Practicing doctor, Jabraan Pasha, MD, FACP, talks with Finding Joy about the work he is doing around inequities in the American medical system. Dr. Pasha’s proximity to healthcare as a child led to his becoming a doctor as an adult. Among many roles, as the CEO of Lean In LLC, the Vice President of Juno Medical, and Host of the "Lean In with Dr Jabraan Pasha" podcast, Dr. Pasha’s efforts include overseeing pipeline programs, reducing implicit bias in medicine, giving keynotes and leading workshops on implicit bias and representation in medicine, and hosting the Lean In (to difficult conversations) with Dr. Jabraan Pasha Podcast. Listen in to learn how Dr. Pasha sparks the potential for children like him to follow in his footsteps.
“Finding Joy: The Health Care Professional’s Journey to Well-being" is a podcast resource developed by a team of interprofessional education researchers from Washington State University Health Sciences Spokane. They’re promoting well-being among students, faculty, and healthcare professionals during challenging times. Funding is provided by the Health Resources and Services Administration.
The Interprofessional Education Research team wishes to thank the following individuals for their invaluable contributions to this project:
• Dr. Barb Richardson, nurse, educator, and interprofessional champion;
• Cameron Cupp, creator of the “Finding Joy” musical score and current enrollee at WSU Elson S. Floyd College of Medicine;
• Washington State University staff from Marketing and Communications, Financial Services, and the Collaboration for Interprofessional Health Education Research and Scholarship; and
• Claire Martin-Tellis, Executive Producer, and Solen Aref, student intern, who developed the first five episodes of the “Finding Joy” podcast.
This episode of “Finding Joy” was produced by Doug Nadvornick, Program Director, Spokane Public Radio.
If you would like to reach out, please contact our team by sending an email to: medicine.ipoc@wsu.edu We also encourage you to visit our podcast blog as well as our team's website at: https://opioideducation.wsu.edu/about/.
Practicing doctor, Jabraan Pasha, MD, FACP, talks with Finding Joy about the work he is doing around inequities in the American medical system. Dr. Pasha’s proximity to healthcare as a child led to his becoming a doctor as an adult. Among many roles, as the CEO of Lean In LLC, the Vice President of Juno Medical, and Host of the "Lean In with Dr Jabraan Pasha" podcast, Dr. Pasha’s efforts include overseeing pipeline programs, reducing implicit bias in medicine, giving keynotes and leading workshops on implicit bias and representation in medicine, and hosting the Lean In (to difficult conversations) with Dr. Jabraan Pasha Podcast. Listen in to learn how Dr. Pasha sparks the potential for children like him to follow in his footsteps.
“Finding Joy: The Health Care Professional’s Journey to Well-being" is a podcast resource developed by a team of interprofessional education researchers from Washington State University Health Sciences Spokane. They’re promoting well-being among students, faculty, and healthcare professionals during challenging times. Funding is provided by the Health Resources and Services Administration.
The Interprofessional Education Research team wishes to thank the following individuals for their invaluable contributions to this project:
• Dr. Barb Richardson, nurse, educator, and interprofessional champion;
• Cameron Cupp, creator of the “Finding Joy” musical score and current enrollee at WSU Elson S. Floyd College of Medicine;
• Washington State University staff from Marketing and Communications, Financial Services, and the Collaboration for Interprofessional Health Education Research and Scholarship; and
• Claire Martin-Tellis, Executive Producer, and Solen Aref, student intern, who developed the first five episodes of the “Finding Joy” podcast.
This episode of “Finding Joy” was produced by Doug Nadvornick, Program Director, Spokane Public Radio.
If you would like to reach out, please contact our team by sending an email to: medicine.ipoc@wsu.edu We also encourage you to visit our podcast blog as well as our team's website at: https://opioideducation.wsu.edu/about/.
Finding Joy podcast with Dr. Jabraan Pasha
This is “Finding Joy: The Health Care Professional’s Journey to Well-being.” It’s a podcast developed by a team of interprofessional education researchers from Washington State University Health Sciences Spokane. They’re promoting well-being among students, faculty, and healthcare professionals during challenging times. Funding is provided by the Health Resources and Services Administration.
[theme music]
I’m Doug Nadvornick. Dr. Jabraan [juh-BRON] Pasha [PAW-shuh] has a very full life. He’s a practicing internal medicine physician in Tulsa, Oklahoma with an administrative job at the University of Oklahoma. He also hosts a podcast that touches on some of the inequities in the American medical system. Today, instead of asking the questions, he’s answering them, including how and why he got into medicine.
Jabraan Pasha: “I actually had a pretty significant heart condition when I was a baby at a tumor in my heart and that required open heart surgery. Now, it was about one year old, which is actually exactly how old my daughter is right now, and actually made me more comfortable around it. You know, I had that proximity of healthcare my entire childhood and young adulthood and why I became a doctor.”
Doug: Jabraan Pasha grew up in Tulsa.
Jabraan Pasha: “And then I left and went, you know, really far away, up to Kansas at the University of Kansas for undergrad. And I stayed there for medical school. And then I finally got out of the Midwest and I went to Mayo Clinic in Phoenix for residency. Did my internal medicine residency there. And at that point I was really open to settling anywhere but Tulsa, honestly. But some things happened. I was seriously seeing my girlfriend who was from Tulsa at the time, and my family who were willing to, you know, move from Tulsa, but were there as well. My parents, my brother, my two nieces and nephew. And I also was pretty excited about some things that were going on in Tulsa just in terms of development. And, you know, I thought about it, I was like, I think it's time to go home. And so I didn't anticipate that to be the case when I left, but I've been back for nine years and it's been a wonderful experience to be back in my hometown practicing medicine.”
Doug: “So, like many doctors, you juggle a lot of things. Tell me what you do besides, you were, you're telling me that you had hospital work this morning. What other things are that are part of your professional life?”
Jabraan Pasha: “A lot. Obviously I still see patients. I'm shy of a full-time hospitalist. But I also have some academic responsibilities. I am assistant dean of student affairs at our institution. And so in that, I oversee our pipeline programs of really recruiting folks that have traditionally been overlooked into healthcare underrepresented minorities, people from rural backgrounds, people who have historically not had opportunities in healthcare. And so we've built some pretty great pipeline programs to do that. I'll also oversee our scholarship programs, which is great, because I literally get to give money to students to go to medical school for free. That's a really cool opportunity that I have. And I also oversee our mentorship program and get the opportunity to pair our wonderful mentees with our wonderful faculty mentors. Clinically, I also really enjoy ultrasound, point of care ultrasound. I've been doing that for, oh, probably six or seven years now. And I have my sonographer’s license and started our point of care ultrasound curriculum for our residency program. And we also have a curriculum for our medical students, or our preclinical medical students, all roll into their clinical years, their third and fourth years with some pretty significant experience and point of care ultrasound. So I get to lead that with some colleagues.”
Doug: “And you host a podcast.”
[Excerpt from “Lean In”, including him introducing the podcast and himself]
Jabraan Pasha: “I think I wanted to do a podcast because I think one of my interests, maybe a weird interest, but one of my interests is engaging in difficult conversations. It's something that I've gotten a little bit more comfortable doing and I think I've gotten actually pretty good at having difficult conversations with people. And so I said, what can I do in terms of developing a podcast that I think is going to make some sort of impact on the people who listen. And it was this podcast where really the mission is to help people become more comfortable having difficult conversations. So we talk about a lot of social issues whether it's health disparities or disparities in the criminal justice system. We talk about current events, like what's going on in Ukraine right now. You know, it's me sitting down with some really smart people and just listening. And it's been a lot of fun so far.”
Doug: “You were with Dr. Rob Lim, who was a medical surgeon, I think, at one time and went back to Ukraine for a couple of weeks. Tell me why you picked him and you wanted to talk to him.”
Jabraan Pasha: “Well, one, I just really respect him as a person. He's a standup guy. He's really, really intelligent and every time I talk to him, no matter what we're talking about, I really get something out of it. And so I happen to be on LinkedIn and I see a story pop up from Davidson College that's highlighting his current, at the time, current trip in the Ukraine, where he's teaching citizens of Ukraine, teaching them how to provide care on the battlefield which Ukraine has obviously turned into. And so I read that and prayed for his safe return home. And when he got home, I reached out to him and just asked him would he be willing to share his story and share what he had the opportunity to do, but also what all went into his decision to make that huge sacrifice to go to the Ukraine in the first place.”
Doug: “When you talk about difficult conversations, what kinds of difficult conversations are you most drawn to?”
Jabraan Pasha: “You know, one thing that I'm really passionate about is health equity, and specifically why are certain communities less healthy than others? And what we know as science as a whole, the medical community as a whole. What we're starting to learn is that there are a lot of factors outside of healthcare that contribute to folks being healthy and well. And we know that these social determinants, as they're referred to, are social drivers of health, actually have a greater impact on an individual and a community's health and wellbeing than the actual delivery of healthcare. And one of those specific social determinants of health that it seems weird to say enjoy talking about, but I have a true passion for, is talking about the impact of implicit bias in healthcare and its impact on health disparities and how it shapes these health disparities. And so I spent a lot of time having these conversations and facilitating these conversations actually in and outside of healthcare. But for me, it was, when I learned about implicit bias, it was clear to me that my own biases were impacting the care that I was hoping to provide for my patients. And so I've learned a lot about myself. I think that it has helped me become a better doctor and I think it has helped others become better healthcare practitioners as well.”
Doug: “Tell me about your own implicit biases. What did you learn about yourself that you were really maybe surprised that you found out?”
Jabraan Pasha: “Really great question. You know, I don't think that my biases have really proven to be much different than a lot of folks. But, you know, I've learned how, you know, someone's social background, right? Their social economics can impact how we just interact with them. For one instance, when caring for someone who's experiencing homelessness, a lot of the research shows that a lot of healthcare workers are less likely to make meaningful eye contact with those individuals, less likely to just simply put their hands out and touch them, right? And knowing this, it'll raise my awareness that I too have maybe not been the best doctor that I can for patients who do experience homelessness. And just having that awareness has allowed me to kind of mitigate some of those biases. So that's, I think one example that stands out for me.”
Doug: “So you work through this by having conversations with people, but are there other ways that you think the medical system could address and overcome some of those biases?”
Jabraan Pasha: “Yeah, I think there's a lot of ways. One way that I think, to take a step back, I think we can sometimes get caught up in just talking about these things, right? We just talk about it sometimes just to talk about it. But I think your question is insightful, because we should also be asking, well, what can we do to make a difference and to be better? And I think one low hanging fruit, if you will, is starting to understand the way that we document in medicine how that is promoting biases and just thinking about the words, literally just the words that we write in the chart, and think about how many eyeballs are going to see that phrase and those words that we write and how that can. It's like kicking a can down the road, right? That stays with the patient. And we have to understand that words do matter, and there are certain ways that we need to learn to refer to things that are less bias promoting than some of the phrases and terms that we've traditionally used in medicine.”
Doug: “Do you have an example, maybe, for how that's changed the way you fill out patient charts?”
Jabraan Pasha: “Yeah, for sure. You know, one thing that I used to do, and I think a lot of people do without really thinking much about it, is the use of quotation marks when quoting something that a patient has said, and we often do it to maybe protect ourselves from litigation. But what it also can do is it can stigmatize that patient, socially or racially stereotype that patient. It can cast doubt to what that patient may say. If we say the patient reports that the pain is, quote-unquote, 10 out of 10 or 12 out of 10, if you will, as a reader of that note. It can plant ideas and thoughts in your head. I think another thing that I've started to get away from and get away from completely, or using terms like non-compliant or frequent flyer. We know those terms do something to us when we read them. And the research has shown that it can actually impact the reader's perception of that patient and actually can impact the care that that patient receives as well.”
Doug: “You have become aware of your own biases when it comes to all of this, but how do you get other doctors to be aware of that and change their behavior?”
Jabraan Pasha: “It's important for them to realize that this isn't about pointing fingers or passing blame. It's not about saying that we are bad people or bad physicians. It's actually not something that we should even feel ashamed or guilty of. And that's the first place for me to start, is to help people understand. And it's actually part of the human experience. It's part of the world around us. It's the part, it's part of the way that our brains work, that we develop these biases. And so if that's the case where we shouldn't feel ashamed or guilty about it, and once people realize that it kind of removes a barrier, it makes it a little bit easier to talk about. And so I start with that, and once they realize, hey, okay, maybe I too have these biases. It allows them to have an awareness of these biased thoughts that may come to their minds, right? And maybe recognize it before they translate that thought into an action. And so it's not as much about eliminating these biases, because I don't believe that we can wipe away all of our biases, but acknowledging them and recognizing them so we can mitigate their impact is really what we should be striving them to do.”
Doug: “Is this part of the curriculum at the University of Oklahoma Medical School where you are a faculty member? Is this something that that is part of the training for the new generation of doctors?”
Jabraan Pasha: “It is and I think it should be everywhere. To be completely honest with you, no matter what medical school you go to, you're going to learn how to deliver care, right? You're going to learn how to take a history and listen to heart and lung sounds, right? But we should also place value in these, what used to be called soft skills, and I think that undervalue how important they are. These are pertinent skills to being a really good physician. And so, yes, this is part of the training that all of our students get. They all are aware of the impact that bias has in healthcare. They are all aware of the health disparities that exist in healthcare. And, really, when they come in, we help them understand some of the questions that they should be asking in terms of why are certain communities less healthy than others and help them understand that it is their responsibility to help us all start to close these gaps.”
Doug: “I want to go back and talk about the pipeline programs that you were talking about earlier. What's your strategy for going into maybe communities where young people being doctors has never really been seen as a goal for these young people?”
Jabraan Pasha: “Yeah. I think the first part is, we just have to have, especially for those of us who are involved in these pipeline programs or want to start them, we have to have some insight to what some of those community members have gone through, whether it be the issues that they've had with healthcare or the fact that you just alluded to, that they literally have never seen a physician that looks like them. And if you've never seen a physician that looks like you, how could you even fathom that you one day could become a physician? And so understanding that, I think, shapes our approach, right? I think it's important that we have people involved in these pipeline programs on our side that are from these communities that are people of color. One thing I'll say, I'll admit it, I, I rarely have my white coat on. I can't tell you the last time I wore my white coat in the hospital. But every single time I'm in front of young high school kids or young middle school kids, or even elementary school kids, I get my white coat out of my closet and I put it on because the optics of that is really important. Someone who looks like them, who's in a white coat, it seems simple and it is, but sometimes the simplest way is the best way. And for them to just see that person, he looks like my uncle, and he looks like me. Maybe I too one day could could become a doctor. And so just realizing that simple, simple approach, I think can be really helpful.”
Doug: “Okay. So you've peaked their interest and you've gotten them thinking, maybe that's something I wouldn't mind doing. What are usually the next steps for them? Because for some, especially in smaller towns, they don't get the science classes they need. They don't get the preparation they need in order to be able to qualify not only for a medical school, but for a four-year school.”
Jabraan Pasha: “Well, after you have that initial contact you have to find ways to maintain contact with these students. And a lot of times that's through various programs, whether it's summer programs where you're seeing them every summer, you're checking in with them, whether it's after school programs during the school year. All of those times provide additional touchpoints. And we know with every increased touchpoint, the higher the chances we're gonna be able to keep our eyes on these students. And along with that is providing mentorship, someone that they can text or DM or call or email who maybe understands what it's like to be from the communities that they're from, that they can lean on, that they can talk to when times get tough. I think all of that's really, really important. But also we do have to understand the barriers that they're going to face, right? And helping to develop programs that are going to help them overcome those barriers. Whether it's, especially for these students, once they get to a four-year college helping them prepare for the MCAT, because we know getting a high score in an MCAT doesn't mean you're going to be a good doctor. But we know it's a hurdle that you have to get over programs that are going to help them afford MCAT prep. You know, one of the biggest differences that I see from higher socioeconomic students who are in medical school and those who didn't quite make it in the medical school, is how did they prepare for the MCAT? For those who have been successful in that test, oftentimes they have a caption course or a Princeton course, and the students that have struggled couldn't afford it, right? And so I think as the gatekeepers of medicine, our academic institutions have to find ways to even the playing field. And that means put your money where your mouth is to help students who have traditionally been shut out of these institutions gain access.”
Doug: “So how are your programs faring? Are you having success or are you struggling with them?”
Jabraan Pasha: “It's good. You know, I wish I could sit here and tell you we've got it all figured out. We don't have it all figured out. You know, we've been doing it long enough now where some of the students that we're in our high school programs are literally matriculated into medical school. And anytime you have that, that's really exciting, right? But we need to do better, like most folks do. And I think one place that a lot of institutions can fare better in improving the makeup of their student bodies is taking a look at admissions policies and seeing where the value was placed. And one challenge I have from my institution, and the rest of the institutions out there, is asking the question, are we placing too much value on GPA and MCAT scores and undervaluing the impact of a unique upbringing or being a diverse candidate? How that can enhance the care that patients will receive, because that's what it's all about, right? Our institutions are training doctors to take the best care possible for their patients. And one thing we know is patients are diverse, and if we are not creating diverse physicians out into the workplace, there is no way that they can provide the best care for those patients.”
Dr. Jabraan Pasha is an internal medicine physician in Tulsa, Oklahoma. He’s also an associate professor in the Department of Internal Medicine at Oklahoma University Health Physicians and the assistant dean of student affairs in the OU-Tulsa University School of Community Medicine. He also hosts a podcast called “Lean In with Jabraan Pasha,” which you can download and listen to wherever you get your podcasts. We thank him for sharing his experiences.
[theme music]
We also thank the following individuals for their contributions to this project:
• Dr. Barb Richardson, nurse, educator, and interprofessional champion;
• Cameron Cupp, creator of the “Finding Joy” musical score and current student at WSU Elson S. Floyd College of Medicine;
• Washington State University staff from Marketing and Communications, Financial Services, and the Collaboration for Interprofessional Health Education Research and Scholarship; and
• Claire Martin-Tellis, the original executive producer of the podcast, and student intern Solen Aref. They developed the first five episodes of “Finding Joy.”
This episode was produced by Doug Nadvornick.
If you are interested in sharing your perspective about well-being as a healthcare professional or would like to reach out, please contact our team by sending an email to: medicine.ipoc@wsu.edu. We encourage you to visit our website at: https://opioideducation.wsu.edu/about/.