Beyond the White Coat

Examples of bias in the delivery of health care are rampant. In this episode of “Beyond the White Coat,” AAMC Senior Director of Health Equity Partnerships and Programs Malika Fair, MD, MPH, speaks with Laura Guidry-Grimes, PhD; Brian Gittens, EdD; Carol Major, MD; and Charles Vega, MD, to explore how academic medicine can move toward more equitable care for all and to dive deeper into how we prepare and train the physicians of tomorrow to be allies for everyone.

Episode Guests:

• Carol Major, MD, is a UCI Health obstetrician who specializes in maternal-fetal medicine and high-risk pregnancies. Major is the co-founder of Leadership Education to Advance Diversity–African, Black and Caribbean, a University of California, Irvine, School of Medicine mission-based program aimed at producing future physicians who are committed to addressing the health needs of African, Black, and Caribbean communities in California, the United States, and beyond.
• Charles Vega, MD, is a professor of family medicine at the UC Irvine School of Medicine and the director of the Program in Medical Education for the Latino Community, a mission-based, dual-degree program intended to address the needs of underserved Latino communities.
• Laura Guidry-Grimes, PhD, is an assistant professor in the Department of Medical Humanities and Bioethics at the University of Arkansas for Medical Sciences (UAMS). Guidry-Grimes received her doctorate in philosophy at Georgetown University. She has worked for over five years as a clinical ethics consultant at multiple hospitals. Along with her consult work, Guidry-Grimes is interested in disability bioethics, ethics of psychiatry, and determining how best to understand vulnerability in health care.
• Brian Gittens, EdD, is the vice chancellor of diversity, equity, and inclusion at the UAMS. Gittens specializes in strategic diversity and inclusion, organizational and leadership development, organizational assessment and analysis, change management, and talent management in support of optimizing organizational performance and quality initiatives. Gittens has successfully led and collaborated on the design and implementation of organization wide diversity and inclusion initiatives, organizational development programs, and competency assessments.

Credits:

• Hosted by Malika Fair, MD, MPH, AAMC senior director of health equity partnerships and programs.
• Produced by Stephanie Weiner, AAMC director of digital strategy and engagement.
• Recorded by Sholape Oriola, AAMC video specialist.
• Edited by Laura Zelaya, AAMC production manager.
• With special contributions from Kathy Gambrell, AAMC senior digital content strategist; Michelle Zajac, AAMC digital copy editor; and Bridget Balch, AAMC staff writer.

You Might Also Be Interested In:

• AAMC Racism and Health Resources
• “New Poll Shows Black Americans See a Racist Health Care System Setting the Stage for Pandemic’s Impact,” The Undefeated, October 2020
• “Racism and Discrimination in Health Care: Providers and Patients,” Harvard Health Blog, updated July 9, 2020
• “A New Hippocratic Oath Asks Doctors To Fight Racial Injustice And Misinformation,” NPR, Nov. 4, 2020
• “How Medical Education Can Help Fight Racism,” Modern Healthcare, Aug. 29, 2020
• “Op-Ed: Diversity Is the Answer to Disparities in Healthcare,” Medpage Today, Aug. 24, 2020
• “Is COVID-19 Making Black Birth More Complicated?,” CBS News, Aug. 10, 2020
• “UCI Podcast: How the LEAD-ABC Program Gives Black Medical Students a ‘Powerful’ Voice,” UCI News, June 16, 2020
• More From the “Beyond the White Coat” Podcast

Providing hospice and respite care for the homeless is tough in the best of times, but it’s especially difficult during a pandemic. Staff members at Joseph’s House, a nonprofit organization that provides a respite and hospice care for people experiencing homelessness, are constantly figuring out new and creative ways to help the population they serve with limited resources or resources that aren’t designed to truly serve marginalized and vulnerable people. In this episode of “Beyond the White Coat: Making the Rounds,” AAMC Director of Community Engagement Clarence Fluker and Liz Fehrenbach, program director at Joseph’s House, talk about what it means to persevere as the organization attempts to serve its community during the COVID-19 pandemic.

Episode Guest:

• Liz Fehrenbach, RN, has worked as a registered nurse and care coordinator for HIV-positive adults and individuals experiencing homelessness for 11 years. Before working at Joseph’s House, she provided outreach, clinical nursing care, and medical case management as the nurse at a small Health Care for the Homeless clinic in Burlington, Vermont. Her background in serving vulnerable populations, along with her interest in social justice and contemplative care, led her to Joseph’s House in 2016. For three years, she provided nursing care coordination and case management for current and former residents. Since October 2019, she has served as the program director at Joseph’s House. In this role, she is responsible for developing and implementing policies and procedures; overseeing quality improvement and management; and supervising our care team of registered nurses, social workers, care aides, and service-year volunteers.

Credits:

• Hosted by Clarence Fluker, AAMC director of community engagement.
• Produced by Mikhaila Richards, AAMC senior digital content strategist, and Clarence Fluker.
• Episode recorded and edited by Laura Zelaya, AAMC production manager.
• With special contributions from Sholape Oriola, AAMC video specialist, and Adedayo Adeniyi, AAMC community health specialist.

You Might Also Be Interested In:

• Joseph's House
• "Joseph’s House: Where Homeless D.C. Residents Find Comfort In Their Final Days"(WAMU 88.5)
• "The Longest Night: Discharged and Homeless" (AAMCNews)
• "As Living With HIV Becomes More Common, Affordable Housing Remains Out of Reach for Many Seniors"(AAMCNews)

Sandeep Sharma, MD, practices internal medicine at So Others Might Eat (SOME), an interfaith community-based organization that helps the poor and people experiencing homelessness in our nation's capital. The times are especially hard for the homeless patients at SOME’s medical clinic who are navigating a new world dominated by a deadly virus. Dr. Sharma and his colleagues struggle to find and work with these patients while sticking to safety measures meant to protect everyone from COVID-19. In this episode of “Beyond the White Coat: Making the Rounds,” AAMC Director of Community Engagement Clarence Fluker talks with Dr. Sharma about what it means to meet the medical needs of SOME’s clientele and how the pandemic has impacted access to much-needed health care.

Episode Guest:

• Sandeep Sharma, MD, has been practicing internal medicine for 17 years with special interests in nutrition, wellness, indigent care and geriatrics. He has a traditional internal medicine practice in Maryland and also practices primary care in Washington, D.C., with So Others Might Eat, a community-based organization which provides medical, dental, and behavioral health services to the poor and homeless population of Washington, D.C. Dr. Sharma is a graduate of the University of Maryland College Park. He earned his medical degree in the United Kingdom and completed his residency training in internal medicine at the Medstar Franklin Square Medical Center in Baltimore, Maryland.

Credits:

• Hosted by Clarence Fluker, AAMC director of community engagement.
• Produced by Mikhaila Richards, AAMC senior digital content strategist, and Clarence Fluker.
• Episode recorded and edited by Laura Zelaya, AAMC production manager.
• With special contributions from Rachel Bunn, AAMC senior digital content strategist; Sholape Oriola, AAMC video specialist; and Adedayo Adeniyi, AAMC community health specialist.

You Might Also Be Interested In:

• So Others Might Eat
• “Delivering Meaningful, Not Marginalized, Care to the Homeless” (AAMCNews)
• "These 10 Graphs Expose D.C.’s Homeless Crisis" (Street Sense Media)

As a fundamental right, housing security is one of the basic means through which people can protect their families and communities during the COVID-19 pandemic. But, as the pandemic rages on and its economic impact becomes more dire, nonprofit organizations with missions dedicated to ending homelessness expect an exponential increase in housing insecurity across the United States. In this episode of “Beyond the White Coat: Making the Rounds,” AAMC Director of Community Engagement Clarence Fluker sits down with Lara Pukatch, director of advocacy at Miriam’s Kitchen, to talk about the connection between housing, health, and health care and how academic medicine can lend its strengths to the fight against homelessness. 

Episode Guest:

• Lara Pukatch is the director of advocacy at Miriam’s Kitchen, a nonprofit organization dedicated to ending long-term homelessness in Washington, D.C. She has over 15 years of experience as a policy and advocacy professional with expertise in empowering vulnerable populations, leading coalitions, and facilitating large-scale institutional change. Lara chairs the Way Home Campaign, an advocacy movement to end chronic homelessness, and also oversees Miriam’s Kitchen’s work to ensure that individuals with lived experience of homelessness are true drivers of the change they wish to see in their city.

Credits:

• Hosted by Clarence Fluker, AAMC director of community engagement.
• Produced by Mikhaila Richards, AAMC senior digital content strategist, and Clarence Fluker.
• Episode recorded and edited by Laura Zelaya, AAMC production manager.
• With special contributions from Sholape Oriola, AAMC video specialist, and Adedayo Adeniyi, AAMC community health specialist.

You Might Also Be Interested In:

• Miriam’s Kitchen
• "Miriam's Kitchen Provides Food for DC Homeless Community" (NBC Washington)
• "Housing is Healthcare" (Street Sense)
• "‘A Pileup of Inequities’: Why People of Color Are Hit Hardest by Homelessness" (The Pew Charitable Trusts)
• "‘Two Sides Of The Same Coin’: Addressing The Link Between Racism And Homelessness" (DCist/WAMU 88.5)
• “Putting a Roof Over Patients’ Heads” (AAMCNews)

In this episode of “Beyond the White Coat,” Geoffrey Young, PhD, AAMC senior director of student affairs and programs, speaks with Max Jordan Nguemeni Tiako, a fourth-year medical student at Yale School of Medicine, on his experience as a learner and as an advocate for racial equity and equality in medical education and health care. Nguemeni Tiako gives his perspective on racism in medical education and his work writing the “White Coat and a Hoodie” column and producing the “Flip the Script” podcast on health disparities.

Episode Guest:

• Max Jordan Nguemeni Tiako is a fourth-year medical student at Yale School of Medicine. He grew up in Yaounde, Cameroon. He earned a bachelor of science in civil and environmental engineering from Howard University and a master of science in bioengineering from the Georgia Institute of Technology. His research interests include cardiovascular health, addiction medicine, and the built environment's impact on health. He is currently spending his research year as a fellow in the Center for Emergency Care Policy and Research at the Perelman School of Medicine at the University of Pennsylvania. He writes about racism in medical education in the medical student magazine In-Training in his column “White Coat and a Hoodie.” He is the host of a podcast focusing on health disparities called “Flip the Script.”

Credits:

• Hosted by Geoffrey Young, PhD, AAMC senior director of student affairs and programs.
• Produced by Stephanie Weiner, AAMC director of digital strategy and engagement, and Kathy Gambrell, AAMC senior digital content strategist.
• Episode recorded and edited by Laura Zelaya, AAMC production manager.
• With special contributions from Zenneia McLendon, AAMC director of digital content strategy, and Sholape Oriola, AAMC video specialist.

You Might Also Be Interested In:

• White Coat and a Hoodie column (In-Training)
• “Flip the Script” Podcast
• AAMC Framework for Addressing and Eliminating Racism at the AAMC, in Academic Medicine, and Beyond
• “AAMC Releases Framework to Address and Eliminate Racism” (AAMCNews)
• AAMC Racism and Health Resources
• “Medical Schools Need to Do Much More to Protect Students of Color From Racism” (AAMCNews)
• “Academic Medical Leaders and Learners Reflect on Police Brutality, Racism, and the Path Forward” (AAMCNews)
• “Ibram X. Kendi Defines What It Means to Be an Antiracist” (Penguin)

More From the “Beyond the White Coat” Podcast >

The history of medicine is filled with amazing scientific discoveries and remarkable innovation, but the profession is also haunted by a history of structural oppression and exclusionary practices that act as barriers for people of color. This history influences the policies, practices, and procedures that govern how physicians are trained in the United States today. In this episode of “Beyond the White Coat,” AAMC President and CEO David J. Skorton, MD, speaks with AAMC Chief Diversity and Inclusion Officer David A. Acosta, MD, about the history of structural racism in U.S. medical education and how that history informs today’s learning environment. 

Episode Guest:

• David A. Acosta, MD, AAMC chief diversity and inclusion officer, provides strategic vision and leadership for the AAMC’s diversity and inclusion activities across the medical education community and leads the association’s Diversity Policy and Programs unit. Dr. Acosta, a family medicine physician, joined the AAMC from the University of California (UC), Davis, School of Medicine where he served as senior associate dean for equity, diversity, and inclusion and associate vice chancellor for diversity and inclusion and chief diversity officer for UC Davis Health. He previously served as the first chief diversity officer at the University of Washington School of Medicine, where he established the Center for Equity, Diversity and Inclusion and was the founder of the school’s Center for Cultural Proficiency in Medical Education.

Credits:

• Hosted by David J. Skorton, MD, AAMC president and CEO.
• Produced by Stephanie Weiner, AAMC director of digital strategy and engagement, and Mikhaila Richards, AAMC senior digital content strategist.
• Episode recorded and edited by Laura Zelaya, AAMC production manager.
• With special contributions from Zenneia McLendon, AAMC director of digital content strategy, and Sholape Oriola, AAMC video specialist.

You Might Also Be Interested In:

1. AAMC Framework for Addressing and Eliminating Racism at the AAMC, in Academic Medicine, and Beyond
2. “AAMC Releases Framework to Address and Eliminate Racism” (AAMCNews)
3. AAMC Racism and Health Resources
4. More from the “Beyond the White Coat” Podcast

Academic medicine is taking a hard look at its role in the long-standing systemic and institutional racism that Black Americans have faced when engaging with teaching hospitals, medical schools, and research programs — an experience that historically has fostered distrust of medicine and health care within the Black community. David J. Skorton, MD, AAMC president and CEO, talks with Lonnie G. Bunch III, secretary of the Smithsonian Institution, about how the history of racism in medical schools, clinical care, and research has impacted academic medicine’s relationship with the Black community. They discuss what can be done to regain trust and become allies and partners in their health and wellness.

Episode Guest:

• Lonnie G. Bunch III is the 14th secretary of the Smithsonian Institution. He assumed his position June 16, 2019. As secretary, he oversees 19 museums, 21 libraries, the National Zoo, numerous research centers, and several education units and centers. In service to the historical and cultural community, Bunch has served on the advisory boards of the American Association of Museums and the American Association for State and Local History. In 2005, Bunch was named one of the 100 most influential museum professionals of the 20th century by the American Association of Museums.

You Might Also Be Interested In:

• AAMC Racism and Health Resources
• “Why I gave up my dream of leading diversity efforts in medicine,” AAMCNews 
• “Racism and Discrimination in Health Care: Providers and Patients,” Harvard Health Publishing
• “How Structural Racism Affects Healthcare,” MedPage Today
• Podcast: Racial Health Disparities: How COVID-19 Magnified a Public Health Emergency
• More from the “Beyond the White Coat” Podcast

Episode Credits:

• Hosted by David J. Skorton, MD, AAMC president and CEO.
• Produced by Stephanie Weiner, AAMC director of digital strategy and engagement, and Kathy Gambrell, AAMC senior digital content strategist.
• Introduction written and narrated by, and episode recorded and edited by, Laura Zelaya, AAMC production manager.
• With special contributions from Zenneia McLendon, AAMC director of digital content strategy; Brandon Brown, AAMC senior outreach specialist; and Sholape Oriola, AAMC video specialist.

The COVID-19 pandemic has amplified the health disparities in America’s communities of color in such dramatic fashion that racism is now seen as a public health emergency. In the season finale of “Beyond the White Coat,” David Skorton, MD, AAMC president and CEO, and Malika Fair, MD,  MPH, senior director of health equity partnerships and programs at the AAMC, discuss what forces are driving the disparities in health care access, how physicians can work to acknowledge and address racism against Black Americans, and what the academic medicine community can do to address institutional and systemic racism. 

Episode Guest:

• Malika Fair, MD, MPH, is senior director of health equity partnerships and programs at the AAMC and an associate clinical professor and practicing physician in the Department of Emergency Medicine of the George Washington University School of Medicine and Health Sciences.

Episode Credits:

Hosted by David Skorton, MD, president and CEO of the AAMC.
Produced by Stephanie Weiner, AAMC manager of digital strategy; Gabrielle Redford, AAMCNews director and managing editor; and Patrick Boyle, AAMCNews staff writer.
Edited by Laura Zelaya, AAMC production manager.

You Might Also Be Interested In:

• Racism and Health - Resources for the Academic Community
• AAMC Press Conference: Racism and Health: How and Where to Make Changes (June 12, 2020)
• “Academic medical leaders and learners reflect on police brutality, racism, and the path forward" (AAMCNews, June 5, 2020)
• AAMC Statement on Police Brutality and Racism in America and Their Impact on Health (June 1, 2010)
• “Why is my community suffering more from COVID-19?” (AAMCNews, May 20, 2020)
• Season 1 of the “Beyond the White Coat” Podcast

In this two-part episode series, David Skorton, MD, AAMC president and CEO, talks with Sen. Roy Blunt (R-Mo.) and Rep. Donna Shalala (D-Fla.) about how health care policy will change for patients, the research community, and the workforce in the wake of the COVID-19 global pandemic.

Sen. Roy Blunt (R-MO) serves as Chairman of the Appropriations Subcommittee on Labor, Health and Human Services, and Education. He also chairs the Senate Rules Committee and serves on the Senate Commerce, Science, and Transportation Committee, among other committee assignments. Sen. Blunt has supported the Paycheck Protection Program and the Health Care Enhancement Act. 

Hosted by David Skorton, MD, president and CEO of the AAMC
Produced by Stephanie Weiner, AAMC manager of digital strategy; Erica Froyd, AAMC senior director of advocacy and engagement; and Kathy Gambrell, AAMC senior digital content strategist
Edited by Laura Zelaya, AAMC production manager

• Podcast: Season 1, Episode 1: Who Gets That Ventilator? Bioethics in the Era of COVID
• Podcast: Season 1, Episode 2: Accelerating Transformation in Times of Crisis
• Podcast: Season 1, Episode 3: A Pivotal Moment for Science: A Conversation with Dr. Francis Collins
• Podcast: Season 1, Episode 4: Preserving Well-being in a Pandemic

In this two-part episode, David Skorton, MD, AAMC president and CEO, talks with Sen. Roy Blunt (R-Mo.) and Rep. Donna Shalala (D-Fla.) about how health care policy will change for patients, the research community, and the workforce in the wake of the COVID-19 global pandemic.

Rep. Donna Shalala (D-Fla.) is an advocate for women’s rights, civil rights, increased access to health care, better education and public schools, and a clean and sustainable environment. She is the longest-serving secretary of health and human services in U.S. history, and in April, Rep. Shalala was appointed by Speaker Nancy Pelosi to serve on the five-member COVID-19 Congressional Oversight Commission. The commission was created by the CARES Act to provide oversight of the law’s spending and financial programs.  

Hosted by David Skorton, MD, president and CEO of the AAMC
Produced by Stephanie Weiner, AAMC manager of digital strategy; Erica Froyd, AAMC senior director of advocacy and engagement; and Kathy Gambrell, AAMC senior digital content strategist
Edited by Laura Zelaya, AAMC production manager

• Podcast: Season 1, Episode 1: Who Gets That Ventilator? Bioethics in the Era of COVID
• Podcast: Season 1, Episode 2: Accelerating Transformation in Times of Crisis
• Podcast: Season 1, Episode 3: A Pivotal Moment for Science: A Conversation with Dr. Francis Collins
• Podcast: Season 1, Episode 4: Preserving Well-being in a Pandemic