Tell us about a DEI initiative in your division that you would like to highlight.
In 2016, I (Susanne Miedlich, MD) learned about the high prevalence of obesity and diabetes in people with serious mental illness during a meeting of the UR Healthy Weight Initiative, and as an endocrinologist, I felt well-placed and inspired to help improve cardiometabolic outcomes in those patients. In studying the literature and more importantly through actively screening patients with mental illness on antipsychotics for diabetes mellitus at the Medicine-In-Psychiatry-Primary Care clinic (MIPS-PC), I learned first-hand that these patients sometimes struggle with multiple health barriers which include depression, substance use, social isolation, poor living conditions, as well as limited access to healthy foods. This project has been funded by a DOM pilot award, and was executed in close collaboration with my dear colleagues in the Department of Psychiatry, Telva Olivares, MD, Steven Lamberti, MD, Kevin Brazill, DO, and Diane Morse, MD, as well as the wonderful nurses and staff at MIPS-PC.
I have since started a weekly, embedded diabetes care clinic at MIPS-PC, and I hope our interdisciplinary work there, in close communication with care managers, primary care providers, pharmacists, and psychiatrists will continue to flourish and lead to improved health outcomes in this high-risk patient population. During my work there, I also learned that, just like in my regular practice, connecting to patients and teaching them can make a huge difference. My personal highlight this year was to recruit two patients for the annual Tour De Cure, a local fundraising event of the American Diabetes Association, which includes a bike ride between 12.5 and 100 miles. Both women were rather inexperienced riders, yet both did it, they crossed the finish line with me and both vowed to join our team again in 2024, next time with more training ahead of the race. We all had a lot of fun that day.
What are the future plans for the DEI initiatives that are being highlighted?
In reflecting on what I learned so far, I hope to put more emphasis on healthy lifestyles and diabetes education, ideally peer-led, into our diabetes care clinic, and for MIPS-PC patients in particular. And of course, for the next Tour De Cure in 2024, I hope to recruit and train with at least four patients from MIPS-PC and ride with them. There is no greater reward for one’s work as a physician than to see one’s own teaching points in action.
What advice would you give others who want to undertake similar DEI initiatives in their division?
Health equity, to me, is a basic foundation of my work as a physician, its implementation can be difficult though. For example, not being able to provide a much-needed medication for a patient because it is not covered by their insurance or because they cannot afford it, or because they do not have insurance in the first place, can be extremely frustrating. Yet, small successes in helping our patients make all the difference. In our division, examples include assisting patients in applying for patient assistance programs, joining national patient advocacy initiatives as my colleague Sara MacLeod, DO, MPH, has done to increase access to evidence-based diabetes medications, or providing care to underinsured patients at St. Joseph‘s Neighborhood Center during our monthly Endocrine Nights alongside our ambitious medical students, as most of my colleagues are doing. I am sure you will find your next endeavor if you remain open and connect with your patients.