Q&A: Melanie Brim of MHC talks about the future of Michigan’s health care workforce
Melanie Brim is the president and CEO of the Michigan Health Council. She was previously the senior deputy director of the Public Health Administration and the state health officer at the Michigan Department of Community Health.
In this Q&A, Brim discusses building up the health care workforce, instilling interest in health care professions in children, and working to create more diversity in Michigan’s health care workforce.
Patrick Jones: What have you been focusing your mental energy on these last few months?
Melanie Brim: “They have been good. Obviously everybody is struggling with the impact of COVID. For us as an organization, we were not terribly impacted and so it’s actually been work as usual for us. Our organization focuses primarily on building, strengthening and enhancing the health care workforce. So as you can imagine all of our key stakeholders, which are typically health systems and other kinds of health organizations, are really struggling with what COVID has done to their workforce. And so for us [the question] is, ‘How do we support our employers, stakeholders, [and] our academic partners in trying to figure out what exactly is going to be the outcome of this whole pandemic on the workforce?’”
PJ: What do you think is the most important issue in health care and health policy in Michigan today and why?
MB: “I think that the whole issue of health equity and health disparities is critical. It is certainly something that the pandemic has shown us. Not that a lot of people didn’t realize that we did struggle with disparities between outcomes between different populations, but I think COVID has certainly shined the light on that to show that we really have so much work to do to address equity among everyone.
One of our major initiatives is working on health literacy, which has a significant impact on all aspects of care, i.e. patients knowing how and where to access care [and] understanding information shared by their provider. This is another contributing factor to health disparities and has become increasingly evident as we are dealing with the issue of misinformation regarding COVID and vaccine hesitancy. To address this, we received a grant from the Michigan Health Endowment Fund to develop, pilot, and disseminate a health literacy curriculum. The grant focuses on educating providers on how to communicate effectively with patients, among other things. We are doing this grant in partnership with PACE Southeast Michigan and Nancy Combs Communication, LLC. The grant started in January of this year and will continue through December 2022.”
PJ: How do you think issues with health equity intersect with issues in the health care workforce?
MB: “So, I think there’s a lot of things. One of the things we think is really important is that the workforce [should] look a lot like the people they serve, and that doesn’t exist. In most of our communities, our workforce does not look like the people we serve. So for example if you’re in a community that’s highly African American, you’d love to see a health care workforce that is also proportionately highly African American, and that just doesn’t exist. How do we change the workforce to look different? That’s a really long process that involves working at the high school level and middle school level to reach students of color to interest them in health careers, to help get them all the way through high school, and then into health professions education programs to actually change what the workforce looks like.
Then the other piece is just the whole impact that implicit bias and unconscious bias has in how providers treat patients. We support the governor’s effort to address this issue by adding a requirement that all licensed health professionals in Michigan take continuing education in implicit bias to understand how our biases impact how we deliver care to patients. It does impact how providers perceive their patients. Then, in turn, what actions they take to care for their patients.”
PJ: Can you tell me a little more about some programs for children, incentivizing them to join the workforce? How important is this work in ensuring a talented and professional future health care workforce?
MB: “There’s two pieces and one is interesting kids in health care in general. There are so many opportunities for other careers. So health care is competing with those students to get them interested in health care careers as opposed to engineering, as opposed to law as opposed to technology, [etc]. We’re trying to reach kids to get them to understand that health care is a really cool place to work, and it’s a great profession.
[Another] one of our programs in particular, which is our K-5 program, focuses on going into schools [in] underserved communities because we’re reaching kids of color. That’s [where] changing the diversity of the workforce is incredibly important. We work to try to build aspirational thinking in kids to [have them] understand that it is possible for them to actually be in those careers. We [also] have a high school program that, pre-COVID, involved about 7,500 high school kids around the state. We keep putting health professionals in front of them, so that by the time they’re applying to college, they’re already saying, ‘I want to be a nurse,’ ‘I want to be a doctor,’ ‘I want to be a pharmacist.’”
PJ: Can you tell me a little bit about what MHC has on the horizon to improve the health care workforce right now?
MB: “That’s a great question. Incentive programs like loan repayment are wonderful programs, they are in many cases particularly important in not only getting students to be in a program, but also to go out later into underserved communities and do their service that usually goes along with loan repayment. But those all require significant funding.
So the Loan Repayment Program we ran two years ago for medical students going into primary care, family practice or primary care residency slots was all funded by the Michigan Department of Health and Human Services through the state budget process. It was a great program that was going to place a significant number over five years [with] lots of new physicians, primary care physicians for underserved communities. It was funded for one year and then we lost the funding. It’s [up to] getting a commitment from the government, whether it’s federal or state, to provide the funding to support that. That’s a tough one because it has been proven to have a really effective way particularly of getting people to serve in communities where there is inadequate access.”
PJ: What gives you hope for the future?
MB: “I think we reached a tipping point. We understand what inequities exist in terms of health care, and we know what didn’t work. We know we have a public health workforce shortage, and we know public health was really stretched to be able to meet the demand of the pandemic. So, I think what gives me hope is that these things are all out there, and people are really having conversations. One, what are we going to do to make sure this doesn’t happen again, so that when the next pandemic comes, we are not struggling to respond to it? [We need to prepare], whether it’s through cross-training people or trying to encourage support for advancing the public health workforce through different strategies. So I think I’m just excited because lots of other people right now are focused on workforce.”
This interview was edited for clarity and length.