President’s Message - Strength Through Differences

2016 - 5 October – 46th Critical Care Congress Advance Program
Todd Dorman, MD, FCCM
In this article, Society President Todd Dorman, MD, FCCM, discusses strength through diversity.

I am a strong believer in the concept of “the wisdom of crowds.” Simply stated, different people bring different experiences and knowledge bases to the table. Hearing and understanding all of them leads to better decisions. I would add, given that we are a medical society, that it also leads to better care.

This simple principle, that groups make better decisions, is important, but all too frequently the crowd is the appointed or elected crowd. Such a makeup is important and often required, but not ideal. If the makeup of the crowd is narrow, there may be a narrow perspective. Narrow perspectives can lead, at worst, to groupthink, where the crowd functions as though it were a single entity or a very small number of people and thus a limited number of perspectives.

The recognition of the limited benefit of a narrow crowd is part of why we focus on diversity. Let me be clear: Diversity is required but insufficient in itself. I do not say this to minimize the need for enhanced diversity. I say this because this is more than just a quota-like issue. For the crowd to be truly diverse, real efforts to include diverse thought and experience are required. If diversity is required but insufficient, then what else is required?

The obvious answer is inclusion. In this regard, inclusion encompasses policies and procedures that foster, support and grow diversity and involvement. Inclusion is about the culture of integration and engagement. For individuals to be involved and importantly engaged, they need to know and feel that they are welcome, that they are valued, and that there is a commitment to their growth.

Why does this matter to the Society of Critical Care Medicine (SCCM)? By our very nature we are diverse; we are a multidisciplinary, multispeciality, interprofessional society. From a gender perspective, our council is about 50% female. Seven of the presidents since 2000 have been female and two of the next four are, as well. The past president is a surgeon, I am certified in internal medicine and anesthesiology, the president-elect is a nurse practitioner, and following her is a pediatrician and then an emergency medicine physician. Indeed, nurses, pharmacists and physicians have led the society.

We should be quite proud of that kind of diversity. Unfortunately, despite our success, we have a long way to go. In retrospect, the sepsis definitions task force that SCCM co-chaired taught us valuable lessons in this regard. As we take a step back, it becomes clear that our representation of all underrepresented minorities is too low. We also would be strengthened by greater diversity at the leadership level as it relates to practice setting and, in this global economy, we could surely improve our international diversity.

This is important to SCCM because we are a team-based society. The data shows that diverse and inclusive teams outperform their peers by 80% in team-based assessments. Thus we can work toward better decisions through building a diverse and inclusive team.

SCCM leadership recognized this over a year ago, and we have initiated several approaches to help address the gap. We have charged the membership committee with reviewing our diversity and with providing a list of recommendations on how we might proceed. The Society leadership has started a series of discussions focused on the need for mentorship. We will work to ensure that task forces and committees represent our value of diversity and inclusion. We will also work to ensure that this is a core value embedded in all our activities and actions. Ultimately we hope to demonstrate our strength through differences.