Podcast to Podcast: Dr. Mary O’Connor meets “Flip the Script” podcast host and health equity advocate Max Jordan Nguemeni Tiako.

Recently featured in the Forbes 30 under 30 list, M.D. candidate Max Jordan Nguemeni Tiako, M.S. channels a passion for health equity and racial equity to produce and host “Flip the Script”, a highly rated podcast on SoundCloud, iTunes and Spotify. There he discusses societal and healthcare issues that disproportionately affect the health of minorities, including racial and ethnic minorities, sexual and gender minorities, both on a national and global scale. These discussions are centered around the work of healthcare, public health and health humanities professionals who dedicate their work in various ways to addressing health disparities. Regular Health Disparities Podcast host Dr. Mary O’Connor finds many common areas of interest during this wide-ranging discussion. Find “Flip the Scrip” at https://podcasts.apple.com/us/podcast/flip-the-script/id1402777078

Episode Transcription

Podcast to Podcast: Dr. Mary O’Connor meets “Flip the Script” podcast host and health equity advocate Max Jordan Nguemeni Tiako.
Published: March 31, 2021

Recently featured in the Forbes 30 under 30 list, M.D. candidate Max Jordan Nguemeni Tiako, M.S. channels a passion for health equity and racial equity to produce and host “Flip the Script”, a highly rated podcast on SoundCloud, iTunes and Spotify. There he discusses societal and healthcare issues that disproportionately affect the health of minorities, including racial and ethnic minorities, sexual and gender minorities, both on a national and global scale. These discussions are centered around the work of healthcare, public health and health humanities professionals who dedicate their work in various ways to addressing health disparities. Regular Health Disparities Podcast host Dr. Mary O’Connor finds many common areas of interest during this wide-ranging discussion. Find “Flip the Scrip” at https://podcasts.apple.com/us/podcast/flip-the-script/id1402777078

Dr. O’Connor: Welcome to the Health Disparities Podcast sponsored by Movement is Life. My name is Dr. Mary O’Connor, Chair of Movement is Life. Today, we have a special guest on our podcast, Max Jordan Nguemeni Tiako. Max is currently a fourth-year medical student at the Yale School of Medicine. He was born in Cameroon and came to the United States when he was 16. As an undergraduate, he studied civil and environmental engineering at Howard University, and then went on for a master’s in biomedical engineering from the Georgia Institute of Technology. Currently, a Yale Medical student, he is spending a research year at the Center for Emergency Care and Policy Research at the Perelman School of Medicine at the University of Pennsylvania. And Max was recently named in the Forbes 30 Under 30 in Healthcare Group. So, welcome and congratulations, Max. And I just want to add that of course, all views and opinions expressed are the participant’s own. So, Max, delighted to have you with us.

Max Tiako: Thank you, Dr. O’Connor. It’s a delight to be here with you. Thrilled to have this conversation.

Dr. O’Connor: Let’s start with you sharing with our audience, how you became so focused on health equity?

Max Tiako: I was raised with a sense of awareness that just life wasn’t fair, basically. That we live in this society where goods aren’t distributed equally. Like in Cameroon, I studied history and I knew our countries that were colonized, we’re sort of like not doing as well economically, which has huge health implications. When I was at Howard for undergrad, you can’t graduate from Howard without taking a course in African American studies, and the one I chose was Education and Policy in Black America. So much of what we discussed covered housing and education segregation, and the history of how much seeking an education for black people in the US was sort of an act of resistance, right? Like people were punished for wanting to read, for learning how to read, for wanting to learn. All of that has just generally made me aware of inequality broadly. And so, I went to graduate school wanting to sort of reconnect with my prior interest in biological sciences or biomedicine. I thought, okay, what’s the best way to do that with a degree in civil and environmental engineering and bioengineering was what made more sense. Like I had the same sort of fundamental understanding of fluid mechanics, mechanics, and materials, those kinds of things and I wanted to apply them to biomedicine at large. And in grad school, working on innovation was cool, but I had sort of a moment where one, I wasn’t, too, thrilled about working a lab, to be honest and also, the realization in one of my pathophysiology classes where we discussed like the epidemiology, like in every pathophysiology class, even in med school, typically you’d discuss some kind of disorder. You talk a little bit about the epidemiology and how the disease is distributed and whatnot. And, you know, something clicked for instance, like the lecture on diabetes, right. Like we’ve made so many strides across the board in a lot of chronic diseases but what hasn’t changed much is like the gap in life expectancy between black people and white people in this country, or certain gaps when you look at like Sub-Saharan Africa and say Western Europe. And I thought, man, all this innovation stuff that I’m working on, was it any good if it doesn’t help close that gap? That’s part of what kind of launched me on this path to medical school. Honestly, like, the combination of not being thrilled about lab research. The fact that it takes a long time. Also knowing that not all innovation leads to a more equal union, I guess. And then in medical school, my awareness continued to grow by virtue of being in class and feeling sort of deeply connected to some of these inequities and feeling like there was sort of a gap in our medical education.

Dr. O’Connor: We’re very happy that you’re so engaged in this space because obviously the more people that we have in the space, my opinion, the faster we can address the challenges that we’re facing. And you’ve been so active in raising the level of awareness related to health equity. You write a column in a medical student magazine, “In Training”, and the name of your column is, “White Coat and a Hoodie”. And you also have your own podcast focusing on health equity called “Flip the Script”. What have you found most rewarding about these activities?

Max Tiako: Some of it is basically being able to connect with people that I never thought I would be able to reach. And it really came to light during this pandemic, where I had the opportunity to talk to students who are at Indiana University in a sociology class, right. Like that isn’t something that I’d ever thought would be in the realm of possibilities for me. Being able to have a platform that amplifies the work of a lot of people who are focused on health equity from different walks of life and just sharing that and then also learning, right? Like I learn a lot. With every interview, I feel like I walk away having learned something new. Like, of course when I invite a guest, I read up on them and their work but in the way, I don’t know, carve the questions, have the conversation, I’m left with like a new sort of imprint from the guests. So, it’s a combination of learning, just learning a lot from these casual conversations. But also having like people who teach undergrads tell me, “Oh, I really liked that one episode you did with Dorothy Roberts. I’m going to add that to my syllabus because it’s a different form of media that my students may be interested in.” Or even, I’ve had black medical students at other schools who have read something that I wrote about experiencing racism, like email me out of the blue and said, “Oh my God. Like that meant so much to just read that, right. Like how you were able to put that thing that I’m feeling into words.” And yeah, it’s just incredibly meaningful.

Dr. O’Connor: Tell us about how you use digital channels like Twitter because I know you’re very active on Twitter to really help get the word out. And do you think that’s really where the action is for health equity in terms of us educating people, kind of elevating the message, and engaging a broader audience?

Max Tiako: I mean, I use Twitter. It’s useful in the sense that people engage with content, people engage in discussions. Sometimes it can be really consuming. I always wonder how effective it is honestly because sometimes I’ll share something and I’ll look, I’ll come back later and look at the number of people who liked it versus the number of people who clicked on the link. And there’s such a discrepancy and I’m like, you’ll just liking this, but there is a subset of people who do click on what you post, whether or not they read it all the way, whether or not they listen all the way, I can’t verify that but definitely, there is some amount of engagement that comes from that. I don’t think it’s the end all be all, right. Like it’s not very personal. You don’t get to, I guess build a relationship the same way you would like if you were in a classroom with people and they were colleagues. I do think though that there are opportunities to further engage people that you might not have been able to like for instance, the lecture I gave to undergrads at the University of Indiana or Indiana University was from connecting with the professor via Twitter. So, Twitter really does serve also as sort of, you know, the kind of switchboard or node that keeps a bunch of people connected in different kinds of ways.

Dr. O’Connor: You’re so engaged in this space and one of the questions that I have is how do you avoid burnout with your activism? Because the stressors of activism can be overwhelming to anybody who’s in this space and causes of burnout may be different for me as a white woman compared to you as a black man. And so, I’m really interested in how you see the issue of burnout for those of us that are so passionate about advancing health equity.

Max Tiako: I think I had to learn how to do this. So, my academic advisor is a health equity, a health services researcher, and one of the pieces of advice she gave me early on when I was like a first-year med student was like, “If you’re going to do any activism, you’re going to engage with your classmates, you know try to educate, try to change things, make it scholarship.” So, it’s like doubly productive, right. Like it counts towards something else, too. And then, I’ve also just gotten to become very protective of my time and how I engage with people. So, Twitter is a good example, right. People love just bad faith arguments sometimes on social media and so just knowing like when to engage, when to retract. It’s just so important. I’m not saying I’ve gotten perfect at it. I will get sucked into arguments every, once in a while, but I try really hard not to as much. You know making sure I stay connected with the people that I love and make sure I do the things that I love. I work out. I play tennis. Occasionally, like watch good stand-up comedy. Those are kind of my ways.

Dr. O’Connor: I think that’s great because we all need to keep ourselves healthy and centered in order to continue to engage and advance the agenda, which is health equity. I wanted to get your perspective as a young professional in medicine, on what you see as the primary drivers of health inequity and I know that’s a difficult question because health disparities are complex and multifactorial, but what would you say are the top issues that if we could address or solve tomorrow, would really improve health in our communities, particularly our communities of color?

Max Tiako: It’s a massive, massive issue.

Dr. O’Connor: It’s massive. Yes.

Max Tiako: You know, there are certain things that have just been the same basically forever, right. So, you know, as far back as when, like W. E. B. Du Bois wrote like “The Philadelphia Negro” and discussing basically the consequences of slavery on black folks and what it meant for social life and health. The same things and people consider Du Bois to be sort of like one of the fathers of social epidemiology and a lot hasn’t changed. A lot has changed, and a lot hasn’t changed. And so, like today poverty, right, writ large, just like the degree to which this country has allowed poverty to continue to grow and without enough anti-poverty efforts. And you can break that down into different buckets, like homelessness. The majority of homeless people in this country are black and black people are only 13% of the population. So, homelessness is a huge, huge issue, which then in itself contributes to chronic disease like worse chronic disease outcomes, like substance use disorder, psychiatric disease outcomes like you know a host of issues that really impact the health of our homeless adults, but also of course impacts the health of children who are going to school homeless. I mean, and right now, we’re literally in the middle of an eviction crisis that is disproportionately affecting black and brown people. So, that’s one thing and then under that sort of like poverty umbrella, right. And then, just like unequal distribution of resources from food to the sort of like quality of infrastructure that allows people to access all kinds of services. You know transportation and urban greening spaces, just the built environment, the nature of the built environment as we navigate society and how it shapes even the say the distribution of grocery stores, which then also contributes to issues related to food insecurity. I mean, it’s all intertwined. The black unemployment rate is twice as high as the white unemployment rate all the time. Like even when the president is very proud of like low quote-unquote unemployment like at a steady-state, black unemployment is around 10% and that’s not even counting people who are incarcerated, right, mass incarceration. It’s like a huge driver of inequities both directly and indirectly in that. Like the people who are sequestered in prisons, their health takes a major toll, but also their loved ones, their children, their partners, their cousins. As good evidence that people who have, like teenagers and young black adults who have a sibling that is incarcerated, have worst mental health outcomes. There’s just so much that I would say that fundamentally poverty, I feel like the way we discuss inequity, we don’t often mesh it with class as much as we should. We don’t make it clear, right? Like the police brutality is also a class issue, right. It isn’t necessarily like wealthy or wealthier black people who are getting gunned down by the police all the time. It is primarily like lower-income black people who live in communities that are hyper surveilled and thus are over, how am I going to say this? And thus, are in like significantly increased contact with police. And of course, there are instances where middle and upper-middle-class black people face police brutality. So, I’m not saying that those instances don’t exist, but it’s heavily also, it’s like a race and class issue. And so, we really, even within healthcare have our own role to play in addressing poverty.

Dr. O’Connor: So, healthcare providers helping to address poverty. What do you see as the action steps that we could take as healthcare providers to positively impact the lives of people in poverty?

Max Tiako: Yeah. I think it’s multilevel, right? So, there are things that healthcare providers can do, like at the individual level, and then there are things that healthcare providers can do, like sort of system-level, right. And by provider, I include health systems, hospitals, clinics, and individual providers like you.

Dr. O’Connor: Yeah.

Max Tiako: You know, surgeons, clinicians, nurses, whoever provides some kind of services. And so, I’m going to start with the system-level changes. So, we know for instance that hospitals hire the majority of low wage healthcare workers and healthcare is like the largest industry and the fastest growing industry in this country but a lot of the jobs in healthcare are what people call pink collar, right. So, I walk around the hospital here. The majority of the people who are PCA, like Patient Care Associate or CMS, right, like sort of…

Dr. O’Connor: The lower compensated jobs.

Max Tiako: Right. They are disproportionately black and Hispanic women and primarily black women that are at our hospital here, Yale New Haven Hospital. But that is the case in a lot of hospitals, right. And not every hospital has a decent floor in terms of what is the wage of these employees. So, I know here, I think it’s around $15 to $17, I can’t remember. But we know that for instance, I think a quarter of black and Hispanic women who are low-wage healthcare workers live in poverty and especially, so if they had children. So, really, hospitals have to raise wages. Like that’s such a common-sense thing, right. Just pay people better. You know, some people might argue that if C-suite employees took like a tiny fraction worth of a pay cut that would improve the lives of like dozens. If you think about it, right. Let’s say, theoretically that say a hospital’s CEO makes a million dollars. And I know there are hospital CEOs that make way more than that. So, if you as a hospital CEO decide to lose $200,000 out of your million-dollar salary and like that is four people who can earn $50,000. Right? So, if the argument is that money is limited but then one could argue, well, cut it from the top from the administrator. Just as an example. And then there are other policies. Like for instance, there are some health systems that for instance use contractors instead of necessarily employing all their low wage workers and may not necessarily provide the same health insurance to their employees at all levels. So, like, there’s no reason for a health system to rely on Medicaid to insure any of its employees. Hospitals are fairly profitable for the most part, especially, the non-County hospitals. So really providing adequate wages and health insurance to especially low-wage employees. And then, there being opportunities for upward mobility both for the employees themselves, but also their children.

So, for instance, hospitals that are affiliated, I mean, this one is just off the cuff, I don’t know if it’s been tested. But say hospitals that are affiliated with a university could provide some amount of, like, say tuition remission for children of employees, like when they want to go to college. So, like that in itself and we’re in the middle of a discussion around college debt, like black students and then adults later on in life are far more likely to have any debt and more likely to take on more debt. And so, there are so many different ways through like employment practices that healthcare could address poverty in this country as the big industry that it is. And then, you know, at an individual level, one, how we treat patients. So, I’m going to think about, for instance, people who come to the ED or come to primary care with lower back pain. If they’re not well-treated, if they’re discriminated against, not getting the medications they’re supposed to get, which we know there is evidence around black people receiving lower amounts or no opioids when they show up with the same amount of pain compared to their white counterparts. We often talk about days of productivity loss. A lot of people aren’t able to work when their back is hurting terribly and if they’re hourly employees, then they’re getting their money cut. So, we often only, like when we discussed healthcare discrimination like I rarely ever hear anyone think about what does this mean in terms of this person being able to go back to work and like earn, especially if they’re blue-collar employees, where their job requires them to use their body to work. So, just treating people right clinically is already huge in preventing people from falling into poverty.

Dr. O’Connor: Yeah. I want to follow that theme a little bit, but I want to go back to a second about hospitals. And I’m not justifying any CEO compensation and, of course, you know, there was just a little article on the web today, I saw about some of these astronomical levels of compensation for some very large healthcare companies, not necessarily healthcare systems but others for their compensation. But most hospitals, I believe, and from my experience, do not operate with a very, significant margin. So, you know, their profit margin could be 2% to 5%, and that’s not a lot of wiggle room. And, for example, then when something happens like a pandemic, you know, they can be financially really hit hard, as everybody in the country has been impacted by the pandemic. And we see rural hospitals closing at record rates because they can’t make it. Today, I was reading an article about Mission Health and a large, number of physicians leaving Mission Health that was purchased maybe I don’t know, a year or so ago by the for-profit HCA.

Max Tiako: Yeah.

Dr. O’Connor: And when that deal went through, there was a trust set up in North Carolina. There were policies put in place to try and ensure that care for the community and charity care in the community would continue because Mission Health had been a non-profit and HCA is a for-profit, but Mission Health was, my recollection, they were struggling. They felt that they had, that it was the best option to be purchased by HCA. And so, I think that the finances around healthcare systems and costs are really complicated. It’d be great to give everybody, you know to raise the income particularly of those people that are so critical to the system, right like environmental services and dietary services for them to get higher levels of compensation. It’s just a challenging problem. I’m just pointing out that we have lots of hospitals struggling, hospitals closing, and when hospitals close that can devastate a community.

Max Tiako: Yeah. I mean and I am in no way going to claim expertise in the sort of like the economics behind the decisions that hospitals make. I do know that every year hospitals, like balloon in administrative costs. Like admin costs is one of the big, if not the biggest chunk of healthcare spending, right. And so, I think they can be leaner, right.

Dr. O’Connor: That is right. You’re correct.

Max Tiako: Every year, they hire more admin, right. Like, and they make more money than like primary care providers, right, like the higher-level admin folks in the hospital. And so, I find it hard to sympathize with hospitals writ large, right, when they are looking at the top.

Dr. O’Connor: Got it.

Max Tiako: That’s way costlier than providing living wages at the bottom of the hierarchy. And which is why earlier one of my points was, well, cut the salary at the top. Like if it’s a matter of limited resources or limits in terms of what is the profit margin, cut it from the top and just do the resource distribution. Yeah, that is something I want to learn more about, and I will learn about during residency, this sort of like management aspect of health systems.

Dr. O’Connor: I think I would encourage you to do so. I think you’ll find it fascinating, interesting, and very complex because fundamentally, I mean, this is my opinion, one of our primary problems is the way that we have the payment system set up because hospitals and healthcare systems make their margin in general, off of procedures and imaging and surgery. And so, we are not investing in health. We’re not and it’s not healthcare systems per se. We, as a country, have not invested in the public health infrastructure that would benefit all of us and help our communities be healthier. And then along comes a horrible virus and we have a pandemic, and we realize that we’re not isolated. You know we are all connected and that we can’t separate ourselves. And so, I’m hopeful that one of the good things that come out of this horrible pandemic is a heightened awareness and appreciation that health disparities matter to everyone. It should be all of our concerns collectively.

Max Tiako: I think, generally, there is some degree of awareness that did concern everyone, but there’s a reticence when it comes to cost-sharing of addressing the disparities. And that’s why features like segregation is like forever living. As part of the benefits of segregation is you don’t get to be around black people. So, I’ll use a good example. In the Flexner Report, which was published in 1910, Abraham Flexner comments about black medical schools and black physicians, like part of why, even though, of course, he recommended that most historically black medical colleges be closed because of “quality”. He said, well, you know, keep Howard and the Meharry because we need at least a few “Negro doctors” to take care of the Negro populace so that they can contain tuberculosis in their communities. And so, there was always an awareness, even amongst the most racist of physicians back in 1910, right, that we do live interconnected lives. And so, to Abraham Flexner, the purpose of racial concordance and patient care was more about containing like TB and syphilis and whatnot in the black community, so that it would not seep into the existence of white people. And along with that lives on segregation, right. So, like yes, COVID is an infectious disease that doesn’t respect walls or whatever, but also at the same time, like people, there are all kinds of mechanisms that are created and reproduced to maintain some degrees of segregation like people both in terms of the labor market, people are able to just stay at home and have food delivered at their door and they never see the person who even delivers the food. And like order food to be delivered from whatever neighborhood, but they remain in their nice segregated, but that’s their neighborhood or whatever, right. So, there all kinds of systems in place for people to be able to resist the need for all of us to contribute to health disparities.

Dr. O’Connor: Let’s turn to one more topic that I really want to cover and that is about unconscious bias in healthcare. And I, personally, see this as a big topic, doctors and nurses in our system will automatically form impressions of patients that may not be true. We all make assumptions. For example, an overweight person would be lazy. That’s an assumption we make when we don’t actually know that. That person might be working two jobs to support their family, and they don’t have time for exercise. So, I’d like you to share with our listeners, your thoughts about unconscious bias from your perspective as a medical student and how impactful you think this is or isn’t and what you think we need to do to educate our healthcare providers?

Max Tiako: Yeah. You’re right. I mean the evidence is there. It is incredibly impactful. I see it all the time. And sometimes it’s not even unconscious, sometimes it is conscious and like in fact comes with mockery. But yes, I do think as a med student, I’ve seen it like attending doubts whether a patient’s really in pain or resident doubts whether a patient’s really in pain or the nurse does. And there’s this sort of like interesting team dynamic that takes place where sometimes there’s actually conflict and in favor of, like I’ve caught near misses as a medical student because bias shapes whether you’re negligent towards a patient or not. And so, I am glad that, I mean, that’s one of the values of like diversifying the healthcare workforce, right. That you have people who are going to come from different walks of life and so, they may approach situations differently and challenge your position, versus when everyone is sort of the same background and you just kind of like, all agree with each other and the patient is harmed from it.

So, I think education is good. It’s good that people are aware, but there are pitfalls, right to simply just educating people. So, there’s actually good evidence that when white people are made aware of their biases, if it doesn’t come, like there’s increased anxiety around interracial contact, right. It’s almost like a feature of the sort of white guilt, like, “Oh my God, I think…” Like a heightened fear of being racist or being perceived as racist, because one is not aware of, said biases. So, I think the proliferation of implicit bias training while well-intended may have some unintended consequences that have yet to be measured. But we know from experimental psychology work and social psychologists that there are consequences to raising awareness around implicit bias without any other sort of like contextual education around that or support. Every like, so when we typically talk about stereotype threat generally, we think of it from the perspective of an individual who might be minoritized in a setting. So, like myself as a black man, like being in the hospital, if someone says something racist to me like that may sort of raise my anxieties around being the only black person in the space. Similarly, like I’m sure that there are some white people who are really anxious about being perceived as racist and the unintended consequence of that is an avoidance of interacting with black people or avoiding making eye contact. Like all those kinds of things, which ultimately actually shape the clinical encounter, right. We know physicians don’t make as much eye contact with their black patients. And the reason behind is not well known, right. But we know it’s a thing. They use fewer words, less positive body language and the hypothesis is that it has to do with unconscious bias, and it may also be that this weird, this awareness of unconscious bias makes them tense right in their fear of being perceived as racist. So, it’s both. I think it’s good to be aware of the biases and work hard at making sure we’re addressing them but not actively sort of like arming people with the tools to address them can then have kind of like a ricochet effect. The best evidence that’s out there in terms of addressing unconscious biases, one is like perspective taking. So, basically, imagining you’re stuck in the person’s shoes, like the shoes of this person across from you. And then there’s a theory around just positive contact and its good evidence from this cohort of medical students that, basically changes study cohort. They’ve shown that white med students who have had positive experiences with senior physicians of color, they’ve seen changes in both explicit and implicit biases towards a black patient, as they’ve gone through medical school. The same medical students who are in a sort of like “positive racial environment”, more diverse medical school have also seen improved, like sort of a shift in their negative, implicit, and explicit attitudes towards black patients. So, then what does that mean? In the same study, by the way, they also show that the training didn’t change, the training is not what you might attribute these changes to. And so, I mean, the evidence basically that the best one can do is really diversify the healthcare workforce, make sure that junior trainees especially those who are used to being in the majority, learn to work under, like learn from like authorities or figures of authority who are not always the majority, right. Like have a black attending or, you know what I mean? But it’s hard obviously because black physicians are like 3% of academia, right. So, what are other ways then a white medical student might learn to sort of like take instructions from a person who is black and senior to them? Make medical students follow nurses more, like the other spaces in medicine that are more diverse, but where you as medical students still have to like take orders and I mean, but that in itself isn’t that easy, right? Because also med students have this sort of like ethos or ego of like, I’m going to be a doctor and the superior, you know, the sort of like medical hegemony, right. Like, so I don’t know whether that would even necessarily work when it comes to interdisciplinary care but there’s good evidence that interdisciplinary training in medical school does make med students more sort of respectful of other specialties at large. So, I think generally, the solution is embracing as a health system explicitly embracing like pro justice values and like making clear via subtle signs. Like you know the back of the computer you see in a hospital at a time, like at the VA, there’s the rainbow sign that shows up in the backdrop of your computer. That just kind of random, subtle reminders, but also solid efforts in improving the culture and making sure that people feel that they belong and ultimately ride the bank for everyone’s buckets, like in diversifying the healthcare workforce, which by the way we cannot achieve unless we’re also investing in anti-poverty policies. Because we can’t expand the pipeline if poverty persists.

Dr. O’Connor: Correct.

Max Tiako: Right. So, it’s got to be like a multi-pronged approach.

Dr. O’Connor: Excellent point. We cannot expand the pipeline for underrepresented individuals in healthcare if we can’t support young people getting higher levels of education.

Max Tiako: Yeah.

Dr. O’Connor: Otherwise, there’s no one to select, to train.

Max Tiako: Yeah. Exactly.

Dr. O’Connor: And diversity on the team, I think is so critical. And I loved your point about the interdisciplinary teams because I personally believe that that is the direction that we need to move in terms of how we’re going to deliver higher quality and value-driven and very patient-centered care in the future. So, Max, you have just been wonderful, and I want to thank you so much. In closing, I want to thank our listeners for listening to this episode of the Health Disparities Podcast. And please take a moment to subscribe in iTunes or Spotify, so that you don’t have to miss a future episode. Again, I want to thank Max for joining us today on our podcast.

Max Tiako: Thank you so much. It was nice to be here with you today.

Dr. O’Connor: You’ve been a wonderful and engaging guest and on behalf of the entire Movement is Life family, we thank you for your incredible efforts to promote health equity and inspiring others to join and achieving this mission. So, dear listeners, until next time, goodbye, and have a great and healthy day. Thank you.

(End of recording)

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