16 minute read
Spotlight Guided by Grace, Compassion, and Empath – An Interview With Dr. Joseph “Adrian” Tyndall, MD, MPH
SPOTLIGHT
GUIDED BY GRACE, COMPASSION, AND EMPATHY
Joseph (Adrian) Tyndall, MD, MPH is the executive vice president for health affairs and professor and dean of the Morehouse School of Medicine since July 1, 2021. Prior to Morehouse School of Medicine, Dr. Tyndall served for 13 years as chair and professor in the department of emergency medicine at the University of Florida (UF) College of Medicine from January 2008, until his departure from UF in 2021. He was the first person of color to serve as chair of an academic department in the college of medicine’s history and only the second African American to be named chair of an academic emergency medicine department at a United States medical school. Dr. Tyndall represented the UF College of Medicine as the senior medical school representative to the Council for Faculty and Academic Societies of the Association of American Medical Colleges (AAMC) from 2014 to 2018 and was named a fellow of the Council of Deans of the AAMC. In August of 2018, he was appointed to the role of interim dean of the College of Medicine at UF and then subsequently to the position of associate vice president for strategic and academic affairs for UF Health in 2021. Dr. Tyndall served for more than a decade on the board of directors of the UF Health Hospital System and was chair of the board of trustees for the UF Health Proton Therapy Institute during his tenure as interim dean. Dr. Tyndall’s extensive record of service on boards, committees, and foundations include his service on the board of directors of the Florida College of Emergency Physicians from 2011 through 2021, serving as president from 2018 to 2019. Within SAEM, he has served on the SAEM Development Committee, the SAEM Foundation (SAEMF) Board of Trustees, and as a member of the Association of Academic Chairs of Emergency Medicine (AACEM), the Academy for Women in Academic Emergency Medicine (AWAEM), and the Academy for Diversity and Inclusion in Emergency Medicine (ADIEM). Dr. Tyndall is currently president on the board of trustees for the Society for Academic Emergency Medicine Foundation, emergency medicine’s national foundation supporting education and research in emergency care. He has been a member of the SAEMF since 2018, serving on its major gifts committee since 2021. Dr. Tyndall is also currently a member of the board of directors of the Grady Health System in Atlanta Georgia, and is an appointed member of the administrative board of the Council of Deans of the Association of American Medical Colleges. Dr. Tyndall is a graduate of the University of Maryland School of Medicine and the emergency medicine residency program at the University of Maryland Medical System. He received a master’s degree in health services management and health policy from Columbia University, New York, New York. He started his academic career in Brooklyn, New York where he served in several roles including residency program director at the Brooklyn Hospital Center. Dr. Tyndall is a member of the Alpha Omega Alpha Honor Society and the Gold Humanism Honor Society and an editor of the 10th edition of Rosen’s Emergency Medicine: Concepts and Clinical Practice.
Dr. Tyndall spending a moment with children in Kumasi Ghana Morehouse school of medicine convocation
When you were a child, what did you want to “grow up” to be?
Growing up, I always wanted to be either a musician or scientist. I spent my childhood years listening to some of the greatest classical and jazz pianists of our modern times and honing my skills on the piano and fantasizing playing concerts. But I also was enthralled by the “How and Why Wonder Books,” a series of illustrated books published in the 60s and 70s that were designed to teach science and history to children. I spent my time trying to think up crazy science experiments that I wanted to conduct. Wanting to become a physician came much later.
Why did you choose academic emergency medicine and who or what influenced your decision?
Emergency medicine became a natural choice because of my early experiences. I spent time as a nursing assistant and emergency medicine technician at the George Washington University’s (GWU) Department of Emergency Medicine. The people there influenced me because of the passion they had for the work they were doing, as well as the great skill and humanity with which they pursued it. Their ability to cope admirably under the severest of circumstances, to handle human tragedy with grace, and always showing compassion and empathy at every instance — I wanted to be that. The GWU Emergency Department was the place where I was introduced to academic emergency medicine and clinical teaching. It was the place where I learned a lot about life in my late teens. What was pivotal to my decision to pursue academic emergency medicine was my experiences at the University of Maryland and the mentorship I received there from all leadership but especially the late Dr. Elizabeth Tso who was one of the three original emergency physicians, along with Robert Barish and Brian Browne, who started emergency medicine at the University of Maryland. Many can say that Dr. Tso was a mentor. She was the mother of my career.
What is a personal philosophy that has guided you in the work you do?
I have always maintained a system of values in treating and leading others and leading organizations as well as a reliance on deep personal Christian faith handed to me by my grandmother and mother. I have always been struck by how closely the construct of values-based leadership is aligned to my upbringing, my tendencies and instincts in how I approach the work I do. I have relied heavily on values of self-reflection, true self confidence, balance, and humility to guide my behaviors, my disposition towards others and my effort to always self-improve. In the sometimes highly competitive nature of academic medicine, where the primacy of ambition and hubris sometimes seems as the inevitable pathway to success, I have always yielded to having others go first, and in many aspects of my career, it may not have been an obvious winning strategy.
Although Black and African Americans compose 13 percent of the nation, they account for only four percent of the physician workforce. Clearly much work remains to be done to align the diversity of the health care workforce with the racial and ethnic backgrounds of patients, especially in the field of emergency medicine… What do you believe is the biggest obstacle to achieving substantial diversity in the EM workforce?
The biggest obstacle to achieving substantial diversity in the EM work force is a common and transcending denominator across medicine and science. There simply is not enough equity in opportunity for underrepresented populations in the US. Our education systems also need to be reframed. The barriers are many and begin at the root causes of societal inequities that are determined by both persistent economic and political determinants. The disparities in the opportunity trajectory occurs very early on. If those trajectories cannot be influenced at early stages, the divergence in opportunities and outcomes is inevitable. Achieving substantial diversity in the health care, scientific and emergency medicine work force means shifting the curve by creating opportunities to influence the trajectory for more people of color and greater ethnic diversity for as far back as is practical for us to do.
In your experience, how far have we come (i.e., what are some positive steps/signs you’ve seen)? How far do we still have to go? Do you believe we will ever “get there?
There has been some progress. For a long time, I was the only active African American chair of an academic emergency department. Now, there are more African American chairs of emergency medicine than ever before and delightfully, the national academy inducted several this past year. However, the major economic and political equation for many people of color in this country remains unchanged. Black men in medicine have remained a persistent crisis even if the needle has been ever slightly nudged these last few years and other ethnic underrepresented groups have been persistently challenged in making progress. Will things change? I believe and hope that it will. The U.S. is marching inevitably towards greater diversity,
(left) Dr. Tyndall and his mother. (middle) Dr. Tyndall and his mentor, Dr. Betty Tso, one of the founders of the University of Maryland Medical Center’s department of emergency medicine. (right) Dr. Leon Haley, Jr., Dr. Sheryl Heron, and Dr. Joseph Tyndall
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and we know more than we have ever known before, the importance of diversity for all of society in every framework of health, from discovery to clinical care. This is why places like Morehouse School of Medicine and so many other schools of medicine and institutions of higher learning invest in pipeline and pathway programs that go as far back as middle school to shift the curve. However, meaningful and lasting impact means that society must muster the economic and political will to reach back even further, and invest sustainably to change our communities, especially those marginalized, with an understanding of the costs that resulted from past wrongs, especially in our African American communities.
What is the first thing that comes to mind when you think of SAEM? SAEMF?
Straightaway, I think about research, teaching, and acknowledgement of academic excellence. As a graduating medical student, I received the Medical Student Excellence in Emergency Medicine Award. This was the first time I had heard of SAEM and it is something that I have always remained exceptionally proud of.
How did you become involved with SAEM and, subsequently, the SAEM Foundation (SAEMF)?
My first true introduction to SAEM happened when I first became a faculty member and was asked to become the student clerkship director at my first job in academic medicine at the Brooklyn Hospital Center. Attending SAEM meetings back then felt like being part of an extended family of kindred spirits who cared deeply for the same things I cared about, which was medical student education. I subsequently became involved in the Council of Residency Directors (CORD) and attended my first “Navigating the Academic Waters of Emergency Medicine” — probably the most influential academic meeting I had ever attended to date in my early career. There, I met many of my closest colleagues and friends including the late Dr. Leon Haley Jr. who encouraged me to get more involved in organized SAEM activity. I found myself navigating various interest groups, and committees, but as I reflect 20 years ago, my early sojourn, while not completely aimless, was more about seeking opportunity, contacts, and interests, rather than a guided, mentored or focused approach. I eventually joined the development committee of SAEM when I became a department chair because I had a keen interest in supporting the careers of others. The SAEM development committee eventually became absorbed into the SAEM Foundation.
You are considered a trailblazer who has carved out new career pathways for emergency medicine chairs to follow after they complete their chair role. How have the leadership roles you’ve held within SAEM and SAEMF contributed to you becoming the inspiring leader you are today?
We are the sum total of our experiences, and I would say that it has been more about the relationships that I developed and what I learned from others in SAEM that prepared me for the work I am doing today. At SAEM, I was taught about mentorship, grantsmanship, and the imperative of the academic mission.
What do you believe are the biggest challenges academic emergency medicine (EM) faces moving forward?
The face of medicine and health care is changing, and the pace of change is accelerating. This is occurring across all domains, from fundamental discovery and the role of personalized medicine and ancestral genomics in therapeutics all the way to precision public health and the evolution of health care delivery and advancement of technology that will allow for delivery at scale. The role of emergency medicine must also evolve in this context as we continually assess the scope and breadth of our clinical impact as well as the education and research imperatives that will drive that impact. The biggest challenge is to evolve fast enough to remain relevant. Much (not all) of what we do today, the world will one day be able to do differently and more efficiently in both diagnostic and therapeutic categories. The good news is that emergency medicine is no stranger to rapid evolution. The training and the opportunities I received over 25 years ago are very different from today’s offerings.
How do you feel SAEM and SAEMF is addressing these challenges and contributing to building the pipeline of future EM research and education leaders?
SAEM and SAEMF is driving innovation through the creation of critical opportunities for future researchers, educators, and leaders to pursue ideas that we believe can fundamentally translate to EM practice and impact. The foundation has grown significantly over time, but the critical need, both now and in the future is to scale our ability to support even more funding for more ideas and to ensure that the opportunities become available to greater diversity of individuals.
In 2022, SAEMF made the largest single-year investment in research and education grant funding in its history. What made this possible?
2022 was a phenomenal year for the foundation but I believe it was made possible through deliberate strategic planning around philanthropy, focused partnerships, a record of outstanding stewardship as well as careful and sustained success in the investments of the corpus. People also stepped up. Most of the donors to the SAEMF come from SAEM past and present membership. To continue these successes, we have to accelerate a culture of giving. Keeping this momentum will get us even closer to a critical mass of sustainable funding.
(left) Dr. Henri Ford, Dr. Joseph Tyndall, and Dr. Leon Haley Jr. (middle) Dr. Tyndall and his three daughters. (right) Dr. Tyndall and a few of his mentors
You've been a long-time donor to SAEMF’s Annual Alliance, which is a big reason SAEMF has grown to one of the foremost sources of EM grant funding. Why do you feel it’s so important to support SAEMF year after year?
You only need look at countless examples of how the funding opportunities from the SAEMF has helped to initiate and support successful careers of many. If we are serious about opening the doors of academic medicine to an even more diverse group of people who have a serious focus in emergency care, then we must expand and create even more sustainable opportunities to launch careers. Continuous support is fundamental. It would be great to have someone, or some entity, step forward and triple our endowment, and while that could happen, it will take work and cultivation over time.
Under your leadership, SAEMF has been expanding its partnerships with other organizations concerned about EM research and education. Why and how are these partnerships key to our future successes in EM research and education? What can SAEM members do to help in this area?
I think we all understand that when there is common cause, collaboration is always the superior strategy. The key is finding common cause and ensuring that they align with our interests. I have always felt that seeking out others who care deeply about the same things we care about, would be fundamentally beneficial to pursue. Emergency medicine does not have to do it alone; we never really have. In the past, we were more resistant collaborations, especially with industry, because of conflicts and influences we wished to avoid and loss of control and influence. Learning to navigate these partnerships as a mature entity will be critical to SAEMF’s future growth. Adopting and maturing our philosophy around partnership and collaboration will be key in developing greater opportunities to fund our missions.
Stigma is a leading barrier to mental health care for emergency physicians. Many fear that treatment for mental illness could jeopardize their careers or their licenses to practice. What would you say are the key challenges to addressing this stigma?
Mental health care for emergency physicians is a critical issue that has been exacerbated by the COVID-19 pandemic and tragically underlined by disproportionate rates of burnout and death by suicide in emergency medicine. Broadly and fundamentally, the key challenges to addressing the stigma lie within our education, regulatory, and health systems — all of which are far from optimally designed to allow learners, providers, and physicians to focus on key aspects of caring for the mental and emotional aspects of the human condition and the promotion of well-being.
What do you think the EM specialty and/or SAEM can do to address stress and improve physician well-being?
Influence, advocacy, and education are key starting points. Emergency medicine can contribute through teaching and mentorship and innovation, to challenges that reside at the individual level, starting early in medical education with the reinforcement of adaptive coping skills and the extinguishing of stigma in accessing mental health services. Organizationally, emergency medicine can advocate and influence the redesign and optimization of health care clinical systems that will allow for improved working conditions, reducing unnecessary burdens in care environments while promoting greater clinician well-being.
What can be done to create a sense of safety for EM physicians and medical trainees that would encourage them to ask for help or self-report when they’re struggling with their mental health.
Creating an environment that allows both mentor and mentees to freely express vulnerabilities. Focus on mental health as a preventative strategy rather than an intervention.
Up Close and Personal
What's the one thing few people know about you?
I have perfect pitch as an amateur musician
What is your guiltiest pleasure (book, movie, music, show, food, etc.)?
A good science fiction novel if I could find the time
Who would play you in the movie of your life and what would that movie be called?
Title: Unlikely Path and Sydney Poitier
Name three people, living or deceased, whom you would invite to your dream dinner party?
1. Dr. Martin Luther King Jr. 2. Art Tatum, an American jazz pianist who is widely regarded as one of the greatest in his field 3. Moses Tyndall, my paternal grandfather who died in 1937
Please complete these three sentences:
1. In high school I was voted most likely to star in the school play 2. A song you’ll find me singing in the shower is “Love Cats” by The Cure 3. One quote I live by is “without faith, nothing is possible”
