From the Desk of the ACCP President

February 25, 2021
Jimmi Hatton Kolpek, Pharm.D., FCCP, FCCM, FNAP

This Old House...

Recently, I’ve come to realize that our organization and profession have inherited a “pharmacy home” built upon an overall U.S. “caste” system of racial inequality, but without a full understanding of its structural foundation. Replacing the many longstanding injustices within America in order to dismantle structural racism will of course require time and resources. Along the way, we will almost certainly uncover unexpected flaws. As homeowners, however, we must devote ourselves to reexamining and renovating our existing structures – indeed, ignoring their present, underlying flaws would be disastrous.

As joint heirs, we as health care professionals must share in the care and refurbishment of the house built by generations of Americans before us. Isabel Wilkerson, Pulitzer Prize winner and National Humanities Medal recipient, introduced this metaphor:

We in the developed world are like homeowners who inherited a house on a piece of land that is beautiful on the outside, but whose soil is unstable loam and rock, heaving and contracting over generations, cracks patched but the deeper ruptures waved away for decades, centuries even. Many people may rightly say, “I had nothing to do with how this all started. I have nothing to do with the sins of the past. My ancestors never attacked indigenous people, never owned slaves.” … [Yet] we are the heirs to whatever is right or wrong with it. We did not erect uneven pillars or joists, but they are ours to deal with now (emphasis mine).¹

With respect to our organization and the pharmacy profession, renewing, restoring, and strengthening decades- and centuries-old foundations will require great mental and moral strength and dedication. Furthermore, it will require courage on our part to face what we would prefer not to see. Recently, the journals of ACCP, AACP, and APhA published simultaneously a blueprint outlining the profession’s responsibility to take action in addressing systemic racism: “Pharmacists must stand in solidarity to educate ourselves, step back, and make room for diverse perspectives to be part of our leadership and decision-making.”²

As inclusive leaders within the pharmacy profession, we must accept our responsibility as joint heirs to mend the old injustices. In eradicating the damage, we must move from an “unawareness” of its prevalence (phase 1) to an “awareness” of its persistence (phase 2).³ In so doing, we must also remain determined not to burden our colleagues by expecting them to teach us racial history. Rather, let’s facilitate connections for trainees to join with mentors who identify similarly by life experience, gender identity, background, or race.

Moreover, although differences in privilege, role models, and opportunities remain among us that are not equally accessible to all, we can and should pledge to mentor as allies, create safe spaces, and initiate crucial conversations – choosing silence will only compromise the process of rebuilding.^4,5 As mentors, we must also share our experiences, seek to understand, listen with humility, and, along the way, educate ourselves.

I am grateful for the support of ACCP members and staff in this reconstruction project. Gradually, we will address the needed repairs within our organization, our profession, and ultimately our society. Together with other educators, practitioners, researchers, and leaders, let’s commit to promoting race-conscious, inclusive care and critically analyze our impact on minority and low-income communities, making it the cornerstone of our professional home.

Reference:

1. Wilkerson I. Caste: The Origins of Our Discontents. Waterville, MA: Thorndike Press, 2021.
2. Arya V, Butler L, Leal S, et al. Systemic racism: pharmacists’ role and responsibility [commentary]. J Am Pharm Assoc 2020;60:e43-e46.
3. Brown J. How to Be an Inclusive Leader: Your Role in Creating Cultures of Belonging Where Everyone Can Thrive. Oakland, CA: Berrett-Koehler, 2019.
4. Dukes A. How to better support Black trainees in the biomedical sciences. Nat Med 2020;26:1674.
5. Cerdeña JP, Plaisime MV, Tsai J. From race-based to race-conscious medicine: how anti-racist uprisings call us to act. Lancet 2020;396:1125-8.