Global Engagement Spotlight: Jill Helms

It is more than a topic to highlight, it is a fundamental value that we felt the needed to tackle from unconventional angles. Who better to discuss this with than Dr. Jill Helms, Vice Chair of Diversity, Equity and Inclusion at Stanford Surgery, Professor - Plastic & Reconstructive Surgery.

Congratulations for your new role, and thanks for granting us this opportunity to talk. From an educator perspective, how do you see equity, diversity and inclusion influencing the character-shaping of future leaders in the medical field?

Pandemic reveals: “I may not have recognized it before, but Covid-19 unequivocally taught us that a lack of diversity in our healthcare workforce directly translates to poorer health outcomes. It’s no secret that our communities of color suffered far more than other communities in this pandemic, and it has become abundantly clear that this can be traced back to lack of diversity among our healthcare professionals.”

It doesn’t look good: “This is not just in medicine; it actually extends to all facets of healthcare. Whether I was talking to emergency healthcare technicians and paramedics or dentists or nurses, they say exactly the same thing: ‘Diversity in the healthcare workforce is lacking.’ And lest we think the problem will be rectified simply given more time, the data show this is not the case. The diversity of students in training programs still does not come close to reflecting the diversity in our communities. So without action, its not looking good.”

Working closer with our communities is the key: “I’ve started conversations with educators at our high schools and community colleges and we agree, we have to start much earlier, to show our young people that healthcare is a profession worth considering. Its an enormously rewarding career, and it is our job to demonstrate that they are represented within this broad profession, and that there is a path forward for them to join in.”

How does under-representation in the medical field affect junior students, psychologically?

The data are clear.  “If you don’t see yourself reflected in the people who are delivering your healthcare, then you won’t envision that you, yourself, could become one of those professionals. The fact is, students opt out of those careers in which they fail to see themselves represented. Beyond more data, what we need now is action.”

What does an environment in which everyone feels included, respected and safe mean to patients? Could it change their clinical outcome or treatment tolerance?

Patients are not just the numbers on your chart: “We know that how patients respond to treatment and their health outcomes are impacted by the support network that they have around them. We all know that the doctor may say something, and the patient could ignore it, but you can imagine if you can speak the language or understood the cultural background or the community from which the patient came from, you could in that case convey information more effectively. There are ongoing efforts championed by Micaela Esquivel and Carlie Arbaugh in the Department of Surgery, working on methods to improve patient interviews, ensuring that they are questioned about issues in their environment that can contribute to health disparities. Understanding whether a patient suffers from food insecurity, or homelessness, can help the healthcare worker gain a better understanding about the patient. Patients who had just arrived in the country as immigrants or refugees might have more complex environments that contribute to their overall health and wellbeing.”

Diversifying the workforce: “It’s been repeatedly demonstrated that when we diversify the workforce, we increase awareness – and with it, empathy, inclusiveness, and equity – for patients. The data are there, now we need action, and sustainable solutions. We must work to attract people from a range of cultural and ethnic backgrounds to our trainee programs and to our faculty, and I believe that our Chair, Mary Hawn is doing just that.  There are some challenges we face here at Stanford, such as the cost of living. But I know the University is making strides to address even these issues. I’m optimist that we can make these changes.”

In Global Engagement, we strive to give our residents opportunities to train in different settings. Do you think that this will widen their perspective and help them understand the challenges and limited resources that providers in less fortunate places struggle with on a day-to day basis?

Bidirectional partnerships have a snowball effect: “Absolutely! Our eyes are opened when we find ourselves in new environments. Such experiences challenge us to become creative problem-solvers. We go to such places not only to discover new things about other people, but also to discover new things about ourselves. It’s a transformative experience. I also know that sharing knowledge and best practices we learn here at Stanford with providers in LMICs can have a snowball effect, the small group we train will act as a core team who will train others and others. Its truly a bidirectional relationship.”

In many communities, plastic and reconstructive surgery is an un-affordable luxury and millions of people cannot afford it. How does access to this kind of care impact the functionality, productivity, and the psychological stability of populations worldwide?

Evolving from mission trips to educational partnerships: “In the past, most outreach plastic and reconstructive surgery efforts centered around providing care for children in developing countries with cleft defects including cleft lip and palate. In the last decade, there has been a shift towards sustainable programs, where plastic and reconstructive surgeons focus on training local surgeons and physicians. A great example is Dr. James Chang, who is the Chief of the Division, who has set up clinics in Asia to educate and train local surgeons. I greatly admire these kinds of programs because they train the next generation of healthcare workers.”

Repairing facial deformations is not “cosmetic”: “Some people, when they hear the phrase ‘plastic surgery’ think ‘cosmetic’- and oftentimes view this as an unnecessary and somewhat frivolous expenditure. But stop and think about this: our faces are our identity, it’s how we express ourselves to others, and how others see us. When disease or an accident causes disfigurement, it has a profound impact on our sense of wellbeing. I support many organizations such as Changing Faces that advocate on behalf of people with facial differences, helping to increase awareness in the public, and reducing discrimination in the workplace. But back to cosmetic surgery: if we have the technical skills and the expertise to make someone feel more comfortable with their appearance, why should we not do so?”

Inner beauty: “One thing I learned over the decades of working with people of facial differences is this: perception is everything. ‘Beautiful’ simply isn’t defined by some magazine or photo or painting; it is defined by the kindness, compassion, intelligence, and warmth of an individual. It is optimism and perseverance in the face of adversity. It’s looking someone in the eyes and smiling, instead of looking away. We have to recognize the deeper business of appreciating the beauty that exists inside each of us when we show love to each other.”

In your role as the Vice Chair for Diversity, Equity, and Inclusion, what are your plans, and what more would you like to see?

Unity, to understand the community needs: “I am surrounded by visionaries, from faculty to students, who have revolutionary ideas of how to improve diversity, equity and inclusion in the healthcare profession. My goal in the next short while is to bring them together and help create sustainable programs that can benefit not only people at Stanford but our larger community as well. Local high schools and our community colleges are filled with young people, eager to join us in this healthcare profession. We have to make that on-ramp to a healthcare career more accessible and we do that when we embrace the mission of our colleagues in the emergency medical response services, in nursing, and in dentistry. Together, we are stronger.”

Two things I will work on tirelessly: “Uniting people who have common interest in making the diversity in healthcare a priority (and thankfully, they exist at every level throughout our University!) and partnering with community leaders to ensure our collaborative efforts are responsive to the needs of the community.”

Thank you, Dr. Helms, talking with you is such a pleasure!