JUSTICE, EQUITY, DIVERSITY, AND INCLUSION SECTION
Leading from the Front on Justice, Equity, Inclusion, and Diversity Italo M. Brown, MD MPH, JEDI Section Chair
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s leaders in emergency medicine, it is imperative that we continue to cultivate interest in justice, diversity, equity, and inclusion. In recent years, we have seen a dedicated focus on DEI, particularly its impact on the physician workforce and work environment. While this is a formidable start, it is difficult to gauge how much the needle has effectively moved. One significant hurdle is that our specialty-wide approach lacks collective oversight and an accountability structure. This begs the question: How do we push ourselves (and our specialty) to be stewards of this seemingly new investment if these structures aren’t cemented? Partial buy-in (to JEDI and health equity) impedes progress within the specialty of emergency medicine. To fully embrace our roles and responsibilities, we must acknowledge that these issues are more than a social agenda—they are inextricably linked to health outcomes in our departments. In fact, awareness is only the tip of the iceberg. In the same way we hunt for diagnoses and etiologies of medical problems, we should seek in-depth understanding of root causes of inequity and the forces that widen health disparities. We must also deeply analyze the way that our actions (and inaction) propagate (or dismantle) systems of oppression. Most of all, we have to continually center our patients knowing that they come from diverse backgrounds, exist along various points of the socio-economic spectrum, have varying degrees of health literacy, and experience very unique challenges when engaging the health care ecosystem. This is caring for the complete patient. Moreover, this is how we live up to the expectations of the modern emergency physician.
The ultimate demonstration of leadership in medicine is knowing when and how to go against the grain.
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COMMON SENSE JANUARY/FEBRUARY 2023
The ultimate demonstration of leadership in medicine is knowing when and how to go against the grain. And given the preceding 60 years where issues of diversity, equity, inclusion, and justice were under-prioritized, now is the perfect opportunity to try something new. We should double down on our initial investment (of time, energy, resources, and human potential) and champion the development of specialty-wide systems of oversight and accountability. Bear in mind that this will not happen overnight, and will require rounds of fine-tuning to get it right. By fostering partnerships among EPs across all areas of interest and leveraging our collective talents, emergency medicine can accomplish something that no other medical specialty has done. We are capable, it is our motivation and drive that must be rekindled.