Leadership needs to initiate change in representation in ophthalmology
Click Here to Manage Email Alerts
I have shared my thoughts on social justice, diversity, inclusion, equity and merit in a previous Lindstrom’s Perspective in January 2021. For the interested reader, these thoughts are available here.
I recently returned from the American Society of Cataract and Refractive Surgery meeting in Washington, which was a great success with approximately 2,800 ophthalmologists in attendance. For the second year, I participated in a panel focused on social justice, diversity and implicit bias chaired by Leon W. Herndon Jr., MD, one of our OSN Associate Medical Editors. For me, it was an impactful learning experience.
One learning: Depending on the environment, nearly any group can be considered “underrepresented.” It reminded me of my medical school days when I lived in an eight-unit apartment building in downtown Minneapolis where my wife and I were underrepresented regarding race. My fellow apartment residents were either high school teachers at nearby Minneapolis Central High School or fellow university students. All were Black or African American. On summer weekends, I would play basketball at Powderhorn Park and was usually the only white man on the court. While white men of European and Nordic descent dominate in the state of Minnesota, in this neighborhood, apartment building and recreational park, my white race was clearly underrepresented. It was a different and perhaps better time in downtown Minneapolis, and my Black/African American neighbors were kind and inclusive. Perhaps it is too simple, but for me, it is straightforward to look around in any environment and see which gender, race or other group is overrepresented and which is underrepresented.
The topic for this issue’s cover story is underrepresentation in ophthalmology, especially among retina/vitreous subspecialists. If we focus on race or gender and think of the issue as a national one, according to the 2020 census, the white/European race in America represents 57.8% of the population, Hispanic/Latino 18.7%, Black/African American 12.1%, Asian and Asian/Indian American 5.9%, and Native American 0.8%. Another 4.1% disclose a mix of two races. Women represent 51% in the U.S. and men 49%. Even casual looks around the room at any major ophthalmic congress, including those of our retina/vitreous colleagues, make it clear that only white/European and Asian and Asian/Indian American men are well represented. Women, Hispanic/Latino, Black/African American, mixed race and Native American are underrepresented.
Step one in resolving this disparity is to recognize it. Step two is to act. The next question to consider: Who is in a position and has the power to act? My impression is that only the leadership of a group, whether it be a company, its board of directors, a medical society, a university, a medical school, a specialty or subspecialty, or a practice, is able to make meaningful change.
As a brief example, I might share a few thoughts about Healio/Ocular Surgery News itself. This publication was founded 40 years ago in 1982, and the Chief Medical Editor (not me) and all 31 editorial board members (including me) were white men. To be fair, two were of Middle Eastern descent, but both were men and white. In 1993, we expanded the OSN Editorial Board by 11 to 42 and added one woman, one Hispanic/Latino man and another nine white/European men. In 1996, I was elevated to Chief Medical Editor, and we restructured the OSN Editorial Board with diversity in mind for the first time. We created 13 Editorial Board Section Editors. Four of the 13 were women, and five of the 13 were Asian or Asian/Indian. We were making progress, but missing were Hispanic/Latino, Black/African American, mixed race and Native American. This year, in 2022, for our 40th anniversary, we restructured our OSN Editorial Board again and added five Associate Medical Editors: one Black/African American man, one woman of Asian descent, one man of Asian/Indian descent, one Eastern European man of Armenian descent and one white/European man. Our 14 section editors included four women and six individuals of Asian/Asian Indian descent.
This did not happen by accident. Step one required making a list of potential editors screened according to merit and good standing in the ophthalmic community. However, at step two, the leadership at the Wyanoke Group, the publisher of Healio/Ocular Surgery News, and I considered diversity, inclusion and equity in the selection process. In a medical specialty like ours, merit must be the first consideration, but there is room for leadership to incorporate social justice in the decision-making process. I have found the same to be true in the boards of directors and medical advisory boards where I serve, but only leadership can catalyze constructive change.
Overall, in ophthalmology, I believe we are doing well regarding our Asian/Asian Indian colleagues. We are showing improvement regarding gender by adding more women to our specialty, subspecialties and leadership. However, we continue to be challenged regarding our Hispanic/Latino, Black/African American and Native American colleagues. We are making progress, but this is a journey that will be measured in decades, not days.
Collapse
Read more about
Click Here to Manage Email Alerts