022-23 Distinguished Scholar Series was concluded on Thursday, January 19, 2023 with a conversation with Clyde W. Yancy, MD, MSC, MACC, FAHA, MACP, FHFSA, who currently serves as Vice Dean for Diversity and Inclusion at Northwestern University Feinberg School of Medicine.

This was the first hybrid in-person/virtual conversation in the series, and the in-person event was very well-attended by leadership from UIC, UI Health and external partners and stakeholders including Lurie Children’s Hospital, Michael Reese Health Trust, Loyola University Chicago, the American Academy of Pediatrics and Northwestern Medicine.

Joining Dr. Yancy on stage were Jerry Krishnan, MD, PhD, UIC associate vice chancellor for the Office of Population Health; Terry Vanden Hoek, MD, FACEP, head of Emergency Medicine at UI Health; and Rani Morrison, MS, MSW, FACHE, UI Health chief diversity & community health equity officer.

In his conversation, Dr. Yancy addressed several very timely and relevant topics, including the urgent need to create equity and inclusion in both health systems and in research. He indicated that his key strategies are communication and approaching issues of diversity, equity and inclusion in a fashion similar to how we approach issues of science.

“Stunningly, there is a body of information about issues of diversity, equity and inclusion. You start on the front end and say ‘Let’s inform ourselves. Let’s elevate the discussion as if we have an issue on the table that’s like a disease process and let’s think about the science, think about the theory, and then understand what the opportunities are, what are the options’”, he said. “It’s a very different kind of conversation. But I’ve always dealt with some of the most difficult conversations in this space by being very forthright and bringing the information to the table as information, not as feeling.”

Dr. Yancy went on to explain that the goal is to achieve diversity of thought and ideation. “It’s about getting ideas from places you’ve never seen before so you can build better systems. So we can take out the metrics and post our annual diversity numbers and thump our chests. But that doesn’t excite me,” he said. “What excites me is when we get people in the room that have a different perspective, a different history and give us a different idea. It’s a totally different game, and so I think that’s what we need to be.”

He also addressed his vision for achieving diversity and inclusion in health care and the health sciences. “We either change leaders or we change as leaders,” he said. “We need to have leaders that are willing to adopt culturally affirming positions for the kaleidoscope of people with whom they engage.”

Photos and video from the Conversation with Dr. Yancy can be viewed below.

Prior events in the 2022-23 series featured the following distinguished scholars:

• Patricia Flatley Brennan, RN, PhD, Director, National Library of Medicine, National Institutes of Health
• Kirk A. Calhoun, MD, FACP, President, The University of Texas at Tyler, and Chairman, Board of Directors for UT Health East Texas
• Eliseo J. Pérez-Stable, MD, Director, National Institute on Minority Health and Health Disparities, National Institutes of Health

• Receive Emails for Future Events

JERRY KRISHNAN: Good afternoon, everyone. My name is Jerry Krishnan. If you all could take your seats, we’re going to get started. So first good afternoon and welcome to the latest in our UI Health distinguished scholar series. It’s amazing. I don’t usually read things because I’m pretty good off the cuff. But Aileen has made me very nervous. I think I need to pay attention. If you see me paying attention, Aileen has done such a tremendous job. I want to make sure I don’t let her down. Before I forget because there’s conversations we’re going to have, I’d like everyone to give a round of applause to Aileen Baker and Michael Wesbecher for organizing. (Applause).

Okay. So my name is Jerry Krishnan. I think I know many of you are, most of you here, I’m the associate Vice Chancellor for population health sciences at the University of Illinois. I’m also a Professor of medicine in the division of pulmonary critical care medicine and also serve as the Professor of medicine in the department of epidemiology by statistics. I am welcoming you on behalf of Dr. Bob Barish. He will join us virtually for a small session later this morning. But as many of you — this afternoon. But as many of you know, he usually gives the welcoming remarks. And Dr. Barish wanted me to convey that he apologizes. He had a personal conflict, but really wishes all of you well and hopefully for all of us to learn from Dr. Yancy. So the office of the Vice Chancellor for health affairs, for many of you that are new here, recognize that it is the — it is essentially the coordinating unit for the entire care delivery system, hospital, multiple clinics and an entire network of federally qualified health care centers, and also all of the deans of the health sciences colleges report to Dr. Barish and I see several Deans in the audience. It’s a pleasure to see you and others. So thank you for being here today.

I want to point out, though, that the distinguished scholar series is a little unusual while this is led by the office of Vice Chancellor for health affairs, it’s done in coordination with our health care system and in particular our chief medical officer, our chief clinical officer, chief nursing officer, chief quality officer, chief of diversity and community health equity officer and Rani is joining me here today representing that group. So really it is intended to be at the apex of that care delivery system. How do we have conversations that are important for us to have. We are super excited today that this is our first in-person distinguished scholar series since we started this a few years ago, something called the COVID pandemic got in the way and we are super excited that Dr. Clyde Yancy agreed to join us today. You’re in for quite a show. I’ve already been impressed with the fact that he’s going to do whatever he wants to do today, and so I’m going to do my best to keep us moving. (Laughter) but really you’re going to learn a lot. I’ve already been learning quite a bit. There’s also a number of people joining livestream so we’re going to try really hard to speak in our mic, and if you do have questions, there will be a mic coming to you and do your best to use the mic when you’re answering and speak a little more slowly, if needed.

This series is intended to offer an opportunity to learn from and share with nationally and frankly internationally recognized health care leaders. So I’d like to offer a very special welcome to our distinguished guest today, vice Dean for diversity and inclusion, chief of cardiology in the department of medicine and Professor of medicine and medical social sciences, at Northwestern medicine, Dr. Clyde Yancy. A round of applause, please. (Applause).

Anyone who knows Dr. Yancy I think will agree with me that he is very busy, has a really, shall I say full schedule. So it’s really an honor, Dr. Yancy, that you took some time to be with us today. And we thank you and we look forward to learning from you.

The goal here is really to learn from leaders like Dr. Yancy and for us to also describe to him what we do, what’s our mission, what are the areas we’re working on. And hopefully he leaves us today knowing a little bit more about us and likewise we also leave today learning a little more about Dr. Yancy and how he’s made it, so to speak, or what he’s working on next and what part of our — his future can we be part of as well.

It’s been very exciting to see the seminar series come to fruition. Several years ago, I think, many of you know, I was approached by our Vice Chancellor for health affairs, Dr. Barish, with the idea of engaging health care thought leaders from across the nation in meaningful dialogue so that we can share in their expertise and with our local community to serve our patients better. So our goal here really is to translate some of the conversation we’re having today to actual action. So think about that as you think about the kinds of questions you want to ask.

Dr. Barish specifically told me no slides, Dr. Krishnan. This is a conversation. And really the idea is to host a more intimate conversation. Today really with Michael Wesbecher and Aileen’s help, we’re actually gathering as a community. This was the goal a few years ago. So if you feel a little closer to your neighbors, it’s intentional. It’s to build community, dialogue and friendship. All of you have things in common so if you haven’t had a chance to interact with each other, please do that today, if not during this short session, shortly afterwards. You have a lot in common. We all actually have a lot in common with each other.

Today’s conversation is an exceptional opportunity to engage another national leader from a peer academic health enterprise you might know, this university called Northwestern, not too far away, one of our peers. We’re here to learn and gain deeper insights through his work and experiences. So it’s with great pleasure on behalf of Dr. Bob Barish, our Vice Chancellor for health affairs, that we welcome you as our distinguished scholar today and really for a fire side chat. And I think you’ll see some fireworks, I believe. So a little bit about Dr. Yancy and really we have to cut it down. There was quite a bit to say so I’m going to try to abbreviate his many accomplishments. So first he received his medical degree from Tulane University, School of Medicine in 1982. After medical school he completed his residency at Parkland Memorial Hospital in internal medicine in 1985. As someone from Texas, we always talk about Parkland as a national leader, a place that trained amazing clinicians so Dr. Yancy represents part of that pedigree. He then went on to UT southwestern center where he completed fellowships in cardiology in 1989, cardiovascular physiology research, training in the labs of Mitchell and Blomqvist. And then like I said, there’s a lot to say — advanced heart failure transplant, 1990. He then, because education is something he believes so strongly in, decided he needed a master’s degree in medical management. And for many of you who have risen through the academic chain, you realize your training may be in one thing but as your career progresses, time to learn or relearn or to broaden your area of expertise into people and how to manage and how to lead. Dr. Yancy is currently the vice Dean of diversity and inclusion at Northwestern. He also serves as chief of cardiology as I mentioned and associate director of the Bluhm Cardiovascular Institute of Northwestern Hospital. He old the Magerstadt Professor of chair and also is appointment of Professor of medical sciences. His research includes heart failure, guideline generation, outcome sciences, personalized medicine and health care disparities. Each of these are careers and he works in all of these careers.

Over 700 peer-reviewed publications with an H-index of over 115, let’s just say that’s one of the most highly cited scientific authors worldwide. This is a very rare number of people have accomplished that level of scholarship.

He’s also the deputy editor of JAMA cardiology, senior section editor for heart failure for the journal of American college of cardiology, serves on multiple boards. I won’t read all of them. He’s a former President of the American Heart Association, an elected member of the national academy of medicine and a member of the American Association of Physicians. He has multiple roles across multiple groups within the federal infrastructure FDA, NIH, NHLBI and so forth, clearly someone who the nation looks to in times of need. I recently had the chance to work along side him, and as part of the steering committee, he was the chair of for the committee on collaborating network of networks for evaluating COVID-19 therapeutic strategies, a lot of words essentially called CONNECTS, which is a major NIH initiative for the design and implementation of multiple adaptive clinical trials for COVID-19. So for those of you that have had COVID-19 or family members or friends who have been treated with medications, in part we owe that to Dr. Yancy’s work. Chairing that on behalf of the nation, ensuring that we brought some of the discoveries forward to actually help people in times of need.

So that’s my quick introduction, really quick introduction. (Laughter). I’m now going to also very briefly introduce, because you all know these individuals, Dr. Terry Vanden Hoek, my friend, also Professor, head of department of emergency medicine. He’s had many titles and I think I won’t read all them. And of course Rani Morrison Williams, our chief diversity and community health officer. So with that as a background, again, one more announcement task live streamed. So to the extent to which you want to say something, raise your hand and we’ll bring a mic to you at the appropriate times. Michael will bring it over there. So then I’m going to ask my first question just to kick us off. We’ll do a little bit of asking Dr. Yancy the kind of thing. So I’ve said a lot of things about you, Dr. Yancy and most of it is true, I think. (Laughter). So what, if anything, you’d like to share that’s more personal, that perhaps people don’t realize?

CLYDE YANCY: Probably the first — Jerry, thank you for this opportunity and thank all of you. I know everyone in here has something else on your agenda today and you’ve taken the time to come to be a part of this conversation. And I delight in the idea that this is a conversation and not a presentation. And as we’re sorting that conversation and Jerry gives me the license to say something that’s not in my CV or not on the bio from which you read, I will tell you that I’m a little bit lighter than I typically am. I’m standing a little bit taller than I typically do because my younger daughter is newly married. And that was on new year’s Eve in New Orleans. It was a spectacular moment. But what made it so spectacular is she decided to wed within four miles of the place where her mother was born. And that’s important because I lost my first wife when my daughters were 6 and 7. And I spent about 20 years as a single parent just trying to enrich their lives and help them reach their pinnacle, whatever that happened to be. And for her to go home and have her wedding there and to reach out to family members, distant and near, so that we could all have that celebration, it was pretty remarkable. And I’m still floating a little bit because that was just a terrific moment. I mean, of everything else I’ve done, the two things that I cherish the most are my two daughters, just no question about that.

JERRY KRISHNAN: Great. Thank you so much, Dr. Yancy. Round of applause maybe. (Applause.) So I think, Rani, I think you had the next question.

RANI MORRISON WILLIAMS: And I’m trying to manage my own emotions, Dr. Yancy, as you just hit a few things with your personal discovery that hit home for me. I have two daughters that are my world. I went to school in Baton Rouge, so down the street from New Orleans. I love beignets. But and I spent a long time as a single parent as well. So I appreciate your disclosures on so many levels and really thank you for that.

As we think about your day to day and your career and your professional life, what inspires you in your daily work besides your daughters?

CLYDE YANCY: That’s the easiest question that anyone could raise. I would say not only what inspires me but what inspires you. This should be a cause du jour as you wake en each day. There should be a reason you want to walk to the office. There should be a passion for what you do. I’m someone who can’t wait to get to the office in the morning after my gym session. And I stay as long as possible. I’m the last guy out of the office every night. I’m on a first name basis with the staff that supports our offices because I just don’t know when to stop. And it’s because I love what I do. If you can find, particularly for the early career individuals, whether it’s science, administration, any domain, if you can find that thing that you do that draws you, that’s always in your subconscious, you wake up Saturday morning thinking about it, then you found your niche. And that’s what gets me up every morning, that sense of having an investment, not just an activity, but an investment in what it is we’re trying to do. Jerry correctly identified that — and I am busy — my calendar has shades of pink in virtually every time slot. But I don’t like to think of it as being busy. I like to think of it as being intentional. I want to be certain that our journal does well. I want to be certain that our diversity efforts are doing correctly. I want to be certain I’m mentioning our early career faculty. I want to be certain our enterprise is going exactly where it needs to go. I want to be certain that my own academic work is bringing other people in, giving other people credit, moving other people along. So it’s this sense of being very intentional which translates as being busy. But it’s a sense of purpose and passion that really drives me every day. I’m also trying to find good gumbo in Chicago. (Laughter). I think I found a place — I don’t want to do an editorial, but I think I found a place that’s got good gumbo in Chicago.

JERRY KRISHNAN: You can come by to the stage later if you want to know. Dr. Vanden Hoek.

TERRY VANDEN HOEK: Well, Dr. Yancy, I want to thank you for taking the time to have this conversation today at UI Health and welcome. Thanks. My question is so you have so many accomplishments. What is your most impactful achievement to date that you would highlight?

CLYDE YANCY: Jerry, I must have slipped you a quarter, because I’m delighted again just like Jerry, you give me the license. The thing that I love the most has nothing to do with publications or titles or accolades. Here in Chicago, 12 years ago, we reached out to George westing house college prep on the west side of the city. And engaged them in an enrichment experience where we go to the school, we identify six or seven ninth graders and then bring them on to our campus every summer, what we call the summer intensive program. We’ve been doing it for 12 years. Every one of my — and I call them my kids — every one of my kids has graduated from high school. This is a community that you understand. 75 percent come from college naive families. No one in the immediate families have ever gone to college. And 70 percent are in school lunch assistance programs. These children grow up right in front of me. They go from being shy, inarticulate, to being candidates for top schools, top universities in the country. Everyone has graduated. All but two have gone on to college with full scholarships including ivy league schools, and my first kid is in medical school right now. And these are kids that would have never had this opportunity. I don’t win an award for it but the satisfaction I get when I see them and I sit down and work with them, it’s pretty remarkable when you can see their eyes. Because when I see that ninth grader’s eyes light up because someone has taken the time to induce them to a career in science, I didn’t have that when I was a ninth grader. I just had this dream that I wouldn’t let go. But how many other people had that same dream and never actualized it because there was no one saying let me just enlighten me. Not let me give you anything. Let me just enlighten you and help you see where you need to go. So that’s the thing. That’s the thing that I really cherish.

TERRY VANDEN HOEK: Thank you.

JERRY KRISHNAN: Thank you so much, Dr. Yancy. We’ve heard a little bit about your personal aspirations and accomplishments impact, you’re also in this room are a lot of leaders. Many of the people here are leaders. And in fact, all of you are leaders here. You may be leading yourself, in your family, your neighborhood. So all of us are leaders here. So as you kind of think about that frame of mind, leadership, what do you think are some of the major issues facing leaders in academic medicine today?

CLYDE YANCY: Really an important question. But the first thing I’ll say about leadership is you don’t do it because you get a two-page bio. That’s not why you do it. It’s not about being self-centered. It’s about being selfless, not being selfish but selfless.

Once leaders are of that mindset, then it’s about elevating others and celebrating others. And unfortunately what happens in academic medicine is we have these hierarchical systems. A lot of power is concentrated in a few offices. And what really successful leaders do is first they surround themselves with people with better skill sets. They empower people. They resource people so those people can rise to the next level. And so I think what we have to do is, yes, be aware the exigencies of the day. We’ve got terrible fiscal challenges. We’re constantly trying to make certain that we are playing by the rules in all of the HR domains and that’s a loaded statement. But the most important thing is that if you are a leader in medicine or any other field, what you really are doing is leading people. And if you’re leading people and you have a selflessness about leadership, you’re already 60 percent of where you need to be to be successful. So if you can continue to think about people, and even in the midst of what we’re facing, if you can find that person to elevate, give them the responsibility, coach them to success, let them feel the joy of owning an initiative, navigating the initiative and seeing it to fruition, that’s great. I seek, I covet finishers, people that start a project and will finish it. There are a lot of smart people in medicine. That’s no longer the asset that we seek. Everybody’s smart. I’m looking for the smart person that’s a finisher. We can get something done then.

So I think that no matter what the issue is in front of us as leaders, we need to elevate people. And we’re much closer to being successful than not.

JERRY KRISHNAN: Rani, I think you’re next.

RANI MORRISON WILLIAMS: I am. Dr. Yancy, what strategies do you use to create equity and inclusion in your health system and in research?

CLYDE YANCY: Well, now, this is a very important question, particularly as I look at a kaleidoscope of faces in this audience, because there’s some faces in this audience where this conversation gives you a little bit of heartburn, makes you wonder, okay, all of a sudden I’m going to be targeted. And there are other people in this audience that hear this conversation that say, yeah, that’s right, we need to do something about this. This is not a good thing.

So the real key strategy is communication. And dealing with issues of diversity, equity, inclusion like we deal with issues of science. What’s the history? What are the root causes? What’s the path of physiology. What are the interventions? Where is the evidence? What works?

Stunningly, there is that body of information about issues of diversity, equity and inclusion. But if you start on the back end and every comment is an emote I have comment, it’s very hard to get you to where you need to be. But if you start on the front end and say let’s inform ourselves. Let’s elevate the discussion as if we have an issue on the table that’s like a disease process and let’s think about the science, think about the theory, and then understand what are the opportunities, what are the options, it’s a very different kind of conversation. But I’ve always dealt with some of the most difficult conversations in this space by being very forthright, bringing the information to the table, as information, not as feeling. And if you can do that — because here is a key consideration. If you’re dealing with issues of diversity, equity and inclusion, one strategy is to understand your end game before you start. If your end game is to make someone feel a different way, we can’t manage another adult’s feelings. But if your end game is to change the behavior, we can measure behaviors. And so you start with a different sort of strategy by thinking where you want to be. You’re not going to get a bunch of converts. This isn’t religion. But you will get different behaviors, and that’s what’s most important. So information, deal with it very transparently, peel make the emotive part so people can have comfortable conversations because it is an uncomfortable topic. I heard something just this weekend that was very important to me. The skill that you need to have, Rani, as a leader in diversity and inclusion, the skill that I try to work on, is how can I make comfortable people feel uncomfortable without them walking out of the room. And how can I take uncomfortable people and give them a sense of hope. If I can do those two things, then we can have the conversation and move forward. But the real skill is how can you take comfortable people, make them feel uncomfortable, but in a way that keeps them engaged.

RANI MORRISON WILLIAMS: Thank you.

JERRY KRISHNAN: Great. Thank you. Dr. Vanden Hoek?

TERRY VANDEN HOEK: Yeah, so this has been a remarkable last few years. We’ve all gone through some pretty challenging times and there are still changes going on. And I guess one — one question that I think all of us will be very interested in is how do you stay optimistic?

CLYDE YANCY: So, Terry, we know each other so I can do this. But if I look at everyone in this audience, that preamble starts almost every conversation. The last couple years have been tough. We’ve been through hell. This has been so very hard. You know what? The last couple years have been remarkable. They have been incredible. They have been enlightening. Why? Because you’ve seen the resiliency of the human spirit. You’ve seen what happens when people speak up with a strong voice and say what they believe in, no matter how objectionable it is. And we’re still a country. We’re still the City of Chicago. We’re still at this life effort trying to make it work. I celebrate the fact that we’ve gone through tense moments and we have learned more about each other than we ever knew. We’ve made pivots faster than we ever pivoted. Two walls from here in this fully qualified health center, two walls from here are a number of posters about how avidly you embrace telehealth and how much care you provided. That was an overnight pivot and we did it. And so there’s nothing good about the pandemic and nothing good about the social disruption, but I celebrate the fact that there’s something about the resiliency of people that allowed us to get through this and to merge with a different awareness. I love this notion of that which has been seen can never be unseen, and that which has been heard can never be unheard. We all are functioning from a different perspective now, and we’re getting to a place that we would have taken a decade to get to. So it was tragic. It was miserable, but in the midst of all of this, I celebrate what I’m learning about the human spirit.

JERRY KRISHNAN: Great. Thank you so much. I think our next question actually comes from someone in the audience, Dr. Michelle Mariscalco. So I’m going to let her read her question. But while the mic is going there, I think you can see why Dr. Yancy was selected to be the chair of the CONNECTS steering committee. For those of you who can imagine, we were in a crisis mode trying to figure out how to treat acute COVID. Many of you were in hospital units trying to treat your sick friends. And through all of that Dr. Yancy was able to create a sense of calm, that we had the right people around the table. We’re going to walk through this together, we’re going to problem solve and then be on time. And Dr. Yancy runs really efficient meetings, too, so I think that part of us, our role as leaders, is to exude leadership and demonstrate leadership. And that has to do with how react to circumstances we can’t predict. And I think you’re hearing some of that today in his language. So I was giving a little bit of time to that Dr. Mariscalco could get her mic. There we go. So would you like to introduce yourself, Dr. Mariscalco. I believe you have a question.

MICHELE MARISCALCO: I do. Thank you very much. Nice to see you. Michelle Mariscalco, Professor of pediatrics, pediatric care by training but for the last 12 years I’ve been doing my administrative journey. And so with Jerry I work with Dr. Bob Barish. Dr. Yancy, you have the vision of the need for integrative health, right, and certainly your heart failure team is exuded up and down.

What — and a lot of the work that we do here at UI Health, our federally qualified health center, our hospital and clinics, is again team based and team based work, or we like to think we do that. Tell us in your experience as we develop our teams, what people do we forget to bring into that group?

CLYDE YANCY: The patients. That’s an easy question and I don’t mean to belittle it, but it gets to a theme that was on the table as I was visiting with a T32 trainees. It’s very, very important to learn how to listen when you’re crossing, if you will, a chasm and reaching out to a different group, a community or different group of peers or persons with a different skill set, being able to engage and listen to others. In this integrative model, it really is bringing the patient voice into this. I had the opportunity to be on the ground floor and help start it back in 2010 and I was on the methodology committee where we develop methods for outcome patient centered research and our whole governance was research done differently. That was our mantra, research done differently. I have to tell you when we got different patients in the room, collated to a particular disease, circumstances, and just sat and listened, I heard things I had never heard before. I mean, I had to stop one day and say, look, I’ve been doing clinical trials for 24 years at that point and not a single clinical trial, not a single one, had ever started after we spoke to the patient population to find out what they wanted us to do in the clinical trial. We always say what we thought would be a clever idea, good idea, made sense scientifically. But we never paused and said, let’s talk to the patient first and see what they need. And the best example of this is work done by a friend of mine that I lost in 2017. But we were colleagues in medical school at Tulane and colleagues on the faculty at TT southwestern in cardiology and that was Ron Victor. And Ron had decided in Dallas this little short white Jewish guy, let’s go to south Dallas and go into barber shops and see if we can check blood pressures. I’m like are you crazy? So we went together. And I mean, as soon as we just said we’re here to help and we just shut up, I mean, we birthed this idea of the barber shop blood pressure check. In fact, I wrote an editorial, a bald fade and BP check because we went into communities, we figured out what they wanted. We trained the barbers how to take blood pressures, and now this is one of the most sterling examples of community engagement for the greater good. It’s probably the most effective way we’ve ever controlled blood pressure in an African American community by getting away from Northwestern and UIC and even this FQHC and going to the barber shop with pharm D’s and with barbers and completely blowing it out of the water with blood pressure control. So you’ve got to engage the patients in any integrative model. You have to.

JERRY KRISHNAN: Great. Thank you so much, Dr. Yancy. I think given the business that we’re in, which is a noble profession, this idea of helping others in times of need and when health — you know, when people are in crisis, I think we’ve all had family members, friends, perhaps ourselves to remember that it’s all about the patient. So I’m gonna go a little bit off the cuff here because we’re actually a little ahead of time. I was nervous having too many questions. But actually I’m gonna do a little audible and I hope the individual that’s going to get called up doesn’t feel too pressured here. But someone in the design team here, someone in the institute for health care delivery design who spent some time putting together the telehealth strategy that Dr. Yancy just mentioned, I think there’s — Jennifer Peterson is here, I see Hugh Musick. I see a few people here. Do you want to take the mic and say a little bit about what you heard that was surprising when you brought people together, including patients, that I’m not sure that clinicians may have realized or administrators may have realized. Anything you want to add or maybe a question to Dr. Yancy about telehealth, you know, if you do proper stakeholder engagement. So this is an audible. Does anyone want to say anything? (Laughter) okay. I guess — and I left some options on the table, but — so maybe a comment and then maybe a question. Hugh?

HUGH MUSICK: Sure. Thank you, Dr. Yancy, for everything. I’m — like Rani, I’m very touched by your story. I mean, parent hood, I think, is the end all, be all. So I really appreciate that.

We are human centered designers working within a health care context. And so health care systems are oriented toward efficiency and consistency and delivery. And I think one of the things that we discovered in how telehealth was being deployed was simply as a substitute for in-person care because it had certain attributes that allowed for efficiency. What we discovered by going out and talking with patients and providers is that everybody loved it. What we ran into as a really interesting conflict is it doesn’t work well with the business model. And as a result of that, you had high demand for something that in many ways people preferred to exist in modes of health care delivery. But it’s not sustainable in its current instantiation because of the payer system.

And so on that basis, what we tried to think about was we need to move beyond thinking of it simply as a replacement for the traditional in-person exchange that happens within the exam room and think of the potential of telemedicine as a way to augment and advance the sorts of relationships that can exist between providers and patients but also do something beyond the way that we currently work. We only got there by actually having conversations with people and having them share with us in a very authentic way the tensions that they were confronting and trying to reconcile those things.

So I — when you spoke about communication, it had a lot of resonance. And I think a lot of the work that’s done here in the institute for health care delivery design is centered around meaningful and effective communication.

So that’s a comment, Jerry. Do you want a follow-up question?

JERRY KRISHNAN: If you had a question, Hugh, sure.

HUGH MUSICK: Okay.

CLYDE YANCY: Well, Hugh, before you do that, though —

JERRY KRISHNAN: He’s going to ask you a question, though.

CLYDE YANCY: You made a statement that merits a little bit more discussion because three times you used the word efficiency. And I think we might change the frame here and recognize that health care delivery systems by design are inefficient for the patient. They are efficient for people like me because I can go to my office and the patients are scheduled and a team is in place and I can go through whatever that day’s calendar of visits happens to be. But that’s efficiency for just one user and not efficiency for the ultimate user because the ultimate user has to take a day off from life, whether it’s work or life, has to find a place to park at whatever outrageous fees they’re being charged, has to find something to eat that will not be heart healthy, has to then wait and almost assuredly the visit will not happen promptly on time. One of my former colleagues is in the room. I won’t make eye contact. I don’t want to embarrass anybody, but I’ll just say I’m better now than I was then. But I’m just saying that by definition, it’s a terribly inefficient process for the person that ultimately has to use it. And I think the real benefit of telehealth is this. Even if I am very active and following somebody that is longitudinally, I might see them five times a year. Then what happens the other 360 days of the year? They still have high blood pressure. They still have heart failure. And so this evolution of a different way of communicating with patients that is more efficient for the patient is something that we need to embrace.

Now, the question is how do we use it correctly. And the business model thing is really about leaders getting together and thinking about where are our priorities, what’s our expected return of investment for the procedures we do versus the care we provide. Those are high level conversations that happen in rooms which I’m not always privy. But that’s another part of this equation.

So I would say think about this concept of efficiency and let’s see how we can make it efficient for the patient.

HUGH MUSICK: I think you may have just answered my question, which is with the potential of technology, how do we create a health care delivery system that’s more geared toward people.

CLYDE YANCY: So I really love this dimension as well because one of my concerns about the ease of using technology to answer this question is that the technology unfortunately carries forward and promulgates the same bias that is active in the clinic exchanges. If the information based upon which the technology evolves, comes from an information base that has inherent biases, then whether it’s a human that has implicit bias or a technology that has structural bias, that’s still a problem. Now, technology might well be the answer. So I love it when I get a note on my phone from my NM and it tells me something that my own physician wants me to know. That’s incredibly convenient. That’s great. But is that the way everybody else in the world experiences health care? I don’t think so. So that in and of itself is a bias to people with resources. But I think if we can be smart about technology, remove the inherent bias so that we don’t have data driven biases in addition to behavioral biases, then I think it is a good solution.

HUGH MUSICK: Thank you.

JERRY KRISHNAN: Thank you so much. And maybe we do have — there’s a few more questions we have from the audience that have already asked to ask questions. But if others of you are thinking about a question, maybe just let Michael know and we’ll — I think we have an opportunity for a couple more questions. So I’m going to go to the next question that I know is out there. This actually was submitted by one of our medical students who just met, Adam. Adam is very interested in making sure that he had a chance to speak with you. And he’s a, as you know, a medical scientist program predirector fellow. We just had a conversation with him. Adam, I believe you’re still here. There we go. So Michael, if you want to give Adam the microphone, he has a question for Dr. Yancy again. For some of you who might have a question, let Michael know. We’ll get you the mic.

ADAM: My name is Adam, an M.D. Ph.D. student here in UIC, currently getting my Ph.D. degree in the department of medicine. And I was thinking of a question, that was way more articulate and insightful to one I could have posed. I want to hear the response to your own question. On the Wikipedia page it says you do not believe health disparities in our country can be solved by the creation of new policies but instead asking the question how can we interject compassion, civility and concern for all communities and not allow some communities to remain marginalized. And particularly for those of us in medicine and research who are often downstream of these issues, how can we best contribute to these issues.

CLYDE YANCY: So Adam, thank you very much. Let me give you the back story in a commentary. Every year as we welcome the medical school class to Northwestern, there’s a Founder’s Day ceremony. And one faculty member is given the privilege of addressing medical students and their family members. And my turn came up in 2014. And I wanted something that would be very transparent, very memorable, would be brief, they could walk out of the room with. So I told the families, and of course the medical students, there were three things important for the next four years. Be competent. That doesn’t just mean get a C. That means be capable of doing exactly what your license is supposed to enable. Be civil. Be able to interact with other people, not like yourself, from whatever perspective you start. Be able to listen, be able to engage with others. So be civil, and be compassionate. Remember that in this space, in this room, those of us that are either college educated or seeking health care careers or already hold terminal degrees, in many regards, we may not be the top one percent, but we’re in the top five percent. So if you’re sitting in this room, you have privilege. And be certain that you don’t let that privilege take you away from having compassion to help others.

And so in that regard, my commentary was intended to say that if we can all inculcate these inherent principles of humanism, being civil, having compassion, and being competent, we don’t need a whole lot of policy to be able to do the right thing at the right time for the right patient under the right circumstances. But because we’re not always competent and not always civil and sometimes not compassionate, then policy is the poor surrogate, the poor tool that we use to try to force that behavior. But if we can aim for the high bar, competent, civility, and compassionate, then the policy becomes perfunctory. But it’s only when those things are missing when we need to really focus on policy. And as you’ve seen, most policy is inadequate and imperfect.

JERRY KRISHNAN: Great. Thank you so much, Adam, and Dr. Yancy, for that question. We have another question from the audience, Dr. Calhoon.

ELIZABETH CALHOUN: I’m Beth, assistant Vice Chancellor population of health sciences. So one of my favorite things in my career has been being a mentor and it’s one of the things we don’t reward much, right, in academics, in T32, you don’t get paid to be a mentor. But the most moving story today for me was your high school program, right? That’s fantastic, right? And how do we scale that, right? How do we — I mean, how do we get past the structure? Is it technology something we can do? How do we as leaders reach into that pipeline earlier, right? That to me is powerful. And so I’d love to hear your thoughts on that and sort of help us feel motivated to sort of get behind that.

CLYDE YANCY: So, Dr. Calhoun, thank you so much. I really love talking about the Northwestern scholars program. This year we just reached out to Daniel hill Williams college prep and disabled. So we’re bringing on another cohort for the first time this summer, which will effectively double our size.

I’m grateful to our institution because they give us a lead resource bucket of about $200,000 a year to be able to hire staff and bring the program to fruition. But we don’t pay any physician, faculty. I mean, this is out of your altruism. This is because you wanted to make a difference. And all you have to do is see one kid open his or her eyes. I’ll tell you a story. Last summer it was about orthopedics. These kids went crazy with bone saws. They could not wait to go to the simulation lab, the one you have up here on the fourth and fifth floor. And I mean, they went crazy with bone saws. But that going crazy about bone saws meant they went crazy studying the orthopedic conditions. So in the last day of the program, I’m on the front row listening to these high school students speak articulately about complex orthopedic conditions, why? Because they got excited about that. I don’t need a paycheck for that. I sit there and I’m like, okay, this is good stuff. This is why I get up in the morning. This is part of my passion, to see this next generation. Now, everybody’s got band width, and we have to pay for our time. As a senior leader, we have a little bit more latitude with how we spend our time. But there’s got to be room. There has to be room for us to nurture and mentor the next generation. There just has to be room. When we get to health systems that don’t allow us to do that kind of outreach, then we’ve — we’ve gotten worse at being efficient. We’ve gotten very mechanical. And we can’t do that.

JERRY KRISHNAN: Thank you so much, Dr. Yancy. That’s a great — it’s a very important question because I think — it’s the pipeline issue and getting people excited and energized to learn is the secret sauce here. And all of us, too. I mean, I think we need to continue to learn. The world is changing, and you’ve got to find time in your day to learn, to read, at least with Dr. Yancy’s, you know, he’s the editor of a journal, getting the word out, making sure we’re staying top of mind. But really reading broadly, I think health care, medicine, nursing, biostatistics, whatever it is, that’s fine. But also having the ability to read more broadly so that you stay connected with the community that’s all around us. So I guess I want to give a few minutes to Dr. Vanden Hoek. Many of you know that he is the founder of the champion’s program that also thinks a lot about pipeline and wanted to give him a chance to maybe talk about it or ask Dr. Yancy a question, again an audible. I hope you don’t mind, Terry. But we have — he can’t leave. It’s a little — it would be hard for him to run away here. So questions for Dr. Yancy as it relates to champions.

TERRY VANDEN HOEK: So thanks for the opportunity, Jerry. I guess it gets at a bigger question, something that all of us are very aware of. And that is that we really would like to have a work force in our health care system that looks like the patients we serve. There are some wonderful things that happen when you see that. And there’s still a gap. And certainly a pipeline program is a start. But it gets at how do we do a better job with our resident recruitment, GME. Do you have any thoughts on how we make that better and close that gap?

CLYDE YANCY: Terry, I have a whole lecture on this. This is really a critical conversation because I want to right correct everyone right now. I mean, I’m glad that Rani’s in the room to hear me say this. Everything we do about championing diversity and trying to get a population of health care providers that looks like the population we serve, that’s okay. That’s not why you do diversity. It’s not about representediveness. It’s about excellence. Let me tell you what I mean.

When you’re dealing with sameness, you get the same result. Imagine a bowl of marbles in my hand and all the marbles are tan, light tan. That doesn’t attract much interest. It doesn’t give you any other sense of, well, there’s a bowl of marbles there. What happens when there’s a bowl of marbles and there’s 18 different colors in the bowl. Well, that’s fascinating. That’s interesting. So that’s a simple example. But what it’s telling us is that it’s not diversity of representativeness, getting the bowl of marbles with different colors. It’s about what those colors do. Those colors incite you to think — incite you to think differently, energize you. It’s about the of diversity thought. About diversity of ideation. It’s about getting ideas from places you’ve never seen before so you can build better systems. So we can take out the metrics and post our annual diversity numbers and thump our chests. But that doesn’t excite me. What excites me is when we get people in the room that have a different perspective, a different history and give us a different idea. Corporate America has figured this out. That’s why you see so many more women in corporate America now, because they know to listen to women. And they get ideas they never got before. They’re doing the same thing now with ethnicity, with race, with disabilities, with sexual preference. This is making corporate America better, more facile, more dynamic, more responsive to the community, because they’re listening to all domains of the community. This is not just about having the right face when we see someone that comes in the door. This is about having the right idea. It’s a totally different game. And so I think that’s what we need to be.

Now, the next question needs to say is that sounds well and good. How do we get there? We either change leaders or we change as leaders. Now, what does that mean? That means we either look at our leadership — and I’m part of that now. I’m no longer from the outside looking in. I’m on the inside and people looking at me. We need to have leaders that are willing to adopt culturally affirming positions for the kaleidoscope of people with whom they engage. So if leaders can change and can understand the importance of respecting and accommodating other perspectives, that’s great. But if leaders are unwilling to do that, if ultimately leaders are still functioning with the same inherent biases that they’ve always had and everyone in here, including me, has bias. Not a single person should raise their hand if I say who in this room is unbiased. You’re lying. Everybody in this room has bias. But if you don’t have leaders willing to recognize their biases, listen and change, then you need to get different people to be leaders. So you either change leaders or you change leaders. And that’s how you get there.

It’s exactly what we’ve done. I looked at our metrics this week. Our residency training programs are over 20 percent diverse now. When I first started working as vice senior diversity equity and inclusion, it was at 6 percent. Our medical school, entering class is now 30 percent diverse. If you add sexual identity diversity to it, it’s over 60 percent. One out of three first-year medical students at Northwestern comes from a group previously underrepresented or poorly acknowledged in medicine. That’s only because leadership change said this is important. And you know what? It’s a better medical school now. And so I have a bit of force when I have this conversation because this is why I have a restlessness. This is when we have the moment to change for the good. For the good. So think about those things.

JERRY KRISHNAN: Thank you. Great. Well, thank you so much. This has been a remarkable conversation. This is a great pleasure to sit along side Dr. Yancy and just listen and learn. I have to say these are aspects of things that I did not learn listening to you on the CONNECTS steering committee. And I think part of the vision here of having these chats is to kind of push us a little bit, interact, learn from each other. And again, invite all of you here to — many of you have met somebody new today coming in, interact from each other, learn from each other. So as we close our session today, I’m sure I can speak for every one when I say that this conversation has been a pleasure, stimulating, helping us think a little differently. I’ve now started to appreciate the importance of a lit racial in three letters. I can see these three words. I need to start thinking about it that way. For all of you who are deans or Vice Chancellors, take note. Things come in threes here. But we’ve learned a lot.

CLYDE YANCY: So you know why that is. This is a way of knowing without me telling you this. I’m kind of reckless. I’ll ad lib in a minute. When I was in med school, my pathology Professor, he gave a the only test I ever failed. I was so angry. How did this happen? But he taught me this. If you only know one thing about something, you don’t know much. But if you at least know three things about something, you will forever be reasonably well informed. And so that three has stuck in my head since I was a second year medical student doing pathology. So I always try to keep three concepts clear about everything that I’m trying to consider.

JERRY KRISHNAN: Testing it. Don’t forget. (Laughter). So as we bring this conversation to a close, we wanted to present Dr. Yancy a token of our appreciation. And we have a special — we’re supposed to officially call it a. I’m not — plaque, I’m not entirely sure why. It’s actually a crystal. So if you’re willing to stand up, Dr. Yancy, I would like to share with you on behalf of Dr. Bob Barish, Vice Chancellor for health affairs, we’d like to off you the distinguished scholar series plaque as a way of remembering us as you go about your day. Hopefully you’ll put it in a place others will see and inspire others who come to your office to ask questions about what was this thing going on at UIC? And I want you to know that we are recording this session, it will be on our website and I suspect we’ll have a few more people listening to you. So thank you very much. (Applause).