The Importance of Diversity, Equity, and Inclusion in Health Care

A culture of diversity, equity, and inclusion benefits both patients and physicians in the health care setting. Diverse work environments lead to improved creativity, innovation, and problem-solving among employees. Physician diversity leads to improved health outcomes, better access, and higher satisfaction for underserved patient populations.^1,2 Although diversity, equity, and inclusion committees and interventions are now common throughout medicine, more work is needed to increase representation of diverse individuals in health care.³ In addition to patient care, physician wellness has become an important topic of discussion, and mindfulness has been implicated as an important tool to combat burnout. There is a direct correlation between mindfulness and emotional intelligence, which is protective against burnout amongst health care providers.⁴

What Is Mindfulness?

Mindfulness is “nonjudgmental present-moment awareness of one’s own emotions.”⁵ Imagine this scenario: it is 5:30 PM and you have just finished in the operating room. You have several notes left to complete, patients to round on, and you are supposed to go out to dinner with your significant other tonight to celebrate your anniversary. First though, you need to see why the postop day 3 laparoscopic nephrectomy patient hasn’t been discharged yet. You turn the corner into her room and find her seated in a chair eating dinner, still in her hospital gown. “Why isn’t she dressed? She has to get out of here,” you think to yourself. In broken Spanish you ask how she is feeling, and she responds that she has pain in her abdomen. Your exam is reassuring, and you double-check that all her labs and vitals today have been normal. She has been ambulating, eating, and having bowel function. You ask the nurse to please make sure her transportation is arranged for her discharge this evening. It is easy as a resident, or physician in general, to speed through this encounter. We are rewarded for efficiency and with so many competing demands on our time, we quickly move from one task to the next.

Now imagine that as you turned the corner into her room and thought, “She needs to get out of here,” you paused and acknowledged your own feelings—“I have a lot to do before I leave. I don’t really want to bother with getting an interpreter to figure out why she is dragging her feet. I am at risk of ignoring this patient’s needs.” You take the time to dial up an interpreter on your phone. With a few extra questions you learn that her son is away on business until the next day and she is not sure that her husband will be able to take care of her as he was recently discharged from the hospital himself. Mindfulness is the practice of identifying the stressors and feelings that impact us in the moment. Without categorizing those feelings as “good” or “bad,” we can name them and identify how they might impact the current encounter and adjust our actions appropriately to honor the other person’s feelings (empathy). The act of pausing to acknowledge our own feelings makes us more likely to understand another’s perspective and act empathically toward them.⁶

The Correlation Between Mindfulness and Inclusion

Practicing mindfulness allows individuals to acknowledge their inner voice, and in doing so, acknowledge the voices of others. This posture of pausing and listening can improve compassion and empathy for others and help develop a culture of inclusion. When coupled with humility, the habit of mindfulness will help us identify our own biases and correct them prior to action in order to foster respect and understanding. By putting yourself in others’ shoes, you contribute to a working environment in which all team members are valued and have a voice.

Practical Ways to Build a Culture of Inclusion Using Mindfulness

1. Listen. Pause and listen to your thoughts and emotions. Acknowledge them in your interactions with others. We all carry biases, many not obvious or intentional. By practicing mindfulness, we can identify thoughts or comments that could be harmful to others and be proactive in addressing them. If you would like to understand your implicit biases better, take the Harvard Implicit Association Test. This tool can improve awareness of our own biases and, armed with the habit of mindfulness, can change our interactions with others.
2. Consider another perspective. If equity is receiving an invitation to the meeting, inclusion is having a voice at the meeting. Take note of where you have been granted influence and how might someone different from you perceive the conversations you participate in. Look for ways to engage people with different views and perspectives and give them a voice. A diverse team leads to diverse opinions and creative solutions.
3. Practice humility. After establishing the practice of listening to your own thoughts and feelings, humility allows you to consider the feelings and perspectives of others. By sacrificing your time, convenience, and comfort in deference to others, you empower them. An inclusive culture is built by humble individuals who care enough to consider others.