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Spotlight
BUILDING A CULTURE OF INCLUSION AND EQUITY THROUGH ADVOCACY, RESEARCH, AND EDUCATION
An Interview With Ava E. Pierce, MD
Ava E. Pierce, MD, is an associate professor in the department of emergency medicine at UT Southwestern Medical Center, the associate chair of diversity and inclusion for the department of emergency medicine, the director of the Emergency Medicine Research Associate Program, and co-director of the Joint Admission Medical Program (JAMP) at UT Southwestern. Dr. Pierce also works clinically at Parkland Health and Hospital Systems. She obtained her medical degree from Louisiana State University School of Medicine at Shreveport and completed an emergency medicine residency at Emory University School of Medicine. Dr. Pierce completed the Medical Education Research Certificate (MERC) Program and the AAMC Healthcare Executive Diversity and Inclusion Certificate Program and is committed to making innovative changes that will enhance diversity and inclusion and improve excellence in health care, thus strengthening a diverse workforce that will provide culturally competent quality medical care to all. She serves as a member of the UT Southwestern Medical Center’s medical school admissions committee and is a faculty liaison for Housestaff Emerging Academy of Leaders (HEAL), which focuses on professional development and mentoring for residents and fellows from under-represented groups. Her research interests include medical education, diversity and inclusion, and cardiac resuscitation. Dr. Pierce has built a steadfast academic career with involvement in numerous capacities at SAEM. She has been actively involved in the Academy for Diversity and Inclusion in Emergency Medicine (ADIEM) since it was founded and has served as ADIEM’s development officer and president. She was awarded ADIEM’s Outstanding Academician Award in recognition of her impact on the academic success of students and residents from underrepresented minority groups. She has also served on SAEM’s Membership Committee, Ethics Committee, and Diversity and Inclusion Task Force. Most recently she was elected as a 2020–2021 memberat large of the SAEM Board of Directors. She is a member of the National Medical Association, the AAMC Group on Diversity and Inclusion, and a fellow of the American College of Emergency Physicians. Dr. Pierce was interviewed for this article by Dr. Sharon Atencio, chair of the SAEM Pulse Editorial Advisory Task Force.
2019–2020 ADIEM president Marquita Hicks, MD honors Ava Pierce, MD, 2018–2019 ADIEM president at SAEM19 in Las Vegas.
What initially drew you to emergency medicine? To academics?
During medical school, I was interested in many specialties. I was initially drawn to emergency medicine because I enjoy taking care of undifferentiated patients. I enjoyed taking care of all patients from neonates to older adults, trauma patients, cardiac patients, and respiratory patients. In emergency medicine I get to take care of patients at some of the most difficult times in their lives. I have the honor of being the advocate for patients who may not be able to advocate for themselves. I have always loved educating others. Both of my parents were educators and helping others to learn was a large part of my childhood. This love for teaching drew me to academics. During residency I had several mentors who made such a great impact on me and I hope that I can help others as they did me.
My career in emergency medicine has helped me to develop greater humility, resilience, and empathy. The medical students and residents I work with teach me something every day. I feel blessed as an academic physician to be just a small part of helping to educate the next generation of emergency medicine physicians.
Who are some mentors who were influential on your career?
I have been fortunate to have had many mentors during my career. During my emergency medicine residency at Emory, my mentors included Sheryl Heron, MD, MPH; Arthur L. Kellermann, MD, MPH; Philip Shayne, MD; and Leon Haley, MD. In 2014, I completed the AAMC Healthcare Executive Diversity and Inclusion Certificate Program and gained Marc Nivet, EdD, MBA; Leon McDougle, MD, MPH; and Bernard Lopez, MD, MS, as mentors. As a member of SAEM’s ADIEM, Lisa Moreno, MD, MS, and Marcus Martin, MD, joined my growing list of mentors. At UTSW, I have gained not only mentorship but also sponsorship from the late Michael Wainscott, MD, previous UTSW program director; Deborah Diercks, MD, MSc, the chair for the department of EM; Mark Courtney, MD, executive vice chair of academic affairs; Ahamed Idris, MD, director of the research division; and Larissa Velez, MD, associate dean for graduate medical
education and emergency medicine vice chair of education. I have also received support and guidance from Byron Cryer, MD, in the Office of Faculty Diversity and Development.
How did you first become involved with SAEM?
I first became involved with SAEM as an EM resident at Emory. I completed a research project with Arthur L. Kellermann, MD, MPH, and presented the poster at SAEM. This interest continued as I became an attending physician and became active in ADIEM.
Congratulations on your election to the SAEM Board of Directors. What would you like to accomplish during this year?
SAEM has contributed tremendously to my professional development and being on the SAEM board is affording me the opportunity to help promote the development of other academic emergency medicine faculty through SAEM. My goal as a board member is to work with SAEM to make innovative changes and enact creative solutions that advance the mission and vision of the society. I bring the perspective of a former SAEM academy leader with the big picture of where academic emergency medicine has been and is going. I would like to enlist the help of each academy to increase SAEM membership so that the majority of academicians can benefit from the education and research resources that SAEM offers.
I would like to help SAEM implement programs that increase the pipeline of academic EM physicians and build a culture of inclusion and equity, which will ultimately improve the delivery of emergency care for all patients. I will work to 1.) increase the number of SAEM grants to help support the development and retention of junior faculty, 2.) help to design programs to increase mentorship opportunities for medical students, residents, fellows, and junior faculty, and 3.) assist in the implementation of programs that promote physician wellness and mitigate burnout. I am excited about the vision that SAEM has for academic medicine and am honored to have the opportunity to serve the organization that has been so influential in my professional growth.
Taking a moment to thank SAEM leaders who attended the 2019 SAEM South Central Regional Meeting—Increasing Diversity, Inclusion, and Equity in EM: Value of Research, Networking, and Faculty Development. The meeting was hosted by the department of emergency medicine at the University of Texas Southwestern Medical Center (UTSW) in Dallas, TX, September 6-7, 2019. Left to Right: Deborah Diercks, MD, MSc, 2015–2016 SAEM president and chair of the department of emergency medicine, UTSW; meeting keynote speaker Ian B.K. Martin, MD, MBA, 2019–2020 SAEM president, and chair of the department of emergency medicine, Medical College of Wisconsin; and Ava Pierce, MD, 2018–2019 ADIEM president and associate chair of diversity and inclusion, department of emergency medicine, UTSW
Race and gender inequalities, even when openly acknowledged, are challenging and emotional topics for many. How would you suggest people learn more about these subjects and engage in meaningful dialogues to bring about change?
Talking about race, racism, and gender equalities can be uncomfortable and bring about conflict, but it is necessary. I feel that acknowledgement, education, and advocacy are the keys to bringing about change. Data from the CDC shows that Black women are three to four times more likely to die of pregnancy-related causes than White women and the average life expectancy for Blacks is four years lower than the remainder of the U.S. population. We need to identify what implicit biases we have and then work to deconstruct those biases and learn to respond to microaggressions and overt discrimination. It will take systematic change to create equality.
What is the biggest obstacle to achieving substantial diversity in our workforce?
Rather than discuss the obstacles, I would like to talk about some solutions. I think that the things that will help improve diversity in the workforce include increasing the pipeline of individuals interested in emergency medicine and improving the culture that exists once diverse individuals are recruited. There needs to be culture change in academic institutions so that the environment is inclusive and women and URM physicians can thrive, not just survive.
What do you wish the rest of the world knew about the challenges of being a black woman in medicine?
When I spend time discussing the work environment with female faculty, many discuss that they have been harassed. But as a black woman, I have to experience the added complexity of intersectionality where both gender and race contribute to discrimination.
Dr. Pierce enjoying a girls day out with family and friends. L–R: Dr. Pierce’s daughter Angelica Bell, Dr. Pierce, Dr. Pierce’s longtime friends Sharalyn Fontenot, Sherrette Shaw-Fontenot, MD, and Stephanie Meinel Phoenix.
How has COVID-19 affected you and your practice?
I practice clinically in Dallas, Texas. As the number of patients presenting to the ED with symptoms of COVID-19 increased, our ED visits for other serious illnesses declined, although our numbers of cardiac arrest patients increased. I have seen racial and ethnic minority groups in my practice be disproportionately affected by COVID-19, due in large part to inequities in social determinants of health.
Aside from the pandemic, what do you think are the most pressing issues in emergency medicine today?
One thing that I would like to highlight is that structural racism is a public health emergency. Racism is a driving force of the social determinants of health. Injustices caused by racism must be addressed so that everyone can achieve health equity.
Looking back, what advice would you give to your younger self?
I would tell myself and any young faculty starting a career in emergency medicine: Be true to yourself. Follow your passions and be bold about the choices that you are making, because your work can and will make a difference.
If you found yourself with an unexpected day off, free from any responsibilities, how would you spend it?
If I found myself with an unexpected day off, I would spend it relaxing with family and friends.
What do you see as the future of emergency medicine?
Emergency medicine has and always will be the safety net for all patients. No matter how many changes happen in the future, including artificial intelligence and other advances, EM physicians will always be the ones who show up to take care of those who need help the most. As evidenced by how we responded to the COVID-19 pandemic, we are the physicians who will change the face of medicine.
At the end of my career, I would like to be remembered for helping to diversify the health care workforce and working to eliminate health disparities through advocacy, research, and education.
— Dr. Martin Luther King Jr., in a speech to the Medical Committee for Human Rights, 1966
— John Lewis, American statesman and civil-rights leader
Diversity work must be seen as more than just solving the problem of inadequate representation and alleviating the barriers facing disadvantaged and marginalized populations. Promoting diversity must be tightly coupled with developing a culture of inclusion, one that fully appreciates the differences of perspective. Together, diversity and inclusion can become a powerful tool for leveraging those differences to build innovative, high-performing organizations.
— Mark Nivet, EdD, MBA, executive vice president for Institutional Advancement, University of Texas Southwestern Medical Center
