Ideas to Consider #11…Healthcare & Cultural Inclusion

In my last post, I shared that I was not feeling very well.  Unfortunately, that not feeling well ended up in a five day hospitalization with a Hickman Line infection.  Sepsis is not fun, and I am still in the recovery mode with IV antibiotics daily and plenty of sleep.  But, I am definitely feeling better than I was due to high quality care.

In case you are counting, I have been hospitalized three times since April 2020 due to multiple Hickman Catheter infections.  During these 20 plus days in the hospital, I spent significant amounts of time with nurses, technicians, and phlebotomists as well as security, transportation, housekeeping, and food service staff. 

Through and through, I always share with friends and colleagues that the West Michigan hospital systems have the best front-line patient staff I have experienced in my healthcare odyssey which has taken me from West Michigan to the University of Chicago; the University of Pittsburgh (UPMC), and Northwestern Medicine.  Patient care in West Michigan has been and is exceptional.  

Yet at the same time, I have concerns in some of our regional healthcare systems related to cultural inclusivity.  

During my recent hospitalizations, I stayed in three different parts of one hospital system.  As customary, I walked the floors and spent time studying the artwork on the walls, and the stories they represent.  Unfortunately, I noticed that there is not one person of color featured in the art.  They were beautiful scenes of a State Park with people fishing, walking the pier, etc, but the scenes were not inclusive of who West Michigan is today.  There were no Latinx families picnicking or admiring low-rider cars.  There were no African American or southeast Asian families relaxing, having fun.  It is like these people are washed off the canvas of life, and not existent in our region.  

It struck me that if I were Latinx, Black, Indian, and/or from southeast Asia I would not feel as welcome in the hospital or have the same healing experiences as I do as a white person with a Dutch last name. 

Similarly, I found that in another part of the hospital, my room had a large print hanging on the wall that said:

Patience with others is love.
Patience with self is hope.
Patience with God is faith.
   - Adel Bestravos

And to the right of the words, was a colorful abstract with white hands in a praying position.  And I thought:  What would I think if I were not a person of faith?  

Most recently, in a third part of the hospital, I found large pieces of artwork with wooden shoes and tulips, and no artwork that included people of color.

Because of this, I started paying closer attention to other symbols.  And I recognized that the food choices offered were not culturally diverse.  Food choices centered around ‘meats’ like baked chicken, meatloaf, or turkey with potato-based starches, and a salad/soup.  While I am sure it is healthy, and meets dietary guidelines, it was institutional and did not feature culturally relevant foods for Latinx or Asian community members.  It made me remember that at UChicago and UPMC there were menus that included all sorts of options from ‘stir-fry’, rice, and Asian vegetables to different types of tacos, as well as Italian and Polish food (pierogis).

And then more importantly, I thought about the staff diversity I was experiencing, especially in entry level positions like housekeeping and phlebotomy, but also in security and nursing care.  

Again, I went back to my experiences at UChicago and UPMC where cleaning staff were often first or second-generation Americans from Africa, Eastern Europe or Latin America. And phlebotomists were recruited from hospital neighborhoods because they could be trained with a skill that provided higher wages than other local service industries.  Security staff represented those that live within the surrounding neighborhoods.  And for me, it was great fun to talk with big, burly Pittsburgh steel men who were retrained as x-ray technicians, but still had their beards and large arms.  We talked football and other things while setting up for tests and for me, that was a healing experience.

When I asked local entry level staff about their journey to working at the hospital, I did not hear similar stories about how one became employed at the hospital.  What I heard was good networking.  People – many times family – letting people know about needs for cleaning staff and/or phlebotomists, and they applied.  At its face, there is nothing wrong in that.  But one of the great things about healthcare is that there are all sorts of jobs that can improve one’s quality of life with technical training and knowledge.  But many times, people do not know about these jobs until they see them firsthand.  Therefore, access to entry level jobs can lead to opportunities in healthcare like few other places.  Changing recruiting practices is essential to providing access.

National research shows that growing and prospering communities are diverse communities.  One of the best reads related to this subject is Just Growth by Drs. Chris Brenner and Manuel Pastor.  

So, my Idea to Consider is this:  How are our local hospital systems working to continue its journey toward increased diversity, equity, and inclusion.  I have pointed out a few issues like art purchases, culinary choices, and entry level hiring practices.  But I know there are knottier ones too like: 

  • Creating pipelines for African-American, Latinx and southeast Asian nurses so that they can be prepared to move into nurse management; 
  • Recruiting and hiring minority doctors to West Michigan; 
  • Diversifying the Board of Directors.

I am confident that different healthcare systems in West Michigan are further along in this journey than others.  But it is essential that each one thinks strategically how they will continue the journey forward toward more inclusion.  For the care of people in our region, and our long-term economic vitality.


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