A few thoughts about gender equality and respect in the 21st Century

2016.03.30 Human Rights Campaign Corporate Equality Index Best Places to Work Reception 03870
2016.03.30 Human Rights Campaign Corporate Equality Index Best Places to Work Reception 03870 (View on Flickr.com)

I recently finished Sheryl Sandberg’s book Lean In: Women, Work, and the Will to Lead (I know, 3 years behind the rest of society, posting on that later), at the same time I participated in a historic (in my opinion) creation of Workplace Guidelines Pertaining to Transgender and Gender Non-conforming Employees.

I had these thoughts as I was given an opportunity to co-lead (with an excellent leader who happens to be a woman) an introduction to this topic:

  1. Everyone here was made in the 20th Century
    • By definition, today’s health care workforce was born in the 20th Century. The overwhelming majority of us were educated in the 20th Century, which is where much of gender expression was imposed on society:
    • When Did Girls Start Wearing Pink? | Arts & Culture | Smithsonian@SmithsonianMag

      For example, a June 1918 article from the trade publication Earnshaw’s Infants’ Department said, “The generally accepted rule is pink for the boys, and blue for the girls. The reason is that pink, being a more decided and stronger color, is more suitable for the boy, while blue, which is more delicate and dainty, is prettier for the girl.”

    • Fashions: Baby’s Clothes – TIME | Where to buy pink clothes for boys, 1927 – Gender MystiquePink is for boys
    • BBC – Future – The ‘pink vs blue’ gender myth

      Various studies have looked at colour preferences in different age groups. In the US most have found that babies and toddlers, whether male or female, are attracted to primary colours such as red and blue.

    • Medical science is also a conspirator here. With the advent of amniocentesis in the 1980s, and with it, the ability to know a child’s sex at birth, the marketing of imposed gender expression became even more aggressive.
    • The majority of the workforce being “made” in the 20th Century of course is changing rapidly, which is going to contribute to all of the above being an even more distant memory. Since it’s not based on science, it won’t be missed by this physician.
  2. Now that we know that much of what we were taught was arbitrary and not based on science, it’s up to us to unlearn and relearn.
    • This quote really helps with that.

      Notice your defensiveness and accept the discomfort of unlearning and relearning. To be competent in this arena is the same as learning to be competent in anything else. It requires a desire to know, motivation to become informed, opportunities to practice and the willingness to correct your mistakes.

      To say we don’t have biases is to deny our humanity. We all have to practice the desire to learn, with humility. In experience this can be very difficult for people (I’ll be writing more on this, known as the “illusion of objectivity”). Sheryl Sandberg, in her book, has had similar experiences to mine:

      My own attempts to point out gender bias have generated more than my fair share of eye rolling from others. At best, people are open to scrutinizing themselves and considering their blind spots; at worst, they become defensive and angry.

      Sandberg, Sheryl (2013-03-11). Lean In: Women, Work, and the Will to Lead (Kindle Locations 2287-2289). Knopf Doubleday Publishing Group. Kindle Edition.

  3. As we implement the future, we should be aware of its impact.
    • Creating an environment that’s open to everyone versus one where people are helped to “fit in” places an employer squarely in the group of the most elite employers to work for, internationally. I am proud to be a part of one of the 407 best places to work in the United States, with a 100% rating on the Human Rights Campaign Corporate Equality Index.
    • I can’t even count the number of times our work in this space has created more opportunity for thought partnership and mindshare around health in general. Not LGBTQ health, all health, total health. I personally know people who have joined our health system because of the knowledge that we respect this population, whether or not they are a member of it. The same goes for other nationally important stakeholders I have worked with – they are drawn to people and organizations that respect every human, in all work related to health.

      Photo Friday: It’s important for a health system to score 100% on the HRC Corporate Equality Index, too

    • Changing our world to help it learn to love better is the continuation of what a nurse or doctor hopes to become when they begin their training. It’s an incredible leadership opportunity to be part of these professions when we become who we are.

Speaking of leadership opportunities. I encounter them every day, sometimes unexpectedly, and they are awesome.

Just Read: Street Smart: The Rise of Cities and the Fall of Cars

Street Smart: The Rise of Cities and the Fall of Cars by Samuel I. Schwartz (Author), William Rosen (Contributor)

In my regular sojurns into the things that produce health, such as well designed communities and transportation systems, I happened upon this title, a fantastic 101 of what any physician needs to know about the lever of transportation to reduce patients’ reliance on us.

What’s “normal” – a motordom-dominated, car-for-every-human, streets as wide as football fields society, or something else?

The historical anomaly, after all, wasn’t the desire to live in densely populated, walkable communities. That’s how human beings have lived ever since they started building permanent habitations, and then towns and cities, ten thousand years ago. It’s how most people still live outside the United States today. What was different about the United States of America (and a few other places) from the 1920s to the 2000s was the aspiration of most people to live as far away from work and shopping as they could afford.

It turns out that something else is normal. As a 20th Century child, I was completely duped by motorized mobility. However, I, like Schwartz, had a spark, as I recall riding my bicycle to my medical school classes, and learning, slowly over time, that I really disliked driving, despite living in world engineered to glorify it.

What we gained in “mobility” we lost in “access,” which was taken away from our communities in the 20th Century, and is slowly coming back in the 21st.

But mobility isn’t what’s really important, for either happiness or prosperity. What matters is access. And it’s just as easy, and a lot more efficient, to improve access— to stores, or entertainment, or employment— by decreasing the distance between, for example, home and supermarket than it is by increasing the speed by which to get from one to the other.

Totally makes sense to me, as it was almost immediately apparent when I moved to Washington, DC sans car and realized that what I left was ABnormal.

What I didn’t realize until I read the book was that I performed a “deprivation” study on myself – so called when people who are regular drivers are asked to forgo using a car for one week. And, here’s what happens:

Before and after their week of auto deprivation, the study’s participants were interviewed in depth about their experiences. Two-thirds of them reported that the absence of a car exposed them to new experiences. They felt more connected to their communities. Many felt literally claustrophobic when they returned to driving after the deprivation experiment.

Yep, me too.

My fellow Washingtonians are clearly joining me on this journey, as US Census data shows:

Car-Free Generation Y, Washington, DC #ActiveTransportation

I didn’t realize until half-way through that I’m actually featured in author Sam Schwartz’ (@GridlockSam – so named because he came up with the term when he was New York City’s Traffic Commissioner) book from 2012. “Steps to a Walkable Community” was produced for AmericaWalks (@AmericaWalks). I’m page 148 – where two of my favorite things are highlighted – walking meetings and Washington, DC 🙂 . So, I was primed to enjoy the education.

Doctors love designers and traffic engineers, too, especially the ones that think like us…

As I have written previously:

Just Read: The Third Mode: Toward a Green Society, (how engineers impact our health as much as doctors)

So this book is a great companion to that idea, explaining in human terms how enlightened engineers plan cities, including conventional wisdom, unconventional pitfalls, and trends that we need to know about in health. It’s similar to the education I’m getting from architects and other physicians catalyzing the design for health movement.

Millennials and the decline of the car

One of the most important trends Schwartz points out is the relatively unexpected (or unwanted by some) decline in vehicle miles traveled per person:

If all eighty million Millennials retain their current driving habits for the next twenty-five years, the US population will increase by 21 percent, but total VMT will be even less than it is today, and per capita VMT— the vehicle miles traveled per person— will fall off the table.

They’re just not driving as much. And it’s not because they’re environmentalists. As Schwartz points out

In a 2011 poll, only 16 percent of Millennials strongly agreed with the statement, “I want to protect the environment, so I drive less.”

Driver Licenses – addicting people to cars in their youth as much as cigarettes?

We know that if teens can avoid smoking before age 18, they’re unlikely to ever pick it up. Almost no one starts smoking after age 25.

So it goes with driver licenses:

GDL (Graduated Driver License) programs don’t just delay driving; in many cases they reduce it permanently, since history shows that, if drivers haven’t gotten licensed by the time they’re twenty, they’re unlikely ever to do so.

So as teens get driver licenses later in life, they’re less likely to adopt driving. That plus their experience as children of parents experiencing societal gridlock for the first time in history puts us in the position we’re in now, which is a great opportunity.

Americans spent 421 million fewer hours stuck in traffic in 2011 than they did in 2005. For the first time, the number of cars being “retired” is actually greater than the number of new cars being sold.

Making Streets Smart, the physician role, because we do have one.

Designed to Move 30121
Watching New York City completely change before our eyes – circa 2013 – Designed to Move 30121 (View on Flickr.com)

I like the approach to educating neophytes like me in the book.

Schwartz covers everything from the dynamics of movement in our cities, for example the impact of “skinny streets” (they reduce rather than increase congestion), to the modeling of pedestrians traveling on sidewalks, to the promise of driverless cars (hint, maybe the science of movement doesn’t support the promise).

There’s a really good discussion of equity in transportation as well in the examples of Houston, and the transportation meltdowns in Atlanta, Georgia, created by inequity, which has held the entire city hostage. For active transportation to work for cities, it has to be inclusive.

We talk about the penetration of things like step counters, fitness bands, and wellness programs, usually in the 10-20% range. The penetration of utilizing transportation of some kind on a daily basis is near 100% (and spending time in a building 90%).

It’s not a question that our cities are changing, it’s a question of how they are going to change. Just walk outside and take a look. It’s what I did in September, 2013, with Jeff Olson, one of the founders of the bikeshare system used in much of North America. We just sat in front of the flatiron building in New York and watched the bikers go by (A Walk Through New York – Designed to Move – is this our 1968 moment in creating active cities?).

2016.07.19 Smart Growth America Policy Forum 00840
2016.07.19 Smart Growth America Policy Forum 00840 (View on Flickr.com)

Today, I enjoy giving people the tour of the complete street that the Center for Total Health in Washington, DC sits on.

After I ask if they know what Complete Streets are (most in health care don’t), I remind that communities do not become this way magically, and also that a complete street by itself does not create health. Humans do that, and now it’s our time to take priority.

Isn’t this century marvelous?

Infographic - tracking a complete street - a year of active transportation - center for total health
Infographic – tracking a complete street – a year of active transportation – center for total health (View on Flickr.com)

Just Read: Becoming Steve Jobs, The Evolution of a Reckless Upstart into a Visionary Leader

Great read about leadership and the uniquenes of one person, and also an insight into the commonalities of people born into the baby boomer generation that Steve was a part of.

We can learn as much, if not more, from failure, from promising paths that turn into dead ends. The vision, understanding, patience, and wisdom that informed Steve’s last decade were forged in the trials of these intervening years.

Steve’s gift was even greater: he saw clearly what was not there, what could be there, what had to be there. His mind was never a captive of reality. Quite the contrary. He imagined what reality lacked, and he set out to remedy it. His ideas were not arguments but intuitions, born of a true inner freedom. For this reason, he possessed an uncannily large sense of possibility—an epic sense of possibility. – Laureen Jobs, 2011

Just Read: The Next America: Boomers, Millennials, and the Looming Generational Showdown

I don’t know where I came across this book by Paul Taylor (@paultaylordc) from the Pew Research Center (@PewResearch) but I did, and it combines a lot of interests of mine (and a lot of other people). Specific to me, an ongoing following of the Pew Internet (@PewInternet)’s former researcher and brilliant community colleague in DC, Susannah Fox (@SusannahFox), and a lot of work I’ve done in diversity and inclusion as well as technology, that has caused me to read a lot of the reports cited in the book. So it’s in one package here, which is great.

I’m going to make a small editorial comment in the era of open leadership which is that I’m confused by the extremely restricted copyright notice in the book itself, which is paired with an extremely un-restricted embed-as-you-please approach on the Pew Research site itself. So I’ll respect the book of course, but embed from the site. I think the book adds some helpful comparisons over time of the type “When Gen X was Gen Y’s age…” which is important.

Actually this is the only quote I’d like to share:

As a people, we’re growing older, more unequal, more diverse, more mixed race, more digitally linked, more tolerant, less married, less fertile, less religious, less mobile, and less confident .

Taylor, Paul; Pew Research Center (2014-03-04). The Next America: Boomers, Millennials, and the Looming Generational Showdown (Kindle Locations 157-159). PublicAffairs. Kindle Edition.

This is a good setup for the book, which walks the reader through the changing demographics of our country. Very helpful in understanding the importance of immigration to our future, as well as mythbusting about the institution of marriage, which has been in decline farther and faster than before the LGBTQI community came to it

The Generations

As is the case in the study of demography these days, Generation X is ignored, it’s all about the Baby Boomers and the Millenials. No big deal. I choose to interpret based on the data that Generation X is a lot closer to Millennials in social circumstance and attitudes than it is to the Baby Boomer generation.

Just one more quote that I thought intriguing:

The sheer size of the Boomer cohort has led to a lifetime of stressful intragenerational competition for a limited share of top spots in schools, colleges, and careers.

Taylor, Paul; Pew Research Center (2014-03-04). The Next America: Boomers, Millennials, and the Looming Generational Showdown (Kindle Locations 592-594). PublicAffairs. Kindle Edition.

This is not the situation for Generation X, of course.

The Gini Coefficient and Income Inequality

I was introduced to the Gini Coefficient which is a measure of income distribution (inequality), closer to 1 is more unequal, and I did a little searching. It seems that there are different estimates of the U.S.’ number. The U.S. Census number is .4811, where others like the World Bank and the OECD come up with a more moderate number.

I don’t have a preference for either, I’m embedding the OECD numbers below, because they show the comparison which shows big differences between countries. Hint: look at France.

Diversity, inclusion, generational change

The picture here is pretty clear. In the area of acceptance, the world is learning to love better. Two relevant charts below:

Growing Support for Same-Sex Marriage across Generations
How the Generations See Themselves

Of note, I couldn’t help noticing the congruence of these two quotes, from very different people.

“If We Want People To Like Us, We Have To Like Them First” – Bobby Jindahl, Governor of Louisiana


“At the end of the day, if you are for the community, you love the community, and you help the community grow, it will show you the love you show it,” – Mally H, a 21 year old transgender woman, in Washington, DC

Just something to think about, which is that it appears that everyone agrees, love always wins 🙂 .

Co-designing a health system for a future generation – Our Generation Y UnFocus Group

This week, in a most awesome way, turned out to be a fantastic bi-coastal collaboration between our sibling innovation centers, Garfield Innovation Center, where I was with its Director, Jennifer Liebermann (@JRuzekLieberman) earlier in the week (see: Through the eyes of interior architects: The new Garfield Innovation Center + future of healthy building | Ted Eytan, MD), and Center for Total Health, where Jennifer Liebermann was with us in Washington, DC, to help facilitate an “UnFocus” group for people who are part of Generation Y.

The purpose is to help Kaiser Permanente and our digital health team (@KPDigitalHealth) vision how health and health care should be and how it can be for a future generation, 10 years from now. There are a lot of choices and options, and a lot of smart people who we work with that know what’s possible. At the same time, everything is always better when it’s co-designed with the people that will be served by it.

Thanks to UnFocus group members for being interested in and caring about the future. We are interested too, because it’s where we spend a lot of time. Cathedral building rather than brick laying 🙂 .

See the rest of the photos from the evening here: 2014.09.25 UnFocus Group – Generation Y – KP Digital Health – an album on Flickr

Request for Proposal: Can I be your mentor (and vice versa?)

I’m posting a request for proposal for my next mentorship relationship, not because I’m such a fantastic catch, more because I want more people to engage in these relationships.

I’ve enjoyed two awesome mentorship relationships (see: Now Reading: Don’t hand the keys over, collaborate with Gen Y | Ted Eytan, MD and Being a mentor, enjoying colleagues who are millenials. Look at these SMARTER Goals | Ted Eytan, MD). It’s time for the next one.

Why? Because (a) if someone knows how to do something better than me, I’m interested in knowing about it (b) I’m not that smart and my ideas are not that unique and (c) I and others have been conversations lately that confirm I am not the only one who believes in (a) and (b), which is a more important discovery than that any of us knows how to solve a problem.

A little background

I took a look in my electronic files and I remember a time, oh around 2008-2009, when I read stories of other companies who had set up so-called “intergenerational mentoring” programs, iconic places like Time Warner, Cisco, and Booz Allen Hamilton (How Gen Y & Boomers Will Reshape Your Agenda – Harvard Business Review) and wondered if we could be one of those companies and have programs like that. It turns out that we could, we are, and we have such a program, and are listed as one of the … The 10 Companies With The Happiest Young Professionals.

It’s what we wished for, so let’s take advantage/let’s keep it that way/spread it to others. If we did it, you can too.

Here’s what I’m looking for, then. Hint: copy, modify, and create your own (and share the results with me in the comments or via twitter).

Thanks for the use of this template that I modified slightly.

Request for Proposal: Mentorship relationship

Project Description

  • Mentorship relationship: Structured, ongoing connection with another person who seeks to perform at their best for Kaiser Permanente members and help our organization produce total health for our members, their families, and communities, and maybe change the world also.

Requirements – Mentee

  • Must be an employee of a Kaiser Permanente entity (medical group, health plan, doesn’t matter) – need to support the home team!
  • Must plan to stay employed by a Kaiser Permanente entity during the mentorship term
  • Ability to drive the relationship, which includes setting goals, sharing experiences, arranging times and venues to communicate – that’s the recommended approach, it has worked so far
  • Ability to break the relationship, if a good fit is not achieved – suffering is optional
  • Ability to place a focus on the mentee’s goals and wishes for the future – we won’t make this about me, that’s for my mentor 🙂
  • Open to experiences that connect you to the member experience more closely and in different ways – we are here for them, after all
  • Able and interested in promoting mentorship to others

Technical and infrastructure

  • Work location flexible, California or Washington, DC preferred – greater likelihood of in person checkins – in person is the new online
  • #activetransportation strongly encouraged, walking meetings will be involved

Assumptions and Agreements

Estimated Duration, Frequency, Type of Contact

  • 1 year
  • Contact approximately every 3-4 weeks, more frequently as needed
  • Any and all modalities (experimentation encouraged, we’ve broken every high tech meeting device already): in person, phone, video, text, tweet

Submission information

Basis for Award of Contract

  • Everyone is awarded a mentor and vice versa, if it’s not me, I’ll help find you one

Here’s my mentorship profile to see if it fits your RFP

My Profile

LinkedIn Profile Ted’s LinkedIn Profile
Last Updated: 09/09/2014
First name Ted
Last name Eytan
Gender (optional) M
Social networks all of them. Try @tedeytan first
Office phone (does anyone have one anymore?)
Preferred contact method Email, Text, Tweet, if I can walk to it, I’ll do it
Current job title Physician Director, Kaiser Permanente Center for Total Health
Job Level Director/Sr. Director
Department/Functional Area The Permanente Federation, LLC
Regional Affiliation The Permanente Federation, LLC
Office location Washington, DC
Year I started at Kaiser Permanente 2008
I want my role to be: Both
Number of Mentees I’m willing to Mentor 1
  ✓ Click to Read Expectations of Mentors and Mentees       I have read, understand and agree to the ‘Expectations of Mentors and Mentees’
As a Mentor…
  ✓ I want to share my knowledge and help KP be the Best Place to Work
  ✓ I want to know what others are doing to be more patient and member-focused
  ✓ I want to improve my performance in relationship to the value compass
  ✓ I want to expand my network
I have subject matter expertise (SME) and/or experiences in the following areas: Information Technology, Clinical Medicine, Diversity
I Have These Skills Being more productive
Developing career path
Discover and develop my strengths, talents, abilities
Interviewing for a new position or Interviewing others
Navigating Kaiser
Setting goals
Time management
I Have These Behaviors Champions Innovation and Change
Communicates Effectively
Deals with Ambiguity
Develops Self/Others
Drives for Results
Focuses on the Customer
Takes Accountability
Highest level of education Medical School
Schools attended University of California, University of Washington, University of Arizona
Employee Resource Groups GenKP
KP Pride: Lesbian, Gay, Bisexual, Transgender and Intersex employees
Other groups I belong to and other projects/activities in which I am involved with at Kaiser Permanente Transgender Member Health Equity; Transportation/Food/Physical Activity and Health; Kaiser Permanente Center for Total Health – part of the Kaiser Permanente Innovation System
Activities or groups I am involved in outside of Kaiser Permanente ActionDesignDC, ActionDesigner.net