Now, let's look at some cases for discussion, and remember we would like to hear from you, the audience, your questions and experiences. So now we'll take a few minutes to field any questions from the audience. You can feel free to raise your hand or indicate that you have a question if you'd like to provide some thought for discussion, or if not, we'll talk about some cases. Want to just start with a case to kind of get the day flowing, Dr. Kashaw? Sure, sounds great. Which case would you like to start with? Let's go to case number four, Modeling Inclusive Behaviors and Creating a Safe Space. All right, I'm going to start us off here by reading the case briefly. The prompt is, you work in a large endoscopy unit where the majority of technicians and nurses are of Hispanic heritage. One of the electrosurgical units keeps having issues, so you call the biomedical engineer to assess it. The biomedical engineer comes and asks you what the problem seems to be happening with it. You explain that one of the technicians has had trouble with getting one of the programs on the machine to work. He exclaims, expletive, Mexicans. You are shocked, and you notice that there are two nurses nearby who look at you in shock and turn away. After the biomedical engineer makes the changes to fix it, you tell him that you can't say things like that. I work with them, and if they report you, you can be fired. He blows you off. You notice that you are getting the cold shoulder in the endoscopy unit since the incident. You ponder your situation. If you report him to HR, he could be disciplined, even fired. And you fear that you'll be labeled a snitch, harming your relationship in the department and beyond, and that he could come find you and retaliate in some way. And in addition, that won't undo the damage done with the other technicians and nurses. You realize you did not say those despicable words, and that the biomedical engineer did, but you feel that you are being painted with the same racist brush. So what are your options? Thanks, Neil. I think I'll see what people say before I discuss what I would do. Yes, Dr. Williams, we're looking forward to hearing your thoughts. This is right in your wheelhouse. And we'll see if we have any thoughts for discussion from the audience. None from the audience yet. We have a couple of questions in queue after we discuss this. So Dr. Williams, if you want to go ahead and offer your thoughts, and any other panelists, I'll let you know if anybody chimes in from the audience or if anyone raises their hand. Yeah, I'll acknowledge I think this is challenging. I think it's hard to... Let's be honest, we hear things that is maybe more common than we think it is. And I think it's really hard to figure out how to push back, how to advocate for someone else. I think HR, if you're reporting to HR, it can't be anonymous. The person will be identified. But the first thing I would probably do is have a conversation with the engineer and ask him, you know, where is this coming from? And not just say you can't say things like that. I'd say you can't paint everyone with the same brush, and I think you're stereotyping. And have a conversation around where that comment came from. In terms of the endoscopy unit, I think you have to be very mindful, because sometimes people may want to deal with things themselves. And you may think you're supposed to come in and say something, when in reality someone else may say let me deal with this. And I would have a meeting with them and have a conversation around what they heard. And just get their reactions. And just say, I acknowledge this is an incorrect behavior. And ask that group, how would you like me to deal with this? Or do you want me to deal with this, or do you want to deal with this yourself? Not everyone wants to report people to HR, and I completely understand that. But the potential of getting that group, the two nurses who heard, and I'm sure they went and spoke to everyone else, and just say, listen, can we talk out, again, active listening, understand their perspective. What happened? What was your reaction? What was the impact? And then let's discuss as a group collectively how to deal with this. And they may say, we don't want to move forward. I've had situations in my real life where someone said, I just don't want to, let's not do anything about it. And you have to respect that person's choices. Me, personally, would probably pull the tech aside and have more conversations with the engineer. But I'd actually give the group the opportunity to let me know how they'd want me to handle it. I'm not saying that's the right way. I'm just saying that's what I would do personally. Thanks so much for your perspective, Dr. Williams. I also wanted to add just some of my own thoughts. I think that in dealing with situations like this, we often think of HR as sort of the principal, and you don't want to call in the principal or go to the principal's office. But I think it's useful to remember that our HR colleagues are really there for us as a resource, and people who we can partner with in order to ask difficult questions that we may not immediately have the answers to as endoscopists or technicians or whomever. And it's also sometimes helpful to include someone from HR just to provide that expertise in navigating these complex situations. And because sometimes having one-on-one discussions with team members can lead to a slippery slope and then later on down the road turn into a he said, she said kind of game. So I've actually had some really good success in incorporating HR in discussions, even in a more informal way, just to have their expertise and their thoughts on the scene. I will agree with that. I think if you're going to have a conversation between the techs and the engineer, then HR should be present. In my experience, they tend to do an investigation. But if you're going to have a conversation with the two groups together that are in conflict, then having a third person's HR is very helpful. I was going to just say that to bounce off of Neil's comments regarding HR, sometimes in different institutions, HR doesn't necessarily ask for names. So sometimes anonymous reporting can happen. And this is a situation in which team culture can be affected, right? You've diminished psychological safety, diminished the team culture overall when things happen like this. And I think this has to be called out. I mean, I hate to see this guy or this biomedical engineer get away with something like this without some sort of action taking place into figuring out. I agree with trying to understand what his perspective is, why he might have mentioned this expletive, and also dealing with the other employee who's witness to this as being part of this situation, in which other people look at this as, well, you were part of this conversation with this biomedical engineer, and so you are also responsible for what he said. And it can create division. It can fester in ways that have downstream consequences. And so I do think it does need to be addressed. HR can come in and have a general conversation about cultural humility, what kind of behaviors are to be expected. And I think it is reassuring to others within the endoscopy unit to make sure that they feel like they're valued and that their perspectives matter. Sometimes they will offer solutions to this problem or conversation that leaders might not necessarily think about, HR might not necessarily think about. And so it's important to hear everybody's voice when situations like this occur. So I agree with the comments made by Neil and Renee. And I hope that this doesn't happen in endoscopy units, but I do know from endoscopy units around the country, around the world, that things like this can happen, and hopefully you've gotten some ideas about how to address them. Yeah, I think I should also mention that when I mentioned getting the person's perspective, my response would be, why did you say that? It's a way to have someone, number one, confront their own biases and name it. Because people say things a lot of times, and sometimes we respond in, let me keep quiet. What I've done, because I've had people say comments, it's, why did you say that? Because then now you have to name those biases that you have, and you have to confront it internally within yourself. So I think HR is a good idea. I think people are very variable in how they respond to HR. Some people are just very scared of HR, and they may not necessarily want to involve them. But I think from a leadership perspective, offering that option is really important, because it shows that you are serious about dealing with negative and negative environment, and it makes them feel validated. And I think Gerard said something really important. It's important that people feel validated. And when something like this happens, and you pretend it didn't happen, it really invalidates that person's experience, and it really invalidates, it makes that person feel like they're not a part of that team. And it's important to make sure that that is explicit, that we heard this, we're going to deal with this. Whether or not the person who overheard it, or they text aside that they want HR not to be involved, the fact that you as a leader is willing to say we're going to bring this to a higher level, actually is very important to them. But by asking that engineer specifically, why was that comment made? You could say you can't say things like that, I work with them, but I would be like, well, why did you just say that? And that really makes people pause, and then they have to really think about that comment and where it's coming from. And then those internal things start to come out. Yeah, and I'll just add, and hopefully everyone can hear me now that my internet's a little more stable, I apologize. I could not echo what everyone said to such an extent with this particular case study. A few things that Gerard had also mentioned about kind of not only the need to speak up, but I think also it's noticeable as a leader if you don't speak up. So in a situation like this, especially as a leader, someone whose true role is to create a culture where people feel safe and feel valued, a situation like this highlights the need to speak up as well. And so if you are not comfortable speaking up, then that's a problem for all of your leadership and the trickle down effects of everyone with whom you're trying to build a team. Yeah, I will say within my role, I have faculty and trainees coming to me with issues similar to this, and I always recommend discussing with HR. About half the time, they decline. The other half will go through with it, but when it comes to the investigation part, some people step back at that time point. But it's always something that I will offer, but I leave it up to them to decide if they want to pursue it, in essence, but I think that's important. And the audience has come in with a few thoughts and questions on this case study, so I'm just going to read one at a time and let you respond to it. So the first one is what is wrong with calling out the biomedical engineer, respectively, in front of the endoscopy staff? I find in a situation like that, again, I think it depends on your personal thing. I would have asked why. My response would have been, why did you say that? In the moment, I would have said it, but I think people get very defensive sometimes when you do things like that, and if you're calling out the person, what's the reason behind calling it out? To me, asking the person why, have them confront their own bias, I'd do it right within the same space, but you don't want to create a very negative environment, because people get very defensive. They're like, well, and I've had this happen to me in real life, where people are just like, and then when they get defensive, they can't learn, and they can't understand what's wrong with that behavior. If that's something that's comfortable, someone else is comfortable doing, that's fine, but I tend to like to talk to people one-on-one first, and then we bring the group together to have a conversation, because I think that just works better in terms of conflict resolution. But if you're calling him out in front of everyone else, he's going to get defensive, and he's not going to want to learn, and whatever biases he has, this is my opinion, he may just double down on those biases versus being willing to listen and say, wait a second, I just did something wrong, and maybe I need to really work on myself about these assumptions that I have or stereotypes. And I think that's where I'm coming from, but in that moment, my response has been, why did you say that? So if the two nurses were text-related, they would have seen me say it, but I would have said, why? Because I found that to be, that really stops people in their tracks. In the past, I would have been like, oh, my God, I can't believe you said that. Now I'm just like, well, why did you say that? Yeah, I agree with that. I think that creating a blame culture is not the right way to address that situation. And the next comment is, in this situation, the person did not say the words, but the biomedical engineer did. The team painted him with the same brush. So how does the individual painted with the same brush express empathy and understanding while clarifying that he was not the one who said it, or felt that way, so that the team does not continue to convey judgment and anger towards their own team member while addressing the biomedical engineer's failings? I think, to be honest, I'm a very big leader. I think, to just say, honestly, in the moment I was scared, I was shocked, and I didn't know how to respond. And I think people appreciate honesty, because that's what happens in most cases. I think, again, luckily this hasn't happened that much in my life, but when a situation happened to me in training where someone said something to me, my entire team just froze. And that's why I mentioned about pretending like something doesn't happen really impacts you negatively. And you could tell they were just uncomfortable, so no one said anything. But I think just being honest and saying, listen, I'll tell you, a patient said to me they don't trust me because I'm dark. And they said it in front of my entire team. And the entire team, who were nice people, just froze and said nothing. And I think it's important to be honest and say, you know what, in that moment, I just was uncomfortable, and it's not a situation I'm comfortable dealing with. Please understand, I think what he did was wrong. But my response was just based on me just being uncomfortable. So I think just be honest, and that's probably the best thing to do. I think what you can say is that, you know, you heard what the biomedical engineer said. You don't agree with it. You know, you are someone who advocates for inclusivity, that you would like to explore this with the leader, particularly if you're somebody who's just a team member and not a leader or manager within the endoscopy unit. This might have been, for example, a technician, another nurse who may not have that responsibility of leadership. You could say that I heard what he said, and I'm sorry that he said that. It wasn't me. I don't agree with it. I'm going to talk to our nurse manager. I'm going to talk to our physician director and say, you know, is there a way that we can approach this situation in which blame doesn't get assigned, but people learn from what happened? The biomedical engineer, his perspective is understood, and he is then led to understand that such comments are perceived as racist and, you know, understand what his perspectives are in order to make him learn in a way that broadens his horizons, his cultural intimacy associated with different people. I think also, if you've worked in this space for a year or two years, people know who you are, and people know what your values are, so also be comfortable in the part of yourself you brought to work. So people will know, okay, assuming if you just started a week ago, that's different, but I guess trust in the reputation you yourself have in that workspace. But I think to that point, you can very much say, I did not agree with the comments. This is not how I think. You know me. You know this is not my personality. However, again, you know, responding in the moment can be challenging. I think that in itself, and I empathize that this has been a negative impact on all of y'all, but remember, you have a reputation at work. People know who you are. So trust in that reputation and how they're going to respond to you. Maybe in the moment they're cold shouldering, but later on, once they've gotten over that initial anger, and they start to think, oh, wait a second, we know this person, we've worked with this person. Clearly, he's not in agreement with what was said. So think about those differences. It's a very, it's a complex thing, I agree. And there is no, there are a lot of variety of right ways to respond to it. We have a comment here I believe incorporating in our team's mission goal and cultural differences policies, as well as discussing expectations regarding no bullying in the workplace, etc. Should occur with the entire team, whether via a meeting or by printing the policies and having each employee review and sign them discuss why it was brought up that this should occur. Did you have something to add to that. The only thing I wanted to add based on this prompt is that the incorporation of a no bullying concept I think is really important, because I think nowadays, especially from everything with social media, even outside of work, for example, and things in the workplace nonverbal cues. I think that there are so many ways that people can feel bullied, that I think it's really important to be open to that, and to try our best to recognize it when it happens. And kind of how I was saying earlier, I think our HR colleagues can be really helpful in helping us recognize those situations and avoid them when possible, and if they are occurring, help us deal with them accordingly. And one other comment that I'll just make and I'm so glad that the audience member commented on this is that a lot of the discussion so far has been excellent and kind of surrounding how to deal with the situation in the acute setting. Who do you talk to who do you notify how do you address the employee who mentioned this but this comment from the audience member is so important because it brings up how you can learn from this in the future. And I think some of these incidents can really be spun in a positive way for team building, discussing with your group at a later date, the idea of kind of no bullying and making sure that everyone understands this situation, maybe without feeding the details to those who are not aware, but just the recognition that you can learn from situations like this and you can become stronger as a team because of them. Completely agree. I think, unfortunately, these things do happen. I think they will continue to happen. I think people continue to feel uncomfortable, which is normal, but how you respond as a leader and as a team makes a huge difference in that sense of, I guess, psychological safety moving forward. So happy, thank you guys for including the case. I think it's unfortunate, but it happens. I will read two more comments. Well, I will read three more comments that came up on this, and then we have a couple of questions on leadership. So I'll read these three comments all together. I'll let the panel react if you are interested in adding any additional comments in response to these three that I'm just gonna read, and then we'll move to some leadership questions. The first one is, appreciate publicly and criticize privately, was what one person said. Another person said, confronting someone on the spot usually leads to conflict, but behavior like this is unacceptable. I like the idea of meeting with the team to discuss this event, but reporting this to HR and their higher-ups should be mandatory. And the final comment I will share is I had a similar experience and the only person making derogatory comments was taken to HR. So those were three additional things that came in. So do we have any other comments from the panel? If not, I'll go on to the leadership questions. I agree. I'm gonna comment on mandatory. So in my institution, it's mandatory to report things to HR. When I mentioned people stepping back, and what our HR does normally is they will investigate, but they will reach out to the person and in maybe two cases, when they've reached out to the person to discuss, the person declined to participate in the process. So that's where that comment came from. So if I told someone in leadership this happened, they're like, I have to report this to HR. But whether or not the person who's the victim, I guess, decides to move forward may be a little different. But I do think to your point, Gerard, you should always offer an HR alternative. Thank you. Okay, I'll move to our first leadership question. How do you lead effectively when the hospital administrator is a manager and not a leader? You wanna cut us off Dr. Shulman on that one or? Yeah, I mean, this is a great question and a challenging one. I think that partnership with everyone involved, recognition that people have different leadership skills and that it's important to make the distinction between kind of being a manager and being a leader, like I discussed about in my first talk, but also the recognition that as a leader, even if you partner with more of a manager type position, you bring something unique and different and nuanced to that situation as well. And you can escalate that relationship by recognizing those differences that I mentioned kind of between managing and between leading. So I think it's important to recognize that maybe even if those around you are predominantly managing, there's benefits to that. And especially in the endoscopy unit, you need people around you who are very good managers or things will fall through the cracks, but you can take your partnership in that partnership with your administrator and recognize that you bring something unique as well to that situation that can be profoundly important. So you can be the innovator, you can be the escalator, you can be the forward thinker, you can help construct the team to manage the day-to-day very, very effectively while you then take the group to the next level. So I think, especially as I mentioned, I really truly think the endoscopy unit is a very unique experience where you kind of have to do both as a good leader. And so depending on those around you to help with some of the more managerial tasks, if that's what your team does best is okay. And then you can take that relationship to the next level by kind of escalating what you can bring that's unique to that partnership. I think also, and I think someone, the point was made that leadership is not inherent. You're not necessarily is a born leader. Considering, depending on your situation and your particular world, offering some sort of leadership training or leadership course, if possible, if it's feasible. Again, every unit, every place has a different ORCS charter structure. But if you think that person could be a better leader, is there any internal resources around leadership training? Like NYU has a bunch of different courses for leadership training, but if you think there'd be a benefit to that person, it's okay to consider it if that is a possibility. Yeah, I can't echo that enough. And I also see a question in the chat about how to improve emotional intelligence. And as you may have heard, one of the major tenants to that is leadership courses like this, and like others that may be available at your institution. We had someone who joined our leadership course who basically came in saying, I have terrible emotional intelligence. And I actually thought the first critical step of emotional intelligence is self-awareness. And that person who is an excellent leader in many other ways recognized that that was one thing that he really needed to improve upon to take his leadership to the next level. And so what we did during that course is really basically create situations where he would be forced to kind of recognize his self-awareness, his empathy, all of those critical things that I had mentioned in my talk to make you better at it. And I can't agree with Renee enough. Some people are born, a very small percentage are born as excellent, excellent leaders. And it's always amazing to see those people in action. But I think many of us acquire leadership skills as we're put into different situations. And as much as you can kind of mimic those and discuss those with colleagues and with people who bring different strengths to those conversations, I think it can really make you a stronger leader and especially the next step from kind of managing to leading. So one of the things that I probably would have asked some clarifying questions regarding that participant who asked that question when he's faced with somebody who's a more of a manager than a leader and how do you address those things is, is it from a personal thing in which that team member wanted to bring something innovative to the endoscopy unit and felt like the manager wasn't allowing that person to do something like that as a leader and trying to figure out if there's a way to ask for that. And so is there a way to identify if there's something specific that that person wants to improve on with the team, can that person do that project? And it doesn't have to be a physician, it doesn't have to be a nurse, it can be a technician who is very interested in turnover times and they may propose some solutions to the problems that are at hand and they take over championing that particular project. So just be open to opportunities. Gretchen, did you wanna add? I would, so there are some, hopefully my camera doesn't bug out here, there's some really great resources out there, particularly when you're trying to have those difficult conversations, when you feel like you're communicating with someone who's not hearing your intent or you're coming from two very different places and there's some great literature around appreciative inquiry and how you ask the question of the person who you're having trouble meeting that with. So if you're working with an administrator who's more of a manager than a leader, who is like they're inside the box and you're asking them to step outside or you're just, you're not aligned, asking those questions to try and uncover what their roadblock is and to try and gain that common ground. And there's some very, very direct ones that you can use, right? Like you can say, what would it look like if we did something like this? Or can you help me understand what the barrier to exploring this might look like? And so a lot of this is anchored in coaching someone through that roadblock that they've hit. And as a leader, if you're trying to, if you feel like your bag of tricks is empty and how you then advance that, you feel like that's a place that you can't get through, there's really great resources out there with executive coaching, mentoring groups that are out there to help you think through those difficult things and to really help you process them because it could be something that you're struggling with a communication tool as well. And remember, communication goes two ways. You have to have the message and you have to have the person receiving the message. And if they are just closed down to hearing your message, you have to find a different way to ask the questions. Completely agree. I think I'm going to put a plug. I think coaching is a immense resource and it's extremely helpful, especially if you're in a leadership role, especially around having conversations. I think you made some really great points. I also wanted to add that, at least from the physician standpoint, and this is also the case for nurse leaders and even technicians as well. Sometimes it can be daunting to think of as a physician, for example, oh my gosh, I need to take time away from my practice and my family to go find a course or travel to it or spend time after hours on weekends and whatnot. But one of the easiest ways to start to develop these skills is to get involved in your institution's medical staff. At my previous institution, I wanted to get involved on committees and medical staff. And then a lot of these situations just came with throughout the course of the normal quarter or the year, being in meetings and being in situations where I was having to talk to physicians or help physicians with productivity, for example, and all these different situations. And then at one point, our medical staff ended up actually paying for us to all attend a leadership course. So that was something that just happened very organically. That was a really nice surprise and it was really, really useful, but I didn't really have to do much else except for just get involved with my fellow physicians and the medical staff. And I think that could be a great resource as well, that you don't always have to perhaps reach for something and take so much dedicated time away from your routine. The answers could be right there in front of you in the course of your normal day to day. We've got Kesha come in that was just related. What do you do to find a good executive coach? What are things you look for in an executive coach? Gretchen, I see you smiling. Do you have some comments? I do, actually. A lot of your organizations are going to, especially if you're in an academic medical setting, they're going to have resources for this already. In fact, most AMCs have contracts already with coaches, but there are a number of different coaching platforms out there. You want to find somebody who's certified first of all, because that gives you some framework around it. And you can often find someone who's attuned to either what your practice area is, or if you're a physician or you're a nurse or you're an administrator, there are coaches who do tend to have a little more fluidity in certain areas more than others. But one of the beauties of coaching is if you find a true coach, you're going to do an interview session first before anything starts, where you're going to make sure you have alignment. They're going to ask you questions. You're going to be able to ask them questions and you're going to make sure that your goals align. And most coaches are going to tell you, I can help you, or I think there's someone that's better aligned for that. But really finding that person that you can trust and you can have that open conversation with, because otherwise you're not going to advance. But I would check with your division, your department, and Dr. Schulman, I'm happy to give you a list of resources too. Yeah, thank you. Yeah, we can share those. I was going to say one other thing to add is that sometimes you can actually put the executive coach into a negotiation. So when you are escalating to take on a new leadership position, or when you are negotiating for a new job, I've heard that some people will say, I will come to your institution, but can you guarantee me an executive coach? It didn't even occur to me when I was transitioning to my first faculty position, but I've heard other people do this. And this is not just for new faculty. This is for seasoned faculty. These are for department chairs. I know our division chief, I know the department chairs, they all have executive coaches that have been extremely influential in their careers. And it's not just for physicians and nurses. So for the other team members on this course call webinar, there are resources for you as well. And I think it's okay to ask. I'm a very big proponent of asking for things that you need. I mean, whoever your leadership just say, hey, I think I would like an executive coach. That's how I got my first one. I just asked for it. Now, the more someone will do say no, but you can ask maybe inquiry. And I think Dr. Schulman made the great point that you're in a leadership course right now. So you chose to be here or somebody asked you to be here, which is a big statement. And so if any of you happen to have resources, podcasts or whatnot also that you listen to, please feel free to share them in the chat. We want to keep the questions in the Q&A, but if you want to share a good podcast, a good article or something, please go ahead and share. This is, again, quality is a team sport. Everybody on the line today is a member of this team. So why don't we put resources in the chat, keep our questions in the Q&A and Dr. Cashaw, we actually have been given a case study. So I'm gonna go ahead and read that if you don't mind. A colleague has an abrasive, angry, aggressive and mercurial demeanor, language and personality. They have been taken to HR, had anger management courses and various other measures taken by the health slash hospital system. My staff complained to me regarding this, but I am a younger and relatively early career physician. The staff feel that their complaints and concerns are moot as they know the physician will not be let go due to the region seriously being short of gastroenterologist. I have not approached him because I have not witnessed these instances and have limited interaction with him, but I strongly believe them of what I know of their personality. My concern is also of retaliation of an unknown degree. How does one approach such a situation? Any thoughts on this from the panel? Well, I had a slightly different but kind of along the same line situation. In this case, it was a trainee with an attending and the retaliation fear was really, really real. And I asked the person, can you write down examples of these incidents? Give me specific examples of what's going to happen. I also had to make sure the person felt protected because clearly by giving examples, it was going to identify who was making the complaint. And then I met with that particular faculty member. And when I initially made the comments, you create an uncomfortable environment. The response was again, very defensive. And then I had data. I think data is extremely important. If you're going to tell someone that you're having negative behaviors, you have to give them objective data. Here are the situations or the times when this occurred. And that's when we're able to move forward and have a conversation. So I think since if you have any witness behavior yourself, just have the person write. If they're comfortable again, and you have to really make sure the person feels protected. And I just had a conversation. I had me plus another leader have a conversation with this faculty member. And I had a two page document that documented specific things that had occurred. I'm not saying the faculty member was happy with me. They weren't, but I use data as much as I can. Yeah, the other important thing I think would be to, you know, find out from HR and approaching HR, if HR has what kind of comments, suggestions that they've had for this particular colleague. And then also, you know, try to address the ultimate goal, which would be to get that colleague to be more collegial, right? To be more respectful. And I think sometimes showing that person that they would have a better environment. They would have a better relationships. Their work life would be so much better. Their productivity would be so much better if those kinds of behaviors changed towards a positive effect. I think, you know, just kind of illustrating that, you know, whatever examples occurred, if they were done in a different way that was more positive, that they might actually be happier in what they're doing. Showing them the horizon of how it would look if their behaviors changed would actually dramatically improve their own life, I think is something that highlights or showcases to them, you know, maybe that there might be a possibility of change for the better, not just for everyone else, but for themselves. So I was actually in this exact same situation as this attendee. I was a new GI attending, fresh out of fellowship and same deal. It was a small community hospital. There was a board senior physician and I was the new kid on the block. And I didn't want to be seen as coming in and stirring the pot and all these things. And what I ended up doing, which was really helpful, is I found another physician, different discipline, different department, but I engaged someone who had a similar level and even a little bit more seniority and a slightly longer tenure at the hospital than this particular physician who was being problematic. And I went to this person for help and I was very transparent. And I said pretty much exactly what you said in the comment box, that I'm new here. I understand my staff is really affected by this. I believe them. I have a great relationship with them, but how do I go about this in a way that is tactful, but is also respectful? And I just don't feel comfortable doing it by myself or sounding the whole HR alarm bell. And this one particular senior physician, we've become really good friends ever since, was really, really helpful. So that was one way that I thought that maybe I can think outside of the box here and even engage someone who is not in this specialty, has very little to do with this situation, but maybe willing to offer a helping hand. And I was lucky in that this person was really, really helpful, but that may be a suggestion for you in this situation. Thank you.

discriminatory remarks

workplace inclusivity

Hispanic heritage

psychological safety

HR involvement

leadership skills

bias confrontation

endoscopy unit