The Payoff of the Equity Lens

Aug 3, 2023 | Coaching, Thriving

Before becoming a physician coach, back when I was a full-time writer, I attended a talk on racial health disparities for a piece was writing for a national non-profit whose mission is improving the US healthcare system. The speaker shared an image that I have now shared with others many times since. There are a couple versions but the one I like the most involves bicycles.

When everyone is given the exact same equipment, resources, and support to do their job (equality), it will fit for some and not for others. Sure, it is “fair,” but it does not enable everyone to do their best. The result is a great deal of frustration, inefficiency—and lots of untapped human potential. This does not serve the good, or performance, of the whole.

If instead, everyone is provided with the equipment, resources, and support they need to do their job, based on their individual needs (equity), each person can contribute to the betterment of the group. Fully tapped human potential.

I like to share this image when I speak about the specific challenges that women physicians face. Lactation support is a great example.

Let’s say you’re a 35-year-old physician who’s just returned from maternity leave after giving birth to her first child. You need to get back up to speed after weeks away from work. You need to find childcare arrangements for an infant. And, to be able to continue breastfeeding, you need to figure out how to add in pumping multiple times a day to keep up your milk supply. All this while being awakened several times a night by a crying baby.

Using an equality lens, where everyone gets the same schedule, breaks, and salary support, she needs to navigate these new challenges on her own. She tries fitting in pumping sessions while on the phone or computer between patients and running behind or taking an unpaid break and receiving a smaller paycheck because of it. Either way, she races like a soul possessed through the day to finish seeing patients with enough time to rush across town to get to daycare before the late fee kicks in. She’s got charting left to do, so she’ll be on the computer as soon as the baby is asleep. Then, after another sleep-interrupted night, she wakes up to start all over again. How long would you last at this pace and stress level?

If instead, we use an equity lens, she would have paid breaks twice a day where she could access a clean, private space for pumping with fresh supplies and a designated refrigerator. Under less stress about time and money, she’d have an easier time transitioning back to work and maintaining her milk supply. She’d still be dealing with interrupted sleep, but her days would be and feel easier.

With this type of support, how much more likely is it that she will stay at her job? Given that a physician has the potential for working 30 or more years, doesn’t six months or so of lactation support seem like a wise investment?

It’s all in the lens you use and the timeframe you consider.

Where in your life might you apply an equity lens to request needed resources, supplies, or support for yourself—or for a colleague? If it means you’re able to stay, it is well worth the cost to your employer. 




Diane W. Shannon


Diane Shannon is an award-winning writer, author, and coach. Since leaving practice as a primary care physician due to burnout, she has worked to support physicians in achieving their personal and professional goals and to highlight the changes needed to reduce burnout, improve career satisfaction, and protect the bidirectional healing power of the patient-physician relationship.

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