Who are you?
I am a 44-year-old Chinese-American male who works as a hospitalist at Beth Israel Deaconess Medical Center (BIDMC), an academic medical center in Boston. BIDMC is affiliated with Harvard Medical School, where I am an associate professor of medicine.
If you are about to join or renew your SHM membership, you can expect SHM to ask some questions it’s never asked before. What is your gender? What is your age? What is your ethnicity? I would not be surprised if you wondered why SHM is asking these questions. What does it have to do with my membership? Why are they asking now when they never asked before? I do not remember other professional medical societies asking these types of questions—should I be concerned? Is this an unnecessary invasion of privacy?
Call to Action
Nearly two years ago, when I had the good fortune of being elected SHM’s president-elect, I asked, What do we know about SHM members? As it turns out, it’s less than I thought we knew.
SHM has been in the survey business for years. The most visible survey is the annual productivity and compensation survey (see “Survey Insights,” p. TK). The data from this instrument have become very important, thanks to the many of you who have participated. In the early years of hospital medicine, everyone wanted to know how hard others were working and how much others were getting paid. If others had a better compensation package, it was the proof one needed to go marching into the C-suite asking for more support. If others were making less, it was the competitive advantage one needed to land the next hot-prospect hospitalist.
To be fair, I remember the surveys also asked about hospitalist age and employment model. But I don’t remember any questions about gender, race, or other personal information. The survey was the productivity and compensation survey, so maybe it had nothing to do with gender and race … but maybe it should.
Diverse, Yet Not So Much
Over the years, when I’ve walked the hallways at the SHM annual meeting, I got the sense that it was a reasonably diverse crowd. Take a look when you are at the San Diego Convention Center in April, and I expect you will agree. I grant you that it is generally a younger crowd than what one would find at most medical meetings, but I see people of many ethnic backgrounds, and there are equal parts women and men.
What was striking to me, however, was when I walked into some of the smaller conference rooms where the SHM committee meetings were being held and where the leaders sat. That crowd didn’t seem nearly as diverse as the crowd in the bigger rooms. I remember asking one of my colleagues whether he had the same perception. He told me he didn’t see it that way. Then again, it dawned on me that he is white and works at an academic medical center. What if he walked into leadership committee meetings filled with women from under-represented minority groups who work in community hospitals? My guess is that he would notice right away.
But my perception is biased, so when I became SHM president last spring, I asked that we assemble some facts about our members. SHM pulled together a task force, which developed a survey and took a snapshot of SHM membership. Some of you may have received this survey; it was sent out to thousands of SHM members.
The survey results, which were shared recently with SHM’s board of directors, confirmed my suspicions: SHM membership is a reasonably diverse crowd when it comes to gender and race. When it came to the SHM committee membership, I was right and wrong. The percentage of women and under-represented minorities on SHM committees reflected overall SHM membership reasonably well, but it was clear that fewer women and under-represented minorities held senior leadership positions, such as committee chairs and positions on the board. I suspect this is no different at other professional medical societies and more of a commentary on medicine than on SHM.
The most striking difference, however, did not have to do with race or gender, but instead had to do with employment model. Hospitalists who work at places other than academic medical centers are clearly under-represented in SHM leadership positions.
Action Item: New Knowledge, Better Understanding
So what do we do with this information? Am I suggesting that we set aside special seats at the board table for specific types of people or special-interest groups, some seats just for women, and some just for hospitalists who work in community hospitals? I am not advocating any such action.
I did ask SHM leadership to initiate action to help us continually understand the makeup of SHM membership and compare it to representation at the leadership level. SHM leadership overwhelmingly agreed. This is the reason you are being asked to volunteer personal information when you renew your membership.
It is my hope and belief that SHM will use this information appropriately when they organize committees and build leadership teams. This information, if used appropriately, will help SHM leadership understand its potential bias and guard against unintended consequences of their actions.
I recognize that some people will argue that the questions being asked are not sufficiently comprehensive. We should also be asking about other individual characteristics. You may or may not be right, but at this time, I think we are taking a step in the right direction. Further steps may be forthcoming in the future, but let’s not let perfection be the enemy of good.
If you have any comments about this article, please contact me at JosephLi@HospitalMedicine.org. I’m also available on LinkedIn (JosephLi) and Twitter (@_JosephLi).
Dr. Li is president of SHM.