Integrating cultural competence

Building a diverse veterinary profession is one of many priorities for addressing today’s challenging economic climate, so the AVMA is renewing its focus on the development of cultural competence skills for everyone in the profession, from veterinary students to seasoned practitioners to organizational leaders.

Offering guidance on cultural competence is not a new idea. The Association has, for example, hosted eight annual diversity symposiums.

What is under way, however, is an eventual shift from the AVMA Diversity Symposium held at the AVMA Annual Convention to formats for enrichment that will be accessible to many more members.

The August 2012 appointment of longtime AVMA staff member Dr. Beth Sabin to the new position of associate director for international affairs and diversity initiatives opens the door for an expanded emphasis in this area. She notes that an AVMA objective under its workforce strategic goal is “to promote and nurture increased diversity, including cultural, ethnic, gender, and racial representation, within the veterinary workforce.”

In 2014, diversity, inclusion, and cultural competence themes will be integrated into convention programming, such as the practice management and gender and generational sessions already being offered.

As the AVMA shifts its focus, 2013 will be a transitional year. The ninth diversity symposium, scheduled for July 21, will be held—but with some interesting twists.

For one, the operative word is “practical,” with take-home resources and online tools abounding.

Also, the current class of AVMA Future Leaders organized a morning workshop to precede the diversity symposium, which will be a half day this year. The Future Leaders Program selects promising veterinarians to identify a project through which they can create usable tools for the profession. The 2012-2013 class chose to help equip AVMA members with tools and skills to practice culturally competent veterinary medicine for optimal patient outcomes. The Future Leaders are also assessing the correlation of professional success with application of cultural competence, among other related goals.

The link between cultural competence, changing U.S. demographics, and improved animal health care is the focus of the 2013 diversity symposium that afternoon.

“This year’s symposium goal of generating different viewpoints and bringing tangible opportunities to attendees dovetails with the Future Leaders project,” Dr. Sabin said. “The afternoon will build on the Future Leaders sessions. We hope attendees will stay for more about the practice side and for more tools.”

Another 2013 innovation is the collaboration that generated the afternoon session. The key collaborators were Dr. Sabin; Dr. Christine Merle, manager of the Practice Management and Professional Development Section for the AVMA Convention Management and Program Committee; and Dr. Evan M. Morse, the Cleveland practitioner who has coordinated and moderated the AVMA diversity symposiums over the years.

Dr. Morse organized the first symposium in 2005 after AVMA President Bonnie Beaver called for presenting a symposium at an AVMA venue to sensitize a larger segment of the profession to diversity.

He said, “Veterinarians must take care of all animals, and simultaneously represent all groups of humans. That idea lies at the heart of the AVMA Diversity Symposium.

“Having been instrumental in bringing this idea to life through the eight earlier symposia, I am truly gratified to see that the AVMA is now integrating diversity and inclusion education into its overall convention programming, along with many other readily accessible cultural competence initiatives.”

Dr. Morse added, “I now feel like a doting parent who has a healthy child growing stronger and healthier each year. I hope to be around when this child becomes an adult and takes its rightful place in the noble and humane profession of veterinary medicine.”

Dynamic new data will be presented in the afternoon session. AVMA President-Elect Ted Cohn will describe Association initiatives and introduce Michael Dicks, PhD, the first director of the new AVMA Veterinary Economics Division. Dr. Dicks will present current and aspiring practice owners and managers with data from the 2010 census and results of the IHS Global analysis of the U.S. veterinary workforce, which was commissioned by the AVMA and was due, at press time, to be released in April. His goal: to offer marketing that is targeted and reaches untapped client populations.

A session on diversity recruitment and retention will show attendees how to scale their efforts to small businesses. An owner whose practice has grown by recruiting with an eye to diversity will share insights.

Ensuring a safe and secure food supply also hinges on culturally competent veterinarians, given changes in U.S. and global food production systems. Dr. Dan Thomson of Kansas State University will lead a session on how understanding cultures has increased compliance by food animal clients and how that equates to improved animal health.

Rounding out the afternoon, Dr. Sandy Amass San Miguel will overview resources, talk about programs she oversees at Purdue University, and coordinate an audience-interactive panel discussion.

Zoetis, formerly Pfizer Animal Health, is sponsoring the ninth symposium, as it has previous ones. It has also provided funding for the Future Leaders Program since its inception in 2011 and is sponsoring the morning workshop.

Themes of past AVMA diversity symposiums have included diversity and inclusion as a valuable business asset, fully engaging a diverse staff, promoting change locally, becoming aware of unintentional intolerance, using inclusivity to harness greater creative potential, developing strategies for diversity, and understanding how the dental and medical professions have promoted diversity.

Keynoting the eighth symposium last year, Dr. Henry Green III of Purdue said diversity work is seen predominantly through a social justice framework as the correct thing to do. This framework is starting to morph into a dignity movement focusing more broadly on combating rankism—the exploitation or humiliation of those with less power or lower status—to create an inclusive environment, not simply a diverse one. In the mid-1980s, as attacks on affirmative action gained steam, a paradigm emerged focusing on how diversity improves business performance, Dr. Green said. “In the end, diversity is a driver of excellence,” he said, and a lot of evidence shows this drives productivity.

Similarly, Dr. Malcolm Kram, who works part time in a Delaware practice, said, “Diversity in the workforce is an issue, but lack of inclusiveness is the problem.” Clients and staff share more information in a safe environment. He said, “Inclusion is more than just the right thing to do; it is good business.” The buying power of the lesbian, gay, bisexual, and transgender community, which he said spends more on pets than any other, is projected at $835 billion by 2014.

Winter Haven, Fla., practice owner Dr. Mitsie Vargas told attendees that to compete in this economic climate, one must cater to the clientele’s demographics. She said the top dividends of culturally diverse teams are more creative and synergistic ideas, an improved business reputation, an increased customer base, increased efficiency with regard to globalization, and fewer lawsuits.

Over the coming years, the AVMA Veterinary Leadership Conference in January and the convention in summer will be the primary venues for cultural competence training, but Dr. Sabin said supplemental resources will be generated, such as modules planned by the Future Leaders.

At the 2013 leadership conference, Rosalie Chamberlain coached the new workshop on becoming a dynamic leader by building culturally competent organizations and creating an inclusive environment. She told JAVMA News, “Whether one is a lab animal vet or a professor or is in an organization or a hospital, diversity is everyone’s responsibility, and inclusion is a big factor in anyone’s culture. It’s more than race and ethnicity, and also includes the culture within a practice or an organization.

“I don’t have to be the same as another person, but I need to have the cultural competency to understand how they see a situation.”