WRNMMC, Bethesda, MD  –   A day after the one-year anniversary of the murder of George Floyd, Walter Reed National Military Medical Center’s Diversity, Equity and Inclusion (DEI) Council hosted a fireside chat with retired Army Brig. Gen. (Dr.) Norvell Coots on May 26 in WRNMMC’s Clark Auditorium.
Coots, president and CEO of Holy Cross Health, as well as president and CEO of the Maryland Region of Trinity Health, discussed challenges he’s faced moving up the ranks in uniform and out as a person of color, as well as organizations incorporating DEI within their agencies.
Following a more than three decade military career, including serving as the final commander of the Walter Reed Health Care System and Walter Reed Army Medical Center, Coots joined Holy Cross Health in August 2016. In 2018, he was one of 14 executive leaders to receive the Distinguished Healthcare Leader Award from the National Association of Health Services Executives for his dedication to health care in his community. In 2019, he was named to Becker's Hospital Review's 2019 list of 105 Physician Leaders to Know. Sponsored by the American Medical Association (AMA), the list names physician leaders nationwide who have demonstrated "outstanding leadership and clinical expertise throughout their careers."
Despite a distinguished military career and his accomplishments since hanging up the nation’s uniform he wore for 34 years, Coots said he still faces racism, discrimination and bias, in addition to those who question his credentials.
Coots further explained the military has it challenges, but it has probably led the nation in DEI, desegregating its ranks during the late 1940s ahead of many other organizations, and incorporating Equal Opportunity (EO), Equal Employment Opportunity (EEO), anti-bias training, non-discrimination training, and other regulations and policies designed to enhance DEI. “But we are certainly a microcosm of greater society, [which has struggled with DEI],” he added.
The retired brigadier general said DEI must be driven by leadership, and DEI “doesn’t necessarily cascade down unless leadership pushes it. You lead by example. You lead from the front, so you have to get ahead of all of this.”
In March, Army Col. (Dr.) Andrew Barr, WRNMMC director, and Navy Command Master Chief Randy Swanson, senior enlisted leader at WRNMMC, signed a DEI proclamation committing the medical center’s leadership to “creating, maintaining and nurturing a diverse, equitable and inclusive workforce [at WRNMMC] that motivates and empowers the staff to provide high-quality patient-centered care… All staff, patients and visitors to the President’s Hospital will be treated with dignity and respect as we work collectively to eliminate bias, prejudice and racism from our military medical team. We are committed to and ever vigilant in our efforts to identify and combat ideologies within our ranks and organization that contradict these guiding principles.”
In discussing the racism, discrimination and bias he faced, Coots described circumstances during his freshman year as a West Point cadet before he transferred to Howard University, where he earned his bachelor’s degree and his commission after completing ROTC. One incident involved a swimming instructor being surprised Coots could float, saying to the young cadet, “You’re black, your bones are heavy and you’re not supposed to be able to float or swim.”
Coots also recalled later in his career, a military medical assignment officer describing him as “our great experiment” after the officer placed him in a medical assignment that “aristocratic blacks” weren’t expected to do well in, but Coots “survived” and excelled.
The CEO said during his military career, he’s not sure if he was “seen as anything but black, [and] very often, people would not see me as an officer.” He explained that he continues to face the same challenges in the private sector.
“There are not a lot of me in CEO positions, especially not in big health systems,” Coots said. He explained that when he goes to conferences and meetings among his colleagues, he is often the only black person, or one of a small few of CEOs of color in attendance. “Sometimes I’m standing outside waiting for my car to be pulled up, and someone will come up and hand me their car keys [assuming I’m the valet],” he said.
“In the military, I would sometimes have my credentials questioned,” he continued. “If I said I graduated Howard’s ROTC, the person I’m speaking with would say, ‘Did you say Harvard?’ I would say, ‘No, I said, ‘Howard, and we’ve been ROTC since 1916 just like Harvard. There is no substandard here.’
“In the private sector, my pedigree was questioned because of [me] coming out of the military,” Coots added. He explained some people in the civilian sector don’t understand the in-depth intensity of military medical education and training, and that it’s on par with that provided at the best medical institutions.
“Do other people have their pedigree questioned quite as much? I don’t think so. I’ve talked to other black CEOs, and they’ve all said the same thing…every time they turn around, their pedigree is questioned,” Coots said.
In responding to an audience member’s question concerning the disparities in health care in America among various communities, Coots said these inequities have a long history in America. He added the eugenics movement in the United States, and studies such as the Tuskegee Experiment, have also caused many individuals to distrust the U.S. health-care system.
“At the end of the day, it’s about economics,” Coots said in relation to some of the disparity in health care in the United States. “Economics rule everything.”
Regarding organizations and systems building trust, Coots said, “Your organizations and leaders have to look like the people they lead. People have to be able to see themselves in leadership. People have to be able to see themselves on their wards. People have to be able to see themselves in their doctors, in their nurses. Not only does that make them feel comfortable, but that feeds into the future generation. If you never see yourself, you never believe you can be that.
“I tell young people to never give up on yourself,” Coots added. “If you don’t believe in yourself, why would you expect someone else to believe in you? Never give up on your dreams,” he added.
Coots concluded the discussion quoting author and theologian Sharon Daloz Parks, who stated, “Those who practice leadership for equity must confront, disappoint and dismantle, and at the same time energize, inspire, and empower.”
“The hard truth is that you may have to be able to tear down your organization’s status quo in order to get to the root and rebuild it in a way that people understand what’s going on. It’s a continuum, and we have to get to true equity in this country,” he said.