Patricia (Pat) Dawson, M.D., FACS, Ph.D., recently joined UW Medicine as Medical Director for Healthcare Equity). She will partner with Paula Houston to help achieve diversity, inclusion and equity within our organization and in the delivery of equitable patient care. With experience at local healthcare organizations including Virginia Mason, Group Health and Providence, Dr. Dawson most recently served as medical director for the Swedish Cancer Institute Breast Program and True Family Women’s Cancer Center.
In a recent interview, she talked about her life, inspirations, going through medical school without any “like” role models and being a book geek.
Q: What drew you to UW Medicine and this role of Healthcare Equity Medical Director?
A: I’ve been involved in clinical medicine for 40 years, and along the way I have been involved in organizational issues around healthcare equity, diversity, inclusion and cultural competency. I originally wanted to retire around this time and then figure out what would come next, but then I heard about this opportunity at UW Medicine. I was struck by the work being put into it — preparing and building structure, the groundwork that’s been done — and I looked forward to the opportunity to work with Paula. Our paths have crossed, and I had great admiration for her work from afar.
Q: What work have you done in this space previously?
A: At Group Health, I was part of a group that moved their diversity committee from reactive to proactive, developed language on gender differences and cultural competency, and established the role of Medical Staff Diversity Director. I did a lot of reading on how do you do system change and then decided to look at graduate programs. I wound up at The Fielding Institute where I got my doctorate in Human and Organizational Systems with a focus on equity. Unfortunately, there was nothing as focused at Swedish/Providence … there was an equity of care committee and I tried to move it to a more formal, prospective structure, but didn’t get a whole lot of traction.
Q: How has bias/inequity touched you personally, particularly regarding healthcare issues?
A: I have experienced inequity in the medical profession myself as well as hearing and being a witness to my father’s experience. He was an Army field surgeon but when he returned to the States in the 1950s, he couldn’t get hospital privileges at many places. He ultimately got credentials at Presbyterian Hospital in Newark, New Jersey. He was a general practitioner with an office in our home, and I got to see the intimate connection he had with his patients. He served a population that didn’t have many resources, and some actually paid for their care by making him meals or dessert.
As a medical student, I thought I’d follow my father’s footsteps in internal medicine but I hated it; my next rotation was surgery and I loved it even though friends were discouraging because as a black woman, there were no peers as mentors.
I did my first two years of residency in the late ‘70s at the University of Medicine and Dentistry of New Jersey in Newark, where there were just a handful of women surgical residents and only two female attendings. We also weren’t doing a good job with African-American healthcare at that time, so I was always interested in how different groups get treated differently and have different outcomes. Even now I still see it — I’ve seen late diagnoses because underserved populations didn’t know they could get care and access resources.
After my two years in New Jersey, I came to Seattle and trained at Virginia Mason from 1979 to 1982, where I was only the second woman to finish residency (and the first woman of color). It was an isolating experience of feeling different, “other,” not fitting in, and feeling more scrutiny. As Canadian politician Charlotte Whitton said, “Whatever women do, they must do twice as well as men to be thought of half as good. Luckily, this is not difficult.”
In 1998, I did my dissertation (which was turned into a book) at The Fielding Institute, called Forged by the Knife: The Experience of Surgical Residency from the Perspective of a Woman of Color. I tried to identify and gather stories from across the country but only found six; almost all hadn’t talked about their experiences before, and unfortunately, it’s still an issue in surgery, though awareness is building now, thanks to the #MeToo movement.
After residency I did a year of solo private practice in Arlington, Washington, where I was the only surgeon in town. Talk about culture shock. After about 14 years at Group Health, I then went into private practice with Providence/Swedish because of their multidisciplinary breast care practice and their strong values to care for everybody. After a few years, I became employed by the Swedish Cancer Institute.
Q: Healthcare equity is a pretty big task … what are your priority goals?
A: I want to do work in context of the whole team, to look at how do we tackle this together. UW Medicine’s healthcare equity blueprint is aspirational, and we can’t do it all at once. I also want to build credibility in the community. We need to take a look at the data and disparities of our care and see where we can make the most impact. And I want to identify physician/provider champions in the organization and see how the healthcare equity team and I can help facilitate change through them and how I can help entity leaders be successful with their diversity and inclusion goals.
Q: What are your passions? How do you spend your time when you’re not at work?
A: Walking, reading (mostly fiction) and writing. Reading to me is a window into other worlds and experiences and an escape from the current world. I always have a huge list of books to read and electronically access the library and put things on hold. I’m a bit nerdy and have kept a list of every book I’ve read since I was in high school. I’m currently reading Emergency Contact. The last book that blew me away was When They Call You a Terrorist; it’s a powerful look at people’s lives and the deliberate systemic inequities that placed them in this condition.
I also love to spend time with my spouse, children and their children (two grandkids, ages 7 and 9, and one on the way in December) and to travel. Having been born in Jamaica, I’ve spent a lot of time in the West Indies, but hadn’t been to Europe until I was older. I love the south of France, Spain, and have a big desire to go to Scotland and Wales. I never liked the idea of a cruise but went on a small ship recently from Barcelona to Lisbon and loved it and became more curious about them I’d like to do a riverboat cruise through France. But my dream would be to go somewhere wonderful and have someone else plan it.
Q: Who are some of your role models and inspirations?
When I was a medical student, I didn’t really have role models who looked like me or understood me. There was one black neurosurgeon and he was kind to me, and when I did my residency at Virginia Mason, there was an attending there who treated me with respect. He was one of the best technical surgeons I met, and he knew how to make a connection with his patients. In my practice I had mostly female patients and I was depleted at the end of the day because I felt that all I was doing was giving an info dump. That really turned around for me when I read Pedagogy of the Oppressed. The author, Paulo Freire, discussed the limiting concept that students are just empty vessels, but he recognized that they bring their own experiences, strengths and needs. I saw that I could apply that to my practice and this concept changed my world overnight, freed me to be myself as a doctor and helped me see patients in a different way and made my work more fun and enriching.
Other inspirations are Barack and Michelle Obama who lead through positive change while maintaining integrity. I’m also intrigued by why people have certain sensibilities. I have two older brothers, and one was always passionate about social injustice — perhaps learned through my parents, who were involved in civil rights and had a variety of diverse friends, so we were never exposed to stereotypes and bigotry at home as kids. I got my bachelor’s degree in sociology, and one of my jobs after graduation was as membership director of the ACLU in Newark. My spouse is the incoming board chair for the Planned Parenthood of the Greater NW and Hawaii affiliate, so you could say social justice is in my DNA. I want to work toward a society that respects and works for everybody.