What can Mayo Clinic do to diversify its workforce?
By shutting the Plummer Building doors in July 2020, Mayo Clinic hoped to symbolize “closing the door on racism,” in recognition of a $100 million commitment to furthering diversity and inclusion efforts on its campuses.
Among the key priorities listed is a $5 million annual pledge to “increase recruitment and retention” of physicians, nurses and supervisors from underrepresented groups — something the health care industry at large has struggled to do.
While Mayo has been recognized for its efforts in building a diverse workforce — notably, being named to DiversityInc’s Top Hospitals list for nine years straight — issues of inclusion still plague the medical giant, specifically at the very top. As of this report, there is only one person of color — out of 16 positions — serving as an officer or director.
So, just under a year after the initial headline-making moment, we wanted to check in and learn more about the Clinic’s strategy to attract, retain and develop physicians and other staff members from diverse backgrounds.
We talked with Dr. Anjali Bhagra, medical director of Mayo’s Office of Diversity, Equity and Inclusion, to learn more about the scope of the Clinic’s commitment, what programs Mayo plans to prioritize over the next decade, and the benefits of creating and sustaining a diverse health care workforce.
This is a transcript of our conversation, edited for brevity and clarity.
MCB: Let’s talk about the $100 million pledge announced last summer… why did Mayo decide to make such a commitment at that moment?
Dr. Bhagra: The extent of the commitment was driven by the need of the hour. We were seeing the effects of the pandemic, which none of us had experienced before. We were all aware of inequities within health care and the workforce … but the exponential effect that the pandemic had — with marginalized communities being hit harder, outcomes being significantly worse in those communities, and the rapidity with which certain populations were impacted — exacerbated those inequities.
I think there was this pulling back of the sheets, if you will, of some inequities due to the pandemic — and then we saw the ‘second pandemic’ with George Floyd’s killing. There was a heightened awareness of the racial inequity piece and how complex it is, and I think it led to a more rapid understanding of cultural inequities.
When I think of the timing of this, it was about addressing those dual pandemics, and in terms of the robustness of the commitment, it was unanimous. We are all a part of this problem. We are not immune to this. This is very much a problem within — as it is outside — the walls of Mayo Clinic. There was no shying away from admitting that fact, which I think we did boldly.
MCB: We know about half of this commitment — $50 million over 10 years — is dedicated to recruiting and retaining a more diverse workforce. What specific strategies will the Clinic employ to meet its goals?
Dr. Bhagra: Well, this commitment was made with a very fundamental understanding that change must be meaningful. It’s not difficult to build simple metrics, but it is really difficult to build metrics that are meaningful, where we are pushing ourselves for change that is harder. That was goal number one — build that foundational understanding.
Second was to make sure we were doing the work with the people, as opposed to for the people. The last thing we want is to do this work without humility, you know — we want to understand the personal stories behind a phenomenon that has lasted for centuries.
So, within HR, we have diversity and inclusion specialists who foster relationships with global and national organizations. There is an expectation within each department of diverse recruitment, and once we recruit these people to Mayo, we take responsibility to develop their careers. Our job does not end when we bring diverse individuals into Mayo Clinic.
Our CEO and COO, Dr. Farrugia and Mr. Bolton, actually have scorecards that the People and Culture Committee at Mayo review every week, with updates on goals for diverse hiring and recruitment — and those are ambitious goals. We track our top leadership recruits and what percentage of our leadership are women or people from underrepresented minority [populations].
Mayo is not just doing this with internal stakeholders, either. We are a founding signatory member of the Racial Justice in Business initiative by the World Economic Forum. That spans across 40-some organizations, impacting around seven million employees across the globe. As part of that agreement, we’re working to establish a global standard: what does it mean to be an anti-racist organization?
It’s an incredibly complex task, but that’s our recruitment piece — targeted recruitment, tracking it by using data and analytics, having multiple partners across the country to bring in a diverse talent pool, and hiring within the community.
MCB: Before we go too far — Were all of these programs created as a result of the 2020 pledge, or were some already in place?
Dr. Bhagra: Our approach was to double down on what already existed. We have a tightly-knit group of diversity and inclusion specialists — this didn’t just happen because of George Floyd. We wanted to be agile and nimble, and give an extra boost to what was already in place. Our leadership has always been committed to lifting women and minorities in leadership positions. That’s not new.
There are several grants that have been announced from that $100 million commitment, but the scorecards and metrics... those already existed. We’re using the same frameworks.
MCB: It has been 10 months since the announcement. How has the Clinic been doing in terms of meeting its goals?
Dr. Bhagra: I can tell you we’re already surpassing those goals, but another goal is to keep moving. I don’t know how much we are able to share, but this is something we monitor on a weekly basis, and right now we are surpassing even our most aspirational goals, but we still have a lot of work to do. These scorecards show the talent we are bringing in — now we have to continue to develop them.
MCB: As a person of color, a physician, and as someone holding a leadership position, what challenges do you think the health care industry faces in terms of diversity and representation?
Dr. Bhagra: We have to understand that our external environment really impacts everything that’s happening in health care. What impacts health outcomes the most is social determinants. It’s seldom what happens in the doctor’s office alone that determines what happens, but more so a patient’s access to food, to housing, transportation, and access to digital care in the past year.
I would say the challenges facing the industry today are very much aligned with our societal challenges. I think pigeon-holing the problem inside health care is a narrow approach to a very wide problem, if that makes sense — however, health care is moving incredibly fast right now. Remote care is an incredibly important issue: rather than patients coming to us, how can we get to them? That’s a huge opportunity within health care, but the issue is digital equity — are we going to reach the ‘have-nots,’ or are we going to reach those who are already privileged? We have to be intentional about how we utilize this technology.
MCB: We hear a lot in the past year about the importance of hospital staff reflecting the makeup of a community. Could you speak to how representation of diverse communities in staff could affect the patient experience?
Dr. Bhagra: There is evidence that concordance with backgrounds does impact patient outcomes in certain conditions. However, we want to be very careful — we don’t want to send out the message that, for example, a Black individual should only be cared for by a Black doctor, or that a white patient should only be treated by a white doctor. In fact, we have policies to avoid any inequitable behavior or ‘asks’ from a patient with regards to race and ethnicity.
Having said that, I think our population at Mayo Clinic should definitely reflect the makeup of the community. There is no doubt about that. We’re monitoring representation in our physician staff and our Allied Health staff — that’s another metric we look at regularly, and there are certainly opportunities to improve.
When I look at the national benchmarks, there are some areas of concern. If we look at the number of Black male applicants to medical school, the numbers from this year are roughly on par from 1977. That’s a huge problem. If you think about that — ‘what can we do to solve this problem?’ — it’s not just about extending applications to med school. It’s about going into high schools and educating kids, and that’s where our efforts come in. Our efforts are in creating pathways when kids are impressionable, and making them aware of the opportunities.
MCB: This sounds like something that could take generations to achieve.
Dr. Bhagra: Oh, yes. We certainly want to remain energized in the work, but we don’t want to over-celebrate the “needle moving” over the span of a few months. This work is not linear — it’s going to take decades. We don’t want to give up too early or start celebrating.
Over the next 10 years, I see this first commitment as a foundational effort, because we don’t know what’s to come. Is this commitment going to grow over the next few years, based on external circumstances? Probably… so we’re going to be nimble, we’re going to be agile, and move everyone along.
Isaac Jahns is a Rochester native and a 2019 graduate of the Missouri School of Journalism. He reports on politics, business and music for Med City Beat.
