UVA Radiology Keynote Lecture Series: “When You Are the Target: A Case Study and Expert Panel Discussion on Racism, Bias and Prejudice Against Healthcare Providers”

Dr. Tracy Downs, Dr. Raymond Liu, Dr. Sanjay Misra, Dr. Kim Penberthy, Dr. Margaret Plews-Ogan and Dr. Arturo Saavedra – Moderated by Dr. Ziv Haskal

Wednesday, June 16th

Increased recognition of bias against Asian-Americans has further focused Americans on current issues of racism and bias. Beyond considering how such bias may impact their patients’ care, healthcare providers themselves can be the target of ethnic, racial, religious and racist attacks and comments in the workplace, from patients or others.

A panel of national experts discussed a recent specific case study of patient bias against a health care provider at a major academic institution. The discussion spanned issues of patient bias, racism and prejudice toward providers and included practical questions such as:

• What should a caregiver do when confronted by bias directed at them (in the moment and after the event)? 
• What is the scope of the problem?
• What is the moral injury experienced by targets of prejudice? How can you respond in the moment, and what resources and strategies should be available thereafter?
• How do you manage an ongoing therapeutic with such behaviors in your patient(s) or their family members?
• What can a provider do when witnessing bias directed against a colleague or others? 
• What is one’s responsibility as a role model, mentor, or educator to address racism events when they occur, and promote healing and understanding?

Resources

From Massachusetts General Hospital

• Patient/Family/Visitor Code of Conduct (PDF)
• SAFER Model (PDF)
• Scenarios (PDF)
• Strategies and Scripting Guideline (PDF)

From UVA Health

• Stepping In – Workshop Overview (Word)

The B.E.G.I.N. Framework (courtesy of Dr. Penberthy)

• Take a Breath – to calm, suspend judgment, and assess realistic choices and goals
• Start with Empathy – “It must be hard being in the hospital… feeling sick… getting this news… “
• State the Goals of Values – “Here at UVA we work as a team, and we treat everyone with respect. We expect the same from you. What you said to my resident… “
• Inquire – “So, can you help me understand… “
• ENgage or Negotiate Towards the Common Goal –  Let’s focus on getting you better, assuming that you will treat my whole team respectfully going forward.”

About the Lecturers

Dr. Tracy Downs, MD, FACS

Incoming Chief Diversity & Community Engagement Officer, UVA Health
Formerly Associate Dean for Diversity and Multicultural Affairs, University of Wisconsin-Madison School of Medicine
Formerly Professor, Department of Urology, University of Wisconsin-Madison School of Medicine

Dr. Tracy M. Downs, MD, FACS, will be UVA Health’s inaugural Chief Diversity & Community Engagement Officer, effective July 1. In this new role, Downs will serve as UVA Health’s leading voice on diversity, equity and inclusion and be a powerful advocate for related initiatives across the health system and, more broadly, in the local community. Within UVA Health, he will support, consolidate and guide efforts to ensure an inclusive, optimal and respectful learning, training and working environment. Within the greater Charlottesville region, he will work collaboratively to improve community health and well-being by addressing social determinants of health to decrease health disparities amongst those who are at risk or currently under-served.Downs comes to UVA Health from the University of Wisconsin School of Medicine and Public Health where he is Associate Dean for Diversity and Multicultural Affairs and Professor of Urologic Oncology.

Dr. Raymond Liu, MD, FSIR

Executive Director, Mass General Brigham Global Advisory
Associate Radiologist, Massachusetts General Hospital
Associate Chair, Business Strategy & Analytics, Department of Radiology, Massachusetts General Hospital

Dr. Raymond Liu is the Executive Director of Mass General Brigham Global Advisory, serving as a leader of the system wide global advisory services team.  Mass General Brigham Global Advisory leads enterprise wide international efforts, focusing on strategy, system coordination, business development, and project delivery on behalf of its member hospitals. Dr. Liu also currently serves as the Associate Chair, Business Strategy & Analytics within the Department of Radiology at MGH.  Nationally, Dr. Liu serves on the Executive Board for the Society of Interventional Radiology, and Chair of the Health Policy & Economics Division.  Dr. Liu graduated from Harvard College and Harvard Medical School and went on to complete dual residencies in pediatrics and diagnostic radiology at Columbia University.  Dr. Liu returned to Boston to complete his fellowship in interventional radiology at Brigham and Women’s Hospital.

Dr. Sanjay Misra, MD, FSIR, FAHA

Professor of Radiology, Mayo Clinic

Dr. Sanjay Misra is a Professor of Radiology at Mayo Clinic Rochester and a Fellow of the Society of Interventional Radiology and the American Heart Association.  He is a Physician Scientist, and his clinical practice encompasses peripheral arterial disease and dialysis vascular access management.  His research has been funded by the NIH since 2010 and includes understanding the mechanisms of hemodialysis graft failure and drug deliveries and stem cell to prevent venous stenosis formation.  He has performed a phase 1 IND trial using autologous adipose derived mesenchymal stem cells to prevent venous stenosis formation in arteriovenous fistulas.  He also has tested translatable therapies using statins coated on microparticles as part of a phase 1 SBIR study and Vitamin D3 encapsulated in PLGA composed of nanoparticles.  He has several patents issued for preventing venous stenosis formation in hemodialysis AVF.

Dr. Kimberly Penberthy, MA, PhD, ABPP

Chester F. Carlson Professor, UVA Department of Psychiatry and Neurobehavioral Sciences
Co-Director, Physician Clinical Evaluation Program, UVA Health
Co-Director, Effective Coping and Communication Skills for Physicians Program, UVA Health

J. Kim Penberthy, PhD, ABPP, completed her internship in clinical psychology in the Department of Psychiatry & Behavioral Sciences at the Eastern Virginia School of Medicine in Norfolk, VA and a fellowship in behavioral medicine in the Department of Psychiatry & Neurobehavioral Sciences at the UVA School of Medicine from 1998-2000. She is trained to work with patients who have chronic medical conditions, such as cancer, diabetes or HIV, as well as people who suffer with addictions, and conducts research exploring effective treatments for people with co-occurring psychological difficulties, addictions and medical conditions. She is a founding member of the UVA Contemplative Sciences Center and the co-director of the Effective Coping and Communication Skills for Physicians program, which is a national CME program helping to improve the interpersonal skills of physicians. She joined UVA’s Department of Psychiatry & Neurobehavioral Sciences in 2000 and is currently a professor.

Dr. Margaret Plews-Ogan, MD

Brodie Professor of Medicine, UVA Health
Co-Director, Wisdom and Well-Being Program, UVA Health

Margaret (Peggy) Plews-Ogan holds degrees from the College of Wooster (BA), Pace University (MS), and Harvard Medical School (MD). She completed an internal medicine residency at Brigham & Women’s Hospital, Boston. For five years after residency, she worked with migrant farmworkers in eastern Virginia. Now Brodie Professor of Medicine, Dr. Plews-Ogan has practiced and taught inpatient medicine at UVA since 2000. She was division chief of Hospital and Ambulatory Medicine, Geriatrics, and Palliative Medicine for ten years. Her research began in the area of medical error, disclosure of such errors, and coping with medical mistakes; this led her to study how physicians learn from failures and ultimately to the arena of wisdom, including how wisdom is gained in the wake of difficult experiences. Dr. Plews-Ogan currently co-directs the Wisdom and Well-Being program, a system-wide UVA Health initiative to address stress and burnout, nurture professionalism, and provide coaching for faculty and staff. Most recently, she designed a training program in responding to disrespect and bias in health care, a program that’s become a national model.

Dr. Arturo P. Saavedra, MD, PhD, MBA

Chair and Professor, UVA Department of Dermatology
Chief of Population Health and Health Policy, UVA Health

Arturo P. Saavedra, MD, PhD, MBA, currently serves as Chief of Population Health and Health Policy and has been chair of the Department of Dermatology since October 2017. As a clinician and researcher, he specializes in the care of complex medical dermatology, with particular interest in HIV dermatology, severe drug reactions that manifest with dermatologic complications and care of oncologic and post transplant patients.

 

About the Moderator

Dr. Ziv Haskal, MD, FSIR

Professor, UVA Department of Radiology and Medical Imaging

Dr. Haskal is a tenured professor of radiology and medical imaging in the Division of Interventional Radiology at the University of Virginia School of Medicine. He received his M.D. at Boston University School of Medicine and completed residency and fellowship at the University of California, San Francisco. As a sought after teacher and educator, Dr. Haskal has given more than 500 invited lectures worldwide and been awarded numerous honorary fellowships, national, international and societal awards for leadership, service and research excellence. He has designed, participated or led more than 40 research trials. Dr. Haskal has also published more than 400 scientific manuscripts, chapters, review, abstracts and editorials in journals ranging from Human Gene Therapy and the New England Journal of Medicine, to Circulation, JVIR, Radiology, Hepatology and more. Dr. Haskal was the editor in chief of the Journal of Vascular and Interventional Radiology (JVIR) from 2011-2020, doubling its manuscript submissions, raising its impact factor and introducing numerous print, electronic and new media offerings.