Q&A with CDEI-FM Chair: Bottom Line Is Improving Health of Communities
Feb. 13, 2025, David Mitchell — In 2021, the AAFP surveyed members to determine what family physicians needed to address health disparities and social determinants of health in their exam rooms and communities. The following year, the Academy launched the Commission on Diversity, Equity and Inclusiveness in Family Medicine to meet the needs members identified by ensuring the Academy considers disparities in care, health and the family physician workforce in all its work.
After AAFP commissions met in in Kansas City, Mo., last month, AAFP News talked with former Academy President and current DEI Commission Chair Ada Stewart, M.D., FAAFP, of Columbia, S.C., and commission member Adena Hicks, M.A., M.P.H., M.D., of McDonough, Ga., about the Commission’s accomplishments and importance, and to clarify misconceptions about DEI.
What’s some work from the Commission’s first years that stands out for making a difference in policies or recommendations that advance family medicine?
Stewart: We are still in our infancy. I am proud of all our work so far. I am particularly proud of the Ending Ableism Policy. Ableism was something that many of our members were not familiar with. During our work on this policy we found that the Academy did not have a definition for this term. We began with defining ableism. The adopted policy helped us recognize the need for additional training and awareness around disability and ableism. (Disability is the 2025 topic for the Congress of Delegates-mandated annual training for commission members and members of the Board). In addition, we had an resolution that was sent to us from the 2021 COD titled “Ensuring Inclusion of AAFP members with Disabilities.” These helped guide our recent agenda item focus on disability.
Also, our commission members serve as liaisons to the other AAFP commissions so that we can be a resource. We also have external liaisons. Currently, we have family physicians Dr. Elizabeth Lee-Rey from the National Hispanic Medical Association as well as Dr. Javette Orgain, representing the National Medical Association. They bring insights from their organizations on how we can best do our work and vice versa. We’re looking to form liaisons with other groups that can help us to do this work, which is all about addressing health disparities.
Hicks: I want to echo the importance of the health equity lens that we’re embracing by having the Commission on DEI-FM.
In the current climate, it’s thought of like, “You’re taking away something,” or, “You’re demanding something,” or, “You’re forcing people to do something.” The structure of our commission really does away with that mindset because we’re interrelated within the Academy. We’re sitting on other commissions. They’re talking to us and we’re talking to them. We’re having a better understanding of service, which is really what DEI is. It’s more of a philosophy of “How can we best serve?”
It’s a cool experience to be working within the Academy and really embracing the idea of health equity through partnership-building, making policies and position papers, having frank discussions and asking, “What are we missing?”
How is the Commission’s work helping members who have disabilities and the patients with disabilities that members care for?
Hicks: The work that we’re doing is just learning how to effectively and efficiently serve others. That’s our goal. And the work that we’ve been doing with disability and ableism are good examples.
We looked at the surveys that our physicians who identify as disabled submitted so that we can better serve our colleagues and consider what other things they need. We looked at what disabled means, understanding our own blind spots, and where we could practice better in service to our patients and our communities.
So how can we better serve? Dr. Michael McKee, a family physician who is hearing impaired, and his team at the University of Michigan developed a module that can be used in Epic to screen and track disabilities within the EMR more easily, and help physicians and clinician teams accommodate and support patients more effectively.
Stewart: We’re bringing in other people to help us to do this work.
We had the honor of hearing virtually from Dr. McKee. He is doing great work and helping us better care for individuals who have a disability and to use best practices. He’s co-director for the Center of Disability Health and Wellness at the University of Michigan Medical School, and he is developing curricula.
We’re going to look at how can we best educate members through the training that we offer and consider if we need to develop toolkits.
One of the commission’s original directives was to expand leadership opportunities for family physicians. How does it do that?
Ada Stewart, M.D., FAAFP
Stewart: Serving on an AAFP Commission is a leadership role. I emphasize that at all our commission meetings.
For many of these individuals, this is their first time to serve on a commission. This is an opportunity for us to build leaders and build that leadership track. When they attend these meetings, they are able to network and reach out to other leaders, including members of the AAFP Board of Directors who serve as commission liaisons. Serving on a commission gives one the foundation and hopefully the encouragement to seek other leadership roles within the Academy.
We also are encouraging our commission members to attend the National Conference of Constituency Leaders to really spread their wings within our Academy.
Hicks: For me, serving on the commission was an intentional step into leadership. I had served on a public health committee for the Georgia AFP. I was looking for more opportunities.
It definitely provides connection with other leaders in a deeper way. It’s an opportunity to grow your leadership skills. Whatever stage you’re at, being part of a commission definitely helps take you to the next level.
Why does the Commission’s work continue to be so important?
Stewart: Let’s go back to why this commission was formed. It was to inform our Academy how we can better address the diverse needs of our population, as well as our diverse membership.
We did a member survey regarding where our Academy stood regarding addressing health disparities in care, health and with workforceWe already had a long history with our Center for Diversity and Health Equity and many other efforts going back to the 1970s. The survey showed us that although we were doing well, we had room for improvement. One of those areas of improvement was increasing opportunities for leadership within our Academy.
Adena Hicks, M.A., M.P.H., M.D.
This commission was born out of that. We’ve made some strides, but we still have a long way to go because we’re still seeing disparities in things like maternal mortality and infant mortality in the Black community.. We still have a lot of gaps that need to be addressed.
Now more than ever, it is important for this commission to do its work. We have our scope of work, and I can quote it: “Our commission will inform, develop, promote and evaluate recommendations, policies and procedures that promote health equity, reduce health disparities and foster inclusive, person-centered care across a wide range of topics and not limited to those underrepresented in medicine. LGBTQ+, ability (including physician ability), workforce development, health equity, social justice and anti-racism in medicine.”
Hicks: It’s important for us to be properly informed because there’s a lot of misinformation out there, and I think a lot of the fight against diversity and inclusiveness stems from people being misinformed about what it is and not understanding our history.
Dr. Camara Jones argues that ignoring the historical roots of inequality makes disparities seem natural. By overlooking past injustices in resource distribution, we wrongly assume that striving for equality is unfair. Although the U.S. was founded on the ideal of equality, it has never provided it for all. Instead of idealizing the past, we must focus on achieving true equity, as it remains unmet. Failing to do so only deepens existing inequalities.
Any final thoughts?
Hicks: The commission is not here telling members what to do because we know it all. It’s a group of people who want to serve and serve well, looking for areas where we can do better.
It’s not like, “I know all about this, and I’m going to tell you.” It’s more like, “What do you know? What can we learn? Where are my blind spots? What don’t I know?” It’s so that we can really be empowered to serve the best that we can.
Stewart: It is important that we continue to promote health equity and reduce health disparities as well as promote a more diverse workforce to allow us to improve patient health outcomes for all. This includes identifying gaps and working to close those gaps, as well as identifying our unconscious as well as our conscious biases to better care for the communities that we serve.
The bottom line is improving the care of our patients and the health of our communities.