David Lubarsky, Vice Chancellor of Human Health Sciences and Chief Executive Officer of UC Davis Health, discusses the power of collaboration and how health equity can bridge social gaps.
Q
What do leaders need to bring to the table to be successful in health equity?
You have to lead by example, commit and understand that diversity delivers a higher performing organization. There are many CEOs who still don’t believe that. But there’s plenty of data showing that organizations perform by incorporating a higher range of ideas and perspectives, not only financially and operationally, but in terms of effectiveness in taking care of the community in health care. The asset [for the organization] is the community.
Diversity also matters because patients want to see doctors and nurses who have backgrounds similar to their own. This leads to more effective prescription medicine and helps in effectively addressing health equity. If a CEO really doesn’t believe it, then it isn’t a core pillar to make decisions.
It is crucial to have patients and the community advocating for your organization when you’re doing the right thing. By prioritizing equity and sustainability, leaders can establish themselves as service providers who genuinely care. This approach garners support not only from patients but also from internal employees, leading to improved business outcomes and reduced turnover rates.
Diversity also matters because patients want to see doctors and nurses who have backgrounds similar to their own.
Q
Can you describe your work with Medicaid to address behavioral health needs in foster care children and increase the patient population you serve?
When I arrived, we didn't have a good relationship with state Medicaid leadership. Instead of asking them what they could do for us, I asked them what they needed. By focusing on the needs of foster child programs on Medicaid, we realized the lack of trauma care and the alarming rate of incarceration among these children. We doubled child psychiatrist fellowships at our own cost and worked with the county to establish a clinic that provided proactive care for every foster child. Our goal was to change the approach and improve outcomes, even though it seemed challenging and costly. This is the least thing we could do. We were wrapped in FQHC city funds – they wrapped our costs into their cost and reimbursed through Federal Government to provide the type of medical care every foster child deserves. We opened 26 clinics with FQHC at our cost, no profits, fully under contracts, to drive better healthcare outcomes.
Q
Was it difficult to convince stakeholders internally? How did you go about it?
Convincing stakeholders required leading through influence and starting the process of convincing everyone. We didn't have contracts to take care of Medicaid patients initially, and many believed it would bankrupt us. However, by developing true partnerships, such as with the county, we were able to establish formal agreements and expand our services. Helping people and accomplishing mutual goals strengthens relationships and generates support. Even commercial insurance started recognizing and appreciating our organization's efforts, leading to increased business.
Q
What is the significance of equity goals in your organization?
Equity goals are crucial across four pillars: community, organization, people (employees and students), and patients. To ensure progress and inclusion, we aim to involve everyone in the strategic planning process. Hosting town halls allows individuals to provide input and actively participate in shaping our equity strategy. We believe that linking HR strategy to equity strategy creates a powerful connection. By setting voluntary equity goals and measuring progress, we can advance our commitment to equity and drive positive change.
Q
What other leadership traits are important to drive these initiatives?
Having a truly diverse team is valuable because leaders can't become what they can't see. It is crucial to consider all backgrounds and qualifications during the hiring process, ensuring a transparent and open approach. This includes providing training in implicit bias and involving diverse individuals in search committees. Furthermore, efforts should be made to hire locally from underserved communities and to change job descriptions in ways that eliminate institutionalized barriers, such as degree requirements. Setting explicit goals, implementing apprenticeship programs, and actively engaging with the community are also important aspects of leadership.
It is essential for people to stop viewing programs aimed at equity as handouts. They are not about giving something for nothing but rather providing a helping hand to individuals who want to succeed and be recognized for their skills and hard work. Employees in various roles, from food services to patient safety officers, deserve to be valued for their contributions based on merit rather than stereotypes or biases. By adopting the right attitude, working hard, and dedicating ourselves to inclusivity, we can create a positive and engaged workforce and provide the best care for our patients.