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					Cross-Cultural Health Care Conference

   Are you really listening?
   Multicultural issues for a
   community-based medical school

   October 8, 2011

   Jerris R. Hedges, MD, MS, MMM
   Professor & Dean
   John A. Burns School of Medicine
My goals for this talk
   Share my multi-cultural journey
   Share some of the many multicultural areas
    within a medical school from the perspective
    of the dean
   Summarize our shared responsibilities
My journey

   Raised on farm in Pacific NW
    –   Ancestors crossed great plains/Rocky Mountains
        in covered wagon - ox carts
    –   Attended public schools from grade school
        through medical school
    –   Only ethnic diversity I saw as child were NA
        classmates and my Spanish Teacher
    –   Pacific NW still about 80% Caucasian
Which surfer doesn’t belong?
My journey

   Brother – LGTB
   Brother-in-law – Hispanic
   Practice – emergency medicine
    –   Limited use by Caucasians, unless poor or injured
   Residency – urban Philadelphia: 75% AA
   Faculty position – urban Cincinnati: 65% AA
   As OHSU medical center leader – promoted
    diversity in recruitment – all levels
OHSU – research team
Departmental - Recognition
Governor John Burns
championed education
- vehicle for opportunity
Chosen from and for Hawai’i

1,500 applicants, 66 chosen
   90% Hawai′i residents
   One of most diverse ethnic student bodies
What is diversity at JABSOM?

   Ethnic
   Cultural
   Socio-economic
   Geographic
    –   urban vs rural in-state medical students
    –   international in regards to graduate students
   Sexual/Gender
   Role - responsibilities
HR Issues

   Hiring - EO/AA
    –   Protected classes
   Dispute resolution
    –   Fact finding
    –   Team composition
   Disciplining
    –   Grievances
Student issues

   Selection
    –   Pipeline - opportunity
    –   Screening criteria
    –   Interview and selection process
    –   Notice, balance, communication
   Evaluation – Disciplining
    –   Process, process, process - documentation
    –   Faculty mentoring
Clinical faculty & patients

   Diversity – squared
   Interwoven ties to community, hospital(s) &
   All are aware of and concerned regarding
    –   Social justice
    –   Equitable opportunity in inequitable world

   Health Disparities
   Especially Native Hawaiians & other Pacific
    –   Department of Native Hawaiian Health – Center
        of Excellence
    –   RMATRIX – Clinical translational research grant
Research initiatives
Na Po’o No’o - thinkers
Global health

   Okinawa – Chubu Hospital
Student – eyes on Samoa
My goals at UH-M JABSOM

   Create the culture that will succeed in…
    –   our locale,
    –   our cultural/economic environment, and
    –   our place in time
   Build the programs that will enhance this
    culture and leverage what the school can
    bring to our community and the world
   Have our employees choose to be involved
    because they are making a difference for the
    world through their job
Traditional academia

   Focused on individual
   Unforgiving of errors
   Fragile egos
    –   Grudges & suspicions
    –   Feuds & cliques
New academia

   Pono – ethical balance
   Light shined on bad behavior
   Reward for individual and team work
   Mutual support and recognition
   Shared vision & community connection
   Understanding through communication
    –   Tolerance is not enough
Organizational culture

   Always there implicitly or explicitly
   If misbehavior tolerated, climate changes
    –   Fear, intimidation
    –   Demoralization
    –   Inequities of opportunity result
   Awareness & communication are needed

   No amount of money can take the place for
    not having to work for a living…

   Hedges 1969
Building on Culture
   Tribal Leadership:
    Natural Groups to
    Build a Thriving

   Dave Logan, John
    King & Halee
Summary of stages

Stage   Mood                   Theme
5       Innocent wonderment Life is great
4       Tribal pride           We’re great –
                               and they’re not
3       Lone warrior           I’m great – and
                               you’re not
2       Apathetic victim       My life sucks
1       Despairing hostility   Life sucks
Shared responsibilities

   Adopt healthy organizational culture
   Foster inclusive groups
   Communicate, communicate, communicate
    –   Ask & listen
    –   Test assumptions
    –   Explain concepts, processes, decisions
    –   Seek transparency – encourage others
JABSOM vision

   Attain Lasting Optimal Health for All

JABSOM Core Values

   Collaboration: Shared accomplishments in the spirit of

   Diversity and Inclusion: Respect for the entire spectrum of
    human experience

   Excellence: Guiding all of our efforts in research, education,
    and service

   Innovation and Discovery: The generation, application, and
    transmission of new knowledge

   Pono: Balance – with integrity, morality, & equity
     – e.g., taking action to eliminate health disparities in the spirit
       of social justice
Mahalo nui loa

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