Diversity Matters Revisited: Opportunities for Change in Radiation Oncology

By Tammy McCausland

This blog post sources its content from “Diversity Matters Revisited,” an article published in November 2020 in SROA’s quarterly news publication, Radiation Oncology News for Administrators.

George Floyd’s death on May 25, 2020, and the subsequent protests across the United States and around the world, coupled with the COVID-19 pandemic, have highlighted injustice, inequity and disparities for people of color across the country. Dr. Parul Barry, clinical assistant professor of radiation oncology at UPMC Hillman Cancer Center, said the Black Lives Matter (BLM) and racial justice movement “has brought to light a lot of the issues in disparities of care that we see in the clinic and in research. For example, we see differences in disease-related outcomes and in enrollment in clinical trials.”

The COVID-19 pandemic has also changed patterns of practice and impacted access to care.

“This movement not only highlighted the injustice of George Floyd’s and Breonna Taylor’s deaths, among so many others, but it also showed us that women and minorities often experience

a disproportionate number of worse outcomes in the care they receive. We’re seeing, on a real-time scale, how limited access has further impacted these outcomes,” she said.

A radiation oncology workforce that is more reflective of the diversity of the cancer patient population could improve patient care and disease-related outcomes. “A reflective workforce is

not one where we simply check off the boxes in terms of hiring based on race, gender or sexual orientation, among other factors. A workforce should also be reflective of patient experiences.

We all come from different walks of life, and some have had more privilege than others,” she said. “In the hiring process, it’s important not only to seek diversity in terms of race, gender

and sexual orientation, but also to identify if an applicant may have had less opportunities, access or resources. The depth and breadth of a person’s life experience often informs their practice of medicine.”

Radiation oncologists must listen carefully to patients and empower them to talk about their social history. In doing so, they can help optimize the care patients receive. “Women and

underrepresented minorities implicitly understand that there are disparities in care, and they see that there are differences in access to care. As a provider, I want my patients to feel comfortable

in discussing any concerns that they have so that we can effectively address them,” she said. “For example, patients who have lost their job due to the COVID-19 pandemic are at high risk for incurring significant financial toxicity due to depleted funds and loss of their employer-based insurance plan. In these cases, engaging social services and finding means for support is

critical for them to receive the care that they need.”

The major societal events this year echo what many radiation oncologists have already been writing and talking about. “There’s a need to improve mentorship and sponsorship of women and

underrepresented minority faculty in radiation oncology. Identifying and removing the barriers we face as physicians and leaders in the workplace is just so important. I think that

the movement really has shone a spotlight on these issues,” she said. Dr. Barry explained that she feels lucky to have had such wonderful mentors and sponsors during her career.

She’s optimistic that the movement will result in lasting change. “I think this movement has really caught the attention of administrators and leaders in the field, and I do see efforts

being made at all levels to make lasting change and to promote women and underrepresented minorities in the workplace,” she said.

At the national level radiation oncology societies are focusing on addressing such disparities through sessions at their annual meetings and on committees dedicated to improving diversity in the field. “They’re empowering committees on health equity and diversity to look into ways to reduce disparities that disproportionately affect  women and minorities,” she said.

She encourages administrative leaders to engage women and minorities in positions dedicated to improving diversity in their departments. “We have experiences and viewpoints that are unique and that could help promote and foster a more equitable environment,” she said. In hiring, she said, “It’s really important to look at a candidate as a whole. In the interview process, you’ll often be pleasantly surprised to learn what people can bring to the table in light of their diverse background and experiences.”

Administrators should consider candidate CVs they may be inclined to overlook. “Be open in terms of who you bring in for an interview. I think that that’s one easy way to diversify the workforce,” she said.

Dr. Barry cautioned that there can also be diversity and no inclusion. “While increasing diversity is important, it is also critical that we make people feel included. As we grow and put more emphasis on improving diversity, we need to become compassionate to the experiences of those who are not like ourselves,” she said. “And while you may not have had a specific experience, you can say, ‘I understand. What can I do to make it better? How can I help?’ I think you can increase sensitivity and improve inclusion by being more compassionate as a person. While building compassion does take work, it is worth it.”

There’s a role for everyone to help improve diversity—by educating themselves about the issues and participating on these diversity and health equity committees. “It doesn’t matter if

they are the most junior resident, a department chair or dean, or senior administrator, the best way is to get involved,” she said

• Diversity