Creating Safer Spaces in Medicine

Jennifer Spector, DPM:

Welcome back, everyone, to Podiatry Today Podcasts, where we bring you the latest in foot and ankle medicine and surgery from leaders in the field. Today we have with us Dr. Janet Simon, who recently shared with the audience at the American Association for Women Podiatrists Scientific Conference her topic of Creating Safer Spaces in Medicine. She's sharing a few details with us today about this really interesting topic and how everybody in this audience can get involved, on either the patient level, the provider level, or even at the community level, to be part of this important concept. Dr. Simon practices with the New Mexico Foot & Ankle Institute in Albuquerque, New Mexico, and is the Executive Director of the New Mexico Podiatric Medical Association. We're happy to have her with us today, and welcome, Dr. Simon.

So, at the AAWP conference, you recently spoke about creating safer spaces in medicine. Can you talk to us a little bit about why this is so important?

Janet Simon, DPM:

Let's begin with the historical fact that medicine has often not clearly identified bias and issues of diversity and equity, and we are certainly a lot more aware of the importance of all of these social factors, and let's say we're probably getting better educated as to how it affects our patient care, quality of care, and sometimes there is the addition of discussion of how it impacts the providers. So, I've been involved, I think, with trying to carry on this conversation of the importance of physician wellness and also how these factors of diversity, equity, and inclusion need to have an ongoing conversation, and not just a conversation, but clear action steps that individuals, groups, professional organizations, essentially all of us can be a part of, because it is clearly not an individual, just you, yourself, addressing these concerns. It's the entities that we all work in and our communities. I've always been a real community person and feel that it's important if you're a part of that community, you have to have a voice, and that voice can be in many ways. So, that's a part of, again, this concept of safer spaces.

Jennifer Spector, DPM:

It sounds like the end goals have multiple layers and multiple potential frameworks in which this could occur. Could you give us a couple examples of what creating a safer space in medicine might look like for, say, a patient or a provider?

Janet Simon, DPM:

With patients is, number one, I think identifying how we obtain information from them, and we often like these categories that are set up on intake forms, and oftentimes our patients don't fit into those clear categories. And so having certainly many more options and not just, oh, one or another, and if you don't fit into the options, what do you do? So, certainly being much more culturally aware, as well as aware of the clear traditional biases that biases have been a part of institutionalized medicine.

For providers, I mean, some of the same things apply. I would certainly say since we all work within different group environments, yes, there, let's just say, are a few still independent providers, but they're working in some form of team. It's rare that there's a person out there by themselves. So, again, having understandings of cultural differences, how clearly people may need different support systems within our practices, and that tends to go to something I spoke about in regards to the organizational culture. What's it like within your group? We all hope that it's a friendly, warm environment, but I know that that's not always the case.

Jennifer Spector, DPM:

So, can you share a couple of examples of what some of these action steps might include? What can providers like DPMs do right now in their practices to contribute to this at either the patient level, the provider level, or the community level?

Janet Simon, DPM:

Within the, again, better awareness of how are we gathering information from our patients and being, again, a little bit more culturally aware that sometimes how questions are posed, how we actually sometimes physically interact. For instance, since I do work with Native Americans, it's not unusual that in their culture, having eye-to-eye contact is not something that is comfortable, at least let's say until they perhaps know you and have a little higher-level trust. So, I think many of us culturally often, if we're not connecting and sort of looking somebody in the eye, feel that perhaps they're being dismissive or not necessarily hearing or interacting, engaging with you, but that's not always the case. Many cultures are often taught culturally that it's a sign of respect sometimes not to immediately have that eye-to-eye contact. So, a better awareness of the different cultures is certainly number one that providers can do. As I had referenced, take a look at your intake forms and how questions are being posed to your patients. Are there options that would be more sensitive to their particular situations?

From the provider viewpoint, I would hope that there are, let's say, again, spaces that people can be comfortable in bringing up if something is not personally comfortable to them, how they might able to express it, have ways of doing that. I unfortunately just recently heard a member of our podiatry community who expressed feeling harassed and bullied within the environment that they're working, and that's upsetting obviously to all of us, to know that someone is feeling that they don't have options for speaking up because of fear of retribution. So, that may be something to do.

Jennifer Spector, DPM:

Are there any particular resources that you recommend for folks to get to know a little more about some of these populations or some of these action steps so that they can become better educated and be part of the positive change?

Janet Simon, DPM:

Yes, there are good resources available. One of the ones through the Office of Minority Health, which is called Think Cultural Health, is available online through thinkculturalhealth.hhs.gov, and that has wonderful resources, as well as some free CME online courses available. Also through the Minority Health site, which is the minorityhealth.hhs.gov, is also another knowledge center that has a variety of topics. Something that is called CLAS, C-L-A-S, Culturally Linguistically Appropriate Services, and again, that has a large resource base for people. Also, there is a whole series of modules through the Center for Health Equity that is housed at the AMA website, and that also is free and provides CME credits to individuals who go through the modules.

So, I certainly encourage folks, there's the information out there. Obviously, we're all sort of stretched for time, and I just would say sort of set it up, commit to doing an hour a month or so. You don't have to stress yourself out on this, but it is something very, I think, that people often connect with. When I have brought this up, everybody sort of goes, "Oh, this affects so many." All of us, as you've mentioned, our patients, ourselves, our families. So, it's very good to, I think, have some better working knowledge, and as you're saying, action steps. And sometimes it's these little things that we do that can make a big difference for people.

Jennifer Spector, DPM:

Absolutely. Those little things can go a very long way. So, we appreciate you sharing this with us today. I think it'll be a really interesting continued conversation even after the AAWP conference.

Janet Simon, DPM:

We hope so.

Jennifer Spector, DPM:

We'd like to thank Dr. Simon once again for sharing her insights with us, and we're very grateful to the American Association for Women Podiatrists for having us cover their conference. For more coverage of the AAWP Conference, among other select conferences in the podiatric community, make sure to check out podiatrytoday.com, under Conference Coverage. For this podcast and all other episodes of Podiatry Today Podcasts, you can find those online at podiatrytoday.com, SoundCloud, Apple Podcasts, or your favorite podcast platforms.