UCLA Health neurologist leads way in diversity efforts for his specialty

‘It really requires getting down to the DNA of an organization and making some alterations,’ says Dr. Charles Flippen.

A diversity officer can improve patient care, trainee education and departmental diversity among faculty and staff. More and more institutions are recognizing the need for a diversity officer, but many find themselves unsure how to establish such a position.

A new roadmap from the American Academy of Neurology, co-authored by Charles Flippen, MD, professor of neurology of the David Geffen School of Medicine at UCLA, lays out a strategy for identifying the needs of a departmental diversity officer and providing financial, administrative and emotional support.

Black and Latinx patients are less likely to see a specialist for neurologic conditions than white patients, and often, progressive conditions such as Alzheimer’s or Parkinson’s may go undetected and untreated. “In part due to lack of access to specialists and less than robust primary care, early signs of neurodegenerative disease are not picked up,” said Flippen.

A neurology department diversity officer can improve care for these patients both by creating conditions that help recruit and retain diverse faculty, and by training medical students and residents how to be vigilant to the disparities faced by patients of all backgrounds.

“It really requires getting down to the DNA of an organization and making some alterations,” Flippen said. “In order to be successful, you really have to build in structures that become standard operating procedure, as opposed to a parallel track to the normal operations of our academic process.”

Dr. Charles Flippen

As the vice chair of education and residency program director for the Department of Neurology, Flippen has been deeply involved in addressing these challenges at UCLA Health. For several years, the department has offered a Diversity in Training Scholarship, a fully funded clerkship opportunity for medical students to train at UCLA. “I’m proud to say that the first student to participate in this program is now a third-year resident in our program,” Flippen said. “That’s been a fruitful addition to our residency program.”

The neurology residency program includes a lecture series that explores the history of the city of Los Angeles and the structural inequities faced by its minority communities. Understanding how historical policies have shaped current conditions will help doctors better meet their patients’ needs.

“Even though they may have been changed or taken away, the echoes from those policies continue to impact communities of color, with respect to housing, jobs, education and health care,” Flippen said.

A diversity officer can help raise awareness of these realities among the patient population, but that burden cannot fall on one set of shoulders. Increasing diversity among faculty and staff helps increase sensitivity to cultural and societal issues that affect health. The role of the diversity officer is to address the difficulties that stand in the way of sustaining a diverse faculty.

To create the roadmap, Flippen and colleagues surveyed diversity officers in neurology departments across the nation, to compile their concerns and strategies for success. Some of the obstacles they identified include:

  • The “Diversity Tax”: Faculty members from under-represented groups are often expected to do the lion’s share of diversity-related work.
  • Unequal compensation: Under-represented minority faculty earn less money and receive fewer promotions.
  • Representation fatigue: Faculty may feel like the lone representative of their race or gender in a department, and that any mistake will reflect poorly on their entire group.
  • Process knowledge gaps: Faculty who grew up in economically disadvantaged circumstances may lack the ingrained familiarity with cultural norms needed to get ahead in their profession.

The authors went on to outline several key strategies for supporting a diversity officer:

  • Collaboration with departmental leadership: In many cases, the diversity officer is a junior faculty member with little access or influence over departmental policies. For the officer to work effectively, there must be channels for communication with key department leaders.
  • Financial and administrative support: Equity and diversity work takes time and energy, and these efforts should be compensated with salary, travel and professional development resources.
  • Promotion of career development: Ensure that the diversity officer has adequate support for fostering their own careers, and provide proper recognition of EDI-related work when considering achievements for promotion.

By publishing this roadmap now, the authors hope to seize on a moment of increased societal awareness of how racial inequality affects everyone. “Even though the working group had origins well before the unfortunate incidents of last spring, they created a much more urgent environment for the publication,” said Flippen. “A lot of academic institutions were doing some self-examination.”

As the chair of the Department of Neurology’s Equity, Diversity, Inclusion Committee, Flippen says UCLA is doing well compared to academic centers nationwide, but that we must hold ourselves to a higher standard.

“This work is not quick, and it requires persistent effort,” he said. “We are a top 10 medical center, and we should be top 10 in our efforts in addressing equity, diversity and inclusion, and eliminating disparities in care.”

Caroline Seydel is the author of this article.