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Episode #7 of the Charged podcast.
Aswita Tan-McGrory, MBA, MSPH, is the deputy director of the Disparities Solutions Center at Mass General. Beginning with the Peace Corps after college, Aswita has devoted her career to lifting disenfranchised groups. Hear how she’s also charted her own path to success and leadership along the way.
In her role as deputy director at the Disparities Solutions Center, Aswita Tan-McGrory, MBA, MSPH, helps chart the center’s growth. She is a key member of the senior management team and supervises the broad portfolio of projects and administration of the center. These include collaborations with internal and external partners on guidance on collecting race, ethnicity, language and other social determinants of health data; developing disparities dashboards that stratify quality measures by race, ethnicity and language; and developing recommendations for data collection in pediatric patients.
Aswita also oversees the Disparities Leadership Program, an executive-level leadership program on how to address disparities, and the Healthcare Quality and Equity Action Forum, a national conference for healthcare leaders interested in addressing disparities.
Aswita has over 20 years of professional experience in the areas of disparities, maternal and child health, elder homelessness and HIV testing and counseling. She received her MBA from Babson College and her MS in Public Health from Tulane University. She is a former Peace Corps Volunteer, where she spent two years in rural Nigeria.
Q: Thank you for being here. Our guest on this episode is Aswita Tan-McGrory. Who is the deputy director at the Disparities Solutions Center at Mass General. And Aswita, I think a lot of people here, Disparities Solutions Center don't really know what that means. So can you explain what you do?
A: Sure. So our center is very unique. It's probably one of the first in this country that's based in a hospital. We really work on addressing racial and ethnic disparities in healthcare. And we work with a lot of different organizations on how to do that. We've sort of figured it out by doing it here at MGH, and then we've just created a model that we help other organizations to do the same thing within their own institution, tailor it to their own institutions. And a lot of that work that we do is really about developing guides e-learning modules on addressing disparities. And then, we also have an executive leadership program. So we have a lot of healthcare leaders that come to our center, work with us for a year and then take the learnings back to their own organization and implement the strategies that we've worked with them on.
Q: Can you talk about maybe one system that you've successfully changed?
A: I think we've been very successful here at home. We have fantastic leadership buy-in. We've been doing this for a long time so this is really a marathon, it's not a sprint. And we have a lot of key stakeholders who are interested in the success of the work that we do. They're very engaged with us, and then I think everybody really has a very high expectation of MGH. We're one of the leaders in the country. And so, people look towards us to see how we approach this. That doesn't mean that we have all the answers or that there aren't things that we should fix. But I think we've been very successful in sort of engaging folks in this organization to get along, you know, the ride with how do we make sure that we provide the best care possible. You're not really providing quality of care if you're providing it only to one part of the population, but not another part of the population. So we know in this country that your health can be affected by the color of your skin, the language that you speak or the neighborhood that you live in. And so, we really work with organizations on how to address disparities in care, specifically around racial and ethnic minorities. That's what we've been doing. And it's really been sort of an interesting movement over the past couple of years as people sort of acknowledge that disparities exist, but then how do you address those disparities in the context of everything that's going on – healthcare reform, elections. So it's very challenging to keep that focus as an organization because there's a lot of distractions and other things that you have to attend to. So we really work very hard for the organizations to sort of seamlessly integrate this into the work that they do.
Q: That makes a lot of sense. So you've spent a lot of time, a lot of your career working with disenfranchised groups trying to reach out. Can you tell me a little bit about how you ended up doing that work?
A: You know, it really wasn’t until I was much older that I learned my grandfather was really a social justice advocate for the Chinese-Indonesians back in Indonesia who didn’t have a lot of rights. And so, I think just being around that environment where he really was advocating for those people who had no voice or no power influenced sort of my direction and what I chose to do. And then, I did call. I think I told you this before. I called the Peace Corps office when I was like a senior in high school because I was like so gung-ho. It was either the Peace Corps or Greenpeace.
Q: And what do you like about that work?
A: Well, it's very mission-oriented for me. So I feel like what I do matters. I think that's really important. I was talking to a friend of mine yesterday and he was like, You know, if you moved over the business sector, you could probably make a lot more money and you would have some swanky title. And you know, it sounds alluring, and I do have an MBA, but I just don't think I would last very long. You know, I've been doing this for like three-plus decades, and so I don't know that I could make a shift.
Q: Can you talk more about the nuts and bolts of how you go about the integration?
So we have a very national presence. And then we also do things locally. So for example, we'll do events like Stand Against Racism here in the hospital. Or we do, we highlight researchers that are doing some fantastic work in disparities and their research.
So it is really a little bit about education and then it's about working with leaders around the country, but it's also providing guidance on how to do this, in a nutshell. So that's really what our center does.
Q: Sounds like it's almost like an incubator.
A: Yes, it–
Q: Where you kind of try things here, figure it out and then push it out, or bring people in, educate them, push them back out. Is that accurate?
A: Yeah, I mean, I think we're like a learning lab, right? In some ways we're very entrepreneurial because I don't think we have all the answers. In connecting with other organizations, we can sort of combine together and figure things out. But we have been sort of at the forefront of this work, so people see us as leaders in this area. And we've been very fortunate to have the support of the hospital to, you know, try different strategies and to incorporate our work within the quality space. I think that it is very sort of entrepreneurial and like a learning lab. And then we sort of spread that nationally. We're really trying to create a movement. We always talk about that in the Center. We're trying to create a national movement where other organizations are also thinking about this – like, how can we provide the best care possible to everybody, not just people who are of a certain race or who speak English or who have insurance, commercial insurance. Just everybody, how do we do that?
Q: Can you talk more about maybe some current projects you're working on here or current issues you're trying to work through?
A: A big piece of our focus now is working on sort of challenges that patients who don't speak English very well or don't speak English at all face in our institution. We've actually seen that there's a lot of disparities by language. The other piece that we're working on a lot is around this diversity issue. How do we make sure that not only is our workforce diverse, our leadership is diverse, and then as well how do we make sure that people feel welcomed here, both patients and employees. I think that's important. We tend to focus a lot on patients. And then we forget that a lot of our patients are also our employees. There's a lot of leadership movement now in thinking about how are we doing for our employees? Are we achieving success there in what we're trying to achieve in what we consider our patient population.
Q: For patients that maybe English isn't their first language or don't speak English, how are you solving that?
A: Well, we have a very robust interpreter service department. Really great. Fantastic leadership. But I think it's really about people feel that if we have a patient who doesn't speak English very well and there's a language barrier, everything they do is going to take more time. Nobody has time for that. Not in a system where you're currently working in where everybody's short of time and we're just trying to be efficient. So I think we have to overcome that mental resistance where you're okay with providing a little bit less quality of care to somebody because there's a language barrier. Which isn't your fault, but you know you feel like, well, you know, I don't know that I need an interpreter because I can't get one right now. That's not okay. And we need to message that. And so, we need to sort of overcome that resistance. Because we have the interpreters here. We have video interpretation. We have phone interpretation. And yet, we still have patients who don't have an interpreter during their visit. And why is that? And I do think there's a little bit of an internal barrier to realizing that we need to make some accommodations for these patients. Certainly, if I was in China, I'd want an interpreter. You know?
Q: Absolutely. I've been a patient in a foreign country where people couldn't speak to me, and it's scary.
A: Yeah, absolutely.
Q: And it sounds like it's sort, at least in this realm, it's a combination of systems and practice and sort of culture change. Is that accurate?
A: Yeah. I mean, we have sort of system barriers and I think we always tend to focus on, sometimes on that. And then we kind of don't really work on sort of the culture. I talk a lot to organizations about, what is your organization's culture that's maybe the barrier to what you're trying to achieve? Because what you're trying to achieve doesn't sync up with the culture, right? And so, then how can you sort of integrate what you're trying to do within the culture?
Q: What does success look like from the perspective of the Disparities Solutions Center?
A: I mean, I think, you know, when leadership talks about this, unprompted, in their daily work, that's when you know you've hit success. It's not me feeding leadership lines or slides but they actually talk about it at a keynote address or they insert it in their, you know, email that goes out to all of the employees. I think that's when you know you've really moved to a certain level, where people are really interested in doing this kind of work and see it as relevant and important for the organization.
Q: And you said we don't always know what the answers are. How are you figuring out what the questions are?
A: Well, I mean, I think this is why we have that executive leadership program. People come to us with the questions. So they'll say, I have this barrier and I'm trying to do this; how do I get to where you are? And so, then we have an environment that doesn't look like MGH, but still has the same issues. So we can then, you know, sort of try to figure out, like, how do we solve that problem. For some organizations, for example, it's like they're a massive healthcare system in, you know, ten different locations, each with a different electronic health record system. So how do you try to do what we do at MGH, but none of the systems talk to each other. So that's just like a very minor example. But those are the things that we work on.
Q: I think as you said it, people might think it's a buzz kill, or people don't have a good sense of what it means to change. So are there tangible changes or things that you've seen?
A: You know, it's interesting because we live in this current context where I think people are more open and honest about racism and the impact it has. And so, it's really forced all of us to have these very honest conversations about what is happening. I think we were kind of in a bubble where we thought we made a lot of progress and then the last couple of years have shown us that, okay, maybe we weren't doing as well as we thought we were. And so, I think I'm very proud of whenever I can have a very honest conversation with leadership or other organizations where there's a lot of transparency, where people will just say, Yeah, we have a problem. So the field has very much changed, where we've gone back to our roots and said, You know, this isn't about always cultural competence or– terms sort of evolve to make people more comfortable about this conversation, but in reality this is a really uncomfortable conversation for most of us.
Q: How do you deal with that discomfort?
A: Well, I'm very direct. So, oftentimes when I do a presentation, I'll tell a personal story about myself and about some of the challenges I've faced. And by taking the spotlight off other folks, it allows everybody to kind of have a very engaging conversation that isn't about anybody being blamed. It's really about telling a story about some of the challenges that I've faced in my past. And then doing sort of an interactive exercise to highlight that.
So really having a very direct, frank conversation that isn't sort of emotionally charged for folks I think helps level set this conversation. And then also, backing it up with data. And I think when you balance the personal story with the data, then you have a better success at having these very difficult conversations. And also being very vulnerable. By sharing the story of myself, it allows people to kind of get into that space where it's okay to share things or to be really frank about how you're feeling or what you've experienced in the past.
Q: Do you find that by opening yourself up it gets other people to open up?
A: Yeah, absolutely. I mean, I talk a lot about this in terms of how do we engage populations that don't necessarily want to engage with the healthcare system? And I talk a lot about some of the things that I've experienced that probably my primary care provider doesn't really know. And it's not because she's a bad primary care provider, but because we've never really been in a space where she might have shared something about herself and then I would have shared something personal about myself. So I think if we want to engage folks, you've got to kind of, throw some skin in the game. And so, I think for a lot of times what has been successful for me is to kind of just share some personal piece of myself. And that allows us to have a conversation.
Q: Yeah, absolutely. It's so interesting. A friend told me a story recently. He has a Latino last name and he has a PhD and he went to the doctor and the doctor walked in and he greeted her, and without even asking any more questions, she asked him if he wanted an interpreter. Without finding out anything. And he was kind of taken aback because this woman made a judgment based on kind of three pieces of data without the really essential one, that this is a person who's grown up here and really doesn't need an interpreter. So it's been interesting to see how just those little moments can have a really big impact.
A: Someone would say that those are my microaggressions, right? But from her perspective, she's probably being really efficient and she's basing that on her experience. Is she right? No. But her intention is good. And I think we have to remember that. For the most part, people's intentions are good. But sometimes the good intentions contribute to bad outcomes. So we have to talk to people about that. It's the things that you do, the unconscious bias that you have that may lead you to provide certain kinds of care to one set of groups and a different kind of care to others. So I don't think there's any bad people in this. I mean, I wish life was that easy [laughter] – this is the bad guy and this is the good guy. You know, there’s nothing like that, you know.
Q: Yeah, it's a lot more gray in the middle. How do we go about pointing out those missteps or microaggressions without causing further problems?
A: You know, it's hard because I have this problem myself. When somebody does something where I'm like, you know, you do take that step back and you're a little shocked. And then the moment for you to sort of address it passes. So you do really have to give some feedback of some type, if possible. Maybe not in that moment, but maybe a next moment, to say, Hey, I just want to talk to you about when this happened. Can we just discuss that? And maybe sometimes in the moment isn't the right moment because you're emotionally charged. And so, for you it becomes a real emotional thing. But for this person, they're like, I don't know what the big deal is. I just did X, Y and Z. But I do think most people appreciate getting some kind of feedback, because if they're offending you, they're probably offending other people and they have no idea. This is how we get leaders at the top who are, you know, have really kind of problematic behavior, but I always think, well, didn't anybody actually ever tell them when they were younger that they were doing these things that are a problem? Most likely not.
Q: Absolutely. I'm curious to know, you travel around quite a bit for work. When you're in different places, do you see the same problems with different challenges?
A: They're the same, but dressed differently. So I'm from the South as well. And you know, we have racism in the South, but it just feels different. In some ways, it feels a little bit more open. Whereas here, Boston's known for being really progressive, but yet we have our problems, too. And you just can't name it; you're like, why am I not moving upwards? Right? So I think you do see the problems everywhere else, but because of the local context or the environment, it's just dressed slightly different. So the approach that you take has to be different and you have to tailor your approach.
Q: I think working with the populations you're working with I imagine can be taxing or frustrating. What drives you to keep doing that?
A: Well, I really have a very personal connection sometimes. I think it's important to have a personal connection to the work that we do because it is very draining and sometimes a little depressing when you look at the big picture. I try to be engaged on a very personal level. I don't see patients. You know, my daughter, her school sent out this note when she was in 1st grade, and it said "ask parents to donate food for morning snack" and– because a lot of kids were coming to school and they didn't have anything. And I was really shocked. I mean, I live in Somerville; it's like the hottest real estate. I was like, why are we having this problem here? And so, this other parent and I cofounded this food backpack program and we really provide meals over the weekends for kids who rely on the free lunches and the free breakfasts as their main source of food and then weekend comes and they don't have anything. And so, doing that has really– You know, this is not something I get paid for. I do it in my dining room. I mean, just being around that much food [laughter] in large quantities just gives me anxiety. But I'm doing something that's not about me and it's really just about helping other people. And then that translates into the work that I do every day. It sort of kind of keeps me engaged and, you know, gives me a sort of, a motivation for why am I doing these things because this problem's not solved at the local level and I really have to work at a national level.
And then you look at the news and you see all the news then I think, well, I can't change that, but what I can do is sort of on a smaller scale. So I'm doing something. I'm feeding kids. That makes me feel a little bit more balanced in the day.
Q: I’m curious, How many sandwiches do you make every week?
A: We’ve made 120. Can you imagine?
A: Yeah. So we started with 15 and then over the course of four years it's 120. And that's just kindergarten through 6th grade. So we just haven't had the capacity to expand it. But what we do is we buy prepackaged lunches and then– so the job is buying that, bringing it to my house, and then I basically make my family stand around the table and we sort of put them together.
Q: So, You're the deputy director of the Center. You are a woman. You are a person of color, maybe not the person people would imagine to be in the leadership position. So can you talk about that experience?
A: Yeah, I mean, I think we're in an academic medical institution, and I'm not a clinician, I'm not a researcher. So for folks like that, there's a real clear path to leadership positions and promotions. And I don't think that the path is as clear for somebody like me. So it's been a little challenging to try and figure out how do I move upward and forward. And then there is the sort of weird double standard, I think, in the workplace where people don't expect a lot from me because I'm not a clinician, I'm not a researcher. But at the same time, the bar for me is really high. There's no cushion for failure. That's kind of how I feel. And I think that in our system, because we're an academic medical center, if you're an MD or you're an RN or a PhD, you are sort of afforded this automatic level of credibility that has taken me years to get. I think just being aware of that, you know, has helped me realize like what is the sort of barrier I'm feeling, right? And then I realize it's really not about me, it's about the system. And so, then your strategy changes and you're like, well, okay, so then how do I make my own path forward?
Q: So what do you think your strategy has been?
A: You know, I try not to have an ego in all of this. I just think about, what's the big picture here that we're trying to accomplish? And then I just try to execute and deliver on what I said I would do. And you know, really try to just work very hard and realize that, you know, it's not going to be easy.
Q: Are there particular challenges you think you've come up against?
A: We talk a lot about mentorship. And I think there is this sort of thinking that a mentor has to look like you or be the same race as you or the same gender. And I've just generally found that's not true. If we did that, I just don't think that we would have a diverse leadership at all. If we wait for somebody who looks like me, somebody who's Dutch Indonesian [laughter] to tell me how to move up the ladder, it's not going to work. And then the other thing is, I think we're really discounting peer mentors. So I have a lot of colleagues who are my age or, you know, we have a lot in common, whether it's kids or it's what we chose to do, and there is some, you know, they– we mentor each other. We're more like a sounding board. So I think people are always looking for that magic person that can open up the doors, but– and that looks like them. But in reality, you're probably not going to find that. So you know, I think that's been challenging, trying to figure out, well, who's going to help me out here? And you know, there have been some really surprising allies.
Q: Is there on in particular that stands out?
A: He's going to love this, but that would be my boss. [laughter] My boss, Dr. Joseph Betancourt. You know, we've worked together for like 13 years now. So it is kind of like this relationship where he's taught me a lot. And a lot of it is about just watching what he does and how he does it, and then just kind of thinking, okay, would I do that, or would I do something different? And finding my own style. He and I are very similar in some ways, but we're also very different and we have very different leadership styles. So I had to figure out, like, what is the way that I come across? And you know, as you know, I'm sort of a little bit more casual. And so, I have to figure out, how does that work in such a, you know, academic environment like Harvard.
Q: You talked a little about being a leader, finding your own way of being a leader. Can you talk more about that?
A: I think I just try to be very direct, very, you know, compassionate. I think that's sort of a theme in my life is, I try to understand where people come from in my daily life.
Because a lot of times, when issues arise, if you don't understand the context of the other person, it's hard to solve that problem. So I think that's what I try to do.
Q: What strategies do you use to do that, to really understand other people?
A: So I'm the person that never asks you what you do for a living, what your religion is, or your politics. And I really would rather hear about where you've traveled, or maybe about your family, or what you like to eat or drink. So I really try to connect with people on a very personal level and try to find something in common that isn't about work.
And then, when you've built that relationship, it just helps smooth over some of the bumps in the road. And that's really been my strategy, sort of unconsciously, but I'm realizing that, you know, it's something that I like to do. I realized that's really what networking is, where you really get to know everything about somebody that's not about the work. And then, you know, that helps you sort of, you know, do your ask maybe in the future or work together better.
Q: So, When you think about the other people that you work with, are you thinking about empowering them, lifting up other people on a day-to-day basis?
A: Yeah. You know, I try to share what I call the playbook with them, these sort of unwritten rules that people have that they don't tell you about, but if you break them it can really impact your career trajectory. And so, for example, one of them is, like I see a lot of people reaching out to national experts by email and saying, I would love to meet with you to talk about X, Y and Z. And then in that same email, they're like, And here's when I'm available. And it's usually like tomorrow or this week. And I just, it sort of kills me because I'm like, if you're smart enough to know that there are national experts, then you should be smart enough to know that they're probably really busy, and you are going to need to work around their schedule with their assistant to schedule this meeting that really only benefits you. It seems so simple, but, you know, it's about first impressions. A lot of these, like, unwritten rules are about first impressions. And so, what impression did you just make on everybody that's on that email? It's not a good one.
Q: That's an amazing tip.
A: It happens all the time. It drives me crazy. It's like my pet peeve. I think you need to realize that people come in and see, for example, Joe Betancourt, or even myself, or if they apply for a job, your job interview doesn't start when you meet with me. It starts way before that. It starts when you are emailing, when I either reach out. It starts when you're working with one of my teammates to schedule it. And I always ask people on my team, How did this person treat you? How did they respond to your emails? Because there's been plenty of times when– and it's happened to me as well. When you're in the room with somebody that you think is important and you ignore all the other people that you don't think is important, that's so telling. And so, a good leader will suss that out. Because it's not just about you, it's about how your team's being treated. So I do ask my team a lot, like, What's the conversation like? Were they nice to you? Did they say hello? Or did they, were they rude? That's important information for me to know. So, that's something to think about for people that, you know– there's all sorts of data that can be collected that you're not even aware of.
Q: I think that's great advice when you're young and just trying to figure out what to do in the world and there's nobody teaching you, you know.
A: Yeah, I mean, I think we forget sometimes that not everybody has a parent that can tell you, like, This is what you should do. Not everybody has the parent who can tell them what they should write in an essay or how they should get dressed. So these are minor things, but if you don't nail them, they're huge. So sometimes I think this is part of the problem with keeping people of color in our system because we don't give them enough support. Once they get in the door, we're kind of like, Well, you made it in, so here you go. Hope you do well. And then we don't address some of the gaps in education or support or resources that other folks have and they don't have. And so, then they end up making mistakes or they don't get mentored on how to perform in a certain way that fits in with the system. And then, I think they're very disappointed that they don't do well. I think other people are like, Well, this is probably why we shouldn't have brought them on board, you know? So it's sort of this vicious cycle.
Q: Yeah, it's almost like a feedback loop that, it's detrimental to itself.
A: Yeah, are you bringing people in to say that you have a diverse group, but then you're setting them up to fail. I think we need to think about those systems, right? If a system is geared towards a certain population of folks, and then other people who don't have that set of resources come in, but we still expect them to adhere to this system, does that really work? Or do we need to change our system? Obviously the answer is, we need to change our processes.
Q: Are there practical steps that you think we can take to do that, to make it more welcoming and more sustainable?
A: I mean, the thing that I always do when I get recruited or somebody wants me to look at an organization, I go straight to that page that has the picture of everybody, and I click on it. And then I look to see how diverse they are. And that either– I don't care what your mission says, if you don't have that diversity, then you're missing something. And I think this is– organizations are realizing this and this is why there's been a lot of push into sort of trying to figure this out. It's really challenging. You know, we need to be aware of the face of our institution. What does it look like? I mean, we can say that we've very committed to addressing disparities, but then if we don't look like a certain way, then are we really doing the job? And I think people are really loathe to make changes, you know. There's sort of this sense of, Well, this is how it's always been done. And it's worked so far, you know. And it's like, well, it's not really working. It's working for some people, but it's not working for others. I mean, I literally feel sometimes like I've clawed my way to the position that I'm in. And then I always have this visual of myself where I'm like sort of hanging on with my nails while I'm like sort of [laughter] pushing down with my leg the people below me. But just, you know, it is so hard to make it in this system if you don't have all the right tools, the right pedigree, the right education. It's not easy.
Q: So as you said, you've made it and it can feel like it's very precarious. I imagine it can be really easy to get to a place where you've made it and you just harden and kind of want to, as you said, kick everybody else down. So how have you resisted that?
A: I mean, my strategy is to be really honest with folks about the challenges of getting to where I am. It's not easy. I had to work really hard. And I continue to work hard. And the bar that I set for myself is very high. I mean, I don't clown around. And I just can't because you only get a chance– because, for somebody like me, you only get a chance at the seat of that executive table once. And then once I mess it up, not only am I messing it up for myself, I'm messing it up for anybody who would follow in my footsteps behind me. So I'm very conscious and self-aware of that. But I'm also very honest with folks about the challenges of that. So I talk a lot with my team about– okay, so we were in this meeting and here's what happened behind the scenes that you didn't know about. So I really try to sort of unpack that mystery so that people have the context of why things happened and why we ended up at a certain place. And that allows them to sort of process things, you know, when they eventually get to that leadership position.
Q: That's amazing. I love that kind of pulling back the curtain of here's all the things that were happening.
A: Yeah. I used to work for a woman who would not tell you the things that you needed to know. She would send you into this meeting and you had no idea. And it was like, actually you just realized like– afterwards she might tell you something. You're like, why didn't you tell me that in the beginning. Right? Why didn't you make my life easier?
And I think it was just– I don't know, she– it's not that she was a bad person; I just think that nobody ever did that for her. And so, she kind of made it up, you know, the ladder in a very tough way. And she kind of expected you to do the same thing.
Q: You've got this amazing career where you're dedicated to lifting up these groups of people that might not get a lot of attention. How does that feed back into your family life?
A: I really try to make my kids be more compassionate and have more empathy for others. And then as a leader, I do that myself. Like I said, I really try and understand where people come from so that I can better understand why some of these issues come up. I think that's really what's missing. Sometimes when we look at the news, is there's a lack of compassion and empathy. And so, I try to instill that in my family by sharing with them the work that I do.
Q: Yeah, that's really cool, I love it. It's sort of like you do the pull-back-the-curtain both at work and at home.
Q: It manifests in different ways, but it's this similar sort of thinking beyond just what's right in front of you.
A: Well, I have an undergraduate degree in art history, and I think in part I loved art history because I didn't just want to look at a painting; I wanted to know, like the story behind a painting. And then I've kind of, as I've gotten older, realized that's really just kind of what I'm always interested in. You know, I'm the geek that after like some TV series, I go and then [laughter] do the aftershows, because I want to know like what did the director do to get this shot, you know? But that's really my interest, is sort of like peeling back and really trying to understand what I'm seeing in front of me, how did it get to be this way.
Q: Yeah, that's makes a lot of sense then with what you do because looking at disparities, you can't just look at what's on the surface, you really do have to peel back and what's behind and what's behind and what's behind.
A: And it started way earlier, right? What we're seeing in disparities now started when the people were young. And so, a lot of the trauma that people experience manifested itself then into health outcomes. So I think we really have to go more upstream and think about what's happening earlier in life that's resulting in some of the disparities that we see today.
Q: I want to ask you a little more about mentorship because I think it's something that we hear a lot right now. And if you read as a young person approach your career, what should you do, you often get this advice to look for a mentor. Which again, there's nobody telling you what to do or how to find one or how to connect to one. So how have you gone about finding your mentors?
A: Well, you know, I think a surprising mentor has been a friend of mine where he is now the– he's now in San Francisco. And he's the chief of hospital medicine. I think he was the first person that really sort of validated some of the struggles that I was facing. And he really, all he really did was say, You're great. [laughter]
Q: So simple!
A: So simple! But you know, in a competitive environment, you just don't hear that a lot. And so, he really just said "you're great, and I think you can do it." When I said I wanted to go for my MBA, a lot of people were like, What? What's happening? I mean, I would think you'd go for your PhD. He was like, That makes sense. And, can I go with you when you look at the different schools? So he was, I remember I was at Babson, I was the information session, and he was in the car reading all his peer-reviewed articles and going through like 20 of them while I was at the session. He's not the same gender as me. He's not the same race as me. But when we talk about our backgrounds and how we've gotten to where we are, we have a lot in common.
Q: I love that. It's again kind of like peeling back the layers. The person on the surface might look like, well, this isn't a person I could connect with, but we're all so much more than what you see when you just look at someone.
A: Yeah, I think it's important to not take things at face value.
Q: And what about, if you think about, I don't know if you've been in a place where you're looking for a mentor and there isn't an obvious person to look to. What would you say to that person?
A: I mean, I would say something to both the potential mentors and the mentees. You know, for folks, if you see somebody that you think would make a great leader, you need to invest in them. And I don't know that enough people do that. They might say, oh, that person's great, I love working with them. But if you think they're a great leader, then you need to share that playbook with them. You need to help them out. And then for the mentee, I would say don't go for the obvious. [laughter] You know, kind of expand your horizons and not think that, oh, you know, this person's really well known in a field, Dr. So-and-So, so I want to go and meet with them and I want them to be my mentor. The person who's going to be your mentor is the person that's going to be honest with you about what you're doing and where you might need to polish things up and where you're successful. That is so much more helpful than somebody that's not going to be able to meet with you in the next six months and who's really busy anyway. You really need somebody who's going to give you the honest feedback and give you that playbook. And also, they might not be in a leadership position that you think they are. It might be somebody a little lower on the totem pole. Or they might be the person behind that leader that you're trying to reach out to. So I think people need to expand their sort of stereotype of who a mentor is.
Q: How do you think–I’m curious because as you’ve said that you’re a really straightforward person and you really value giving feedback. But it’s not any easy thing to do to tell people things they don't want to hear. It's hard to hear things you don't want to hear. So how have you learned to do that?
A: You know, I was born in Holland, and Dutch people are actually – I found this out later and it sort of made sense – they're very direct to the point of being borderline rude. And then, I have the Indonesian side of me where it's very much about saving face and not making somebody feel bad. So I think kind of had both of them in me for like 13 years before I moved in. So I am a very direct person. I mean, people, my team tells me that all the time – you're so direct. And in some ways it can be very refreshing, right? When you're sort of lost and you're trying to find your way and somebody's very direct with you, I think that's really helpful. And I'm always very clear that this isn't personal, right? This isn't trying to knock you down. This is about making you better because ultimately if you're better, the team is better. And I am nothing without a good team. I really am not. And so, I'm really just investing in sort of the harmony of everybody. And I think once you sort of lay that out to folks, that this is really about growing them and growing their leadership skills, they're open to feedback.
Q: Have you found that it opens the door for people giving you feedback?
A: Yeah, I mean, I think people know that– I mean, I don't go around seeking feedback. [laughter] I mean, I like to feel good, too. But I mean, they do know, like, I want to know, you know, if there's something I'm doing. It's difficult because if I'm in a position of power over somebody else, even if I say, I don't care, just tell me, I think people are still reluctant. But I think if we practice it, you know. And a lot of times I make a point of asking team members, Well, what do you think? Right? And then they'll feel comfortable to share them. Or I also really learned to read people's body language, to sort of – you know, again, the art historian – to see, like not just take things at face value, like what's coming out of their mouth, but see, you know, when you work together, you know when somebody's twitchy. So sometimes I'll just be like, Hey, what's up, you know? I'm noticing this. What's going on? And then they'll be like, Okay, let me tell you.
Q: Thank you, Aswita, for being here. It’s been truly a pleasure speaking with you and learning about what you do. But before you go, I’ve got my final five.
What do you think is the best advice you've ever gotten?
A: Best advice I heard was that your word and your reputation mean everything. And that you should not give away either one of them lightly. Because otherwise you don't anything for your hat to hang on. So I really take that very seriously because it's kind of true, you know, that those are things that really help you in your career. If you're known for something, or people know that when you say you're going to do something, you're going to commit to something, you'll do it. There's an immense amount of value to that.
Q: We're calling this podcast "Charged." So I'm curious to hear, in the context of what you do, what does that word mean to you?
A: To charge myself for this kind of work, I really have to have a very personal engagement to it that allows me to sort of remember why I'm doing this. And so, oftentimes I'll ask our team members, you know, how are you making someone else's life better that's not about this work, that's outside of this work, and is not about benefiting you in some way or your career in some way.
Q: When you need to recharge, what do you do?
A: Find your family. And it doesn't have to be in a traditional sense. And I don't care what it looks like, but find your family and spend time with them. I really think that's the way to recharge.
Q: When and where are you happiest?
A: So this is very cheesy but very simple. When I'm with my two daughters at Target, and obviously we love Target for many reasons because we never leave it without spending at least $60. But it's also about just spending time with them, doing something very ordinary and then creating a tradition that we will do when they're older. So like, I went to Target with my mom. And then the other piece that, you know, where I'm really happy is when we're in Hawaii. And I don't think I have to explain that one to you. [laughter]
Q: I think that’s pretty clear. Last question. Do you have any rituals that help you have a successful day?
A: Well, I try to get to the office early. So before the emails come in, before the meetings start, you know, I like to be there and to try and get settled and try to shoot some of my emails out without anybody responding. But that really depends on getting my kids to school on time and out the door. I thought I was doing fantastic today, and then I realized once I got to my office that I have a black blazer on, but put on the wrong pants, the blue pants. So you can have a ritual but it doesn't necessarily guarantee success.
Q: Thank you, Aswita for being here today.
A: You’re welcome, thank you for inviting me.
Q: It’s great to speak with you and we look forward to see what else happens at the Disparity Solutions Center.
A: Thank you.
Listen to next episode: Pamela Jones, MD, MS, MPH: Forging a Path to Neurosurgery
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