45: Changing the Culture of Medicine From the Top Down with Dr. Phyllis Dennery

“How are they going to make croissants and not have the recipe? A grocery list? Not have the equipment that you need to make something? It's the same concept. How are you going to be a Chief or Chair or the Dean or the Provost or whatever you want to be without having some sort of roadmap?” -Phyllis A. Dennery, MD, FAAP

In today’s episode Coach Gabriella Dennery MD sits down with her sister, Dr. Phyllis A. Dennery, Chair of Pediatrics at Brown University, to have a frank and rich conversation. They discuss topics including leadership, women in medicine, race and medicine, medical careers, diversity and changing the culture of medicine, mentorship and so much more! 

 

Dr. Phyllis Dennery attended medical school at Howard University College of Medicine, and completed her residency at George Washington University at Children’s National Medical Center. Her fellowship in Neonatology was completed at Case Western Reserve University - Rainbow Babies and Children’s Hospital, Cleveland OH.

Phyllis A. Dennery MD is the Sylvia Kay Hassenfeld Chair of Pediatrics at the Warren Alpert School of Medicine at Brown University, Pediatrician-in-Chief at Rhode Island Hospital, and Medical Director of Hasbro Children’s Hospital. She is also Professor of Molecular Biology, Cell Biology and Biochemistry at Brown University.*

Excerpts from the show:

 

“So tell me a little bit more about how you see your journey in medicine as a leader. What was the easiest thing for you and what was the biggest challenge for you?” -Coach Gabriella Dennery MD 

“When I first thought about medicine, as you well know, our family is riddled with physicians throughout the whole family and that was almost a premeditated or predestined choice to go into medicine for many of us in the family. However, at one point I sort of thought, ‘Oh, do I really want to do this?’ I thought about genetics. I wanted to be a geneticist and a scientist. But somewhere along the line I realized when I was an undergraduate that I really did want to go to med school and that was something that was a passion that I wanted to have. So I put my energy into it and said, ‘Ok, I'm going to get there and really make it work.’ So I ended up going to Howard University and enjoying medical school more than I thought. It felt very familiar. It's a lot of stuff I already knew in my mind, or that made sense to me. Then, deciding what to do next, when I was a third-year medical student I walked into the neonatal intensive care unit because we had a pediatric rotation. So now, we would never have a baby out in the open so somebody could reach in because that's not good safe practice and you know, infection control. But there was a tiny baby on a warmer bed and the attending physician reached over and placed her little finger into the space, and the little baby grabbed her little finger just like that, and I said, ‘Wow!’ I said, ‘I want to be a neonatologist because these little creatures that are so fragile will go on to become human beings that participate in this life! This is what I want to do.’ So I pushed for that. That was something that I really thought was my calling. So I realized I had to do a whole lot of things before I got there. I trained in pediatrics and then trained in neonatology and I did all those things, and then I finally ended up with my first position in neonatology at Stanford University.” -Dr. Phyllis A. Dennery, MD, FAAP

‘When I got there (Stanford University), I realized how important research was for me. I wanted to understand why these babies had problems with their lungs. What was causing the problems? Was it the oxygen we were giving in order to support them? And I studied that and I'm still studying that for the last 30+ years. So a strange thing happens in medicine. You're asked to serve as a physician doing clinical work, doing research, doing whatever you're doing in academia, but all of a sudden people say, ‘Well look, this person is doing so well as a researcher, as whatever.’ And they say, ‘Oh she'll be a great leader.’ Well, I don't know how those two connect but that's how people see it. If there is a connection between your skills in the lab or whatever research you're doing and you becoming a leader? So I was approached for many leadership opportunities to become a division director in neonatology. That's what took me to the Children's Hospital of Philadelphia where I spent the next 12 years after spending 14 years at Stanford. Twelve years of my career as a division director in that unit and of course, when you spend time there, you develop programs, and that became more fun for me. To think of strategically engaging people and building programs and making things happen and developing other people. How do you help other junior people learn about what their passion is and how they're going to make that passion happen? So I saw it as a way to pay it forward.  Then, after 12 years of doing that, they said, ‘Oh now you’ve got to do more.’ So I was recruited to be a Chair here at Brown University, the Chair of Pediatrics. So it's an opportunity to really engage others and to take people and help them see their way through this difficult and complicated path of getting a career that is satisfying and fulfilling. So that's kind of been the journey that I've taken and why I’m where I am.” -Dr. Phyllis A. Dennery, MD, FAAP

“As far as leadership is concerned, did you feel like you knew what you were doing right off the bat?” -Coach Gabriella Dennery MD

“Unfortunately, that's what I say is wrong with that system. They don't prepare you as much as they should for the opportunity that they're saying you're so good at. They don't know that. But there's a lot of on-the-job learning. But there are many opportunities now that are much more clear about ways in which people can train to become what they are excited about. So now my journey continues and it's much more strategic about how I get to know what I am getting myself into in these next steps and these next opportunities. And so I took a lot of leadership development courses through various national organizations and also locally to better understand what are some of the pitfalls of becoming a leader. You want to be a leader that's inclusive. You want to be a leader that has a way of thinking that helps people and isn't reactive, isn't strident, isn't many many things. So there's lessons to learn. Because we all have our personalities. But sometimes we have to also understand how our personality traits might affect others and make their lives either good or bad.”  -Phyllis A. Dennery, MD, FAAP

“Phyllis, I asked you before we started recording if you were the only black chair at your medical school.” -Coach Gabriella Dennery MD

“My answer can be really simple, yes. But a much more in-depth answer would be to say I really hate the concept of ‘the first’ and ‘the only’. Because the whole point is where it becomes irrelevant. Where it's just as likely that you or your colleagues of color or the woman next to you could be that person versus it just being relegated to men. So right now we're so happy, ‘Oh there's the first this and the first that,’ but the reality is, it needs to become as normal and as accepted and as common as it needs to be for the population.” -Phyllis A. Dennery, MD, FAAP

“What does that mean in terms of your work right now though? What is your impact on young doctors of color who are looking at you and saying, ‘Whoa’?” -Coach Gabriella Dennery MD

“Well, you know just my face makes a difference in young people who are looking at a website and say, ‘Oh,’ and they reach out and they say, ‘Oh, I'd like to talk to you, work with you, do something with you.’ It's a bit easier for me to recruit someone who is of color. So the higher you are in the hierarchy, the more impact you have on who will be there with you. So it's so much easier for me to recruit someone who is like me. I can have much more credibility as a recruiter of these people into my department by saying, ’It’s safe to come here, it's a good place to be. It's a place where you could grow,’ than someone who doesn't represent what I represent. Sometimes they don't come. But one of which, a really brilliant guy, he's now my mentee. He said, ‘I’d like you to mentor me.’ We meet monthly or every month to talk about his career path and I send opportunities his way. So there are ways in which by just being who we are we can help grow that group so that we are not the only one. That's my passion. My determination and what I do is that I feel like a lot of people talk about, ‘Let's diversify the medical school class, let's diversify this one that one.’ Doesn't matter as much in my opinion. I could get a lot of people all upset. But if you have a leader who represents that diversity, so that now you can keep bringing more residents and students and fellows of color into the mix. So it's not that it doesn't matter to do it from the ground up. A lot of people use that strategy. The question is, that pipeline is awfully long and ‘leaky’ in that you send people elsewhere too. But if you bring people into leadership, you can make a difference in that culture. Because someone gets on their bully pulpit and says, ‘No we're not going to accept these micro aggressions. This very white supremacist educational model where you don't think about these things, and how they affect us, and make us feel like we don't necessarily belong.’ The other day some white man was talking about how just not having bandages of color can influence a child in thinking they are outside of the norm. So why aren't we having bandages that are brown and beige and not just white or light? Similarly, when we show a picture of a disease on a white skin, do we now prevent people from seeing and understanding how that disease would look on a brown skin? There's so many things that, only people who are thinking about that, can help change the medical curriculum and can help broaden people's perspective of disease and what's normal. I can play a role as a leader and not feel that I'm going to get reprimanded for saying things. Saying we don't have enough women in leadership at our university. We have two women chairs in the medical school and one is me as a woman of color but there's just two. If you add the Biomed (Department) there's maybe one or two more, so it's very limited when you think about it. So we have to make a difference there.” -Phyllis A. Dennery, MD, FAAP

*“Phyllis A. Dennery,” vivo.brown.edu/display/pdennery

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