YSM’s Power Day Highlights the Role of “Radical Listening” in Using Power Well

When Nancy Angoff, MD ’90, MPH ’81, MEd, professor of medicine and then associate dean for student affairs, and Ann Williams, EdD, RNC, a former professor at Yale School of Nursing (YSN), founded Power Day 20 years ago , some health care leaders were against it. They tried to focus on professionalism instead, but they didn’t change course because it was about power.

Twenty years later, the hierarchy in medicine can still be problematic. Power Day, Angoff explained to Yale School of Medicine (YSM) MD and Physician Associate (PA) students who attended this year’s event on Nov. 19, is an opportunity for students to shift their focus from how they have experiencing how power is used, to thinking about how they will use power, as soon they will all be practicing medical professionals.

Assistant Professor Shefali Pathy, MD, MPH, moderated the day and welcomed YSN Dean and Linda Koch Lorimer Professor Ann Kurth, PhD, RN, CNM, MPH, who introduced the keynote speaker, Kinari Webb, MD ’02. Webb, Angoff says, is an example of someone who uses power well, and Webb’s focus on the health of the planet is important for health professionals to learn about because the environment is an important social determinant of health, for example affecting the access to healthy food, water, clean air and green space.

In her recently published book, Guardians of the Trees: A Journey of Hope Through Healing the Planet, Webb stated that while people like to categorize everything, she “became more confident in separating artificial constructs, such as ‘health’.” Poverty ‘, ‘psychosocial well-being and environmental conservation’ had played a part in bringing us into so many problems on the planet. It really is one, and removing these dividing lines creates holistic solutions.”

On Power Day, Webb described the alarming challenge facing the planet: Humans must halve the carbon in the atmosphere by 2030 if we are to survive. She approached the issue optimistically, both telling that she had recently had a child, which she described as “a radical act of hope,” and talking about the work she and others are doing to tackle global warming while simultaneously combating global warming. improve healthcare.

After explaining the important role rainforests play in absorbing pollutants and CO2 — and how damaging deforestation is therefore — Webb shared how, when she was a student studying orangutans in Indonesia, she realized communities were illegally cutting rainforests. because they needed money for health care. Since the issues were intertwined, she wanted to find a cohesive way to deal with them, and with this goal in mind, she entered medical school.

On a rotation in Indonesia during his stay, Webb saw how large aid organizations were not listening to the needs of the local communities they were supposed to help. To tackle deforestation and improve health, she explained to the students, “we need to work with indigenous communities in a way that recognizes power.” With this model, Webb founded Health in Harmony, an international non-profit organization. By ‘listening radically’, employees in Indonesia, Madagascar and Brazil – all of which are local in each country and mainly led by women – meet local communities. The listeners explain to the communities that the communities are the guardians of the rainforest’s precious resource, and ask what they see as the solutions to protect it.

Health in Harmony then provides funding and support to implement exactly what each local community wants, with every detail of the solution designed by the community. For example, in Madagascar, the communities have designed mobile health clinics because villages are isolated, causing long commutes to access health care. Health in Harmony-supported efforts in Indonesia have reduced illegal logging by 90%, have protected more than 100 million pounds of CO2 from being released into the atmosphere since 2017, and have given 120,000 people access to health care, among many other positives. effects.

Angoff believes that Health in Harmony’s model of putting power to good use by listening to what people in communities need is an important lesson for students to apply to patient care, that health professionals should listen to patients. Webb led an interactive, radical listening exercise with students toward the end of the day to provide them with useful tools for effective listening.

Angoff had planned that Robert Dubrow, MD, PhD, professor of epidemiology, and faculty director, Yale Center on Climate Change and Health, Environmental Health Sciences, School of Public Health, would follow Webb on Power Day, to bring the environmental problem to the local level. Climate change is the “greatest public health threat of our time,” Dubrow told the students, before discussing why health care, which is responsible for 8.5% of U.S. greenhouse gas emissions, should play a leading role in reducing emissions. the emissions. He shared several steps the industry can take to do this, from using electrical power generated by renewable energy, to switching from single-use products to reusable products, to increasing the use of telemedicine, to providing universal access to health care, which would reduce the use of intensive emergency care. He emphasized that sustainability delivers a fourfold benefit: less pollution from healthcare, better public health, better patient care and lower costs. On a more micro level, he discussed how individual health professionals can model sustainability in their clinical practice, advocate for climate action and serve as trusted messengers of climate change.

A traditional part of Power Day is recognizing residents nominated by medical students for modeling the responsible, positive, and beneficial use of power in healthcare relationships.

This year two residents were honored:

Rebecca Fine, MD ’19 (nominated by Aishwarya Pillai)

Nishant Pandya, MD, MPH (nominated by Chigorziri Konkwo)

In the PA program, sophomores selected graduating student Dao Ho for this award.

Since 2018, Power Day has also included the presentation of the Robert Rock & Tehreem Rehman Medical Student Activism Award. Students nominate peers who “have taken a professional or personal risk in the service of justice and social justice and whose work has led to significant or lasting change.” The award is named after Robert Rock, MD ’18 and Tehreem Rehman, MD ’18, who started the US Health Justice elective and contributed to cultural change in medical school.

Two MD students were recognized, Olamide “Ola” Olawoyin (nominated by Chinye Ijeli) and Abrianna Tasillo (nominated by Chigorziri Konkwo), as well as PA student Maria Dalzell (nominated by the sophomore PA class).

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