Dr. Julie Silver: Strategies to Address Workforce Diversity, Equity, and Inclusion, Part 1

RUSK Insights on Rehabilitation Medicine

Dr. Julie Silver is an associate professor and associate chairperson in the department of physical medicine and rehabilitation at Harvard Medical School

PART 1

Her presentation is a data-driven lecture for individuals who believe in science. A big theme in her work is to focus on tipping points that will drive change faster. An important large study reported in the journal Lancet in 2018 attracted widespread attention. Researchers looked at clinical practice guidelines. They found that the representation of female authors was low, but even lower for female physicians. Looking at PM&R since then shows similar findings. Problems were not being solved because while medical societies indicated that they were not at fault, their journals expressed the same opinion. It became obvious that many organizations were working together in ways that were complicit. Not many women were included in the clinical practice guidelines. Compensation is an important issue that also was studied extensively. Dr. Silver provided an example of how men were compensated more than women for performing similar procedures. She discussed medical recognition awards that also reveal a considerable amount of disparity that favors men over women. The same holds true for minoritized groups as explained using the concept of inexorable zero. A promotion problem is involved in this situation, which can be fixed. Additionally, her lecture also focused on challenges pertaining to faculty retention. Women physicians are more likely to leave academia at all career stages. A key issue is enabling individuals to feel that they belong.

PART 2

In Part 2, Dr. Silver began by indicating that thinking about belonging and social integration are super important. There are two bodies of literature--a retention literature and a belonging literature. Very few studies have looked at them together. One investigation that did so found that women who have fewer belonging components are more likely to leave their workplace and more likely to stay if they have more of these components. What can be done right now to improve the situation? Her answer is that individuals should be told that they belong. Inclusion is not a synonym of belonging. She provided examples of constructive steps that have been implemented at other academic institutions. Mentoring is a critically important model. She described how she works with individuals in helping them to feel that they belong and indicated five strategies that leaders can implement. Let’s not assume that progress happens. Instead, let’s believe the science and follow the data. When looking at the proportion of women on specialty boards, they found in a comparison study that six boards decreased and that two stayed the same. Progress does not just happen on its own. In PM&R, there was an increase, but it still is not really at the equitable level. We must continue to focus on it. The same holds true when looking at race and ethnicity.