This article has been adapted from an interview in the Canadian Society of Physician Leaders’ Leading the Way podcast series.* In this episode, aired on 1 Sept. 2021, Dr. Johny van Aerde (executive medical director of CSPL) spoke with Dr. Bolu Ogunyemi.
Boluwaji Ogunyemi, MD, FRCPC is an early career physician who is assistant dean for social accountability and clinical assistant professor of medicine at Memorial University in St. John’s, Newfoundland. His writing has appeared in a number of prominent publications, including the New York Times and the Globe and Mail. In this interview, Dr. Ogunyemi talks about his clinical and advocacy work with marginalized populations and reflects on his own development as a leader.
Congratulations on receiving the Early Career Volunteer Award from the Canadian Dermatology Association for your work in social justice and health advocacy in downtown Vancouver’s Eastside. Tell us a bit about the work that you did there.
It began as part of an elective rotation at the Pender Clinic. I was drawn to the way the clinic functions; it focuses on equity and meeting people where they are. Once I finished the four-week elective in dermatology, I kept working even though I wasn’t getting academic credit for it. For me, that clinic was very important because that was one of the first times that I really saw dermatologists’ role in providing equitable care to a marginalized and underserved population. Top
You have also done work for the Equity in Medicine leadership team, Black Physicians of Canada, and Canadian Doctors for Medicare. How do you link your work in dermatology with equity?
Dermatology is actually closely linked with equity. For example, atopic dermatitis is rampant in many First Nations’ communities. It is undertreated and can be associated with cutaneous viral and bacterial infections that are also undertreated. Part of the cause is crowded housing, especially on reserves. First Nations’ housing has been neglected by the federal government for decades. Poor housing quality and mould can contribute to an increased prevalence of cutaneous infections. Children often need oral therapy, sometimes intravenous, and have to be flown to major centres to receive care. This is really a preventable problem.
We can provide equitable care by meeting folks where they are. Teaching the people who regularly provide care in these communities how to deal with the medical side of these infections is important, but a lot of the work is based on culturally safe care. For example, it’s important to have material translated into their mother tongue, because family members may not speak or read English. Top
It’s important to treat them as people. When I gave a talk to the community about what they can do about atopic dermatitis, I gave it in their healing lodge. For many members of this First Nation, this was a place where they were more comfortable than in a clinic, which can be associated with “white coat” doctors. I think it’s important to meet folks where they are.
Some people say, “I don’t see skin colour; I see people” or “I see humans.” How do you respond to a statement like that?
I realize that a lot of folk are well-meaning when they say that. One thing that frames equity is intention, but so is impact. When you’re on the receiving end, the impact kind of renders the experiences that racialized folk have as unimportant. Every human is shaped largely by our experiences; we all do see race and ethnicity, and it affects the way that everyone perceives us in the world. So many folk who are marginalized have, unfortunately, suffered — some more than others — because of their race, their skin colour, even their hairstyle. When folk say they don’t see colour, those experiences are made invisible or negated in a way. So, while the intention is good, the impact also has to be considered. Top
If we look at determinants of health, what is the role for physicians to play as advocates?
It’s important for physicians to be humble, because we aren’t the final arbiters of health. For example, in Newfoundland and Labrador, a health accord has been proposed. Many members of this accord are non-physicians because it’s important to leverage virtual care; so, we need policymakers, those in economics, technology, etc. If you’re a physician, you should be good at delivering culturally competent care, but you may not be an expert in policy, you may not be an expert in economics, you may not be an expert in technology or even in administration. We need to realize that we have some of the skills, but certainly not all. We have to find out who else we need on board.
I do think that there is a role for physician leaders as advocates. Many physicians assume leadership roles in health — not just medicine, but in health more broadly. Many leadership skills aren’t taught in medical school or in residency: administration, managing a team, conflict resolution. These are all skills that aren’t necessary to a practising physician, but are important in the broader way of organizing health and ensuring that we can have good health outcomes. Top
What is a leadership trait, skill, or style that has been most valuable for you up to this point in your career?
I’ve certainly been putting deliberate effort into communication. I don’t think I was ever a gifted speaker, but I kept on practising and put myself in uncomfortable situations. I delivered a 16-minute TED talk from memory. That was important for me. I have given a number of keynote speeches since, so I think part of it is becoming comfortable in that realm.
I don’t think I’m naturally gifted writer. Every time I submit an article, I know it might be rejected. Sometimes, I’ll have major edits, but I just keep revising and revising. It’s this growth mindset that has allowed me to develop my writing to the level that it has been published in the New York Times and most major Canadian newspapers.
Communication is something that everyone needs to practise; whether it’s working with groups or chairing meetings, it’s all about practising. One thing I’ve learned more recently is that it’s a skill to make sure you can communicate with people whose voices may not otherwise be heard. It’s not just the loudest voices that we need to value. It’s all voices and learning how to get on the frequency of someone else and make them feel like they can contribute and have their contribution valued.
I’m so honoured that we had this time together. On behalf of the members of the Canadian Society of Physician Leaders, I thank you very much for giving us your time and your wisdom.