5 THINGS WE MUST DO TO IMPROVE THE US HEALTHCARE SYSTEM
BY AUTHORITY MAGAZINE EDITORIAL STAFF
Republished from Authority Magazine
I would also encourage drawing on input from experts, community members, and creative partners to address the intersecting and multifaceted identities of the individuals the approach aims to serve. A traditional unidimensional approach, for example, solely engaging underrepresented minorities, falls short. That is because merely focusing on one facet of an individual or a community’s experience fails to recognize health as a dynamic condition that responds to an individual’s particular circumstances and how they interact with their identity.
As a part of my interview series with leaders in healthcare, I had the pleasure to interview Anthonise Louis Fields, PhD.
Anthonise Louis Fields, PhD, is a Director of Strategic Collaboration at Bristol Myers Squibb (BMS) and serves as Head of the COVID Taskforce. As an immigrant from Haiti, Dr. Fields is passionate about health equities. In her current role, Dr. Fields functions to define one aligned strategy for BMS and leading US Academic Institutions through collaborations. She directly interfaces with BMS leadership and Institution Executives to define strategies, evaluate opportunities, develop innovative solutions, and cultivate a trusted partner relationship.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
As a 5-year-old immigrant from Haiti, I did not speak English. Fortunately, math spoke for me and convinced an observant roving teacher to recommend a class placement change. That small gesture redirected my journey from Special Education to the Gifted track. Science and math continued to expand my fortunes and differentiate my education, providing year-round access to school and a buffer from a rough neighborhood in Brooklyn. My parents stressed education and modeled hard work and social responsibility. When I matriculated at the University of Pennsylvania, there was no need to pack those lessons for they were my core.
During undergraduate, performing research on tissue from patients that were still in the hospital, I learned from my mentor, Dr. Elizabeth Bernstein Rand, how research can expand options for patients who have exhausted all treatments. With a broader perspective on careers that would address my values, passions and skillset, I accepted an offer with Merck in the Vaccine Analytical department headed by my lifelong mentor, John A. Lewis. He provided invaluable mentorship that shaped the critical thinker and leader I became, and his sponsorship set the stage for future roles leading a group of vaccine novice scientists at Janssen, developing the project management platform and strategy for a new organization focused on external research collaborations at Bristol Myers Squibb (BMS), and now functioning as one of the leads in the US Market.
At BMS, the intersection of my passion to advocate for marginalized patients and my Strategic Collaborations role led to the development of the company’s first Health Equity forums. We convened a multidisciplinary group of leading experts in the Healthcare ecosystem to provide insights, inform BMS strategy, and collaborate on solutions to address cancer disparities in vulnerable minority populations.
There is an overwhelming need felt by patients with serious diseases, and BMS affirmed the values underpinning its mission by empowering and enabling us to innovate, act with urgency, and hold ourselves accountable to our diverse patient community. When it was evident the COVID-19 crisis had a disproportionate impact on Black and LatinX populations, a quick Saturday conversation with the head of the Black Organization for Leadership and Development (Shamika Williams) turned into an opportunity to lead a matrix team of Global People & Business Resource Group leads in developing urgent solutions that expanded the already significant BMS initiatives.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
At Merck, I had the privilege to lead several vaccine analytical campaigns. For those unfamiliar with this process — representative samples from large manufacturing batches are collected to verify the batch possesses the attributes that support optimal function. To claim the samples are surrogates for the batch, we eliminate differences and document every step.
And that I did; I collaborated with the team, implemented control procedures, prepared documentation, obtained materials, even cleared my evenings and weekends to accommodate off hours collection.
My Department Head was thrilled with the preparation and graciously extended priority access to the on-campus van to reduce the transportation time between the manufacturing and testing labs. I was stupefied and left that meeting believing I would lose my job. I couldn’t drive. After much handwringing and considering alternatives, I informed him and prepared to handover the project.
Well, I did not have to; my direct manager lived minutes away, drove the van, ultimately taught me to drive, and through that experience, we forged a great partnership and friendship. This was one of my first memorable lessons in self-advocacy. The lesson here is to ask for help, ask for it early, and believe you are worth the investment. The value you bring far outweighs any potential shortcomings.
What do you think makes your company stand out? Can you share a story?
One of the remarkable qualities of BMS is our dedication to patients. Earlier this year, BMS, in partnership with GRYT Health, launched the COVID Advocacy Exchange, responding to urgent needs of the global patient advocate community stemming from the COVID-19 pandemic. The Exchange is a completely virtual platform designed to unite advocacy organizations, industry leaders and patients across disease states. The goals of the platform are to synchronize advocacy efforts, facilitate resource sharing and promote collaboration among participants as we all continue to navigate the pandemic and beyond. The COVID Advocacy Exchange currently hosts live discussions with health care experts — more than fifteen sessions by the end of this year — which are also recorded and saved on the Exchange so that participants can watch on-demand, whenever best suits them. There’s also an Exhibitor Hall for advocacy organizations to share information about themselves and what they’re doing, to again, help one another during this unique time.
Recently, I had the opportunity to participate as a speaker during one of these afore mentioned sessions focused on health equity and how COVID-19 has impacted people experiencing racial and ethnic disparities, the LGBTQ community, and those with accessibility needs. The aim of this session was to discuss steps we can all take to address health inequities. In doing so, my colleagues and I engaged in a meaningful conversation with advocates as we shared practical advice to help them promote heath equity within their work.
It’s programs like this that I really think make BMS unique.
What advice would you give to other healthcare leaders to help their team to thrive?
At BMS we view diversity in the broadest sense — including age, ethnicity, race, culture, gender, gender identity and expression, sexual orientation, abilities and disabilities, religion, socioeconomic background, veteran status, thinking styles, and life experiences, among other differences. Each of these dimensions provides a lens that captures the full needs of our diverse patient base.
Many organizations promote diversity and inclusion but stop shy of real change, such as having diverse leadership at every level and providing just equitable development and advancement so there is parity at all levels of the organization.
According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
This Commonwealth Fund study analyzed healthcare systems using five criteria. Despite spending the most on healthcare per capita, the US ranked last overall when benchmarked against ten other developed countries. Three criteria contributed to the poor standing of the US: access, equity, and administration efficiency.
- Americans reported the lowest health care access across the entire population. When comparing high-income earners, 26% of Americans reported having trouble gaining access to health coverage, while only 4% of British people reported the same challenge. The difference is even more staggering when benchmarking access among low-income earners cross-nationally; nearly half (44%) experienced challenges in the US, whereas only 7% in the UK.
- This highlights another cause for the low rank of the US health care system — significant inequities based on income, race, sexual orientation and other diversity dimensions.
- Furthermore, as the only nation in this analysis without nationalized healthcare, the administration efficiency score ranked lowest as well.
The US does outperform other developed nations in prevention; we have the highest rate of breast cancer screening, as well as the highest rate of flu vaccinations. Additionally, the availability of innovative technologies and drugs and specialized procedures are world-renowned. These analyses, when taken into context, can aid leaders across the healthcare continuum in identifying ways to improve the system and achieve better patient outcomes.
You are a “healthcare insider.” If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
There are a few ways we could improve the overall US healthcare system. I would employ upstream interventions that target the root causes of health disparities such as poverty, food insecurity, and access to healthcare resources, among others. When I spoke on this topic [health inequities] as part of the COVID Advocacy Exchange, I also noted that we must consider how organizations across disciplines develop meaningful solutions to promote health equity; collaboration is key.
I would also encourage drawing on input from experts, community members, and creative partners to address the intersecting and multifaceted identities of the individuals the approach aims to serve. A traditional unidimensional approach, for example, solely engaging underrepresented minorities, falls short. That is because merely focusing on one facet of an individual or a community’s experience fails to recognize health as a dynamic condition that responds to an individual’s particular circumstances and how they interact with their identity.
This kind of multifaceted approach pools disparate but complementary knowledge, tools, and resources that can produce great benefits more broadly.
Though it’s nice to suggest changes, what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?
When delivering this kind of approach, I would consider the positive impact storytelling can have to inspire health behavior change. We are motivated by others’ experiences, especially if we can see ourselves represented in their stories. It is also why diverse individual representation in healthcare leadership, clinical trials, and other healthcare settings is so vital.
A health expert who understands the community they aim to serve can better develop culturally competent initiatives and provide a trusted voice that individuals can rely on. Corporations and leaders can make representative leadership a priority within their organizations and support others in similar endeavors. For example, the Bristol Myers Squibb Foundation recently dedicated $100 million of the foundation’s larger $300 million equity pledge to increase the number of clinical investigators from racially and ethnically diverse backgrounds. These investigators will then be partnered with medical students to act as their mentors.
Additionally, corporations can consider collaborating with non-traditional partners such as social media influencers, artists, TV personalities, and writers. Creative partners can help foster innovation, disrupt harmful tropes, and bring about new outcomes. For example, during the recent COVID Advocacy Exchange session, I mentioned Beyonce’s partnership with Peloton as an example of a non-traditional collaboration. Beyonce and Peloton collaborated to provide students at Historically Black Colleges and Universities (HBCUs) with a two-year digital Peloton membership in recognition of Homecoming season, an annual fall tradition among HBCUs. The membership offers students access to fitness classes spanning the gamut, with everything from strength training to meditation to cardio. While this collaboration pays tribute to an important occasion for many current and former HBCU students, it will simultaneously help inform the health and health behaviors of a specific community.
Speaking of communities, as one of the other panelists participating in the recent COVID Advocacy Exchange session noted, they know as much about their health needs as public health experts do. That is why it is so critical to include communities in each step of designing health interventions. For example, engaging them in community-based research helps prioritize the research agenda to investigate the issues of most concern for the community and helps promote a sense of ownership from within. Ultimately, community engagement can help develop more sustainable interventions that will inspire change.
We’re interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health, and general health. What are your thoughts about this status quo? What would you suggest to improve this?
Mental health is an extremely important aspect of a person’s overall well-being, and it has been highlighted as a result of the pandemic. In June, the COVID Advocacy Exchange actually hosted a session focused on mental health and psychosocial support for patients while navigating these uncertain times, and I’d like to echo the mental health experts who were a part of this discussion by highlighting that we do not have a specialized mental health care system, let alone comprehensive mental health care, in this country. The infrastructure for triaging mental health issues does not yet exist. Access to mental health care is largely regional and dependent on other social determinants of health like income. Moreover, stigma associated with mental health issues is an additional barrier to mental health care, further complicated by cultural views on seeking support for psychosocial wellness. I think there is an opportunity to improve this status quo.
One potential solution to begin to move from parallel tracks to one track is to increase awareness and utilization of virtual counseling. Virtual therapy can improve access to mental health care by removing logistical barriers like transportation and, as exemplified because of COVID-19, has actually been shown to reduce stigma as more people are sharing their mental health journey digitally while quarantined. The creation of more peer to peer support groups can also help reduce mental health-related stigma by building connections and a sense of shared experience.
While addressing barriers to mental health care is not a simple task, supporting our loved ones’ mental wellbeing can also be as simple checking on them, asking how they are; things we’re all capable of.
How would you define an “excellent healthcare provider?”
At their core, “excellent” healthcare providers put patients at the center of everything they do, and are driven to help patients live healthier lives and prevail over illness. In doing so, excellent providers both bring and can integrate others’ diverse experiences and perspectives into their work — effectively collaborating to provide the best possible care to their patients on an individual basis. And, as I mentioned earlier, healthcare providers who understand the communities they serve and can bring a culturally competent approach to their practice are a key variable needed to address and dismantle inequities and disparities.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
After spending a week and the entire weekend repeating — unsuccessfully — the same failed experiment — my mentor and department head at the time, John Lewis, wrote and handed me three sayings related to doing research. I’ve reflected on all three throughout my career, but the Nobel laureate Physicist Richard Feynman’s quote, “The first principle is that you must not fool yourself — and you are the easiest person to fool” is one that has become foundational.
This quote is a reminder that we must all overcome the constraints of our legacies and challenge the contributions of our automatic, intuitive, and unconscious thinking if we are to successfully obtain the optimal solutions we are seeking.
To develop the innovative solutions we seek, we must not become complacent, yet we be fooled. Therefore, I strive to question the information before me; the assumptions that become facts after repetition or familiarity, I consider risks. As a matrix leader at BMS, I have seen all of this made easier when diverse stakeholders are consulted and inclusion is prioritized along traditional diversity dimensions such as race, ethnicity, gender, sexual orientation, and along infrequently considered dimensions, for example the introvert/extrovert personality scale.
As a matrix leader, I’ve also witnessed the foolishly narrow solutions offered by a homogeneous team; and I’ve also observed the well-earned innovations provided by a diverse and inclusive team that considered multiple view perspectives. With ever more complex problems ahead, we need not be fooled.
Are you working on any exciting new projects now? How do you think that will help people?
At BMS, we are clear that underserved minorities have been devastated many times over by COVID-19 — morbidity and mortality rates are higher for Black and LatinX people and these communities have also felt economic fallout, with lower income jobs and black- and brown-owned businesses disproportionately impacted. The virus’s consequences are further compounded by a pervasive disinformation/misinformation campaign that leaves these vulnerable communities running to the wrong doors for safety.
To debunk misinformation and raise vaccine confidence, the BMS COVID-19 Taskforce, which I lead, has partnered with community organizations who act as ambassadors and trusted medical professionals who can dispel myths and deliver the truth about the virus, clinical trials, vaccines, testing screening, and preventative measures to reduce transmission. Recognizing the disproportionate economic impact, the Task Force has also supported diverse businesses by providing grants to community organizations who will in turn fund restaurants to provide meals to frontline workers.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
In healthcare, we operate with urgency and believe in the power of science to address some of the most challenging diseases of our time. We accomplish this collaboratively and are mindful that diversity and inclusion are enablers.
In Thinking Fast and Slow, Daniel Kahneman summarizes decades of his research on the two systems of the brain (emotional/bias prone and logical). He shares how they fight for control of our actions and introduce unconscious simplistic substitutions to reduce the complexity, especially under heightened time pressures. Since this reflects our regular working conditions, there is a need for awareness of these tendencies and for the implementation of controls to avoid errors.
Certain books never leave you because they’ve forever changed your soul. In A Fine Balance, Rohinton Mistry weaves a tale that leaves an indelible reminder of the human spirit to live, survive, and thrive. This is what we encounter in healthcare. As a result, we act with urgency.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger!
For me to say STEM saved my life is not hyperbole, particularly when considering my precarious start in this country and the land mines that littered the terrain all around me. Because of that experience and my gratitude for the gifts I have received along my journey, I have a deep passion for inspiring young, underrepresented minority students to pursue STEM.
This is urgent since the technological divide and the skills gap is widening. To close that gap, I have worked to first, ignite the possibilities in minority children for a future in STEM by speaking at various schools and sharing my journey. Additionally, I’ve partnered with the BMS STEM Council and schools, day care and community groups in my local community to bring simple science experiments to kids of all age and background.
To increase impact, expand reach, and close the gap even further, I would encourage collaboration among those who are working to expose all students to diverse STEM professionals, through either speaking engagements, mentorship, etc. To demystify STEM and make it more accessible, I would recommend developing a fleet of STEM buses that would provide hands-on STEM instruction to multiple underserved and under-resourced schools. Collaboration with local universities, underrepresented STEM professionals, and even proficient young students would make this more sustainable. Since the goal is not just to inspire but also support and nurture, a sustained engagement through a community of practice, regular science fair opportunities, and local STEM club participation would be important.
How can our readers follow you online?
Feel free to add me on LinkedIn.
