The Clinical Problem Solvers Episode 188: Antiracism in Medicine Series – Episode 10 – Counterspaces in Medicine: Creating Safe Spaces and Redefining Value
In this episode, we invite the powerful sister duo Oni Blackstock, MD, MHS and Uché Blackstock, MD to share their experiences on leaving public health and academia to become social entrepreneurs, creating their own organizations in health equity.
Episode Learning Objectives
After listening to this episode learners will be able to…
Recognize some common factors that influence Black women’s decisions to leave traditional health careers
Define counterspaces and understand their value
Apply tools to combat burnout that could be applied to traditional or alternative health careers
Credits
Written and produced by: Michelle Ogunwole, MD, Naomi F. Fields, LaShyra Nolen, Chioma Onuoha, Rohan Khazanchi, MPH, Dereck Paul, MD MS, Utibe R. Essien, MD, MPH, Jazzmin Williams, and Jennifer Tsai MD, M.Ed
Hosts: Michelle Ogunwole, MD, Naomi Fields, and LaShyra Nolen
Infographic: Creative Edge Design
Audio edits: David Hu
Guests: Oni Blackstock, MD, MHS and Uché Blackstock, MD
Time Stamps
00:00 Introduction
03:49 Defining “CounterSpaces”
5:22 Why Drs. Uché and Oni Blackstock created their counterspaces
17:54 Value gained outside of academia, public health
24:08 Finding balance in racial equity opportunities
34:17 On challenging the self-sacrificing mentality in medicine
42:26 On “doing the work” within academia
49:01 The meaning of sisterhood
52:20 Closing Remarks
Episode Takeaways:
Definition of CounterSpaces: CounterSpaces are academic and social safe spaces that allow underrepresented faculty to promote their own learning, wherein their experiences are validated and viewed as critical knowledge; they have space to vent frustrations by sharing stories of isolation, microaggressions or overt discrimination; and they can challenge the deficit notion of people of color and establish and maintain a positive collegial racial climate for themselves.
Root causes of the exodus Black women physicians from academia and public health: In many academic and public health institutions, Black women feel undervalued, untitled, underfunded, and undersupported. Their contributions to diversity, equity, and inclusion efforts are expected, but not compensated or rewarded. They are disproportionately passed over for promotions and opportunities despite quality work. These factors directly contribute to the growing trend of Black women physicians leaving these fields to pursue nontraditional health careers.
You are gifted!: “Sometimes you’re in these environments [academic, public health] for so long where you’re undervalued and underappreciated, you’re not supported the way that you should be, that you actually start thinking that– or start forgetting that you’re actually someone with gifts to share.” — Dr. Uché Blackstock
Self-sacrifice is not the highest virtue: Medicine is its own subculture where people are expected to make sacrifices of their time, personal and family life, and finances in order to demonstrate that they are good physicians. It is okay to say that you don’t want that for yourself, and work to actively counter this cultural norm in order to live a fulfilling personal and professional life.
There are opportunities to advance racial equity inside and outside of academia: For those who feel driven to pursue racial and health equity work within academia and/or public health: (1) understand what you value from working at an academic institution and recognize that there may be options to do that work outside of academia (e.g. research), and (2) build a support structure that enables you to stay true to your values as you work to create change from within.
For those having a hard time deciding if they should stay in academia or other traditional research or public health roles, Dr. Oni Blackstock offers important advice about listening to and trusting oneself:
“… just listening to your intuition, that’s like our main form of knowing. We have all these other forms of knowledge in books and what we’re taught in school, but really many times, the answer lies within us. So, again, just making sure that we’re in tune and listening to what we feel like our needs are. And if they’re telling us to leave, that we are true to those voices and we leave. And if they’re saying there’s work for us to do here, we want to stay and we have the support to be able to do that, then do that.” — Dr. Oni Blackstock
Pearls
“The work of liberation is the work of freeing the soul to be exactly who we were meant to be.” — GirlTrek
The role of an abundance mindset in achieving work/life balance
Many of us operate from a scarcity mindset; we feel that opportunities are limited and therefore take all opportunities that come our way without regard for our genuine interest in the opportunity or our true time availability. Especially for people early in their careers, there is an unspoken pressure to accept all opportunities that could possibly advance one’s career. It is impossible to achieve work/life balance when operating from this mindset, and as a consequence, it leads to burnout.
However, with an abundance mindset, one recognizes that opportunities are not finite and that saying no to one opportunity frees up our ability to say yes to a better opportunity that comes along later down the line. Dr. Uché Blackstock shared an example of how she experienced a tension between a scarcity mindset and an abundance mindset when deciding whether to continue part-time clinical work or to devote full-time effort to the organization she founded. When she embodied an abundance mindset and let go of her clinical career, she was free to say yes to even more fulfilling opportunities that came her way.
Relatedly, Dr. Oni Blackstock discussed the importance of pausing before committing to opportunities. White supremacy culture creates an artificial sense of urgency so we often respond reflexively. By taking a moment to pause and reflect, one can take on opportunities that align with one’s values and that one has adequate time for without sacrificing personal responsibilities. Taking a moment to pause ensures that we react from our authentic self and not from institutional culture.
Cultivate tools to sustain a career in traditional and alternative health careers
Cultural norms rooted in white supremacy and capitalism create an environment that extracts goods, time, and energy from people without providing a source from which to renew those resources. Dr. Oni Blackstock advises listeners to be “cognizant of the day to day ways in which these systems work against us,” and to actively fight against this culture with things that replenish ourselves. Tools that Dr. Oni Blackstock uses include: daily meditation, creating a gratitude list of 3 things each morning, and yoga and exercise several times a week. Additionally, she spoke about the importance of mentorship and a strong support network so you have people to turn to for advice and encouragement.
Finding effective strategies to replenish oneself is important for anyone advancing racial equity work in their careers as social entrepreneurs, academicians, public health officials.
Dr. Oni Blackstock shared a treasured quote around this idea: “ Learn to drink as you pour, so the spiritual heart cannot run dry and you always have love to give”-Ma Jaya
Self-reflection is a vital component of professional development
It is easy to become consumed by various career opportunities that are presented to us. In order to maintain one’s ability to effectively transform the existing culture of medicine into an anti-racist one, it is important to find time to reflect on one’s journey and direction. Below are some questions that CPSolvers ARM host Dr. Michelle Ogunwole synthesized after this conversation with Drs. Oni and Uché Blackstock.
What are the things (situations, contexts, people) that are making you question your gifts?
What are the wake up calls that we need in our life? How can they help you in your next step?
Who are you taking advice from?
What is keeping you from being your authentic self?
References
National Academies of Sciences, Engineering, and Medicine 2020. Promising Practices for Addressing the Underrepresentation of Women in Science, Engineering, and Medicine: Opening Doors. Washington, DC: The National Academies Press. https://doi.org/10.17226/25585.
National Academies of Sciences, Engineering, and Medicine 2021. Impact of COVID-19 on the Careers of Women in Academic Sciences, Engineering, and Medicine. Washington, DC: The National Academies Press. https://doi.org/10.17226/26061.
Blackstock, U. Why Black doctors like me are leaving faculty positions in academic medical centers. (2020, January 08). Retrieved from https://www.statnews.com/2020/01/16/black-doctors-leaving-faculty-positions-academic-medical-centers/
Forrester A. Why I Stay – The Other Side of Underrepresentation in Academia. N Engl J Med. 2020;383(4):e24. https://www.nejm.org/doi/full/10.1056/NEJMpv2022100
Doll KM, Thomas CR Jr. Structural Solutions for the Rarest of the Rare – Underrepresented-Minority Faculty in Medical Subspecialties. N Engl J Med. 2020;383(3):283-285. https://www.nejm.org/doi/full/10.1056/NEJMms2003544
Blackstock, O, Blackstock, U. Opinion: Black Americans should face lower age cutoffs to qualify for vaccine. https://www.washingtonpost.com/opinions/black-americans-should-face-lower-age-cutoffs-to-qualify-for-a-vaccine/2021/02/19/3029d5de-72ec-11eb-b8a9-b9467510f0fe_story.html
Disclosures
The hosts and guests report no relevant financial disclosures.
Citation
Blackstock O, Blackstock U, Ogunwole M, Fields NF, Nolen L, Onuoha C, Williams J, Tsai J, Essien UR, Paul D, Khazanchi R. “Episode 10: CounterSpaces in Medicine: Finding Safe Spaces and Redefining Value.” The Clinical Problem Solvers Podcast. https://clinicalproblemsolving.com/episodes. July 15, 2021.