Diversity Toolbox columnist Dr. Lisa M. Greenhill is senior director for institutional research and diversity at the Association of American Veterinary Medical Colleges. She collects and analyzes data and produces reports related to academic veterinary medicine to include the applicant pool, enrollment, institutional economic impact and diversity. She earned a master’s degree in Public Administration (with a specialization in health policy) from George Mason in Fairfax, Va. and an EdD in Higher Education Administration and Organizational Change from Benedictine University. She is an accomplished author and public speaker on a range of issues related to diversity, organizational leadership and Federal advocacy efforts.Read Articles Written by Lisa Greenhill
Businesses and organizations collect a huge amount of data. For example, the American Veterinary Medical Association maintains divisions that gather copious amounts of data about veterinarians and veterinary practice. At the Association of American Veterinary Medical Colleges, I annually collect and analyze data related to student enrollment, applicant numbers, faculty and research.
Why do we spend enormous resources collecting and analyzing data? Because it helps us better understand what is happening in our veterinary space. It allows us to explain what is happening and sometimes why it happens, and data allows us to be better advocates for the veterinary medical profession. Data also allows us to be storytellers.
As individuals involved in veterinary business, you understand the value of data collection. You likely collect a great deal of information about your clients and patients. You likely collect demographic data about your clients that helps you better understand them.
This month, I would like to explore the value to your practice of collecting various kinds of demographic data. The collection doesn’t just enhance the general data you likely gather about your clients, it also sends important messages about core values related to diversity within your practice.
Check the Boxes
Including demographic questions on client forms gives you much more detailed information about your clients as individuals. The data becomes even more powerful when aggregated as it can reveal trends and shifts in the demographic makeup of your clients and the surrounding areas that feed your practice.
Much is often made about encouraging people to self-identify using a bunch of boxes. You might ask why knowing whether a client is black or a Spanish speaker would matter to your business. These are not new questions. In fact, arguments are made that demographic data collection serves only to advance disparate and possibly discriminatory practices against smaller subpopulations. The phrase “We are all a part of the human race” is frequently used to refute the need to gather demographic data. The reality is that this adage serves to redirect conversations about discrimination, marginalization and disparities to less controversial topics. An unwillingness to gather data that might reveal something concerning does not mean the concerning thing will not persist.
Asking demographic questions is appropriate, and this data is a positive tool that can enhance your business and your role in the community. With health data, you can examine whether outbreaks are localized to a ZIP code or a specific neighborhood. Imagine having a little more data that might reveal a health education language issue or another sociocultural dimension to the health issue.
Your ability to identify this dimension and offer culturally competent solutions is good for everyone affected. This data can help your business identify specific needs, like multilingual practice staff to better service the population. The data also may reveal opportunities for community-specific outreach about public health and pet ownership. These are all things that the veterinary profession is known for, but consistent collection of demographic data can enhance your knowledge base and your ability to serve your clientele.
There is overwhelming evidence in human medicine that physicians treat minority, or otherwise underserved, patients differently by offering fewer treatment options, pain alleviation and one-on-one interactions. Clearly, veterinary medicine has a different patient center, but veterinary professionals will certainly want to know if a quiet trend showed similar marginalized patterns of care among clients. Such patterns result in different health outcomes and, quite possibly, the search for new, more attentive and inclusive practices.
What to Ask
Once the decision has been made to ask a battery of demographic questions, the next step is deciding which questions to include on your client information forms. Standard questions will focus on race and ethnicity, gender and primary language, and questions may be framed as multiple choice. For race and ethnicity questions, you may find that providing the following options are sufficient:
- Asian/Pacific Islander
- Native American/Alaskan
- Race not listed here
At AAVMC, we recently updated our questions regarding gender and gender identity. We advocate the inclusion of a third, nonbinary gender (“A gender not listed here”) as an option in addition to male and female. While the number of individuals who select the third option is small, the inclusion of the option represents two important values:
- A commitment to inclusion because some individuals to not identify on the gender binary. Having a third option signals that this is a core value and a belief that their presence is important enough to acknowledge and include in your data set.
- The inclusion of these individuals in the data set creates a greater likelihood of generalizing your research findings.
Inquiring about language skills will help you plan for the future of the practice. Numerous bi- or multilingual veterinary practices exist. These practices are largely in areas where a need was identified early.
As populations migrate, you may find an increase in limited English proficiency (LEP) individuals in your client base. This will be noticeable anecdotally, yet data will provide the confirmation you need to make evidence-based decisions to seek out language skills on your own or in future practice hires. Having this evidence will aid decision making in the development of promotional materials and community outreach. Ultimately, the collection of this data is about enhancing the relationship between the veterinary practice and the client.
Human health research shows that LEP is associated with health disparities, poor treatment compliance, increased medical errors and low client satisfaction. Your business is reliant on providing excellent veterinary medical care and customer service. Understanding how language proficiency plays a role in that care and service is critical in an increasingly diverse environment.
Creating an Inclusive Business
Adding or modifying just three questions to your client intake forms can help you make a huge step forward in creating and embracing a diverse and inclusive veterinary business.
First, gathering information about race, gender and language provides your business with three additional data sources that can inform decision making.
Second, this data can and should inform your relationships with your clients and can influence your patients’ health outcomes. In my diversity work at AAVMC, I often tell students that clients trust veterinary medical knowledge. The place where things are most apt to break down are in the relationship between the veterinarian and the client. If the client does not think you really see them and respect them, then the relationship is potentially doomed and all that veterinary medical knowledge doesn’t matter.
Finally, although data collection is often meant to inform the gatherer, including these questions on forms serves as a source of information to your clients. The inclusion of these questions signals that you see them as individuals, that you recognize providing veterinary medical care is about both the animal and the client, and that you want to create a business environment that embraces diversity. This is an easy, passive way of creating an inclusive business environment.