July 14, 2023
Dr. Stormee Williams, pediatrician and Chief Health Equity Officer at Children’s Health Dallas, talks about the barriers that exist to health access, and the ways in which these can be addressed and improved while building trusting relationships with patients, families and communities.
Transcript
Dr. Angela Kade Goepferd: This is Talking Pediatrics, a clinical podcast by Children’s Minnesota, home to the kid experts where the complex is our every day. Each week we bring you intriguing stories and relevant pediatric health care information as we partner with you in the care of your patients. Our guests, data, ideas and practical tips will surprise, challenge, and perhaps change how you care for kids.
Welcome to Talking Pediatrics. I’m your host, Dr. Angela Kade Goepferd. James Burroughs returns this week with another equity action segment, as he talks with Dr. Stormee Williams, pediatrician and chief health equity officer at Children’s Health Dallas. Listen in as they talk about the barriers that exist to health access, and the ways in which these can be addressed and improved while building trusting relationships with patients, families, and communities.
James Burroughs: Welcome to Talking Pediatrics. This is James Burroughs, senior vice president and chief equity and inclusion officer at Children’s Minnesota. I’m here at the Equity and Inclusion Suite, and I’d like to introduce you to Dr. Stormee Williams. Hello, Dr. Williams. How are you?
Dr. Stormee Williams: I am great. Thanks for having me.
James Burroughs: Well, thanks for coming onboard. We really appreciate it. We hope to learn quite a bit from you today about health equity, and the work that you’re doing, and who you are as well. And we’re going to share that with our listeners, if that’s okay with you.
Dr. Stormee Williams: Absolutely.
James Burroughs: So Stormee, tell the audience about yourself. Tell a little bit who you are and what makes you who you are.
Dr. Stormee Williams: So I’m Stormee Williams, and I am a pediatrician by training, and I’m also the vice president and chief health equity officer at Children’s Health in Dallas, Texas. My work in pediatrics really started in the community. I’ve always had a passion for community health, and so my first job out of residency was in a federally-qualified health center. That really solidified my passion for this work, as well as opened my eyes in a totally different way for really working within the community and learning about the unique needs that my patient families have.
James Burroughs: Now, how did you decide you wanted to be a pediatrician? Something that you’ve always wanted to do?
Dr. Stormee Williams: What’s interesting is, I do not have that story of always wanting to be a pediatrician. I actually went to college with an intention of majoring in engineering. So it was kind of that thing where in high school you’re interested, or you do well in math and science. So my teachers and family said, “Oh, you should be an engineer.” And I said, “Okay.” Didn’t really know what engineers did. And then during my sophomore year, I had an internship with an engineer. It was a biomedical engineer. We were designing prosthetic limbs, and I was like, “This is so interesting and so cool. But what does it feel like, and how do we know what the patient’s going to feel, and how are they going to be able to use it?” And the engineer kind of laughed at me and said, “That’s not for us to figure out. We focus on the how, and we leave it up to the doctors.”
But I guess I kept asking questions about that, and so he came to me later and said, “Do you want to be an engineer? You sound like you want to be a doctor, and that’s because that’s what doctors do.” So I went home that day and just decided to volunteer at a hospital to see, “What do doctors do, and what does it involve? And more importantly, how much longer will it take for me to do that versus become an engineer?” And because of engineering and pre-med courses, it really wasn’t too far off in terms of what you needed to be pre-med. So, I switched my major going into junior year to become pre-med. And then when I got to medical school … And I should say even before that. I’ve always loved kids and babies, so I always was volunteering in a nursery and things like that. So, there was no surprise that I went into pediatrics. But I will say, doing my rotations in medical school, it was the resilience of the kids that really spoke to me, and that just kind of solidified it for me.
James Burroughs: Let me ask you this. So, you’re vice president and chief health equity officer for Children’s Health. What’s your day-to-day like? What does that mean, to be in charge of health equity at a hospital system?
Dr. Stormee Williams: I am responsible for the overall organizational strategy towards achieving health equity. At Children’s Health in Dallas, we define health equity as a fair and just opportunity for all patients to achieve their highest level of health. So it really starts at the beginning of educating our staff, from the executive leadership down to the frontline staff, about what health equity is, what it looks like for us in practice, and why it’s important. So when I look at devising that strategy, I really start there, with education. What does this look like in practice? But then also why it’s important for every single part of our staff, from our environmental services, to food services, to our practicing physicians and nurses, to understand why we should be aware of health equity, but then also look for ways to diminish as many disparities as possible.
James Burroughs: How do those people who aren’t serving the patient directly, how do they figure out what their role is, or how do you help them figure out what their role is?
Dr. Stormee Williams: I’ll give an example. We have an amazing security and parking staff, and we are located very close to … Our main hospital, I’ll say, is located very close to downtown Dallas. We are in a major medical complex along with our faculty partners, UT Southwestern. It’s a very busy area, so we needed to secure our parking. And for a while there, we had paid parking for our patient families. And when I was a pediatrician in the community, I had patients who would see me, and then I would refer them to our hospital for specialty services. Sometimes, you know how it is, it might take two months to get into a certain specialist. But the need was that urgent and dire that we still needed to get them in, and I would wait for my patient families to get into the hospital or get in for that appointment.
I will never forget a mom who went to the hospital to have that appointment and turned around. I was looking forward to getting a note back from the specialist to say what happened during that visit, what they thought her treatment plan should be. So when she came back in my office, I said, “What happened? Why didn’t you go?” And she said, “Oh, I couldn’t afford the parking.” So, she turned around. She knew that she had enough money for gas for her car, but then saw the arm to the parking lot, and just turned around because she didn’t think she had enough money to pay for parking.
So, I let our security and parking staff know that. From there, they just said, “We had no idea.” It’s something that we who have jobs, who have good jobs where we can afford things like parking, where we don’t think we would have to turn away from reaching healthcare. But once we let that information out and let everyone know that this was something that was important and it was a barrier to healthcare access, our staff jumped right in and said, “What do we need to do to make this better and to accomplish the goal of getting these patient families in?” So, they eliminated the charge for families who are coming in for our services for parking.
James Burroughs: Can you talk about some of the things that Children’s Health is doing or you’re doing from a visionary scope or strategy scope to address those for your patients and families?
Dr. Stormee Williams: It goes back to what I stated before, education. So learning about social determinants of health, and I know that Children’s Minnesota has done such a great job in this area as well. But when you study social determinants of health, you realize that it’s so much bigger than food and housing. Those are the two that come up the most, but there are so many other nuances to that. So one of the things we did was to learn about social determinants of health, and learn from other organizations who were assessing those needs. But then we also used our community health needs assessment to see what it is that our community needs, and that is a reflection of the care that we provide at Children’s Health. So once we started there, strategically we involved multiple stakeholders.
So everyone from social work, to our nursing staff, to our ambulatory and inpatient leaders. We brought them to the table to say that, “This is something important that we need to do. How best can we do this? Where do we even start?” There are so many different models across the country. Some places start in their primary care practices. Others, inpatient. So, we had to figure out the best place. And I will tell you, it did not come easy. This was a multiple-year type of project, and it’s still ongoing. Ultimately, we decided to start in our ambulatory practice. But even before we got there, just selecting the questions that we would screen our patients for was a challenge. And we wanted to make sure we had a validated tool that we could use and things that our families would understand.
So, we did decide to have a tool that was on paper initially. And I’m sure, like everyone else, when we started this, it was actually during the height of the pandemic. And we saw that all of our staff, our frontline staff was just so busy. So to get them to hand the family a paper to fill out a survey, or ask those questions and then input those results into the electronic medical record was such a limiting factor. It just felt very burdensome for our bedside staff.So we said, “Let’s use technology. Let’s put this in the hands of the families directly.” So we worked with our IS, information services team, to create a digital survey so that upon check-in, they could fill out that questionnaire. And if they miss it there, then when they check in for their ambulatory or outpatient appointment, they could be handed a tablet to fill out those questionnaires as well. And that would feed directly into the electronic health record. That took us from being able to screen a couple-of-hundred patients to thousands of patients in the first few months of implementation.
James Burroughs: One of the things we hear about with community, and building relationships, and healthcare interacting with their patients and families is the lack of trust sometimes that families have in the system. Some of that’s because of their experiences, some of that’s because of experience of others, and some of that’s because of things like systemic racism, or bias, or things like that. What do you are doing at Children’s Health to address those issues of building that trust or establishing that trust?
Dr. Stormee Williams: We’re so fortunate that we have a great leader for patient experience that educates us on the importance of trust-building. But not just trust. Relationship-building. When you are caring for a child, your desire is to care for the whole child, which includes the family. So if we can break down those barriers of trust and communication difficulties, then typically we get to the heart of the matter. And that’s really where we focused. On building relationships, making sure we have adequate ways for communication, and that includes really investing in our interpreter services.
We are in Dallas, Texas, and so about half of our patients at our Dallas campus are Hispanic. Of course, a large proportion of them are Spanish-speaking. But that’s not the only language that we take care of. This is a very diverse area, and I’m sure every major city in America sees that level of diversity. So we have to make sure that not only do we have an interpreter system that we can reach multiple languages as needed, but also that we have caring staff that recognizes when there’s a language barrier. When we do that, we let families know, “This is your right, to be able to speak to someone in your healthcare team in the language that you feel most comfortable.” That is the first step when it comes to building that trust.
James Burroughs: I know that your job isn’t easy. I know partly because I have to share in that job here in Minnesota. What are some of the things … If I gave you, let’s say, a million dollars today, and I said it could help eliminate some of the barriers or the things that get in your way of getting this work done, how would you invest that resource of making it better around health equity?
Dr. Stormee Williams: So many needs I think about. One would be the number of uninsured children that we have here in Texas. That is one of the things that we rank high in, and we are not proud of that. But because of that, it really creates just a strain on the system, but also for the family. So, no parent ever wants to have to use the healthcare system. And when you have to, and the first thing you have to think about is affordability, that is something that speaks to the heart of us as pediatricians. We want to take care of patients, and we want to take care of our smallest of patients regardless of what they can pay or what their families can afford. So the first thing that came to mind when you said that, it was some of these uninsured, or really the uninsured children that we have in our area that really could benefit from primary care as well as specialty services.
James Burroughs: As we move forward in what we consider addressing those social determinants of health and health equity, one of the things that comes up quite often is a lack of diversity in our staff of pediatricians, nurses, and other types of clinicians as well. What do you think we can do, Stormee, to increase that racial diversity and overall diversity in the medical staff?
Dr. Stormee Williams: That is a challenge, and that’s something that I talk about, and it’s something that’s always in the back of my mind, because our diversity as a country is increasing. But the diversity, especially of those underrepresented in medicine, there’s some diversity there, but not necessarily of those underrepresented in medicine. So when I think about it, I think we need to start a lot earlier. Sadly and often, those who decide on a career in medicine is exactly what you talked about in the beginning. Did you think about this as a little girl? But those of us who do outreach, usually hospitals and those who are doing outreach, typically go for those kids … Or those kids who get the opportunity to learn more about careers in medicine typically are those in AP classes, doing well, have already been deemed smart, good kids. So, we’re missing a huge number of kids. And one of the things that I’m actually working on is trying to get in front of smaller kids. Elementary-school-age, middle-school-age, regardless of their behavior and regardless of their grades. Because oftentimes, you can become something once you see it.
So our goal is to get doctors, and nurses, and respiratory care therapists, and radiology techs to go into some of these schools in under-resourced areas and talk to them about their jobs. Because a lot of us don’t know that those things exist. We think doctor, lawyer, police officer, fireman oftentimes when we’re little. But there’s some great careers in medicine that don’t have to do with blood, because that’s another thing that we hear, and they don’t necessarily take eight years of education to be become. So I think that’s one of the ways that we start, is talking to kids who are much younger and introducing those things. And then exposure. I love today when we look at some of the television shows on TV, and you see more diversity when it comes to those represented onscreen. So, I think and I hope that that will also improve just a kid’s outlook on what they might be able to become later on in life.
James Burroughs: But also too, the fact that people are seeing people like you. A strong African American woman who’s a pediatrician. That if you grow up in certain neighborhoods, when you don’t see images of success, you then get the thought that you could only be what you see. So, we’ve got to show them those images of success. So, thank you for all that you do as well. One of the things we want to make sure that we do … And you talked about what you would do with an investment of an additional million dollars. But also too, one of the magical things about this show is, I’m able to give people wishes. I can only do one wish. I’m not a genie. I can’t do three. If I could give you one wish to change the world as far as health, and wellness, and wellbeing is concerned, and you can have any wish you want to, what would that wish be? And what would you want to have happen in the world we talk about of health equity?
Dr. Stormee Williams: Honestly, it would be universal access. It seems like such a far-off dream, but that really speaks to the crux of it. There are people who live in major cities and those in rural areas who just do not have access to any healthcare, let alone primary care or pediatricians. So, I would just have to say access to healthcare.
James Burroughs: Although that dream is big, there was once upon a dream that healthcare wasn’t serving people who looked like us. Who were Black, African American. But that dream is now here. We’re actually doing it. Got to do it better, but we can do that. So, I look forward to that universal time when we can say that no one is turned away because of lack of access to quality healthcare as well. Well, Stormee, I really appreciate you coming on. I wish you all the best in your work at Children’s Health. As we’ve talked before, I look forward to partnering with Children’s Minnesota and Children’s Health in Dallas. And also save some kids’ lives, and introduce this career of health equity and medicine to a lot of other people. So, thank you for coming. I really appreciate it.
Dr. Stormee Williams: Thank you so much for having me, James.
Dr. Angela Kade Goepferd: Thank you for joining us for Talking Pediatrics. Come back each week for a new episode with our caregivers and experts in pediatric health. Our executive producer and showrunner is Ilze Vogel. Episodes are engineered, produced, and edited by Jake Beaver. Amie Juba is our marketing representative. For more information and additional episodes, visit us at childrensmn.org/talkingpediatrics, and to rate and review our show, please go to childrensmn.org/survey.