How Diversity Can Improve the Healthcare Experience with Bernard J. Tyson, Kaiser Permanente

Clifton Leaf, Editor-in-Chief, Fortune and Bernard J. Tyson, CEO, Kaiser Permanente

Kaiser Permanente, a health care provider founded in 1945 and headquartered in Oakland, California, is made up of three organizations: Kaiser Foundation Health Plans, Kaiser Foundation Hospitals, and Permanente Medical Groups. It has embarked on a journey to transform healthcare in America — to make it more accessible and affordable for everyone, particularly those in vulnerable and underserved communities.

Kaiser Permanente counts 694 medical office buildings in addition to 39 hospitals across California, Georgia, Colorado, MidAtlantic States (District of Columbia, Maryland and Virginia), Hawaii, Oregon, and Washington. It employs more than 200,000 people, who are mostly women, and hires annually around 10 percent externally, with voluntary full-time turnover at seven percent. People tend to stay at KP for a long time —nearly 29,000 people have been with the organization for 20 years or more.

Bernard J. Tyson will discuss the impact of diversity on a company’s talent and culture and explain how it helps to improve patient care, as well as the ways it can create a better work environment for all.

Key Takeaways:

  • Discover how one of the largest healthcare providers in the U.S. has learned to retain its best employees.
  • Methods by which a focus on diversity and inclusion can create a Great Place to Work For All.
  • The struggles that the medical industry faces as it embarks on a plan to make healthcare accessible and affordable for everyone.
Show Transcript

Interviewer:                     You are a passionate champion of diversity and inclusion. A lot of people, including many of the folks in this room, get diversity right. They know how to bring in different faces, voices, backgrounds. Inclusion is a lot tougher. Tell me a little bit about what that difference is and how you make it work.

Bernard Tyson:                Sure. It's both how to make it work and how to continue to work at it because it's not a magical solution and it just happens. I guess I came to understand later that there really is a difference between diversity and inclusion, and sometimes we just combine the two as if the assumption is that if you have the diversity, you automatically get the inclusion. But the fact of the matter is, if you look at many of our organizations historically, when we were focused, rightfully so, on diversity, it was, for the sake of this discussion, a number count, right? So, do we have-

Interviewer:                     A check box.

Bernard Tyson:                Yeah. Do we have African-Americans, do we have women, do we have ... It was more of a number count. But what would happen is you would maybe get the number count, but the dominant culture has already decided what the environment is going to feel like, operate, and you have to assimilate, and you have to become one. So if you stop and think about that transition, it's sort of like you leave your real self outside and you come in and figure out how to get along to be a part of, and then when you finally really step back and look at the reality of that, most people come to terms with, I'm not being my true self, my 100% Bernard. So we work very hard on the inclusiveness, which is, you have a right to be at the table, you have a right to be who you are, you have a right to think the way you think, and the objective here is to celebrate diversity and get all the different perspectives and walks of life and different ways of looking at issues and challenges because we're all working towards the same end point, which is the mission of the organization.

Interviewer:                     When you say you work really hard at it, I think this is the part that's so challenging for a lot of folks because it's like, how do you ... do you train leaders at every level in encouraging this kind of be yourself-ness?

Bernard Tyson:                Yes, and part of my job as the CEO is to really work hard at creating the right environment. So in Kaiser Permanente, I feel strongly that we need to encourage and celebrate a speak up environment, which I would argue is the most powerful tool for getting people to be who they are. It's a creative environment where you can share your point of view. I have a view, you have a view. I symbolize that by having an American flag in my board room, in my office, and in my conference room, and I talk to people all the time when they come into my office that we live in a great country, and you have freedom of speech, and you get to say what you want to say. You may have to deal with the consequences of some of the things you say, but you get to say what you want to say. So you should not give up your freedom when you come into my office.

Interviewer:                     Let's get loud, though, because if everyone is speaking up, and you have an unusually large organization, 200 thousand plus employees, and it was mentioned, in eight states and the District of Columbia, that's a very big organization. There aren't a lot of really giant organization on the 100 Best Companies to Work For list, and that's because it's a challenge, it's a whole different set of challenges.

Bernard Tyson:                Right.

Interviewer:                     So encouraging that kind of speaking up in a larger organization, it must present its own set of challenges.

Bernard Tyson:                Oh yeah, but it's a beautiful thing. To me, it's a beautiful thing.

Interviewer:                     Yeah.

Bernard Tyson:                But I have to clarify, though, because what was happening in the beginning, I started out by saying, "I want everybody to speak up. You're in America. This is a beautiful place. No matter what people might say, it's still a great place, and you get to speak up." So people started speaking up. And then I started to get some feedback because some people were speaking up and telling their bosses, supervisors, "No, I don't think I want to do that."

Interviewer:                     Did they use that language, or different language?

Bernard Tyson:                Then the person would say, "No, but you need to do it. We need to get this done." They would go, "Well, Bernard said we could speak up."

Interviewer:                     Right. Challenging.

Bernard Tyson:                So I had to add to the 'speak up', right?

Interviewer:                     Speak up and listen.

Bernard Tyson:                Yeah. We have three things. We have the duty to speak up and speak out, right? We have the duty to listen, and there's always a decision maker in that context. So when the decision is made, you then have a duty to line up and make the decision possible. So that's the three point plan.

Interviewer:                     So I'm not going to name companies, but recently there was a very big technology company in California in which they also have a speak up culture, or had one, and one of those employees said something really offensive, and felt like it was his right to say it. Do you have a strong point of view about the value of your company and the alignment of the values of the people who work for that company? It's challenging obviously, especially in a partisan age, in an age where people feel very strongly about different kinds of ideals, to have a wholistic organization, but you actually think that Kaiser Permanente values should thrive in this case.

Bernard Tyson:                Oh, absolutely. A speak up culture in the 21st century with social media and everything has a set of complexities to it, and you're touching on one of them. When the value system of an individual or individuals contradict the value systems of the organization, how do you address that in a speak up environment? And we've-

Interviewer:                     You said that so much better than I did.

Bernard Tyson:                Yeah. We've had issues that we have to deal with, and at the same time, as I said earlier, you want a speak up environment, but it doesn't necessarily mean that there aren't issues or consequences that have to be dealt with in the context of what we stand for as an organization while we respect the rights of individuals, and this comes up quite a bit with social media. I think the second thing that is very relevant is that people bring issues into the organization that are happening on the outside, and I get tweets and I get memos all the time saying, "Why don't you speak up on this issue, Bernard, as our leader?" And that's the other phenomenon that is happening inside of our organization and across the country.

Interviewer:                     You did that famously after, I think it was Trayvon Martin? Yeah.

Bernard Tyson:                Michael Brown.

Interviewer:                     Michael Brown. Yeah. And when you ... there's so many issues, and I know that many of the leaders in these companies feel that pressure as well. How do you pick and choose what to speak out on?

Bernard Tyson:                It's a work in progress, no question about it because that is one of the challenges. When I did the Micheal Brown LinkedIn article, it was really intended for me to contribute to the discussion and to offer a perspective. I think we all remember what happened to Michael Brown, unfortunately, and I saw the narrative in the country change from how awful it was for anyone to be shot down and left and obviously to go through that whole process to a narrative of what he was doing beforehand, and getting away from the heart of the issue. And I thought that I could contribute by talking in real terms about a person who happens to be African-American who is a CEO of a, at the time, a $65 billion company, and how I'm treated in the C-suite versus how I'm treated on the street. So I gave that contradiction with factual information of a day in the life of Bernard Tyson on the streets of America.

Interviewer:                     It's a powerful piece and everyone should read it. You know, we talk a lot about values. There's also something called mission, and one of the things that really sets KP apart is a sense of mission. You've talked about the fact that you have obviously 12.2 million customers-

Bernard Tyson:                12.3.

Interviewer:                     Oh, 12.3. 12.3 million customers-

Bernard Tyson:                You can round up to 13.

Interviewer:                     Yeah, I'll do that. But you serve ... in the communities that you serve, there are close to 70 million people. It's about a fifth of the country. And you've said that KP really needs to be a partner in the community. You've done that through addressing homelessness, mental health, food security. Talk a little bit about why mission is so important in creating a great place to work.

Bernard Tyson:                Yeah. Great question. The mission gives us purpose. The mission really helps to define why we're here and what's the significance of us being, in our case, who we are, Kaiser Permanente. I've been inside of Kaiser Permanente for over 30 years, and the mission still inspires me. We've not achieved the full potential of the mission, but when I look at, for example, what you just said, and we call this our 13 66 Strategy. We take care of 13 million people, rounding up-

Interviewer:                     Rounding up.

Bernard Tyson:                And there are 66 million who live in the communities around us. So that's our line of sight. On the homeless issue, it's a combination of the connection of not having a house, or a home, or a shelter, and the impact on health. So we connect everything to health. We also just think in terms of the higher calling. In the 21st century in the most wealthiest country on earth, the idea that we as a society would accept anyone going to bed at night on the streets of America as their bed is unacceptable. So that's the ethical ground on which we stand, and then beyond that, we believe strongly that if you're going to have a healthy community, you're going to have a healthy family, it starts with having a shelter, a place to go and to call home, and that's our connection of how do we deal with homelessness and affordability.

Interviewer:                     So you say 'our' and 'we'. How do employees react to this? How do they respond to this? Are they engaging you in the mission and saying, "Hey, Bernard, I love that we do this. We should be doing this as an extension of our mission."?

Bernard Tyson:                Fully engaged. Fully engaged. We're working on what we call the shared agenda inside of Kaiser Permanente, it's the shared agenda between Kaiser Permanente and America, and the homelessness is one of them. Working on the mind is another one. We're about to roll out three bold ideas that came from within the employee base and physician base of Kaiser Permanente, and it's focused on what we call bold moves, and one of them is how do we want to deal with the mind? And we want to focus on issues of adverse childhood experiences that are traumatic that affects a child that then becomes an adult, and that person is dealing with that issue, in some cases, for his or her life. So now we're working on how do we effect that early on and help to prevent that and educate families about how to address that so that the person is not dealing with that for the rest of their lives.

Interviewer:                     You have been incredibly eloquent on the failure of the healthcare system to separate the head from the body, as you put it. We need to integrate that in our healthcare system. Kaiser Permanente does that. This is an issue in workplaces around the country and around the world, is the separation of the head and the body, and many people, Michael Bush spoke passionately earlier about this need to be inclusive on people with mental disabilities, mental health challenges and their family members, but this has remained one of those areas that is a challenging one for workplaces and communities. How do we change that conversation?

Bernard Tyson:                You know, a lot of it, very pertinent to why we're here, is how to create an environment where you are constantly thinking about the health and wellbeing of your employees and everyone that interacts with your organization, such as what we try to do inside of Kaiser Permanente. The fact of the matter is, I can guarantee you if I asked this question in the audience, which, maybe I should, how many of you have someone in your family, your neighbor, your coworker, maybe even yourself that you know for a fact that they're dealing with some form of a mental illness or challenge. Let me see how many hands. Yeah, this happens everywhere.

It's a common issue. And unfortunately the way we have handled mental health in our country, and now I've learned, globally, is we've created this negative stigma around it, so people don't want to talk about it, we don't want to address it. It's a very complicated issue when you're dealing with a loved one or you are dealing with a mental challenge, and the stigma doesn't help at all. We designed a health system in which it's probably the only organ in the body that we sort of set it aside, so if you have a mental health challenge, you have a separate record, and you go over there to get care and nurturing and what else is needed. And we've been working on, one, destigmatizing it, and number two, trying to create the integrated system approach about how do you begin to treat mental health like we do every other organ and disease that we deal with? And really, to integrate it into the overall practice of care inside of Kaiser Permanente.

Interviewer:                     Well unfortunately, we're out of time-

Bernard Tyson:                Already?

Interviewer:                     On your long list of accolades, you forgot one, which was that you, Bernard Tyson, are one of Fortune's World's Greatest Leaders, so thank you and thank you very much.

Bernard Tyson:                Oh, thank you.