Selected Podcast
Ep. 5: Bridging the Cultural Gap in Doctor-Patient Communication
Roxanna Gapstur, President and CEO of WellSpan Health and one of WellSpan’s Behavioral Health Education Specialists, Ana Tovar, Psy. discuss the importance of a diverse caregiving team for patients, and the organizational efforts WellSpan is taking to create a more diverse and inclusive health system.
Featuring:
In January 2019, Roxanna Gapstur assumed the role of President and CEO of WellSpan Health. She has over 25 years of healthcare leadership experience working in group practice, academic, and integrated health care systems which included health plan operations. Prior to her appointment at WellSpan, Dr. Gapstur was a senior vice president and president within the HealthPartners system in Bloomington, Minn.
Dr. Gapstur has extensive experience in strategic planning, business development and operational leadership in both ambulatory and hospital settings. She has served in multiple executive roles including chief operating officer, chief nursing officer and as a senior executive accountable for population health.
Dr. Gapstur obtained her bachelor’s degree from the College of St. Catherine in St. Paul, Minn., and her master’s degree and doctorate from the University of Minnesota.
She was named a “Top 35 Women in Healthcare Leader” by Minnesota Women’s Health Leadership Trust in 2014. Dr. Gapstur has participated as a member and president of non-profit boards, including the Greater Twin Cities United Way, Minnesota Chapter of the National Hemophilia Foundation and the Minnesota Organization of Leaders in Nursing.
Ana Tovar, Psy | Roxanna Gapstur, PhD, RN
Dr. Ana Tovar is one of WellSpan’s Behavioral Health Education Specialists within the medical education division. She completed her post-doctoral fellowship in clinical research at Western Psychiatric Institute and Clinic at the University of Pittsburg. In addition to working with residents on behavioral health aspects of care, she also provides outpatient services to patients at the Thomas Hart Family Practice Center at WellSpan York Hospital.In January 2019, Roxanna Gapstur assumed the role of President and CEO of WellSpan Health. She has over 25 years of healthcare leadership experience working in group practice, academic, and integrated health care systems which included health plan operations. Prior to her appointment at WellSpan, Dr. Gapstur was a senior vice president and president within the HealthPartners system in Bloomington, Minn.
Dr. Gapstur has extensive experience in strategic planning, business development and operational leadership in both ambulatory and hospital settings. She has served in multiple executive roles including chief operating officer, chief nursing officer and as a senior executive accountable for population health.
Dr. Gapstur obtained her bachelor’s degree from the College of St. Catherine in St. Paul, Minn., and her master’s degree and doctorate from the University of Minnesota.
She was named a “Top 35 Women in Healthcare Leader” by Minnesota Women’s Health Leadership Trust in 2014. Dr. Gapstur has participated as a member and president of non-profit boards, including the Greater Twin Cities United Way, Minnesota Chapter of the National Hemophilia Foundation and the Minnesota Organization of Leaders in Nursing.
Transcription:
Michael Carrese: You're listening to Inspiring Health with Dr. Roxanna Gapstur, President and CEO of WellSpan Health. As she hosts candid conversations about organizational, culture, value, and other pressing issues we face in healthcare and business. Today,
Dr. Roxanna Gapstur: Today, we're going to explore our organizational efforts to create a more diverse and inclusive health system. One where our team members feel welcome, respected, and valued, and where our patients feel safe and accepted too. Today, we'll cover three key areas. The value of physicians and residents who are trained in culturally sensitive approaches to healthcare, the impact of a diverse caregiving team for our patients and how a strong inclusion program helps to retain the best and brightest to care for our communities. Joining me today is Dr. Ana Tovar. She's one of WellSpan's Behavioral Health Education Specialists within our medical education division. She completed her postdoctoral fellowship in clinical research at Western Psychiatric Institute and Clinic at the University of Pittsburgh. In addition to working with residents on behavioral health aspects of care. She also provides outpatient services to patients at the Thomas Hart Family Practice Center at WellSpan York Hospital. Dr. Tovar, thanks for joining me.
Dr. Tovar: Thank you Roxanna for having me, I'm excited to be here.
Dr. Roxanna Gapstur: Ana, you have special clinical and research interest in a variety of areas, but one of them is culturally sensitive approaches to healthcare. Tell me a little more about that.
Dr. Tovar: Well, my interest in doctor, patient communication dates back to graduate school, I actually did my dissertation on doctor, patient communication and patient satisfaction. And I came to realize a while ago that really every interaction between a healthcare professional and a patient is potentially a cross cultural encounter. And that is because a culture is a lot more than just the language that you speak or the area that you might hail from. It really is the totality of all your lived experiences, all your attitudes and your beliefs, many of them about health, illness, and wellness. So as a healthcare professional, when you are trying to partner with a patient, it's extremely important to be cognizant of that because there may be cultural divides or gaps between you and the patient. And if you are going to be able to influence the patient and support them in having the best health outcomes possible, you need to be able to bridge that gap.
Dr. Roxanna Gapstur: That is really interesting. Can you tell us how you're applying that interest to your work in our residency program here at WellSpan?
Dr. Tovar: Absolutely. Skill at interpersonal communication is a professional competency that residents need to be able to develop during their years here at WellSpan or in any residency program. And when it comes to developing a skill, there is no substitute for practicing. So among the tools that we use to help residents develop this competency is a communication and patient experience curriculum, where we use the simulation center and we use trained actors. Now, these actors portray patients in medical encounters and our residents have a, an opportunity to be able to handle difficult conversations, things surrounding say discussions about end of life issues or sensitive conversations about religious beliefs, particularly when they may be conflicting with a recommended medical treatment. These are very difficult conversations for sure, but if they're given real time feedback and they are given educational tools, they're able to navigate these conversations with a lot more ease and much more expertise. And that benefits our patients.
Dr. Roxanna Gapstur: Yeah, this culturally sensitive approach really seems to help our patients feel safe and accepted. What about the diversity of our caregiving team? I think it's important our caregivers represent that breadth of diversity in our communities.
Dr. Tovar: I couldn't agree with you more, and the more diverse our healthcare team can be, the better we can deliver care to our diverse communities. And that's because that cultural knowledge that diverse individual brings and that the perspectives and new ideas that they might also generate help us to connect with our diverse communities in a much better fashion. I can give you an example with regards to gender diversity. It's probably not that long ago that the medical profession was primarily male. That's certainly not the case now. And as a result of having females involved, more women involved in healthcare at all levels of an organization, think of the advances that we've made in women's healthcare, not just recognition about the unique needs of women, but also the ways in which we deliver care in a much more culturally sensitive way. So the more diverse individuals that you bring on board and the more that you empower them and include them, the more informed the entire organization is these individuals. It's almost as if they have x-ray vision and they're able to see blind spots that are invisible to others. They're able to see gaps and opportunities for us to deliver care in much more effective ways.
Dr. Roxanna Gapstur: Ana you'll be familiar with WellSpan's goal of being recognized as a leader in diversity and inclusion. We want to develop a culture where the best and brightest from any background feel respected, are treated fairly and have the opportunity to excel in their chosen career.
Dr. Tovar: I agree completely. And this is the imperative of the diversity and inclusion steering committee of which I'm a member.
Dr. Roxanna Gapstur: Exactly, the committee has grown to more than 20 team members, and it represents a broad scope of diversity. In the first 18 months, the committee has generated a great deal of awareness about implicit bias. And they've identified a few gaps in how we're supporting team members. Do you mind sharing some of the outcomes of the committee's work?
Dr. Tovar: Sure. There have certainly been a lot of initiatives that have sprung from our work, but I'll just touch base on a couple. One is, you mentioned implicit bias and you mentioned creating a workspace and an organization that is supportive and respectful to all. And sometimes in the course of one's work, there may be incidents of insensitivity, whether they are intentional or not or potential bias that may target a particular individual that is a member of our work team. And we don't always know how to handle those types of situations. And we recognize that our team members need some tools and they may need some help. So part of what the steering committee has been working on are some situational awareness aids, that will help you during these types of situations to be able to affirm and uplift all members of our team. We also understand that it's important to create a culture of safety and inclusiveness, and that starts from the top. And thankfully our leaders are very excited about the work that we're doing and supportive, and they are also participating in this type of education so that they can promote this type of environment and be able to support team members in using them.
Dr. Roxanna Gapstur: Yes, I've been impressed by the pace of activity with the committee on under the leadership of Kim Brister. And I'm eager to continue our training and conversations across the system.
Dr. Tovar: Yes. The progress and the pace has been quite impressive. And I think that many people, the feedback that I've received informally is that folks are excited to see that we're having these types of conversations and developing these tools. And they're excited to see more of it.
Dr. Roxanna Gapstur: Well, we've talked about the impact of a diverse caregiving team for our patients, and you've shared the diversity within our medical residency program. I'm wondering how can we retain these diverse providers?
Dr. Tovar: Well, yes, we do have a diverse pool of very talented individuals and we'd like them to stay with us. I think that most people need to feel that they're valued that their work counts and that they're engaged in some meaningful activities. And I think if we develop residents as leaders, while they're here in residency and we help them to connect to some meaningful work, they will definitely want to stay and continue helping us in our mission.
Dr. Roxanna Gapstur: I think those are really valuable insights Ana, it's relevant to our medical residency program, for sure, but really to all of our recruitment and retention efforts across the organization. Let's recap our exploration of diversity and inclusion today. We know physicians and residents trained in culturally sensitive approaches to healthcare are best able to care for our diverse communities. We know a diverse caregiving team helps our patients feel safe and welcomed. And finally an inclusive culture will enable us to retain the best and brightest to care for our communities. It's one of the ways we'll become recognized as a leader in diversity and inclusion. Thanks for joining me today Ana. I really appreciate you being here.
Dr. Tovar: Oh, thank you very much for having me.
Dr. Roxanna Gapstur: That's all the time we have for today. We hope you'll join us for the next episode of Inspiring Health.
Michael Carrese: You're listening to Inspiring Health with Dr. Roxanna Gapstur, President and CEO of WellSpan Health. As she hosts candid conversations about organizational, culture, value, and other pressing issues we face in healthcare and business. Today,
Dr. Roxanna Gapstur: Today, we're going to explore our organizational efforts to create a more diverse and inclusive health system. One where our team members feel welcome, respected, and valued, and where our patients feel safe and accepted too. Today, we'll cover three key areas. The value of physicians and residents who are trained in culturally sensitive approaches to healthcare, the impact of a diverse caregiving team for our patients and how a strong inclusion program helps to retain the best and brightest to care for our communities. Joining me today is Dr. Ana Tovar. She's one of WellSpan's Behavioral Health Education Specialists within our medical education division. She completed her postdoctoral fellowship in clinical research at Western Psychiatric Institute and Clinic at the University of Pittsburgh. In addition to working with residents on behavioral health aspects of care. She also provides outpatient services to patients at the Thomas Hart Family Practice Center at WellSpan York Hospital. Dr. Tovar, thanks for joining me.
Dr. Tovar: Thank you Roxanna for having me, I'm excited to be here.
Dr. Roxanna Gapstur: Ana, you have special clinical and research interest in a variety of areas, but one of them is culturally sensitive approaches to healthcare. Tell me a little more about that.
Dr. Tovar: Well, my interest in doctor, patient communication dates back to graduate school, I actually did my dissertation on doctor, patient communication and patient satisfaction. And I came to realize a while ago that really every interaction between a healthcare professional and a patient is potentially a cross cultural encounter. And that is because a culture is a lot more than just the language that you speak or the area that you might hail from. It really is the totality of all your lived experiences, all your attitudes and your beliefs, many of them about health, illness, and wellness. So as a healthcare professional, when you are trying to partner with a patient, it's extremely important to be cognizant of that because there may be cultural divides or gaps between you and the patient. And if you are going to be able to influence the patient and support them in having the best health outcomes possible, you need to be able to bridge that gap.
Dr. Roxanna Gapstur: That is really interesting. Can you tell us how you're applying that interest to your work in our residency program here at WellSpan?
Dr. Tovar: Absolutely. Skill at interpersonal communication is a professional competency that residents need to be able to develop during their years here at WellSpan or in any residency program. And when it comes to developing a skill, there is no substitute for practicing. So among the tools that we use to help residents develop this competency is a communication and patient experience curriculum, where we use the simulation center and we use trained actors. Now, these actors portray patients in medical encounters and our residents have a, an opportunity to be able to handle difficult conversations, things surrounding say discussions about end of life issues or sensitive conversations about religious beliefs, particularly when they may be conflicting with a recommended medical treatment. These are very difficult conversations for sure, but if they're given real time feedback and they are given educational tools, they're able to navigate these conversations with a lot more ease and much more expertise. And that benefits our patients.
Dr. Roxanna Gapstur: Yeah, this culturally sensitive approach really seems to help our patients feel safe and accepted. What about the diversity of our caregiving team? I think it's important our caregivers represent that breadth of diversity in our communities.
Dr. Tovar: I couldn't agree with you more, and the more diverse our healthcare team can be, the better we can deliver care to our diverse communities. And that's because that cultural knowledge that diverse individual brings and that the perspectives and new ideas that they might also generate help us to connect with our diverse communities in a much better fashion. I can give you an example with regards to gender diversity. It's probably not that long ago that the medical profession was primarily male. That's certainly not the case now. And as a result of having females involved, more women involved in healthcare at all levels of an organization, think of the advances that we've made in women's healthcare, not just recognition about the unique needs of women, but also the ways in which we deliver care in a much more culturally sensitive way. So the more diverse individuals that you bring on board and the more that you empower them and include them, the more informed the entire organization is these individuals. It's almost as if they have x-ray vision and they're able to see blind spots that are invisible to others. They're able to see gaps and opportunities for us to deliver care in much more effective ways.
Dr. Roxanna Gapstur: Ana you'll be familiar with WellSpan's goal of being recognized as a leader in diversity and inclusion. We want to develop a culture where the best and brightest from any background feel respected, are treated fairly and have the opportunity to excel in their chosen career.
Dr. Tovar: I agree completely. And this is the imperative of the diversity and inclusion steering committee of which I'm a member.
Dr. Roxanna Gapstur: Exactly, the committee has grown to more than 20 team members, and it represents a broad scope of diversity. In the first 18 months, the committee has generated a great deal of awareness about implicit bias. And they've identified a few gaps in how we're supporting team members. Do you mind sharing some of the outcomes of the committee's work?
Dr. Tovar: Sure. There have certainly been a lot of initiatives that have sprung from our work, but I'll just touch base on a couple. One is, you mentioned implicit bias and you mentioned creating a workspace and an organization that is supportive and respectful to all. And sometimes in the course of one's work, there may be incidents of insensitivity, whether they are intentional or not or potential bias that may target a particular individual that is a member of our work team. And we don't always know how to handle those types of situations. And we recognize that our team members need some tools and they may need some help. So part of what the steering committee has been working on are some situational awareness aids, that will help you during these types of situations to be able to affirm and uplift all members of our team. We also understand that it's important to create a culture of safety and inclusiveness, and that starts from the top. And thankfully our leaders are very excited about the work that we're doing and supportive, and they are also participating in this type of education so that they can promote this type of environment and be able to support team members in using them.
Dr. Roxanna Gapstur: Yes, I've been impressed by the pace of activity with the committee on under the leadership of Kim Brister. And I'm eager to continue our training and conversations across the system.
Dr. Tovar: Yes. The progress and the pace has been quite impressive. And I think that many people, the feedback that I've received informally is that folks are excited to see that we're having these types of conversations and developing these tools. And they're excited to see more of it.
Dr. Roxanna Gapstur: Well, we've talked about the impact of a diverse caregiving team for our patients, and you've shared the diversity within our medical residency program. I'm wondering how can we retain these diverse providers?
Dr. Tovar: Well, yes, we do have a diverse pool of very talented individuals and we'd like them to stay with us. I think that most people need to feel that they're valued that their work counts and that they're engaged in some meaningful activities. And I think if we develop residents as leaders, while they're here in residency and we help them to connect to some meaningful work, they will definitely want to stay and continue helping us in our mission.
Dr. Roxanna Gapstur: I think those are really valuable insights Ana, it's relevant to our medical residency program, for sure, but really to all of our recruitment and retention efforts across the organization. Let's recap our exploration of diversity and inclusion today. We know physicians and residents trained in culturally sensitive approaches to healthcare are best able to care for our diverse communities. We know a diverse caregiving team helps our patients feel safe and welcomed. And finally an inclusive culture will enable us to retain the best and brightest to care for our communities. It's one of the ways we'll become recognized as a leader in diversity and inclusion. Thanks for joining me today Ana. I really appreciate you being here.
Dr. Tovar: Oh, thank you very much for having me.
Dr. Roxanna Gapstur: That's all the time we have for today. We hope you'll join us for the next episode of Inspiring Health.