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(wondrous music)

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- This is Lab Medicine Rounds,

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a curated podcast for physicians,

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laboratory professionals, and students.

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I'm your host, Justin Kreuter,
the bow tie bandit of blood,

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a transfusion medicine
pathologist at Mayo Clinic.

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Today's a special treat,

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we're rounding with Dr. Bill Morice,

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Professor of Laboratory
Medicine and Pathology,

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Chair of the Department of
Laboratory Medicine and Pathology

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here at Mayo Clinic,

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and also President of
Mayo Clinic Laboratories.

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Also, really relevant
for today's conversation,

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he is chair of the American
Clinical Lab Association.

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Today, we're talking
about laboratory's role

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in health and equity and
why it's so important.

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So thanks for joining
us today, Dr. Morice.

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- Oh, thanks for having me, Dr. Kreuter,

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Justin, and thanks.

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A really very timely topic,

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so I'm delighted to be talking about it.

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- Absolutely, so this might be

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kind of a little bit
of a perspective shift,

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something that we're not used
to thinking about as much

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in laboratory medicine,
or maybe at some levels,

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it's something that's been

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very much part of the
conversation for some time,

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but this is, the audience is very wide.

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We've got clinicians, we've got students,

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we've got laboratory professionals,

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that tune into this podcast,

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so could you start us off
with why is health equity

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important for laboratory
medicine and pathology?

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- Well, it's first of
all, why it's important,

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I mean, health equity is an issue

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that was a real boilerplate
issue prior to the pandemic,

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but the way the pandemic,
the COVID-19 pandemic,

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of course, has played out,
has really highlighted

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the dramatic inequities in
healthcare distribution,

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both within this country and in globally.

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And so, the important role
of diagnostics, of course,

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in managing and responding to the pandemic

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has really highlighted
the role of diagnostics

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as part of that equation,
which we can get into.

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The interesting thing is
that it's not a new topic.

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If you go back and look, one of the,

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the person that many of us think of

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as sort of the godfather
of modern pathology,

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which is Virchow,

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actually was very
passionate about this issue.

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He did a study of,

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I think it was a typhus
outbreak in upper Silesia.

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part of Poland that
was more, was a miners,

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coal miners, they were kind of
the lower socioeconomic group

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and that country

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had really dramatic
impact there because of

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the living conditions
and their access to care.

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And so he started writing about
this and becoming passionate

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about this well over a hundred years ago.

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So interestingly enough,

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it might be the new topic right now,

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but it really goes back to
the founding of pathology.

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- I love how you tie this
in really to the birth

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of our specialty, right?

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So this is something that is entwined in.

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And I like also you're
highlighting that it's really

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this diagnostics effort.

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So this has been around for a long time.

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You're saying even before the pandemic,

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this was a boiler plate issue.

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The pandemic has really
heightened a lot of these issues.

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So what are we learning
about how as a laboratory,

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we may better advocate for health equity?

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- Well, there's a few
really important lessons

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that we are learning,

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like many of the lessons taught
by COVID, difficult lessons,

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but ones that we really
have to pay attention to.

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So one is, and I actually
wrote a blog post

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about this, in the T3 blog post,

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I think on ASU's website,
Arizona State University.

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But if you look by zip code
and in places like in Boston

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and New York City, where
they've actually studied this,

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you can see an inverse proportion
or an inverse relationship

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between poor outcomes for COVID-19

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and access to diagnostic testing,

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'cause they were tracking by zip code,

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the frequency of testing.

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And you can see that in
areas that had poor outcomes,

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there was less testing.

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And of course those tend to
be lower socioeconomic groups.

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Why this is so important is
that if you think back to when

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we really were first responding to COVID

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and thinking about tracking, testing,

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tracking, and isolation as a
key public health approach,

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imagining the pandemic,

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what that meant was that in
areas that probably had closer

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living conditions also had more
people in service industries

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that couldn't work remotely.

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You actually had less testing.

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And so then you have
more spread of disease

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and also in areas where they
had less access to healthcare.

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So it really just showed
how the lack of good access

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to testing was really
undermining what we wanted to do

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to protect those who were
actually most vulnerable

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to poor outcome from COVID.

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So I think that has really
catapulted the whole issue

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of testing and how we use testing back

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to the kind of the forefront of

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the healthcare disparities discussion.

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- Now, if we unpack this a little bit,

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it seems like this data
you're talking about,

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it highlights the lack of
testing and then how that's

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so central and it's such a driver of many

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of aspects of health and equity.

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Where do you, it seems like it's a,

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I don't know if it's one
of those wicked problems.

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It's very complex.

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It's not just more testing,

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but what's the nuance there that we need

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to kind of grapple with.

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Not just more testing, but
I guess better testing.

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- Yeah, yeah, and access to testing.

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I think there's really
two things that we have

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to start thinking about
as a laboratory community.

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That one is with COVID and
the big push for home testing,

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just look at the last wave with Omicron,

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and the massive investment
in angio testing,

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is that and thinking about app based,

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apps that you can use
and companies like Q,

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where you can have a box in your home,

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is that to really be thinking
about not just getting those

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to where there's a cool business case,

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but to where there's a social case

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for access to those tests.

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How can we start thinking about
it in a digital world where

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there's more access to diagnostics?

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It really falls on our profession
to be the voice of where

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those, just like every
laboratory in the hospital,

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we think about where we
need hospital clinical labs

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to support care.

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When we start thinking
about the digitization

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and the building of remote diagnostics,

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we need to be really thinking
about where those diagnostics

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are gonna have the biggest impact

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and really advocating for that.

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Case in point, you think about those,

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why do some of those
lower socioeconomic groups

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have poor outcomes to COVID?

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Because they have a higher
frequency of comorbidities,

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like diabetes and things that really could

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be managed effectively if there

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were better diagnostics early on.

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So you didn't have patients
with end stage disease.

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So really thinking about
what can diagnostics do

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to help people as we go forward,

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in terms of prevention and wellbeing,

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becomes them really important

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because we have to advocate
for that for our patients.

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That's number one,

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the other is just really
understanding why people wouldn't

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wanna use a test.

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And again, and that means
how that information's used,

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because what we found is
that even when some of these

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testing clinics were set
up and we've seen this both

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in the US and globally, as
I've been participating.

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And the other thing I did,

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I actually worked with
the World Economic Forum

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on a group looking at access
to COVID diagnostics globally

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in low and middle income countries.

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And you talked to a lot about, hey,

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we could use these tests to
keep people from going to work

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when they're sick.

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Well, if they're people that depend on,

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they might have a whole household,

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depending on them going and
being able to drive a truck

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across the border, they're
not gonna wanna get tested.

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So really also thinking about
how do we influence policy

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in a way,

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and that's where the American
Clinical Lab Association

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is important for me.

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So how do you think about policies

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that can help support people
wanting to actually get access

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to the test?

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Because it's a whole milieu
but going full circle

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is our profession is really,

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it's not just about doing testing,

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it's about thinking about all

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these issues that surround testing.

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- You bring in a lot of
really neat opportunities.

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You've been able to see
this problem from a couple

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of different perspectives.

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You're talking about changing
this from a business case.

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And I think that's what a lot of us

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are typically thinking about.

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'Cause we're justifying our actions,

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to switching ourselves
to thinking about it

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from a social case.

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That that might be kind of
new for some of these efforts,

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I guess, are there other,

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are there examples of
how we can do this better

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from other professions
that we can learn from?

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- Well really other professions and other,

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really other groups, right?

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So like one of the things that
was really gratifying for me

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was Walé, from our Diversity
Equity Inclusion Group,

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Elegbede, I was gonna,

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I didn't wanna mispronounce his last name,

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actually is very active,

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I think even leads the
local chapter of the NAACP.

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So getting out there
with community groups,

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as a laboratorian, talking
about how tests work,

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what they can tell you, what they can't.

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So really actually I think
a real opportunity for us is

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to think about community engagement,

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which is not something
we typically think about

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in lab medicine, right?

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There's a lot of groups that
are really good with this

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because it's really A, understanding,

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what in those different
communities and cultures,

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how testing is perceived
and then being able to help

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advocate for that.

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So I think that's one area.

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And of course, actually your
area transfusion medicine,

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probably any area in
DLNP with blood drives

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and other things,

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it kind of, that community
engagement's more part of

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the fabric of your division.

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We have to start thinking about that,

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not just for transfusion medicine,

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but really for laboratory medicine.

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And how do we do that?

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I think that's a really important one.

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- So switching also to the policy,

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you mentioned to really kind
of untangle some of these, you,

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I love the take on the take
of that negative perspective

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on that of like,

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why wouldn't somebody do a lab
test and then how that really

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gets to some of those policy
challenges that we have.

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Is that something that's kind of,

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you feel like that your
previous experience as

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a pathologist, as a hematopathologist

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has kind of prepared you for, or are these

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additional skills that
you've kind of picked up

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along the way?

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- I think a little bit of both.

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I mean, I think in essence,

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it really all derives from
what drew me into lab medicine.

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And that is how do we create
information that's accessible

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and actionable for patients and providers.

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That's really the mindset.

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And how do you make sure
that's high quality?

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How do you make sure that it's understood?

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That part is natural.

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Now thinking about how people outside

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of our profession,

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and we spend a lot of time just
in medicine explaining this,

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00:10:41,070 --> 00:10:42,980
even to people that are
using the labs that are other

258
00:10:42,980 --> 00:10:44,540
physicians and providers.

259
00:10:44,540 --> 00:10:45,583
So then you have to take that and think

260
00:10:45,583 --> 00:10:47,710
from an even bigger scale,

261
00:10:47,710 --> 00:10:50,240
how do you make that
understandable for people

262
00:10:50,240 --> 00:10:51,170
that aren't in healthcare?

263
00:10:51,170 --> 00:10:52,060
It's a big challenge.

264
00:10:52,060 --> 00:10:54,300
So I think things like your podcast,

265
00:10:54,300 --> 00:10:56,100
things that, thinking about how you

266
00:10:56,100 --> 00:10:58,840
communicate issues outside of healthcare

267
00:10:58,840 --> 00:11:02,010
is an acquired skill and
one that you can learn.

268
00:11:02,010 --> 00:11:03,400
And you can learn by doing.

269
00:11:03,400 --> 00:11:05,200
So that's probably the new skillset.

270
00:11:06,190 --> 00:11:08,560
Everything in life is,

271
00:11:08,560 --> 00:11:09,710
one thing I've learned in leadership,

272
00:11:09,710 --> 00:11:11,470
it's all about timing.

273
00:11:11,470 --> 00:11:13,030
The timing is critical.

274
00:11:13,030 --> 00:11:14,640
'Cause for the first time,

275
00:11:14,640 --> 00:11:17,820
really there's an awareness
in the highest levels

276
00:11:17,820 --> 00:11:19,900
of policy makers of some of these issues

277
00:11:19,900 --> 00:11:21,470
and a desire to address it.

278
00:11:21,470 --> 00:11:24,170
So they're looking for,
their ear's attuned

279
00:11:24,170 --> 00:11:25,140
to a voice.

280
00:11:25,140 --> 00:11:27,750
Case in point, going back,

281
00:11:27,750 --> 00:11:29,250
there was massive investments.

282
00:11:29,250 --> 00:11:30,650
There have been massive investments.

283
00:11:30,650 --> 00:11:31,610
You read in the papers

284
00:11:31,610 --> 00:11:35,300
about the White House buying
500 million anti tests.

285
00:11:35,300 --> 00:11:37,340
And I read that and think
about what difference

286
00:11:37,340 --> 00:11:38,560
is that really gonna make?

287
00:11:38,560 --> 00:11:40,770
I mean, if it's just people
that can afford to go

288
00:11:40,770 --> 00:11:42,870
to Walmart and buy the tests

289
00:11:42,870 --> 00:11:44,780
and know what they wanna
do with the results,

290
00:11:44,780 --> 00:11:46,940
it's not gonna get us where we need to go.

291
00:11:46,940 --> 00:11:49,430
And I think there is a
frustration from policy makers

292
00:11:49,430 --> 00:11:51,580
about why isn't this making a difference.

293
00:11:51,580 --> 00:11:53,580
I think going back, I mean,

294
00:11:53,580 --> 00:11:55,280
we've always been about the why,

295
00:11:55,280 --> 00:11:56,540
we just have to make sure we're helping

296
00:11:56,540 --> 00:11:57,380
with the right questions,

297
00:11:57,380 --> 00:11:58,690
but we're the right people to do it.

298
00:11:58,690 --> 00:12:00,632
I'm convinced of that.

299
00:12:00,632 --> 00:12:02,010
- I love this.

300
00:12:02,010 --> 00:12:03,670
So what are these,

301
00:12:03,670 --> 00:12:06,670
you've mentioned a couple
barriers that kind of

302
00:12:06,670 --> 00:12:08,610
have been in the way.

303
00:12:08,610 --> 00:12:11,420
Can you kind of take
the listeners through,

304
00:12:11,420 --> 00:12:14,840
what are two or three ways that we here

305
00:12:14,840 --> 00:12:16,570
are trying to navigate this

306
00:12:16,570 --> 00:12:18,933
for increasing healthcare equity?

307
00:12:20,060 --> 00:12:22,510
- Yeah, well, I think one,
there are a couple ways.

308
00:12:22,510 --> 00:12:25,040
One is some of the community
engagement work through Wale

309
00:12:25,040 --> 00:12:27,380
and others, it's just getting out there.

310
00:12:27,380 --> 00:12:29,720
I mean, and I don't wanna say it really

311
00:12:29,720 --> 00:12:31,210
is listening before talking.

312
00:12:31,210 --> 00:12:33,110
So really listening and understanding.

313
00:12:33,110 --> 00:12:35,800
I mean, that's goes back
to our Franciscan values.

314
00:12:35,800 --> 00:12:38,040
Of course, St. Francis was,
that was his, it's better

315
00:12:38,040 --> 00:12:40,640
to understand than be understood.

316
00:12:40,640 --> 00:12:42,580
So I think getting out there,

317
00:12:42,580 --> 00:12:45,480
hearing voices of people
that maybe aren't showing up

318
00:12:45,480 --> 00:12:46,330
to a Mayo Clinic,

319
00:12:46,330 --> 00:12:47,930
aren't showing up to
healthcare facilities,

320
00:12:47,930 --> 00:12:49,670
understanding why, understanding what some

321
00:12:49,670 --> 00:12:50,910
of those barriers are.

322
00:12:50,910 --> 00:12:52,100
I think that's one thing that we're,

323
00:12:52,100 --> 00:12:54,180
a lot of us in Mayo are doing,

324
00:12:54,180 --> 00:12:56,360
a lot of people in healthcare are doing.

325
00:12:56,360 --> 00:12:59,140
I think that's really first and foremost

326
00:12:59,140 --> 00:13:00,290
because it's really,

327
00:13:00,290 --> 00:13:04,060
we have to be just like
when we're in the lab,

328
00:13:04,060 --> 00:13:06,120
we are really thinking about the patient.

329
00:13:06,120 --> 00:13:08,820
We're the person in the
lab and at our microscope

330
00:13:08,820 --> 00:13:11,090
or in getting a product ready,

331
00:13:11,090 --> 00:13:13,260
that's thinking about what
does that patient need?

332
00:13:13,260 --> 00:13:15,450
We're the voice for the
patient in that process.

333
00:13:15,450 --> 00:13:17,470
And now we have to be the
voice for the community

334
00:13:17,470 --> 00:13:18,870
in this process, too.

335
00:13:18,870 --> 00:13:20,730
So that's one thing that we're doing.

336
00:13:20,730 --> 00:13:23,210
The other is that through, with Mayo,

337
00:13:23,210 --> 00:13:26,370
is really one of the things
that we've been very active with

338
00:13:26,370 --> 00:13:28,670
is actually forming partnerships

339
00:13:28,670 --> 00:13:31,270
with diagnostic manufacturing industry,

340
00:13:31,270 --> 00:13:34,410
with companies like
Thermo, because ultimately,

341
00:13:34,410 --> 00:13:37,650
the manufacturers of these products have

342
00:13:37,650 --> 00:13:40,020
to understand how they're
gonna be used or not used.

343
00:13:40,020 --> 00:13:41,770
And again, if we are,

344
00:13:41,770 --> 00:13:43,830
don't have a great sensitivity to that,

345
00:13:43,830 --> 00:13:45,770
many of those companies even less.

346
00:13:45,770 --> 00:13:48,860
So I think it being, stepping
outside of our offices,

347
00:13:48,860 --> 00:13:51,830
stepping outside of our walls
and really starting to think

348
00:13:51,830 --> 00:13:53,850
about a whole ecosystem that has to exist,

349
00:13:53,850 --> 00:13:56,350
from digital tools to the right test,

350
00:13:56,350 --> 00:13:59,490
to the right kind of follow
up actions that are needed,

351
00:13:59,490 --> 00:14:00,630
we have to do all this.

352
00:14:00,630 --> 00:14:02,070
And there's different
areas of lab medicine

353
00:14:02,070 --> 00:14:04,070
infectious disease has always had.

354
00:14:04,070 --> 00:14:06,280
And clin micro always
has had a strong presence

355
00:14:06,280 --> 00:14:07,630
in public health.

356
00:14:07,630 --> 00:14:09,730
So thinking about the things
that are natural connections

357
00:14:09,730 --> 00:14:11,210
and how do we start to amplify them?

358
00:14:11,210 --> 00:14:12,060
I think that's the other thing

359
00:14:12,060 --> 00:14:13,590
that we're really thinking about now

360
00:14:13,590 --> 00:14:15,340
that we weren't a couple years ago.

361
00:14:16,230 --> 00:14:18,680
- Unpacked, as you brought
up kind of partnering

362
00:14:18,680 --> 00:14:21,400
with these, the industry

363
00:14:21,400 --> 00:14:24,190
that's developing diagnostic testing.

364
00:14:24,190 --> 00:14:29,190
How can we, what does that look like?

365
00:14:29,580 --> 00:14:31,417
Can you kind of unpack
that for a little bit?

366
00:14:31,417 --> 00:14:34,393
'Cause I can mention some
of our listeners might,

367
00:14:34,393 --> 00:14:36,441
they hear you say those words, but

368
00:14:36,441 --> 00:14:37,274
what does that look like?

369
00:14:37,274 --> 00:14:40,990
What kind of feedback
can a pathologist provide

370
00:14:40,990 --> 00:14:45,380
that helps them kind
of build a better test?

371
00:14:45,380 --> 00:14:46,270
- Sure, a couple,

372
00:14:46,270 --> 00:14:47,880
I'll give you a couple
real tangible examples.

373
00:14:47,880 --> 00:14:50,743
So one of these things
that have been around,

374
00:14:51,620 --> 00:14:53,230
really, I think started right around when

375
00:14:53,230 --> 00:14:55,000
I started my job in 2015,

376
00:14:55,000 --> 00:14:56,520
as department chair,
which is hard to believe

377
00:14:56,520 --> 00:14:59,230
I've been in this role that long, but was

378
00:14:59,230 --> 00:15:01,790
these things, the devices
that could draw blood without

379
00:15:01,790 --> 00:15:04,140
a needle that you could
send to someone's home.

380
00:15:05,070 --> 00:15:07,310
There are a few companies
that are out there.

381
00:15:07,310 --> 00:15:08,450
Early on in the pandemic,

382
00:15:08,450 --> 00:15:11,160
we thought about the potential
for serologic testing.

383
00:15:11,160 --> 00:15:13,180
So we actually just talked
to the company, said,

384
00:15:13,180 --> 00:15:14,670
can you send us some?

385
00:15:14,670 --> 00:15:15,640
And we can test them.

386
00:15:15,640 --> 00:15:17,390
And we had a group including Dr. Pritt,

387
00:15:17,390 --> 00:15:19,650
and some others that
actually tested a few of them

388
00:15:19,650 --> 00:15:21,040
and just found some things that would make

389
00:15:21,040 --> 00:15:23,710
it really problematic to use them.

390
00:15:23,710 --> 00:15:25,390
And you start thinking about,

391
00:15:25,390 --> 00:15:27,530
especially if they're complicated,

392
00:15:27,530 --> 00:15:29,080
you can give that feedback back.

393
00:15:29,080 --> 00:15:31,570
And some of these companies
now are thinking about, wow,

394
00:15:31,570 --> 00:15:33,730
you know, we can't just make this device,

395
00:15:33,730 --> 00:15:35,200
we might have to have a call center.

396
00:15:35,200 --> 00:15:37,610
We might have to have a video
link that can help someone

397
00:15:37,610 --> 00:15:39,210
understand how to use it.

398
00:15:39,210 --> 00:15:41,810
And then also saying what
you actually need from

399
00:15:41,810 --> 00:15:44,440
a specimen type to be able to use it.

400
00:15:44,440 --> 00:15:47,750
So if we need to
quantify, a dry blood spot

401
00:15:47,750 --> 00:15:50,870
is something we have, been
around for a long time,

402
00:15:50,870 --> 00:15:53,570
it's very difficult to get
like a quantitative serology

403
00:15:53,570 --> 00:15:54,880
off of a dry blood spot.

404
00:15:54,880 --> 00:15:57,470
So you start talking
about with those companies

405
00:15:57,470 --> 00:15:59,000
about how you'd wanna use it,

406
00:15:59,000 --> 00:16:02,239
and then they can start
a whole conversation.

407
00:16:02,239 --> 00:16:03,860
And so those are some of the things

408
00:16:03,860 --> 00:16:05,610
that I think, that's
kind of how that goes.

409
00:16:05,610 --> 00:16:08,690
Like, but you'll find out that

410
00:16:08,690 --> 00:16:10,130
oftentimes they just don't have a lot

411
00:16:10,130 --> 00:16:11,810
of those conversations naturally.

412
00:16:11,810 --> 00:16:13,380
So they're often very appreciative,

413
00:16:13,380 --> 00:16:16,080
even if it's just like, we
wanna use this in our community.

414
00:16:16,080 --> 00:16:18,620
Can we get some exposure
to the technology?

415
00:16:18,620 --> 00:16:20,300
Can we talk to someone on your end?

416
00:16:20,300 --> 00:16:23,332
Like if we wanted to roll it
out, say, to work with it,

417
00:16:23,332 --> 00:16:26,530
a lot of this is again,
very, very specific.

418
00:16:26,530 --> 00:16:28,830
So it might be like work
we've done in the past

419
00:16:28,830 --> 00:16:29,663
with migrant workers.

420
00:16:29,663 --> 00:16:31,943
So you start to think
about some of those things.

421
00:16:32,780 --> 00:16:33,613
- It's really great.

422
00:16:33,613 --> 00:16:35,430
I love how I think you're helping

423
00:16:35,430 --> 00:16:36,520
our listeners kind of,

424
00:16:36,520 --> 00:16:38,920
don't short change this
role of the pathologist,

425
00:16:38,920 --> 00:16:41,910
where we have expertise, where
we got one leg, you know,

426
00:16:41,910 --> 00:16:43,590
firmly planted in laboratory

427
00:16:43,590 --> 00:16:47,130
and the other leg firmly planted
in the clinical practice.

428
00:16:47,130 --> 00:16:50,490
And to understand that we often hear

429
00:16:50,490 --> 00:16:54,280
what are those pain points on
getting a test accomplished.

430
00:16:54,280 --> 00:16:58,390
And that's something that's
very valuable to manufacturers

431
00:16:58,390 --> 00:17:00,930
and that collaboration
is what I'm also hearing

432
00:17:00,930 --> 00:17:04,630
in your answer is, actively reaching out,

433
00:17:04,630 --> 00:17:07,960
helping to develop this will
hopefully result in something

434
00:17:07,960 --> 00:17:12,710
that's gonna be much better
for patients in the long run.

435
00:17:12,710 --> 00:17:14,650
- Oh, absolutely, and thinking about that.

436
00:17:14,650 --> 00:17:17,253
We have that expertise and
how do we start to apply it

437
00:17:17,253 --> 00:17:18,630
for the long term?

438
00:17:18,630 --> 00:17:20,840
So it makes a real
difference in these issues.

439
00:17:20,840 --> 00:17:24,270
And I'll take you back
to one of the early days.

440
00:17:24,270 --> 00:17:28,300
So it's probably late March of 2020,

441
00:17:28,300 --> 00:17:32,430
and I'm sitting in my office
at SDSC right around midnight,

442
00:17:32,430 --> 00:17:34,070
just trying to get through things

443
00:17:34,070 --> 00:17:36,570
and get through my emails
'cause of the onslaught.

444
00:17:36,570 --> 00:17:39,600
And one of the emails that I
get is from someone from a,

445
00:17:39,600 --> 00:17:42,410
one of the native American tribes here

446
00:17:42,410 --> 00:17:43,840
in the state of Minnesota

447
00:17:43,840 --> 00:17:46,890
with a desperate plea, can
we get some COVID testing?

448
00:17:46,890 --> 00:17:48,210
We have a lot of elderly.

449
00:17:48,210 --> 00:17:51,380
We have a lot of people
with healthcare conditions

450
00:17:51,380 --> 00:17:54,890
and we have a lot of communal
living and just really,

451
00:17:54,890 --> 00:17:56,730
and no testing whatsoever.

452
00:17:56,730 --> 00:17:59,220
And so I brought that back to Scott Beck,

453
00:17:59,220 --> 00:18:00,630
we got really passionate.

454
00:18:00,630 --> 00:18:04,210
John Heywood at Mayo Clinic
Labs has helped a lot with this,

455
00:18:04,210 --> 00:18:06,310
but you realize it takes
us a sustained effort.

456
00:18:06,310 --> 00:18:08,681
I mean, it's not something
that can be built over night

457
00:18:08,681 --> 00:18:10,650
and we can't lose that now.

458
00:18:10,650 --> 00:18:12,330
We're all gonna wanna forget about COVID,

459
00:18:12,330 --> 00:18:13,900
but now it's been two years.

460
00:18:13,900 --> 00:18:16,150
And everyone's burned out on COVID.

461
00:18:16,150 --> 00:18:19,220
But the reality is for us in the labs,

462
00:18:19,220 --> 00:18:21,720
we have our foot on
both sides, as you say,

463
00:18:21,720 --> 00:18:24,520
and we know the issues and
it's just applying those

464
00:18:24,520 --> 00:18:25,720
in a different setting.

465
00:18:25,720 --> 00:18:28,200
And it's, I think it's
more long term work,

466
00:18:28,200 --> 00:18:30,720
but overall all it's the right thing.

467
00:18:30,720 --> 00:18:31,553
And it makes such a,

468
00:18:31,553 --> 00:18:33,110
it can make such an impact for people,

469
00:18:33,110 --> 00:18:34,420
even just simple tests

470
00:18:34,420 --> 00:18:36,000
and having access to them.

471
00:18:36,000 --> 00:18:39,233
So that's this experience
I'll certainly never,

472
00:18:39,233 --> 00:18:41,810
that's really, after meeting. I was like,

473
00:18:41,810 --> 00:18:43,030
wow, that's important.

474
00:18:43,030 --> 00:18:44,480
And I think if there's
one thing I can share with

475
00:18:44,480 --> 00:18:47,560
the listeners is that is making

476
00:18:47,560 --> 00:18:50,240
that experience relatable for them.

477
00:18:50,240 --> 00:18:51,073
'Cause it is easy.

478
00:18:51,073 --> 00:18:53,610
It's easy to become sort of a immure to it

479
00:18:53,610 --> 00:18:55,500
because we're two steps removed,

480
00:18:55,500 --> 00:18:57,730
but we're so important
in terms of coming up

481
00:18:57,730 --> 00:18:58,930
with the right solution.

482
00:19:00,620 --> 00:19:03,030
- Absolutely, absolutely, right.

483
00:19:03,030 --> 00:19:05,850
And one of the, what I'm
hearing in your answer too,

484
00:19:05,850 --> 00:19:09,290
is this concept of it's
we don't just learn

485
00:19:09,290 --> 00:19:13,620
from experience, but we learn
by reflecting on experience.

486
00:19:13,620 --> 00:19:16,010
And I think what I hear
you say is, you know, yeah,

487
00:19:16,010 --> 00:19:18,230
everybody's excited to
get past and hopeful

488
00:19:18,230 --> 00:19:22,170
to get past COVID and to
kind of close a chapter.

489
00:19:22,170 --> 00:19:23,170
But like you're saying,

490
00:19:23,170 --> 00:19:26,760
there was a lot of
innovation that came out

491
00:19:26,760 --> 00:19:28,630
of this period as well,

492
00:19:28,630 --> 00:19:32,290
and lessons learned and it
would be a shame not to learn

493
00:19:32,290 --> 00:19:35,480
those lessons and carry that
forward into the future.

494
00:19:35,480 --> 00:19:36,313
- Yeah, I agree.

495
00:19:36,313 --> 00:19:38,430
And yeah, I mean, just for the listeners,

496
00:19:38,430 --> 00:19:40,180
just about everyone listening,

497
00:19:40,180 --> 00:19:42,240
you probably know more than you realize

498
00:19:42,240 --> 00:19:44,129
and have more to
contribute to the solution

499
00:19:44,129 --> 00:19:46,130
than you realize.

500
00:19:46,130 --> 00:19:48,430
Just, I mean, that's certainly, for me.

501
00:19:48,430 --> 00:19:50,590
They're just very what
we would almost think of

502
00:19:50,590 --> 00:19:53,390
as simple questions that
really need to be addressed.

503
00:19:53,390 --> 00:19:56,610
So don't underestimate your
ability to really make an impact

504
00:19:56,610 --> 00:19:58,610
on this, even though it seems like, wow,

505
00:19:58,610 --> 00:20:00,180
lab testing and healthcare equity,

506
00:20:00,180 --> 00:20:01,410
how am I ever gonna effect that?

507
00:20:01,410 --> 00:20:03,010
That's such a huge problem.

508
00:20:03,010 --> 00:20:05,510
So, and I think the pandemic means

509
00:20:05,510 --> 00:20:06,950
that there's a receptive year

510
00:20:06,950 --> 00:20:09,340
and there's a real chance
to make a difference.

511
00:20:09,340 --> 00:20:10,610
- So let's just zoom out.

512
00:20:10,610 --> 00:20:13,350
I've got one final question about

513
00:20:13,350 --> 00:20:16,450
kind of based on what we discussed here,

514
00:20:16,450 --> 00:20:19,700
like, taking this optimistic, future view,

515
00:20:19,700 --> 00:20:23,430
what is the future of
health equity look like?

516
00:20:23,430 --> 00:20:25,860
What does that laboratory support

517
00:20:25,860 --> 00:20:28,430
of health equity look like,

518
00:20:28,430 --> 00:20:30,313
in the coming years?

519
00:20:31,320 --> 00:20:33,610
- I think that, well, how it will evolve

520
00:20:33,610 --> 00:20:34,443
I don't know.

521
00:20:34,443 --> 00:20:36,480
I think that the ideal
future state that we should

522
00:20:36,480 --> 00:20:38,650
be working towards is that no matter

523
00:20:38,650 --> 00:20:40,510
what community you're living in,

524
00:20:40,510 --> 00:20:44,110
that there is enough
education and awareness of

525
00:20:44,110 --> 00:20:46,240
the kind of tests that
you need to be doing

526
00:20:46,240 --> 00:20:48,160
to understand your health

527
00:20:48,160 --> 00:20:50,490
and the knowledge around that result

528
00:20:50,490 --> 00:20:53,010
to help you turn it into
something actionable,

529
00:20:53,010 --> 00:20:55,630
whether it's even something
as simple as you might have

530
00:20:55,630 --> 00:20:59,060
pre-diabetes, here are some
healthcare choices you can make.

531
00:20:59,060 --> 00:21:01,210
Here are some things you're
doing in your community.

532
00:21:01,210 --> 00:21:03,340
Maybe even go back to
community groups and say,

533
00:21:03,340 --> 00:21:06,710
we need more healthy
food options in this area

534
00:21:06,710 --> 00:21:08,400
as a for instance.

535
00:21:08,400 --> 00:21:12,180
So it's a system whereby an
individual can create data

536
00:21:12,180 --> 00:21:13,150
around their health,

537
00:21:13,150 --> 00:21:16,160
that's really actionable in
helping them lead healthier

538
00:21:16,160 --> 00:21:17,610
and more fulfilling lives.

539
00:21:17,610 --> 00:21:18,443
And at the same time,

540
00:21:18,443 --> 00:21:20,720
we're taking all that
information and understanding

541
00:21:20,720 --> 00:21:22,430
where we need to make societal changes

542
00:21:22,430 --> 00:21:24,410
or policy changes that give people

543
00:21:24,410 --> 00:21:27,010
a more healthy environment to live in.

544
00:21:27,010 --> 00:21:28,370
- That's awesome, we've been rounding

545
00:21:28,370 --> 00:21:30,620
with Dr. Morice on the laboratory's role

546
00:21:30,620 --> 00:21:31,940
in health and equity.

547
00:21:31,940 --> 00:21:34,200
Thank you so much for
being here with us today.

548
00:21:34,200 --> 00:21:36,290
- Oh, it was my pleasure, anytime.

549
00:21:36,290 --> 00:21:37,560
- So we're definitely gonna link,

550
00:21:37,560 --> 00:21:39,500
Dr. Morice mentioned that he wrote a blog.

551
00:21:39,500 --> 00:21:41,440
We're gonna be linking
that in the show notes.

552
00:21:41,440 --> 00:21:43,270
And if you'd like to
hear more on this topic,

553
00:21:43,270 --> 00:21:47,120
be sure to register for the
Phlebotomy 2022 conference,

554
00:21:47,120 --> 00:21:48,380
Performance, Public Health,

555
00:21:48,380 --> 00:21:51,320
and People In a Post COVID World.

556
00:21:51,320 --> 00:21:53,890
Dr. Morice will be
presenting on this topic

557
00:21:53,890 --> 00:21:55,990
at this year's virtual conference

558
00:21:55,990 --> 00:22:00,630
that's gonna be on April
21st and 22nd of 2022.

559
00:22:00,630 --> 00:22:02,020
And for more information,

560
00:22:02,020 --> 00:22:06,750
please visit
MayoClinicLabs.com/2022Phlebotomy.

561
00:22:07,610 --> 00:22:09,910
To all of our listeners, thank
you for joining us today.

562
00:22:09,910 --> 00:22:11,340
We invite you to share your thoughts

563
00:22:11,340 --> 00:22:12,590
and suggestions via email.

564
00:22:12,590 --> 00:22:17,590
Please direct any suggestions
to MCLEducation@Mayo.edu.

565
00:22:18,110 --> 00:22:20,690
As always, if you've enjoyed
Lab Medicine Rounds podcast,

566
00:22:20,690 --> 00:22:22,200
please follow or subscribe.

567
00:22:22,200 --> 00:22:23,930
And until our next rounds together,

568
00:22:23,930 --> 00:22:26,870
we encourage you to continue
to connect lab medicine

569
00:22:26,870 --> 00:22:30,843
and the clinical practice
through insightful conversations.

570
00:22:30,843 --> 00:22:33,510
(upbeat music)