WORCESTER MEDICINE
JEDI or Die Hidden In Plain Site: Working with Medical Societies to Actualize a Just, Equitable, Divers, Inclusive (JEDI) and Anti-Racism Health Care System Darilyn Moyer, MD FACP, FIDSA, FRCP
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he elevator story is compelling, the urgency never more critical. Organizational success, including for those in health care, is catalyzed and created by a Just, Equitable, Diverse and Inclusive, or JEDI, environment, free of harassment and discrimination (1). The imperative has never been greater as accrediting and licensing organizations in health care recognize, and require, that safer, higher quality patient care and medical education must be delivered in a JEDI environment. Inaction, or action without significant change, implies tacit perpetuation of the status quo. Despite more than 30 years of organizations trying to ensure that women and others underrepresented in medicine have appropriate representation at AHCs, the needle has barely moved (2). We should not suffer the tyranny of low expectations of just getting one woman and/or Underrepresented Racial Ethnic Group, or UREG, to a position of power but rather settle only for tectonic shifts that give appropriate representation proportional to patient populations. In 2015, 51%, 17.6%, 13.3%, and 1.2% of the U.S population were women, Latina/Latino, Black , and indigenous persons, respectively. In fact, there has not been an increase in proportion of Black men entering medical school since the late 1970s and the number of racial and ethnic minorities in U.S. medical schools only increased from 11.3% in 1980 to 13.7% in 2016 (3). Strong signals for patient-physician racial and gender congruity leading to improved patient outcomes are accumulating (4). Yet, despite the rapid, recent expansion of new medical schools and medical school classes, none of the last 30 have been in conjunction with a historically Black college or university (5). The first medical school opened in conjunction with Cherokee Nation in 2021 as the Oklahoma State University School of Medicine at the Cherokee Nation. The tsunami of data regarding
systemic disadvantages and barriers to women and others underrepresented in the health care workforce are incontrovertible. Women, UREGs and other traditionally marginalized and excluded groups in medicine are recruited, evaluated, promoted, advanced, mentored, sponsored and compensated differently (6,7). Women and UREGs in health care suffer more harassment and discrimination, including in social media (8,9). Now is the time to fix this as potential new physicians, and others in health care, cannot be what they cannot see. As the world’s largest medical specialty organization with 163,000 members, the American College of Physicians has a strong voice in representing internal medicine physicians, who comprise roughly 25% of practicing U.S. physicians. The “practicing” life of a physician is the largest proportion of a physician’s life cycle, hence the important interest, impact and role of physician medical societies in the discussion and solutions. Health justice, becoming an anti-racist organization, and achieving a diverse, equitable and inclusive health care environment are part of ACP’s strategic priorities and goals, as well as for many other medical societies (10). As I stated in a recent interview for the 2020 WIM Conference, “Every society should do the foundational work of systematically and
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Every society should do the foundational work of systematically and comprehensively resetting its organizational vision, mission and goals through a JEDI lens.” comprehensively resetting its organizational vision, mission and goals through a JEDI lens. This foundational work should be directly accountable to the fiduciary board and governance body and should permeate every structure in the organization including committees, councils and local chapters. These new structures, informed by metrics, need to be transparent, evaluated, adjusted and continuously measured. Societies need to generously share their data through publications and presentations. There is excellent language in medical school, graduate medical programs, and health care accreditation and regulatory standards that recognize more JEDI health care environments lead to safer and higher quality outcomes for our patients. The Council of Medical Specialty Societies, comprised of 45 national, professional physician societies representing more than 800,000 practicing U.S. physicians, has Diver-
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