Dr. Hyma Polimera grew up in India dreaming of becoming a physician, and in 2008, she made her dream come true. She became a physician, and eventually moved to the United States and started working at Penn State Health in 2014. In 2016, she met a patient who had multiple chronic conditions, including dementia. She met with the caregiver and the power of attorney. And when she introduced herself, the caregiver immediately asked for a change of physician.

Dr. Polimera suspected she knew why they were asking for a physician change, but she still asked the question. And she said that even though she’d suspected what the response would be, she still felt blindsided when the caregiver said, “I’d like an American doctor.”

Dr. Polimera took that experience to her supervisor and submitted a change-of-physician request form. Dr. Brian McGillen was the supervisor of hospitalists at the time. He first talked to Dr. Polimera and asked her, “Are you comfortable caring for this patient, even though they’ve asked for an American physician?”

She said yes. McGillen knew that she was highly qualified to care for the patient. So he went back to that patient and family and told them, “Your request for a physician change is denied. We will not honor a change request based on bias or discrimination.”

That set a precedent for future diversity, equity, and inclusion work at Penn State Health, explained Shanne Keeny, MISM, CPXP, Director of Patient and Guest Experience at Penn State Health, during the recent NRC Health 2022 Pediatric Collaborative at Children’s Hospital of Alabama.

Today, Penn State Health has an anti-bias policy that follows those same guidelines, which explain that the organization will not honor a request for change of any staff—not just physicians—that’s based on bias or discriminatory thoughts or actions. Conversely, its expectation of mutual respect is shown in Penn State Health’s vision to deliver excellent care, combining the most advanced and innovative techniques in medicine with compassionate and culturally responsive service for patients, families, and communities.

“It can be devastating for somebody to know that a patient doesn’t want them to care for them, based on their ethnicity or sexual orientation, or whatever that aspect of diversity is,” Keeny says. “I think it’s really a testament to the organization’s commitment to diversity, equity, and inclusion that they’ve modified the mission and vision statements.”

While it’s simple to ensure that culturally appropriate hair-care products are stocked in units, it can be tricky to track whether a patient is exhibiting biased behaviors, or assess whether a patient wants specific pronouns used.

Keeny recalls a time when they handled a complaint from a transgendered patient, and over and over, the health system used the wrong pronouns and the wrong name for the patient. “We know we have work to do,” says Keeny. “Our systems don’t all talk to each other, and we’re setting staff up for failure by not having those things available. Since we don’t capture some of this information in our EMR, there’s no way for us to identify people to serve on our councils.”

Penn State Health has partnered with its marketing team to send messages to patient populations asking if they’d like to participate in a specialized council, such as a council for sexual and gender minorities, one for people with a disability, or one for veterans. In a future state, Keeny says they might add recruiting efforts to the end of some of the surveys, asking people if they are interested in representing underserved populations.

“We’ve purposely called this a journey, because I don’t think that there’s a time when we’re ever going to stop talking about diversity, equity, and inclusion,” Keeny says. “And sometimes we think that we’ve been working at this for a long time, and then other days I come into work and I think, Boy, we really just got started.”