Read “As Coronavirus Deepens Inequality, Inequality Worsens Its Spread“ from the New York Times and/or listen to this podcast from the New York Times (also at right).
Read this excerpt from Ibram X Kendi’s book How to Be an Antiracist.
Optional additional reading: “Stolen Breaths” from the NEJM.
Pre-work
Quiet room with enough chairs/space for all participants. If you have a group larger than ~6 people, chairs should ideally be mobile so people can break into small groups and then join the large group again.
Supplies
Activity
Read “caucusing guidelines” to the group
If you have a group that includes multiple levels of medical hierarchy (medical students, residents, attendings, nurses, MAs…) consider explicitly pointing out that expertise in medicine does not equate to expertise on issues of race and equity. One example, “For this exercise, experience and expertise may flip from how they are in clinic or on the wards. The attendings in the room may be the learners today and an MA may be the expert. Let’s recognize that we are all here to learn, share, and challenge each other.”
Break into small groups.
Group size may depend on the size of your large group. We have found that groups of 3-4 work well. Breaking into small groups allows people to be more vulnerable than they might be in a large group. It also makes it challenging to not participate.
Consider the make up of your group and how you might do this. Do you want mixed groups that include all levels (ex. student, intern, attending) or would it be helpful to break into groups that might be more comfortable for challenging discussions (ex. group attendings, students, residents separately)? Are the groups assigned in advance or do you have your group “count off” and then group by number (all the “1s” together, “2s” together, etc.)?
Discuss
Ask groups to discuss their thoughts and reactions to the readings.
Discussion prompts/questions might include:
What are barriers for patients to take time off from work if they are sick?
Are there policies or systems (other countries, company policies…) that reduce these barriers for patients?
What are reasons patients might not see a doctor or barriers to patients seeking medical care when they are sick? (Concern for deportation, medical bills, missing work, lack of transportation…)
Are there existing policies or systems (in other countries, other states, company policies, hospital resources…) that reduce these barriers?
What changes could happen in the US or locally to address these barriers?
What kinds of policies might support patients maintaining social distancing or home quarantine if they have symptoms?
Are there practical things you could do to help support patients or change policy?
What policies or actions (supporting workers, reduce healthcare cost and barriers, reducing inequity…) might save lives and reduce infection risk?
What can you do to promote them?
What practical things could you do to improve public health?
Are there policies you could change within your institution or your community?
Do you have opportunities to talk to politicians or policymakers to help shape solutions?
Are there ways you could use your privilege as a healthcare provider to promote change?
Typically, white caucuses focus primarily on self-reflection and internal work. How might the pandemic be different in that it presents unique opportunities for lasting systemic change?
Report back
Ask each group to share some highlights of what they discussed with the large group.