By: Jake Pitts, MSW | Equity, Diversity, & Inclusion Officer of Clinical Departments at University Health
Health equity is challenging. However, its value can’t be understated. We can’t undo what’s been done but we can work diligently to pursue restorative justice in medicine.
Over the past year, University Health (UH) implemented a project that transformed how we detect, diagnose, and treat kidney disease. We did this because we learned that the previous equation that detected kidney disease, estimated glomerular filtration rate (eGFR), produces a different score for Black patients due to myths in medicine about the kidney performance of members of the Black community. This is called race-based medicine, and it’s terrible.
Race-based medicine Is a system where research uses race as a biological variable, then it is translated to clinical practice, which leads to inequitable care. By using diagnostic and treatment modalities that do not use race as a variable, our Black patients are being diagnosed and treated more equitably.
The Kansas City Learning and Action Network (LAN) members gathered at the Community Health Improvement Leadership Academy sessions to reflect on the past year and consider the future. While reflecting on UH’s work, my thoughts and feelings caught up to me all at once. This collision felt like triumph and tragedy.
“Why were methods like this ever deemed ethical?”
“Our Black patients should have never been exposed to this.”
“Let’s go! We transformed one area, what’s next?!”
We can do better.
Here are four takeaways I gathered from this past year.
1. Evaluate How Your Organization Understands Race
The medical practice leaders in your organization must have definitions and policies that appropriately place race as a frame for understanding discriminatory experiences and building support services that empower communities of color.
2. Eradicate Race-Based Medicine and Activate Race-Conscious Medicine
Algorithms for diagnosis and treatment must align with how your organization understands race. Achieve alignment by pursuing a transformation from race-based methodologies to race-conscious methodologies. This article from the Lancet lists common race-based practices and their recommended race-conscious approaches.
3. Ensure Participation of Physician Leaders and Compensation Team
When you change one algorithm in your system, it affects another. When you move toward a race-conscious approach, ensure you have physician leaders and compensation team members present because they will give insights into how this transformation must be integrated into the education of our treatment teams, the policies affecting care delivery, and the payment and reimbursement processes for that respective area.
4. Take Care of Your Soul
A mentor once told me that your soul is the collection of your body, mind, emotions, and will. As I shared above, this is challenging work. It can affect you in all areas. Be a student of yourself and learn what it means to care for each area of your soul. And as you do this work, regularly give your soul what it needs.
In the pursuit of restorative justice in medicine, it may feel lonely, but never forget that you are not alone.