The importance of advocating for your healthcare, with Dr. Audrea Caesar

Jackie Ferguson: Thanks for listening to Diversity Beyond the Checkbox podcast. Today I am speaking with Dr. Audrea Caesar. Dr. Caesar is UNC Health's inaugural Chief Diversity Equity and Inclusion Officer. In this role, Dr. Caesar oversees and expands DEI and health equity efforts at UNC Health and UNC School of Medicine. Dr. Caesar, thank you so much for joining us.

Audrea Caesar: Thank you for having me.

Jackie: Of course, and I always like to start Dr. Caesar with, you know, just tell us a little about yourself, your background, your family, your identity, whatever you'd like to share.

Audrea: Absolutely. I always lead with where I'm from. I'm from Cleveland, Ohio, and I am extremely proud of that. It is a blue-collar town, It's a sports town and very ethnic, lot of great food, lot of great people. So I always start with that. In terms of identities, I'll just go down the list. I'm a person of faith.

I'm a wife. I'm a mother, a sister. My pronouns are she and her. I identify as a northerner, even though my roots are really in the south. I'm multiethnic, I'm a hip-hop head, world traveler, professor and leader.

Jackie: Wonderful. So well stated. Thank you for sharing that. Dr. Caesar, Let's start with just talking about your early career. You didn't start where you are now, right? So there was, there was a, a journey and a path there. Can we talk a little about your early career?

Audrea: Absolutely. You know, and again, I'm, I'm full of disclaimers, but a lot of people that I've interfaced with, they, they knew what they wanted to do. They knew who they wanted to be and, and the path they wanted to be on. That was not me. Let me tell you. In school I've studied health and also African American, African studies at The Ohio State University.

And somehow I ended up being a social worker. So that was my first job, and at 23 years of age, I was ill equipped and ill prepared to do social work. But back in the day, you didn't need to have a social work degree. You didn't even need to have a masters. You could come in with any bachelor's degree and they would put you through a six-month training program and you could become a social worker.

So I did my six months and then they put me on the street. And let me tell you, the day I quit, I was in tears because I had two clients in one building and, it was a tall building and the elevator was broken. So I literally had to walk down at least 15 flights of steps. And in certain neighborhoods that's uncomfortable, just say that it's beyond uncomfortable. It is dangerous.

So I decided, yeah, this isn't for me. And besides some of the issues that I was dealing with as a 23-year-old, was just way too much. And as a social worker, I didn't have the ability to change anything. I was just really carrying out orders and checking off a list and, and making sure I'm seeing my clients.

And, it just, it wasn't a good fit., I moved on, went to grad school, studied public health. That's really where my passion lies. Public health is really about the community, how we educate the community, how we care for the community, and how we help create healthy communities for everyone. So that was something that I really enjoyed.

Uh, funny story, my grandmother, who's passed away, she was a smoker, a chronic smoker, chain smoker. And she, the type of cigarettes that she smoked was Vice Roy. And so I knew the way to get to her was by eliminating her cigarettes. See, I went to school and in health class, they talked about how bad it was.

You're gonna get lung cancer, you're gonna die, right? So I didn't want my grandma to die, so I took her carton of cigarettes and I broke them and flushed them down the toilet. Oh man. When she caught up with me, oh, it was on chasing me around the house. She was, I thought she was gonna kill me. I really did.

And my parents stepped in and said, you know, she was doing this for your health. So at a very early age, I was a health promoter, if you will. so moving on, after finishing, you know, a Master's in public health and getting into the community a little bit more, I really found my niche working for state government as an ombudsman.

Uh, my role was to help medical providers get paid, so if they had billing issues or claims issues. It was perfect. They would roll out the red carpet for me to come, they would feed me when I got there and then I would fix all their problems and it was beautiful. I did that job for close to seven years and just really enjoyed the interaction between the healthcare environment and the public sector because I represented Medicaid for the state of Ohio at that., moving on.

I said, Okay, this is getting old. I have other talents and skills and I'm not really getting to the heart of who I am, which is really serving my community and doing something meaningful. So I moved on and I had a few other roles, but the one role that changed my life was, I was a business operations director, for a human services agency, in North Carolina. And. I got the opportunity to create something. And so I said, well, what am I good at? What am I passionate about? And so I created a community support and outreach division, where we applied social services, I guess frameworks and techniques, to public health practice. 

So I created a health equity division, and I started our very first health equity collaborative where we had multiple nonprofits, healthcare systems, other public sector organizations to come together to really focus on. The issues that were at play in this specific county and doing so gave me the opportunity to meet people and talk to folks and to really understand what the issues were. Because you've, you've got the academic literature telling you what it is and telling you what the leading causes of death are, and those things are important and we need that, but, also important to hear from people and to understand their lived experiences.

And so that's where I found, my passion. I said, Yeah, this is it. I think my experiences with healthcare also put me in a position where this was something important. I'm a mom, and my birth experience was traumatic and I didn't think I would make it. I didn't think my child would make it. But we both lived and I'll just, I'll leave it at that.

I was really shaken from that experience because all the things that I had been talking about and all the things that I had been working on and doing was playing out in my real life.

Jackie: Wow.

Audrea: It took me three years to tell my story. I was ashamed, but I, I didn't realize that infant mortality and maternal mortality was as big as they were.

I didn't realize that a lot of women were having the same experience that I was having. Didn't matter about my education, didn't matter about where I lived or socioeconomic status. when you're in the hospital and then you're in pain, they only see you.

Audrea: In front of them. And you don't have the opportunity to, oh wait, hold up my degree, then, Oh yeah, I'm, I'm professor here. Here's my titles. Now let's start over. That's not reality. So, that experience really changed me.

Jackie: Yeah. Thank you for sharing that. You know, just to dig into that for a moment, one of the things that I think overall people believe, or that's the narrative that's told to us, is there are these disparities because we don't have the education or we don't have the, we're, we're eating bad foods, right? Or we're not making exercise a priority.

And it, it puts the onus on the patient right, on the individual rather than on the system. But let's talk Dr. Caesar about some of the inequities that exist in healthcare in particular. And then, you know, I always think of, Serena Williams and her experience, right? If you think about all of the things, the narrative that were taught about why there are these disparities, right? Which is never an issue with the system, it's always an issue with the individual. 

You know, you hear, well, they come from low economic backgrounds. That's not Serena Williams. They eat wrong foods and, and you don't prioritize health. That's not Serena Williams, right. A lack of education or, you know, not understanding what the doctor is saying, or you know, what the diagnosis is or how to manage it. That certainly was not Serena Williams, but she had a similar experience in giving birth to her daughter in those inequities. So can we talk a little bit about what the inequities are that exist in healthcare and then what are some of the ways that that we as individuals can advocate for ourselves.

Audrea: Wow. So that's a spring-loaded question. I mean, if you really wanna know all of the inequities, I could probably take the rest of this podcast to run down each chronic disease and show you where the disparities lie. I would say across the board, if you are African American and you were born and raised in the United States, there's a high probability that some disparity is coming your way.

Whether we're talking about cancer, any of the forms of cancer, diabetes, heart disease, you know, I've spoken about infant mortality and maternal and child health. All of those areas are disparities, but I think it's really more important to talk about why those disparities exist., and one of the things that I'm really passionate about is educating medical students on some of the myths out there.

So, you know, I'll, I'll start with this. It’s important to debunk these myths about who people of color and persons who have different abilities, who they are, and the stigma attached to them because there's this internal bias that people experience. And, one of my favorite scholars on the subjects is Dr. Bryant T Marks, and he says, if you live in America and you have a brain, you, you have bias. 

So, we don't look at as frequently are the doctors who are doing the educating. So the faculty, and they pass down some of these thoughts and beliefs that they've had for years and years and years down to their students and your students execute it.

One example is pain management. It's a longstanding myth that African Americans don't feel pain is worse as whites. It's a myth, but it's still being taught in some places. So we have to make sure we call out those different, myths and debunk them and say, hey, look, you have to see people as people.

If we look at genetics and DNA, there's only. 0.1%, and now I believe it's 0.01% that differentiates us. So that 0.01% accounts for our hair, our eyes, skin tone and variations in our features. So, biologically a lot of the things that are being taught are just incorrect.

Jackie: Yeah.

Audrea: You know, another thing that I wanna talk about as it relates to disparities are his historic inequities. So, when a person that comes in speaking another language comes into the healthcare system, we don't have the services that they need in their preferred language. And, and that's something that we should at this point with all the civil rights laws. But let's think back even further with African Americans.

When we talk about historical inequities, we think of Tuskegee, right? That's the biggest one. That's the first one we think of. But in reality, these types of, inequities and injustices have been happening long before the Tuskegee. If you go back to slavery, Dr. J Marion Sims, and you may have heard the story, where he's the father of gynecology and he developed a speculum, but he also did the majority of his testing, if not all of his testing on slaves without anesthesia.

All of these stories. If you think about the Innova story, all of these things that I've read in great books like Medical Apartheid and Just Medicine, they highlight so many inequities that I didn't realize existed. And it scares me, you know, and I'm a person in medicine, and it, it scares me.

Jackie: Thank you for sharing that, Dr. Caesar. You know, it's so important that we learn the truth about these things that exist in our society because we don't, we're not taught that, right? We're, we're just taught the rhetoric or taught what someone else thinks or thought or whatever. But it's, it's certainly not what the truth is of our history.

And the history of the United States. And so it's important to, you know, spend some time with that because that certainly has long reaching effects into healthcare now. Right. And so that's so important. I appreciate that. As we think about advocating for ourselves as people who are underrepresented or marginalized, what are some of the ways, Dr. Caesar, that you recommend that we do that for ourselves?

Audrea: Yeah. I'm going to say vote

Jackie: Hmm

Audrea: The most important thing that you can do is to vote, and not just for presidential elections, but for local government, city, townships, counties, these are the folks that are creating laws and in some cases, barriers that prevent you from having the quality of life that you deserve.

So vote, that's the first thing you can do to advocate for yourself. The second thing you can do is to be informed, you know, with the internet, there's a lot of different sites out there that if you have a question, you can probably research what it is. Oh, no, I have a, I have a left flank pain. Let me Google it.

Jackie: Mm-hmm.

Audrea: Don't do that in lieu of going to your doctor, go to your doctor. But at the same time, if you're looking at CDC, NIH, or other reputable sources like Mayo Clinic, Cleveland Clinic, they're gonna give you some good tips and good information. And give you some good questions to ask your provider, when you go to see your doctor. 

There's no reason for us to go in and not be informed about what our options are, not in this day and age, cuz information is readily available., you know, another thing you can do is find folks either in your church, your community that understand this. There's always somebody that knows a little something about something, whether it's a midwife or you know, a nurse. Find people who are in healthcare if possible, and talk to them.

Jackie: Mm-hmm.

Audrea: You know, it's these relationships. Every church I've ever, ever been to has a, a nursing ministry

Jackie: Okay.

Audrea: and, and they're doing health equity work and health education work. That's a good opportunity to get informed. In addition to that, At UNC Health, we have patient advisory boards.

So we invite the community in to help us do better and be better. And that's something I'm really proud about., we also have opportunities for folks to volunteer with us in our food pantry, which is, I'm proud to say it's a hundred percent staff by volunteers., it's those types of initiatives that can also help you get informed. So, I mean, those are the things that I, I recommend.

Jackie: That's so, so smart and I appreciate that advice. You know, another thing Dr. Caesar just to touch on is what I find, especially for older people who are culturally diverse, they take the information oftentimes, but they don't ask questions right then and there of their providers. 

I love the idea of having those questions as you go in. That's, that's super smart, and it's, you have to prepare, right? You have to participate in your own help. What happens or what is your recommendation when getting diagnosis that you, that you don't understand or that makes you nervous? Where do you, where do you go from there?

Audrea: Hmm. Well that's difficult. So usually, you know, I recommend taking a loved one or a family member with you when you get a diagnosis that is, difficult, it's hard to process in that moment what is happening. So being able to one, take somebody with you so can also hear what you're hearing, but then also ask questions when you're not able to ask questions is gonna be important.

It's also important to forge a good relationship with your clinician.

Jackie: Mm-hmm.

Audrea: If, if that clinician rubs you the wrong way, that's not the right one for. And if that person isn't feeding you with information, particularly resources and support, immediately, that's not the right person for you. You've got to find a doctor who is going to meet your needs and, and isn't in a rush.

So for any of our, you know, the elderly patients that come in, always have a family member, a loved one, somebody who was trusted to be there with you.

Jackie: Absolutely. That's such good advice. I appreciate that. Dr. Caesar let's talk a little about your current work. What makes the work you're doing now personally meaningful?

Audrea: Yeah. So, when I arrived at UNC Health a year ago, there were lots of things happening. Pockets of, of great work in the research space, also happening in our human resources department, around diversity. and one of the things that I came in and said I want to change is that our focus shouldn't be on diversity.

Our focus should be on equity and inclusion. So I changed our department to the Department of Equity and Inclusion.

Jackie: Mm-hmm.

Audrea: And a lot of folks said, Oh, that's not a good idea. You know, why? Why isn't diversity front and center? Diversity has been front and center. We're diverse as an organization, but equity is about closing the gaps and we have gaps at the leadership level.

We have gap gaps in some of our provider ranks and we have gaps and, and even some of our frontline jobs. So we wanna make sure that we diversify across the board. And that's really equity. We wanna make sure that we pay people appropriately.

Jackie: Mm-hmm.

Audrea: So, if you have been in your role for 10 years and you have a new person come in and their starting salary is higher than yours, we need to fix that.

Um, you know, those types of issues around pay compression. I launched, a framework with six pillars, and the six pillars will really help to make sense of how we are approaching the work here at UNC Health. The first is workforce equity, and I mentioned some of those things right there around representation.

The second is building organizational capacity. You have to be able to train folks. And when I say folks, I mean everybody. teammates, patients, and also community. Having educational opportunities for the community is essential for us to have that partnership. you know, the next one is creating an inclusive climate.

Everybody has to have a sense of belonging and, and feel welcomed. If not, then we're not doing our job and folks are gonna be running out the door. We wanna stop the churn and retain folks. the next phase is research. We need to identify where the barriers are. If we have structural barriers in our policy, we need to look at that and apply, an equity lens to the policy.

Then we've got data and transparency. I'll say one thing that we haven't been necessarily is as transparent about, what the challenges are. So we're working hard to, one, share the numbers with folks. They need to know what our employee population looks like. And let me tell you, we're huge. We're, well, not huge in the sense of.

We're huge within the state of North Carolina. We have 19 hospitals, and in thousands of provider practices and primary care facilities and ambulatory surgery centers and et cetera.

Jackie: Hmm.

Audrea: But we need to tell people who we are and then we need to show them.

Jackie: Absolutely. Absolutely.

Audrea: And then the, the vision behind all of this is business integration. We want to integrate equity across the board within everything we do.

Jackie: Mm-hmm. that's so important. And you know, Dr. Caesar, you said when, at the beginning of this, this question, you start with equity and inclusion because. You have to lay the foundation for diversity. A lot of times, you know, because you often hear diversity, equity, and, and inclusion. Thank you. Start with diversity.

Diversity is here. It's just a matter of are you providing the environment to attract diversity within your organization? And not only attract, but retain. Because if you don't have an environment that’s inclusive and equitable, you're not going to be able to keep those diverse employees that you're looking to gain. 

I love that you said that. And, and you know, just a reminder for those who are listening that are, are thinking about diversity, equity, and inclusion, even though that's how we often say it and that's how you hear it, you really need to start with laying that foundation of inclusion and equity, so that you can attract those, those diverse professionals. I think that's so important.

Audrea: Yeah, I like to say elevating diversity through equity and inclusion. That's another way to say it.

Jackie: So yes, I love that, elevating diversity through equity and inclusion. That's great. And then you mentioned transparency and, and I think that's such an important part of the puzzle, but one that you know, no matter what your industry, that's a little bit scary for leaders, right to share. Where you are on the journey, where some of your missteps have historically been and what you're doing to address those things.

You know, historically it professionally where, you know, it's set to be, you know, I've got the answers. Everything's great. Right. We're doing fine. Don't worry. But in providing that, that transparency, it creates a, a level of trust with your employees and with your clients and your customers and consumers that you didn't have before.

And that's something that's very important to our society today is to have that relationship of trust no matter what your industry is. And transparency is, is one of the ways, to get to that. So that's, that's such great advice and I appreciate that. 

Audrea: it's hard not to be transparent when the data speaks for itself. And, and so if we don't put it out there, a lot of what we have from billing data is open source. You know, you can find out. What the disparities are, you can find out, what our quality scores are.

All of that is public information. you know, a lot of people don't know what's public information, but we want to package it in a way that's easy for you to access and that you understand. I want patients to understand where we are and what we're trying to do, and then being honest with ourselves about who we are.

That's, that's what speaks to our mission, and our mission is to serve North Carolinians and to be the state's healthcare system. And so we embody that and we want to do it. So just the transparency piece is, is about truly being that for North Carolinians.

Jackie: Absolutely.

Audrea: Yeah.

Jackie: Dr. Caesar, can you share some of the programs that you're currently working on, what you're excited about working on?

Audrea: Yes, I am really excited about our community division. We just launched it this year, back in July. And our goal is to take our community relationships a step further. In the past we've done outreach, which is showing up at different events, maybe giving out, you know, the swag, the UNC health gear, that sort of thing., and also, with our philanthropic efforts, which are outstanding. 

But now we need to partner. Truly with the community, we need a seat at the table. There are community health assessments that happen and we might be there at the meeting, but we're not actively contributing to the solution. And we're not actively sharing resources that we might be able to do a better job at, at some areas than some folks like research.

You know, we're an academic medical center. We are a research engine, so we have the opportunity to say, hey, we have these resources. Community members, Let's partner with you, nonprofits let's partner with you, health departments. Let's partner with you and let's focus on one thing together to have that collective impact.

That's where we want to be in community. That is essentially health equity. Health equity happens in a local context.

Jackie: Mm-hmm.

Audrea: It doesn't happen, we got three priorities for the state, that's not how it happens. Every community has different challenges and different barriers. We want to be able to look at our footprint of all of our hospitals and say, what are those very specific challenges in that specific area surrounding that specific hospital?

And then start to approach it with community. So we're building a team right now who can do that, and I'm very proud of that because, you know, as I mentioned early on, the focus was on teammates

Jackie: Mm-hmm.

Audrea: and then the focus was on patients. And so I've added the third layer. So we're focusing on teammates, patients, and the community.

Jackie: Awesome. That's so great. Dr. Caesar, you've been in this work for 20 plus years in in the public sector. Tell us a little about the missteps that DEI practitioners make or people who are in DEI and, and trying to create those environments, and those cultures of inclusion and create equity within their spaces.

What are some of the lessons that you've learned in doing this work for so long that you can share with us?

Audrea: The most important thing that needs to happen for anybody doing DEI work is you have to create an organizational structure that prioritizes equity with everything else. That means it can't be buried within HR departments or other departments. It can't be an afterthought. It should be a top tier, senior level position, I should say, executive level position, where you have a decision maker. Otherwise it will be buried and you'll be doing celebrations and events and not really getting to the root of problems and not really dealing with the structural barriers. That's the first misstep. 

The second misstep is around training. This isn't a one and done training. A lot of folks implement diversity training, but they don't outline clear objectives on what they want staff to learn from the training. I'm very specific about what I want our clinicians to take away our teammates and our leaders to take away from this. And then we want you to put it into practice. So we ask you to complete an attestation on what you've implemented over the past year

Jackie: Wow.

Audrea: training. You, you have to have that level of accountability just like you would anything else, you know, for accreditation, audits, everything else, there are clear steps and there's a criteria for what we need to accomplish. We need to apply that same level of accountability, with equity and inclusion.

Jackie: I love that. Thank you so much Dr. Caesar. There's a significant amount of emotional labor and doing this work and a need for external support and battling these inequities that exist, especially when people don't believe that there are inequities, right? What does it take to do this work? What's the personal toll and how do you navigate that?

Audrea: Yeah. The personal toll is tremendous. And, and while we talk a lot about training for others, as diversity practitioners and diversity leaders, we ourselves have to be trained to identify our triggers and identify the things that put us in a place where we can't do the. Or where we are debilitated by what we're seeing.

You know, another thing is make sure you have people like you somewhere that you can sit down and share this experience with, you know, being a person of color and in all white environment. Is probably one of the most challenging places to be in places to negotiate and navigate. So you need to be able to step away and to find people who are like you to share your experience.

And, you know, I always say commiserate, you know, sitting and sharing what's going on in, in your world, your world, because that, that is just so therapeutic. I'll tell you, when George Floyd happened back in 2020, the killing of George Floyd, a lot of people were grieving, but for me, at that time, I was working in city government. I didn't have time to grieve. I had to put a plan into action.

And so I found another way to release what I was feeling. I actually created a video, and the video contained, historical images, paralleled with modern day, and it was like a flashback effect for every picture. And so seeing that it, it brought me to tears.

But I think even more, it brought other people to tears in such a, an emotional release, from the creation of that video. So that was one way that I dealt with some of that pain., because for us it's repeated trauma. It's repeated.

Jackie: Mm-hmm.

Audrea: For a lot of folks who witnessed it, it was the first time that they had experienced something so traumatic on top of the pandemic and on top of the political environment.

So just having just a creative outlet is one of the things that helped me and. Again, family. Family, you, you have to get back to what's important to you, and you have to remember why you started the work in the first place. You know, I, I love quotes. And I, I don't wanna mess up a quote, but I'm gonna share this one because I think it's important.

It can be discouraging, but Dr. Martin Luther King Jr. said, if you can't fly, then run. can't run, then walk. If you can't walk, then crawl. But whatever you do, keep moving forward. And that's such an encouragement to me, because even when it feels like we're not making progress, we've been set back, we need to keep moving forward.

Jackie: Absolutely. Oh, I love that. That's, that's so important and so many things that you just said, I think as a practitioner myself, are so important and one of which is just the network so that, you know, you're not the only one experiencing those feelings and those challenges, and so that's so important. But yeah, I, I think that's, that's so great.

My next question you just answered, which was, what advice would you give someone doing the work when it's difficult to see those gains that might be feeling burned out and frustrated with progress? And that quote from Dr. Martin Luther King Jr. is perfect because whatever the movement, movement in the right direction is good.

And if you're able to contribute to that lead that, that's positive, not only for your local community, but for the world. And so, I love that quote. Love that quote.

Audrea: Yeah, I, I can add to that.

Jackie: Yes, please.

Audrea: So, my pastor used to say the most spiritual thing you can do is eat a snack and take a nap. So, get in rest, is important. Get sleep. Take your vacation time and just have time away. That is extremely therapeutic and you need. You need it.

Jackie: Absolutely. You know, and especially in a time where overwork, right is, is sometimes prioritized and heralded, right? Oh, I worked 60 hours this week and, you know, oh, I work on the weekends and I work through right, in the evening. And, you know, whereas when you're building businesses or doing big things, sometimes that's required, but any high performance requires that work and hustle and rest, and so I think that that's such good advice. Dr. Caesar, what's next for our UNC Health and DEI?

Audrea: Yeah, UNC Health is embarking on some tremendous work. We have recently revamped our system, Executive Diversity, Equity Inclusion Council, and so, we're bringing in leaders from across the system. Every single hospital entity., we have representation from our, physician practice network, and our Health Alliance, which is our value-based care group.

We're bringing all of those leaders together to start formulating how we're going to do the work., we've just hired a new research director and she is outstanding and so we're happy to get some things going there, but really it's gonna be the development of this strategic plan, that we get to carry out from a system perspective that is gonna do the most work across the state.

And we're looking forward to that, you know, I mentioned our community work. But I'll also say we're building a department. In the past we didn't even have a department, so, we're going from having a small team of folks doing health equity, a small team of folks doing what we formally call DEI, now to this Department of Equity and inclusion, which is going to grow tremendously., We've got several positions posted to folks are looking for work. 

Audrea: But the department is designed to be consultants. We're gonna be consultants to help you with your equity action plans. We do a survey every year around climate related to equity and inclusion. That data is so rich and so tremendous. It's gonna inform what we need to do internally and externally. So using that data is, our next step. Cause we just completed the survey this year in 2022.

Jackie: That's so good. Yeah.

Audrea: also on the rise, you know, we're looking at how we better partner with School of Medicine while we are one, UNC Health., we we're going to attempt to do more on the student side of things.

We think of healthcare system, but there's also the school and we wanna support those efforts and we've got a really great leader, over the School of Medicine diversity team. And so I'm real excited to, to partner with them and to. Help them create the new reality. It really starts with our young people and our students and our new docs.

If we can raise awareness to the point where they have some awareness of their personal bias, some of the historical inequities and what they should be doing from a cultural. Competency and sensitivity lens, then I think they're going to do better, and I think we're gonna see some of these outcomes change and shift.

Jackie: Absolutely. That's, that's so great. And you know, again, you said this as we started the conversation, but infusing equity and inclusion into every part of the organization is so important. That's so fantastic. Dr. Caesar, what is the message that you wanna leave with our listeners?

Audrea: Yeah, I, I wanna leave a message of hope. If you look around you in terms of what's happening in society, it doesn't feel hopeful. It feels like two steps forward, five steps back.

Jackie: Mm-hmm.

Audrea: I wanna encourage you to continue what you're doing., your work is valuable. You are valuable. And your workplace needs you just as you are whatever your, your differences are, you are needed, you are valuable. In order to collectively move the needle, we have to be in play to make this better for the next generation. I have no expectation that we're going to make any major strides in my lifetime, but in my daughter's lifetime.

Jackie: Yeah.

Audrea: I think she's going to encounter a very different society and a very different healthcare system. One of the things that I think about is, neurodiversity. We have persons in our family with ADHD and autism., how do we create a workplace that. Is welcoming to those folks. You know, how do we look at differences that includes white people, specifically white men? I never hear that in the conversation, but it, it needs to happen. That's how you reframe the language of diversity, and that's again, one of the reasons why we're moving away from that and focusing on equity. Equity is for everyone. Inclusion. Inclusion is for everyone

Jackie: Thanks for that. That's exactly right.

Audrea: So I, I would just leave it there.

Jackie: Dr. Caesar, thank you so much. This has been such a great conversation. So enlightening. So many great insights. Thank you for spending some time with me today.

Audrea: My pleasure. Thank you for having me.