Episode 19: How to Drive Diversity in the Boardroom

Senior Vice President of CVS Health and Chief Medical Officer of CVS Caremark Dr. Michelle Gourdine discusses tactics to advance boardroom diversity — and how coordinated efforts can make meaningful differences. Further, leveraging her medical background, Dr. Gourdine also explains the challenge of “weathering,” the stressors that one experiences daily — at home and at work — and the biological toll on one’s health. Dr. Gourdine explains the impact on women — especially women of color — in the workplace and in the boardroom.

Transcript

Chris Riback: Dr. Gourdine, thanks so much for joining us. We're looking forward to the conversation.

Dr. Michelle Gourdine: Likewise, thank you for having me.

Chris Riback: So tell us a bit about you. Where did you grow up? How did you arrive at your current role? Was it a straight line or most of life  were their twists and turns?

Dr. Michelle Gourdine: So the last part of that is pretty simple. It was a lot of twists and turns I think like most people's career paths. I grew up in Jackson, Mississippi, and was the daughter of a civil rights attorney and a school teacher. As I went throughout my earlier years, I didn't really make the decision to become a physician until high school. One of the things that sort of influenced my decision was my parents. They introduced me to Dr. Robert Smith, who actually is a well known physician not only in Mississippi, but nationally and internationally. He happened to be the college classmate of my parents. The thing that impressed me about him was his dedication not only to providing great medical care to his patients, but he really was an advocate for patients out in the community. And wanted to create better and healthier lives and focus really not only on patients medical care, but also their wellbeing. That really stuck with me.

I ended up going to the college that both my parents and Dr. Smith went to a small HBCU, historically black college in Mississippi called Tougaloo College, small but mighty. And really that whole focus on advocacy and paying attention to the community was really reinforced there. And in addition, they had a very strong premedical program and it was strong enough that I was able to gain entry into Johns Hopkins School of Medicine. And so that's how I ended up here in Maryland, which is where I currently live. I started out my career providing pediatric care in primarily inner city areas, but moved on to showing the faculty at the Johns Hopkins School of Public Health and University of Maryland School of Medicine.

Governmental public health was a stint that I did after leaving primary care, from there I moved on to be a health policy consultant. And now I currently serve as senior vice president at the University of Maryland Medical System. So a bit of a circuitous path, but one where the common thread in all of that really was service and patient advocacy at its core.

Dr. Alexandria White: Wow, just amazing. So many internationalities that have allowed you to show up in your current workspace. Speaking of workspace and research and passions, what are some research interests that you're doing right now that's keeping you motivated, that's keeping you passionate about public health?

Dr. Michelle Gourdine: Yeah. It's interesting and you'll understand when I explain this, that this research area that I'm going to focus on is driven not only by my professional experiences, but my own personal life story as well. I am a woman of color, healthcare leader in the C-suite. There are not many of us. And so what I experienced relative to that was I'm one of the 4% of C-suite leaders who are women of color. There is also a representation problem to be quite honest, regarding women in general in C-suite positions. One of the things that I've experienced and I've spoken to colleagues of mine who are women... Both women of color and non women of color, who all sort of talk about the fact that when there is that lack of representation there, there is I don't know if it's the combination of a bit of imposter syndrome or working really hard to prove that you belong.

Once you get into that position, which in retrospect you look back and you realize, hey, you're there for a reason and you've earned the right to be there. But sometimes you find yourself really trying to ensure that you are a good fit, that you are a team player. One of the things that I found was sort of maybe a barrier to me for inclusion was around sort of the fact that in reality, people's points of view that they bring to tables where decisions are being made are really shaped by the lived experiences that they have. And if yours are different from the other people who are seated around the table, then you need to take account of that. And sometimes in doing so, that sort of stress that comes along with that can create challenges. There are stressors that women face in positions of leadership. And then additional stressors that women of color bring to the table in terms of societal stressors that are outside the workplace.

What does this have to do with the research that I've been interested in studying? There is a body of research that is known colloquially as Weathering. Dr. Arline Geronimus, many decades ago actually elevated this research. And basically what it says is this, it is the reality that really in any individuals, but certainly it is seen very often in women of color, the stressors that you experience in day to day life, at home, in the workplace really do play a biological toll on your health. They cause biological aging, which sets you up for premature disease and sometimes premature death. And so when you think about this in the context of my work as a physician, and specifically as an executive in the population health and health equity space, you begin to realize that these are contributors perhaps to the health inequities that we see specifically in women of color in leadership positions.

It's sort of a unique set of circumstances and experiences, but how it relates back to the workplace. And specifically to those tables in the C-suite that more and more women are not now occupying is that, there's obviously been great attention that has been paid recently and quite frankly, after what I call the tridemics of the pandemic and the aftermath of that with the racial reckoning. There's been thankfully an increase in the awareness of the need for equity and inclusion and diversity. And what that means in terms of building those workplaces where belonging and inclusion are valued, is there has to be an intentionality about it. And I think awareness with regard to the impact on health and wellbeing of the women in the workplace, and women of color in the workplace is extremely important if for no other reason. And in terms of our ability to be productive in our jobs and to be able to contribute to the overarching mission of the organizations within which we work, this becomes very important.

And so again, tying all of that back to the whole research around Weathering and understanding those connections, hopefully builds an awareness regarding what inclusion actually means in the workplace and how workplaces can work intentionally to include and diversify their workforces.

Chris Riback: Dr. Gourdine, you sit on or have sat on numerous boards. Well, you surely raised the Weathering topic. What do board members say to you when you raise it with them?

Dr. Michelle Gourdine: The first response is actually probably surprise. And that's not a bad thing, Chris, because I think that raising awareness is step one. So talking about that research, but also tying it back to my own personal experiences, tying it back to the experiences of a person who served on a board. Who has been a colleague of other board members. Because then it becomes not just an abstract sort of concept, but actually something in reality that my colleagues can see actually impacted me who... I'm confident in saying, they see as an effective and efficient board member. But understanding then, and beginning to ask questions about... To say first of all, wow, I didn't realize that was a thing, number one. Two, didn't realize how that impacted you but it's helpful to understand that. And then three, it leads into a conversation about how we can be more intentional about inclusion and belonging. In terms of expanding the diversity, and gender, and race and in other ways, relative to board service and relative to our day jobs when we work in executive levels.

And so my relationship with my colleagues lends, I guess a level of credibility because of the relationship that I built with my colleagues. That allows us to be able to enter into conversations which otherwise might be a bit difficult to talk about.

Dr. Alexandria White: Yes. So you mentioned something that with all of your credentials, there's few people who have your identities. So there's a board hypothetically, Dr. Gourdine, that wants to find someone just like you. That wants to find someone passionate about public health and belonging and inclusion, and can be an asset to their board. But they keep saying, we don't know where to look. They're so hard to find. What advice do you have for them?

Dr. Michelle Gourdine: So first of all, setting the intention. And I continue to come back to that word because it's important to say we are going to diversify our board. We want to include a female member. We want to include an African American member or Latino member, et cetera, to the board. Be really clear about what you're looking for. And then there are many opportunities to be able to perform outreach in order to identify those individuals. So first of all, starting with the other members of your board, what connections do they have? What people do they know? What organizations might they be connected to? I mentioned earlier the fact that I'm a product of a historically black college and university, is there specific outreach to HBCUs in order to begin to cultivate future leaders on boards? What work are boards doing? I served on a board that actually did this.

It was more in terms of diversity according to age, because quite frankly, many of us as members of the board were older and we were trying to cultivate younger members. We created a subcommittee whose purpose was to go out and create programming that attracted the best and the brightest, who we knew fit the description of who we wanted to recruit in the future. To expose them to the opportunity, to help them meet individuals who are on the board and be able to understand what it takes to be a member, which almost created like a pipeline of individuals who we could tap. And we were intentional about ensuring that that pipeline was diverse. That was a great thing that one of the boards that I served on did and I recommend that for other boards. Sometimes the need is more urgent obviously, and then you need to employ those other strategies that I talked about.

Direct outreach to specific organizations that attract individuals of color within specific sectors, number of boards when they go out and they determine who they want to nominate as future board leaders. They look at skill sets that they want to include within their boards. So reaching out to organizations of individuals who have those skill sets, which may actually be organizations of color as well because they do exist is also another strategy that individuals can employ. But step one is to be really clear that that is the intention that that board is going to pursue.

Chris Riback: Is there a trickle down or trickle up effect between the board and a company itself? Is that intentionality that you just described within a board around inclusion, around diversity, do you see a knock on effect then at the company level or vice versa? Do you see situations where you have a CEO or you have a management team that is active in that type of approach and that informs the board actions?

Dr. Michelle Gourdine:  I've seen both. So for example, where a board has been more intentional about diversity equity and inclusion, key board members asking very specific questions of management during board meetings and board committee meetings is extremely impactful.

Chris Riback: Funny how questions can encourage one to action.

Dr. Michelle Gourdine: That's exactly right. And vice versa, I've seen very strong CEOs who come and present to the board their strategic plan and prioritization of diversity, equity and inclusion. Which at the end of the day are very moving in terms of the board beginning to think about those concepts very differently, relative to the board structure itself.

Chris Riback: It's not lost on any of us who heard your very top of your introduction that you are from Jackson, Mississippi. Obviously as we're recording this conversation right now, there's a water disaster going on in your hometown. There are two questions that come to my mind. The question that comes to my mind in framing this from a business point of view, putting a business context around a public health, public crisis situation, what roles should companies be playing? What role does business have in a situation like what is happening in your hometown?

Dr. Michelle Gourdine:  First of all, it goes without saying that this is a topic that is very difficult for me to be objective about because that's my hometown. My mom lives there. My sister lives there, my niece lives there. But getting back to your question, I think that I want to put the initial answer in the context of how healthcare systems and specifically the one that I work for operate. And it goes to the core of the organization's mission. We as the largest health system in the state of Maryland, that provides 25% of all acute hospital care in the state, take very seriously our role as an anchor institution. Anchor institutions are those organizations, those businesses that are located within a particular community that are anchors there. It is unlikely for them to leave. They play a significant role in the economic wellbeing and stability of the surrounding community.

                                    And as such, they are very effective should they take on that responsibility very seriously which is what we do in not only direct actions, but also bully pulpit conversations that drive policy towards issues or concepts that are very important. So bringing that back down to the whole issue of the Jackson water crisis, the easy and simple answer is get water to the community. Utilize your resources, both economic, relational and otherwise to ensure that the immediate needs of the community are met. But beyond that, this is a life safety issue. The lack of access to clean water is a public health issue. And at a minimum, I believe that healthcare organizations should use their bully pulpit to speak out about how unacceptable this is. This also highlights issues that are specifically related to health equity issues that we talk about all the time and equity issues in general, because if you study the history of this water crisis the flooding was really just sort of a tipping point.

And this is not the first time that Jackson has had issues with their water. This is a reflection of the disinvestment in public infrastructure in Jackson, Mississippi, that started back in probably the 1970s when schools integrated. We were the last state in the United States to adhere to brown versus board of education. I remember when that happened, I was in second grade and I had to leave my school at mid school year and go to a different school as a result of integration. But what happened was that a large number of white residents in Mississippi left and because they felt that there was a disadvantage to integration of schools is the way for me to put that. And they left and all entered into private schools, but what that meant was the tax base diminished greatly in Jackson, Mississippi.

And in fact, what we now know is not only did a large number of whites leave Jackson. But ultimately a number of black middle class individuals left as well, which even more greatly diminished the tax base that's necessary to maintain the infrastructure, that's necessary for people in Jackson to have clean water. So that's sort of the historical context, but to answer your question, not only in terms of addressing the immediate need of people needing clean water, but also using the bully pulpit and influence and relationships. Quite frankly, including those of individuals who may serve on the boards of organizations to say, hey, listen, there's work we also need to do in order to change policy and to ensure the safety and public health of individuals going forward. And speaking very specifically about how that action needs to take place.

Dr. Alexandria White:    I completely agree. I am also in the state of Mississippi and I have a lot of students who are from Jackson and bore water restrictions all the time. So this is just a climax of what has been happening so thank you for that. As we recap, I want to talk about allyship, Dr. Gourdine. We cannot do everything by ourselves. We talked about finding more diversity on boards. We talked about reaching out to historically black colleges and universities. What can allies do that are listening to this? How can they step up to assist in diversifying boards, increasing belonging in public health, and of course, dealing with public health issues that have been caused due to inequitable practices?

Dr. Michelle Gourdine:  That's a really great question. And allyship to me means utilizing the power that comes with whatever privilege you might have. And let's be really clear, I've got privilege too. So privilege is not necessarily solely race based, but it's socioeconomic based. It's relationship based. Using the privilege that you have and the power that comes from that in order to speak up on behalf of those who may be mistreated, excluded, oppressed. So for example, if you are in a situation where you see someone else who is not being treated fairly because of their gender, because of their race, because of their socioeconomic status, choosing to acknowledge and to verbalize that that is happening, and to talk to the individual. This is something that I've learned recently, because I typically like to swoop in with the superwoman cap and just solve problems for people.

I learned no, not always good. You want to have a conversation with the individual who's being affected by the situation whatever it might be, and ask them how can I be of help to you? Because the important part of allyship is to not take that individual's agency away to act for themselves. Sometimes people just need to understand that there is someone else out there who supports them and who is willing to have their back and speak up for them. But they want to take their own agency to walk forward, versus someone who is stepping in on behalf of that individual to act. And so either one of those might be appropriate given the situation and the individuals that are involved, but it really does start with the recognition that something unfair and inequitable is happening. And number two, the willingness to utilize the power that you have in order to make it right.

Chris Riback: Dr. Gourdine, thank you. You have spent your career making things right. And in the public health world, and in the corporate world, and from weathering to allyship, to increasing representation of boards and beyond, that's just another step in the twisting winding path that you described at the very top. Thank you for the conversation. Thank you for your time.

Dr. Michelle Gourdine:  Thank you. It was my pleasure.

Dr. Alexandria White:    Thank you, Dr. Gourdine. It was nice having you.

Dr. Michelle Gourdine:  Thank you, Alex.