the health disparities podcast

193: Health equity solutions: A conversation with Morehouse School of Medicine President Dr. Valerie Montgomery Rice

A diverse healthcare workforce is critical to improving outcomes for our diverse nation.

In order to achieve this, there needs to be both a pipeline and a pathway, says Dr. Valerie Montgomery Rice, President and CEO of Morehouse School of Medicine.

 

“We need students to believe what’s possible in first grade and then chart a path,” she says.

 

Montgomery Rice says her own love and science and people led her to chart her career pathway that led her into academic medicine. “What if everybody was given that opportunity. What if everybody was told you can be whatever you want to be?”

 

“Every one of my roles has been about how to develop people to bring their best self to work,” she says.

 

Although health equity work can be polarized and be perceived as political, Montgomery Rice says Morehouse School of Medicine is committed to leading the creation and advancement of health equity — both through new solutions and through complementing existing ones.

 

The heart of her message on health equity: It’s about “giving people what they need, when they need it, to achieve optimal level of health.”

 

Montgomery Rice spoke with Movement Is Life’s Dr. Carla Harwell for this episode, which was recorded at Movement Is Life’s annual health equity summit.

 

Never miss an episode – be sure to subscribe to The Health Disparities podcast from Movement Is Life on Apple Podcasts, YouTube, or wherever you get your podcasts.

The transcript from today’s episode has been lightly edited for clarity.

 

Dr. Valerie Montgomery Rice: You know, the word health equity. First of all, the word equity has been so polarizing and can be so political. And several years ago, when Morehouse School of Medicine, we did our big strategic planning session about eight years ago, and we decided that our vision statement would be leading the creation and advancement of health equity, and we use the words creation and advancement intentionally. Sometimes we will be needing to create new solutions. Sometimes we will just be needing to complement and add our assets to those solutions. But that solution of health equity is defined by giving people what they need, when they need it, and the amount they need to reach their optimal level of health.

 

Dr. Carla Harwell: You’re listening to the Health Disparities podcast from Movement Is Life being recorded live and in person at Movement Is Life’s annual health equity summit. Our theme this year is “Health equity solutions from healthcare leaders.” I’m Dr .Carla Harwell, Vice Chair of the Board of Movement Is Life and the Medical Director of University Hospitals, Otis Moss Jr. Health Center in Cleveland, Ohio. Today, we’re diving into the topic of health equity with someone who has a wealth of knowledge and experience with this issue, Dr.Valerie Montgomery Rice. Dr. Rice is the sixth president of Morehouse School of Medicine and an esteemed infertility specialist and researcher. She’s also the founding director of the Center for Women’s Health Research at Meharry Medical College. Dr Montgomery Rice, thanks for being here. Thank you for having me. So tell us a little bit about yourself and how did you get into medicine to begin with?

 

Montgomery Rice: Well, I am from Macon, Georgia. I was raised in what I describe as a small town, single parent, three other sisters and my mother worked at a paper factory, and she worked for 25 years, working the swing shift, and one of the things that she told us was that education would be the equalizer for us to leave Macon and to have choice. She was really into choice. She only graduated from high school, and she really, really wanted more for our daughters. Now, I decided to go to Georgia Tech back in 1979 when I graduated from high school. And the only reason I went to Georgia Tech, I haven’t been a student in the Honors Program, et cetera, and graduating from a high school at that time, which was the largest high school in the nation. Southwest High School had the best basketball team in the nation. Also, we really did win the national championship. And so my science teacher said to me, you’re good at math and science, and they’re looking for more kids to become engineers, Black kids. So why don’t you go to Georgia Tech? That was the extent of the counseling that I had, even though I’m pretty sure I did pretty well on SAT etc.

 

And so I came to Georgia Tech, and I started Co Op, and immediately that first summer in chemical engineering with Procter and Gamble in Ohio, and I at, she at the Sharon Woods plant, and they offered me a job after about five quarters of Co Op, and I became immediately terrified, because I thought there’s no way that I want to be a chemical engineer. And so I went to the encyclopedia. And if you look up, remember that encyclopedia where you look up the keywords, and I looked at math, science and people and medicine came up, and I decided to go to medical school. I called my mother. It was a long distance call. She thought I was crazy. My advisor at Georgia Tech thought I was crazy, and but I knew that I did not want to be an engineer, and that this was all about choice, right? That’s what she had taught us all our life. And so really, I came back to Georgia Tech. There were no pre med majors. And I remember going to talk to my advisor. He said, Why don’t you just go ahead on and graduate with your engineering degree? It was a five year program. And he said, then if you still have this itch to go to medical school, you can do that. Once I started getting that paycheck and shopping, it’s over. So I said, No, I probably shouldn’t do that. So I went over to Spelman College and talked to the advisor there, and I’m talking to the pre med advisor, and she looks at me and she said, you don’t seem to know a lot about going to medical school. And I said, Well, I didn’t know a lot about being an engineer, and that’s working out okay. And she actually did help. Me get into a summer program at Harvard Medical School. I recognized you had to take the MCAT, and so I took the MCAT. Didn’t really prepare for it, but at Georgia Tech, which was the hardest school in America, in my opinion, I did pretty well and ended up going to Harvard Medical School. So it was really just, I think, having no fear and being naive, unbelievable.

 

Harwell: Yes. And I saw one of your podcasts, and you talked about that little pink house, grandma’s house. Yes, grandma’s. And I can, and listening to your story, I can just see how that also played an integral part. And you just when you said the word fear, you know, have no fear.

 

Montgomery Rice: Have no fear. Be fearless. And that’s what I saw. That’s what I saw growing up, my mother left an abusive relationship, did not understand, probably how she was going to make it the next day, but she didn’t want that life for her kids, for her daughters. My grandmother, who worked, lived in the country, in that pink house where we would spend all of our summers, which was quite challenging, no fear and how she would send us to that chicken coop. It was your time to go pick up the eggs. Valerie. And I was like, oh, no, grandmama, no, no, she’s I know it’s your time, okay, and that same chicken sometimes became our dinner,

 

Harwell: Oh, that’s wonderful. All right. You have an incredible amount of experience in many arenas, from patient care and medical research to organizational management and public health policy. Tell us about your So you told us about your career journey to become a physician, but how did all these other interests evolve?

 

Montgomery Rice: You know, it was really very organic. I really loved science and I loved people, and medicine gives you that platform to be able to live out what has become my purpose. And I wasn’t bright enough at that time to understand that, that it wasn’t what I was doing. I was just really following my heart connected to my mind, and really letting it be a part of my spirit. And so when I took my first job after fellowship, so I sort of knew early on that I was probably going to do academic medicine, because I spent my entire fourth year medical school doing basic science research. I was looking at purified hormones and how they would induce what we call super ovulation. So I was pretty clear that I was going to do academic medicine, and so I chose to come do my residency in OBGYN, because Emory allowed me to bring my research with me so I could as an intern, I would be at Grady, working every other night like we did as interns, no 80 hour work week, believe me, and then I would be going over to the lab across the street, injecting my mice to continue my research. And so I continued to do that research throughout and then I knew I was going to do a fellowship in reproductive endocrinology and fertility, because I really enjoyed the opportunity to bridge what was possible for creating opportunity for families women who were having reproductive disorders to achieve pregnancy, and then the surgical approach, as well as the endocrinology disorders that were associated with it. And so it was a great bridge for me.

 

It was a perfect storm. And so I took that first job at the University of Kansas, and they hired two of us, two people, myself and another guy, and we were fresh out of fellowship, and we were rebuilding the division, so I had to gain some administrative skills. And so I relied on the double AMC, the Association of academic medical colleges, and I went to every one of those development courses over my career, you know. And there are so many things that you learn, not just about the finances of academic medicine, but you also learn the people. And it is really always, as I find this, it is about the people. And so every one of my roles that I have taken has been about, how do you bridge this understanding of how to invest and develop people in order for them to bring their best self to work, and if you have a shared mission and vision, you can accomplish great things for the organizations.

 

Montgomery Rice: Wow. So you’re one of our plenary speakers here at our annual Movement is Life Summit. Give us a little snippet about your message that you decided to bring to us today.

 

Montgomery Rice: It will be centered on health equity, I was so happy to hear your topic. You know, the word health equity? First of all, the word equity has been so polarizing and can be so political. And several years ago, when Morehouse School of Medicine did We did our big strategic planning session about eight years ago, and we decided that our vision statement would be leading the creation and advancement of health equity. And we used the words creation and advancement intentional. Sometimes we will be needing to create new solutions. Sometimes we would just be needing to complement and add our assets to those solutions, but that solution of health equity is defined by giving people what they need, when they need it, and the amount they need to reach their optimal level of health. Now, for some people, that is addressing the social determinants of health, that’s addressing access, that’s addressing transportation, that’s addressing childcare, it’s environmental challenges, et cetera. For some people, that may be access to the greatest new immunotherapy for breast cancer treatment. For some people, it may just be about increasing their knowledge so they can make different lifestyle choices. The most important thing is to meet that person’s needs where they are, and there’s nothing political about that. Now in my talk, I will talk a little bit about the political determinants of health, because they are tied together, there have been systemic policies that have been put in place over the years that have continued to influence the social determinants, which then lead to people not being able to capitalize on opportunities?

 

Harwell: That’s what that actually was my next question, because in the US the wealthiest Americans own an increasing share of wealth, and so I’m glad that you’re going to expand on that, that correlation between health and wealth one of the things you’re most passionate about, I believe, is building a pipeline right of people of color in medicine and science. What do you see as the greatest barriers to diversifying the healthcare workforce? And what do you think it takes to overcome these barriers?

 

Montgomery Rice: I think it’s two things. I think it’s will and opportunity. So when I think about the fact that I graduated from a high school in Macon, Georgia, and my class size was 1,049 my high school class with 1,000 there were only three high schools at that time and one small private school in Macon. And I think about the opportunities that I’ve been able to capitalize on that have created the wheel for me to move through those opportunities to accomplish what I am, who I am today, I think about what if everybody was given that opportunity? What if everybody was told that you can be anything you want to be? I’ll never forget that Satya novella, who is the president of CEO of Microsoft, came to speak to at the Atlanta University Center, and he said that growing up, he had the opportunity to be curious and to fail without consequences. What if every child was given the opportunity to be curious and to fail without consequences. Now that doesn’t mean that he got rewarded for those failures, but it didn’t. It also didn’t mean that that was going to be so life changing that he would not be able to realize his potential.

 

And so when I think about it, became very evident to me when I was the dean at Meharry Medical College. Now, when I was at the University of Kansas, I rose to be a tenured professor, and I was really still into my research. I was a vision head. And then when I moved to Meharry, became the Chair of OBGYN, and we were restarting the residency training program. What really perked my interest to take that job was at that time, Meharry Medical College was at Nashville General Hospital for their clinical care. The OB GYN program had been shut down for about seven years, so. And I walked into that place, and I said, Why are why is it that 18 out of 75 students are going into OB GYN, they have no residency training programs, and they have 10 faculty members. And then I saw the interaction. I saw the exposure, I saw the engagement. I saw what was being let those students know what was possible for them, and I said, Okay, what if there were more students given these opportunities? And so you and then I recognized throughout my journey that you have to create, and we always have this controversy, a pipeline and a pathway. So we need students to believe in what’s possible, starting in the first grade, and then we have to help them chart a pathway. So we have Tuskegee Airmen global Academy here tag Academy, which is a K through five school. They have about 20 students in the pre K program, and we adopted this school 10 years ago. So we have a mentoring program there. We have about 100 or so of our faculty, of our employees, who are in that school every day, supporting the teachers around issues that are important, how they can move these students to Now you may say, Well, why would you all invest in a K through five school? Because it’s about what’s possible. Now, if only 10% of those students eventually become doctors, we’re good, you good, yeah. But if 100% of them graduate, we’re really good, right? And so when we took over that school and became a part of that, that family 10 years ago, they were a failing school. And what better place to begin? Right? And we have been in there. And I’m not saying that we are all of the success, but I know that we’ve been an integral part of it, and it is now an Apple star rated school. And we go there and we can see the impact, we can see the reading proficiency, we can see the math proficiency. We can see the aspirations in the students eyes. And they come to our school three times a year, and we host them, and we’re doing science projects, and we’re doing all type of things, and they’ll be right exactly, they’ll be within. So we have programs throughout. So we have K through five, we have middle schools, we have high school programs, we have pre med programs, pre PA programs, pre science programs, throughout. And then, of course, we have the medical school and about 15 other degrees there. And so we’ve just created all of these different pathways, because medicine is a team sport.

 

Harwell: It certainly is.

 

Montgomery Rice: And it requires everybody to be able to operate at the top of their license in order for us to achieve optimal health for everyone.

 

Harwell: That is, that is, that is just phenomenal. Oh my gosh. Tell us about the more in common Alliance and the kinds of solutions that you feel need to be prioritized in order to advance health equity in our nation.

 

Montgomery Rice: So is this really focused on the more common Alliance, as a partnership between Morehouse School of Medicine and common spirit health, which is the largest, the second largest health system in the country. They have about 140 plus hospitals in about 28 states. And so in the middle of the pandemic, we were growing, still growing Morehouse School of Medicine thought that it might want to try and buy two hospitals that were going to close here. And we don’t know how to run hospitals, but I knew some people who did, and so I went to a former board member who at that time was the CEO of Dignity Health, and excuse me, CH I capital health initiatives and Dignity Health, they were just foreman. They were forming common spirit health. And I asked them, would they loan me to executives to serve on a team to help us do the due diligence of these hospitals? Again, we didn’t know how to do this. And they said yes. And throughout that process, they became one. They had co CEOs. They became one CEO, which was Mr. Lloyd Dean, and Lloyd and I started talking almost every Saturday about he was advising what we should be thinking about. His team members were working. And then George Floyd happened, and he and I both decided that we can do something of impact while we’re sitting in the seats that we are humbly being able to sit in. He had a bunch of hospitals that did not have providers that looked like the community they were serving Morehouse School of Medicine has a strong track record of recruiting people from underserved communities, regardless of their race and ethnicity, and influencing their decisions to go into primary care and to practice back in those communities. And so we thought we would bring those two assets together.

 

So we went to our teams. We formed these work streams, five work streams, and we decided to open up five regional medical campuses around the country at their hospitals, so students would be recruited from those communities, go to college, come to Morehouse School of Medicine for their first and second year and their third and fourth year, they go back to those communities, located at those hospitals, and then we are building out 10 GME programs around the country, because, you know, the key to someone practicing In the community is where they do their graduate medical education, right? And so we’re very, very clear about that. And so we started this, and we’re in our fourth year. We have the Seattle campus that’s being built out a campus in Bakersville, in Chattanooga, and Kentucky. We haven’t picked the fifth campus, and we just launched our first graduate medical education program. I am Family Medicine in Santa Cruz, and none of those first residents are African American, and that was not a problem for us. Why? Because three of those persons are from that community, and several of them are Latino, and that is what that population and that demographics looks like. So we’re holding true to our mission of what we why are we doing this? We are doing this so that in those hospitals there will be providers who are tied to those communities who are of that community.

 

Harwell: They look like the people caring for exactly.

 

Montgomery Rice: We believe that is key to cultural competency and culture humility. So that’s what this initiative is about. And common spirit, health, gifted Morehouse School of Medicine, $115 million over 10 years to lay the foundation, and we’re trying to raise an additional 100 million dollars to support this so it is sustainable forever.

 

Harwell: That is absolutely phenomenal. Absolutely phenomenal. I just stand in awe when you think about the direction we’re headed as a nation in terms of health equity, diversity in healthcare, addressing health disparities, all the things that are near and dear to your heart, what gives you hope?

 

Montgomery Rice: You know that is a very interesting question. And I was at an event a couple of nights ago, and it was the black women Resilience Project, and I looked in the audience, and I saw all of these black women physicians and black women who were aspiring to become physicians or into or enter into the healthcare space. And I spoke to them about choice, and I spoke to them about how they actually can control their destiny. The one thing that I’ve been clear about is that we are not necessarily tied to our history so much that it cannot positively change your destiny. You use it as a reference point. You use it as an opportunity to learn from you create a what I call a board of professional advisors, and professional I don’t mean somebody with a college degree, I mean somebody with wisdom who can help you to navigate the system. But what’s most important about all of this, I think in this day and time, people are recognizing how much we can be a resource to one another if we are willing to be vulnerable and to be transparent in what our aspirations are. So when I looked in that room, looked out in that room, I saw women who were disappointed in what had happened in the election. I saw people who were concerned about are we going to cut. Shut down all dei Okay, well, let’s not let those terms be politicized.

 

Everyone knows, and I sit on a corporate board, when you have diversity at the table, whether it’s by race, ethnicity, gender, distance traveled, expertise, experience, the performance of the company is better. You meet your profit goals, your revenue goals, better, quicker, more efficiently and more effectively. And effectively means that you get to serve that population who is the recipient of your product line better, because you have people coming to the table asking you to think differently about your why and your how and who is going to impact medicine is no different. In fact, it’s even more important to have diversity in medicine, because I have to build a relationship of trust with you. I tell my students and people who I get to engage with on a regular basis, the most important question that you should ask when you sit in front of somebody in any circumstance, based on who’s sitting in front of me. What’s possible based on who’s sitting in front of me? What’s possible? If you ask that with every engagement, it forces you to put yourself second and that person first, and then you don’t have to memorize the review of system. It comes naturally, because you’re thinking about, well, how did this person get to the office today? What is really their chief complaint? I’m going to give them this prescription. Would they have a challenge getting this field? Or maybe they are some high flying executive who’s on a plane every other day? Should I be thinking about giving them an exercise protocol for movement, right? Right, when they’re on this plane, right? Should I be thinking about the fact that maybe they don’t have a safe place to go and exercise? Should I be coming up with different strategies for them, because, based on who’s sitting in front of me, what’s possible?

 

Harwell: That’s awesome. That’s awesome. All right, we have a little bit more time. I got wind of something called Dan forth dialogs, yes, that you do monthly podcasts. Yes. Tell us a little bit about that.

 

Montgomery Rice: So in the middle of COVID, again, COVID was just my mother said, Never waste a crisis, right? And we decided we were not going to waste this crisis. During COVID, Morehouse School of Medicine became very, even more involved in the community. We got, we started getting calls from people because of our clinical research, could we do the vaccine trials and data? So we did all the vaccine trials. We were with the Department of Public Health here in the state of Georgia, they asked me to stand on that council. I became the health equity champion for the state around this, and we started early on testing and then being able to provide the vaccines, okay, and doing the trials. And so we were, I was very clear middle of March when all everything shut down that we can’t educate and train medical doctors over zoom, right? And I had one part of my organization that was the Education Administration part. Yeah, we could probably work from home for a moment, but my doctors, our doctors, were there at Grady and Choa and the VA, and they were working their butts off, and they were coming home, changing their clothes in the garage, concerned about infecting their children. It was, it was we were getting hotel rooms. We were doing all of these things for them. On the education administration side, though, I was thinking, Okay, we can’t educate the and train these students, just on Zoom. So we got to get back to work. So I, I it was probably four days within the in the middle of the pandemic. I called up a friend of mine, Ahmad arati, who is the CEO of color genomics, and I said, I know you’re going to change your genomic platform to doing COVID testing. And he said, Yeah, Valerie, we’re about to do this for San Francisco. I said Morehouse School of Medicine and the Atlanta University Center needs to be your first education entity that you do with so we took our campus shield app and we turned that app into our safety app that people had to answer all those questions in order to come on campus. And then we put a testing protocol together, and we started testing people.

 

So we tested twice a week, everybody. Then we expanded that to the Atlanta University Center and the Atlanta University Center presidents and I, who were already doing a lot of things together, we became very strategic about how we were going to get our students back into the classrooms and our faculty and our administration back safely. And I saw leadership at its best. I saw leadership around collaboration, collaboration. I saw leadership around overcoming fear. I saw leadership through empathy. I saw leadership through strategy. And so we decided to start the Danforth dialogs to tell the story about leadership. And so we have expanded that to a host of leaders around the country, for them to tell their story, yes, about what happened during COVID, but then beyond that, and what are the things that have happened in their lives and through their childhood? And one of the common things that happens during the Danforth dialog, everybody has a story about their childhood and how that really has laid the foundation for them to be who they are. So that’s why I know that nurturing at tag Academy, it’s the right thing. They lay the foundation. Possible, absolutely and so that’s how that started.

 

Harwell: As you were telling your story about your journey, it reminded me so much of my own journey, which, you know, my dad was from a small town called Mason Tennessee, had one stop sign, not even a stop light, and he, too, knew that education was the key, and, you know, moved up north to try to make a better life for himself and his future family. So your journey has just been phenomenal. Dr Montgomery Rice, we’re so happy to have you here with us today. I’d like to thank my guest again, Dr Valerie Montgomery Rice, for being with us today. You can find links to more information about Dr Montgomery Rice at the link in our show notes. That brings us to the end of another episode of the health disparities podcast. From movement is life. Dr Montgomery Rice, thank you again.

Montgomery Rice: It’s been my pleasure to be here. Thank you.

 

Harwell: I’m Dr. Carla Harwell, until next time, be safe and be well.