MAYOALUMNI CLINIC ISSUE 3 2019 Oftenwehavepreconceived, antagonistic notions about peoplewhoweknowperhaps onlybysight.…Whenwe become better acquainted, wefindthattheyaresincere, honest, and companionable, and perhaps even that their viewshelpustoclarifyand oftentomodifyourown. — William J. Mayo, M.D., Dec. 14, 1925 LETTER FROM THE PRESIDENT “ One of the signs of a truly educated people, and a broadly educated nation, is lack of prejudice.” — Charles H. Mayo, M.D. Drs. William J. Mayo and Charles H. Mayo understood the value of bringing together people with diverse talents, backgrounds and beliefs to best serve their patients. Their father, Dr. William Worrall Mayo, instructed that “No one is big enough to be independent of others.” He knew that the best patient care required a team of physicians, allied health professionals, scientists and educators working together. What an appropriate time for this issue of Mayo Clinic Alumni magazine, which celebrates the diversity of Mayo Clinic and the continued commitment of our founders to attract the brightest and most diverse staff possible. This issue highlights several of the programs that have developed ERIC EDELL, M.D. (THD ’88) over the past decade and stories of some of the • President, Mayo Clinic Alumni Association individuals these programs have touched. • Division of Pulmonary and Critical Care Medicine It has been an honor and humbling experience • Mayo Clinic in Rochester to serve as president of the Mayo Clinic Alumni Association the past two years. The position provided an opportunity for a deeper connection with a group of extraordinary people. Mayo Clinic alumni are a worldwide family of providers and scientists who are bound by an organizational DNA of patient-centric care that is underpinned in the Franciscan values of respect, integrity, compassion, healing, teamwork, innovation, excellence and stewardship. Together we are Mayo Clinic. I hope to see you at the 2020 International Meeting in Portugal, Sept. 10-12, in my capacity as past president! FEATURES 2 ‘When all individuals are included’ 36 Out of the shadows Embedding diversity and inclusion Often-neglected endocrine cancers benefit in Mayo Clinic from specialist integration 8 A home base 40 Alumni experience life- Mayo Clinic’s Transgender and Intersex threatening medical ordeal Specialty Care Clinic provides for mental from rare endocrine tumor health, hormonal and surgical needs 44 After career of breaking glass ceiling of transgender patients and those with in surgery, Heidi Nelson, M.D., retires differences of sexual development 16 ‘For the first time in my life, I felt 46 Merging minds to accelerate normal, like I was in the right body’ research discovery Gender-affirmation surgery patient story Highlights of Mayo Clinic-Arizona State University Alliance for Health Care joint 20 Recruitment pipeline research efforts Diverse physicians and faculty better meet patient needs 48 2020 Mayo Clinic Alumni Association International Program & Tour 23 Drawn to Mayo Clinic Lisbon, Portugal Programs attract diverse medical students 49 MAYO CLINIC UPDATE 26 Diversity advances the best science Mayo Clinic news, obituaries Training destination for aspiring biomedical research scientists from backgrounds underrepresented in science 29 Enrichment programs advance trainees’ careers About the cover: This quotation is from a larger piece William J. Mayo, M.D., wrote in 1925 for a Rochester High 32 Giving women the tools to take off School publication. It was later sent to J. Pope Dyer, Eastern Advancing research, patents and intellectual Tennessee Education Association in Signal Mountain, property projects Tennessee, for use in radio talks to high school students. ‘WHEN ALL INDIVIDUALS ARE INCLUDED’ Embedding diversity and inclusion into Mayo Clinic Mayo Clinic today is a significant national employer promoting. Ideally, efforts in these areas will with increasing diversity among its staff. Across all be felt by every patient. Mayo locations, 32% of physicians and scientists With change come challenges. A 2015 are women and 26% are a race other than white. organizational climate assessment revealed that Among allied health staff, 78% are women and one-third of participating employees said they 13% are a race other than white. didn’t feel included or free to speak up in their In 2010 Mayo Clinic appointed its first medical work areas. “We’re not at the ideal state yet,” says director of Diversity and Inclusion, Sharonne Hayes, Dr. Hayes. “We continue to work toward achieving M.D. (I ‘86, CV ’90). The diversity and inclusion a truly inclusive workforce that reflects our patient goals are to provide culturally competent care to a population and the world. We’ve made great strides diverse patient population; identify and eliminate and have complete support and engagement from health disparities; become a national leader in Mayo Clinic leadership. the science and promotion of health equity; have “It’s not enough for individuals at Mayo to diversity of all kinds in the workforce and in simply support diversity efforts, and it’s not enough leadership across all three “shields” — patient care, just to bring in diverse people. Diversity will only research and education; and be an organization make a real difference in the care of our patients where everyone feels included and valued. and to the future of Mayo when all individuals are In the last decade diversity and inclusion have included — in discussions, leadership, planning, become embedded in every Mayo location; in and work and personal relationships.” every department, division and work unit; in every Mayo Clinic has six primary goals related to classroom and lab; in every boardroom, meeting diversity and inclusion. After the description of room and mailroom; and in recruiting, hiring and each goal are highlights of recent activities. 2 MAYO CLINIC ALUMNI 1. Provide high-quality, culturally appropriate care in a welcoming environment to all patients. ∙ Analyzed, stratified and reported key patient care outcome metrics by race, ethnicity, gender and preferred language to identify disparities in care ∙ Implemented expanded demographics in Epic electronic health record — sexual orientation, gender identity, preferred name, sex assigned at birth, country of origin, military and disability status, expanded Native American/ Alaska Native subcategories ∙ Introduced Transgender Sharonne Hayes, M.D., Mayo Clinic Office of Diversity and Inclusion and Intersex Specialty Care Clinic in Rochester (page 8) ∙ Renewed contract with Indian Health Service to provide a Mayo hematologist/oncologist ∙ Provided clinicians with a on site weekly at Phoenix new tool, CultureVision, for 2. Indian Medical Center — quick access to information Increase the diversity of a 10-year relationship — such as diet, religious Mayo Clinic patients. to see tribal members with practices and cultural new diagnoses of cancer or considerations about groups ∙ Sponsor and participate in blood disorders for whom they provide care local cultural and community ∙ Collaborated with New ∙ Developed training in celebrations and festivals Town Success Zone, a unconscious bias and ∙ Conducted focus groups with Florida-based organization, stereotype threat U.S. Hispanic, African American on Wellness Rx, a ∙ Offered educational and Asian individuals to better community-led health opportunities to employees to understand these populations’ disparities wellness effort learn about gender transition health care needs ISSUE 3 2019 3 ∙ Introduced four new pipeline programs in which 70+ 3. students from 20+ states came to Rochester to experience the Improve inclusiveness and participation of diverse Mayo Clinic culture in the hope employees at all levels of the organization. they’d see Mayo as a place for furthering academic pursuits ∙ Hosted faculty development ∙ Growing scholarship in ∙ Created Gender Transitions programs and national diversity, inclusion and equity in the Workplace policies, educational events and training topics, both workforce issues procedures and guidelines focused on expanding diversity and health equity to support transgender and health equity in academic ∙ Established 30+ Mayo employees and their colleagues medicine Employee Resource Groups through gender transition ∙ Improved hiring processes (MERGs), with enterprise- ∙ Developed policies, procedures to mitigate bias and increase wide MERGS being African and education for emerging diversity of candidate pools Descent, Latino/Hispanic, issues including guidance for LGBTI, Disability, and how to respond when a patient Veterans; 3,700+ employees is disrespectful, harasses or participate in MERGs refuses care from a Mayo ∙ Conducted Employee staff person due to a personal Experience Listening characteristic Sessions, an enterprise-wide ∙ Updated approach to address 5. initiative to bring employees sexual and other harassment Increase the proportion together to discuss issues in the workplace of women and minorities — including race, religion in senior leadership. and diversity — affecting their lives within context of ∙ Focused on professional social unrest and change; 30+ development of women facilitators have been trained consultants to improve to support employees in these 4. readiness for leadership conversations Increase the proportion of roles, including committee ∙ Appointed department women and minority students, membership and leadership, diversity leaders to work with faculty, administrators and and academic rank pursuits leadership to identify and