Shaping a Healthier Future: Dr. Yele Aluko on Societal and Health Equity
In our latest podcast episode, Gayathri sits down with an industry titan, Dr. Yele Aluko, EY Americas Health Advisory practice's Chief Medical Officer. Dr. Aluko, with a career that spans 25 years in cardiovascular medicine and now at the helm of health equity initiatives at EY, brings thoughtprovoking insights into the urgent call for inclusivity and accountability.
A stalwart in the healthcare sector, Dr. Aluko has carved a niche in developing strategies that steer healthcare organizations toward a competitive edge. His journey, which began in Ibadan, Nigeria, has seen him taking up pivotal roles, including leading the EY Center for Health Equity and serving on advisory boards of notable institutions such as the Harvard Business Review and the International Well Building Institute.
Resource Workbook
For every podcast episode, we've meticulously curated a unique workbook to dive deeper into its themes. Download the Changing Tomorrow Episode Workbook here.
Dr. Aluko, with his rich background and forward-thinking approach, shares insights that are both deep and necessary in today's landscape. Read more as we delve into a conversation that traverses history, equity, and the pressing need for accountability in our strategies.
The Accountability Factor
Over the last two decades, there has been a concerted effort to bridge health disparities, with investments nearing $200 billion. Yet, despite this substantial financial influx, the disparities remain stubbornly persistent. Dr. Aluko brings to the fore a critical perspective: the necessity for strategies that are not just well-funded but are also grounded in accountability and foresight.
He advocates for a shift from activity to impact, urging for strategies that are revisited and refined periodically, ensuring a path that leads to tangible change. It's a call for a more deliberate approach, one that moves beyond mere "busy work" and strides towards real, substantial progress.
Learning from History: Insights from "Medical Apartheid"
Dr. Aluko emphasizes the importance of learning from history, of taking the lessons drawn from the dark chapters of the past and using them to inform a more equitable and compassionate future.
As a must-read for impact makers, Dr. Aluko recommends the seminal work "Medical Apartheid" by Harriet Washington, a deep exploration into the harrowing history of medical experimentation on Black Americans. It's a book that serves not just as a record of past atrocities but as a beacon, guiding us to forge strategies grounded in empathy and understanding.
The Disparity in Opportunities: A Tale of Two Paths
To demonstrate the impact of the systems and structures around us, Dr. Aluko paints a vivid picture of the divergent paths that individuals can find themselves on, largely influenced by the environments they grow up in. He provides a thought-provoking example of two children born on the same day in the same hospital but taking two different turns as they go home.
Dr. Aluko urges us to consider the long-term repercussions of these disparities, emphasizing the role of systemic factors in shaping individual destinies. It's a call to action, urging society to forge pathways that offer equal opportunities to all, irrespective of their starting point in life.
Dr. Aluko's Journey: From Cardiologist to EY's Chief Medical Officer
As we delve deeper, Dr. Aluko shares snippets from his own journey, a path that saw him transition from a cardiologist to assuming the pivotal role of EY's Chief Medical Officer. It's a journey marked by a deep-seated desire to effect broader change, to move beyond individual patient care to addressing systemic issues that influence health outcomes on a larger scale.
Dr. Aluko's career trajectory is a testament to the power of grit and determination, illustrating the impact one can have when they choose to step beyond traditional boundaries and venture into realms where they can foster greater change.
Looking Forward
As the conversation draws to a close, Dr. Aluko leaves us with pearls of wisdom drawn from a career rich with experiences. He shares his no-regret philosophy, a guiding principle that encourages individuals to pursue paths that they believe in passionately, without being held back by fear of failure.
It's a note of optimism, a beacon of hope that signals the potential for change through concerted efforts and a determined spirit. Dr. Aluko's insights serve as a rallying cry, urging us to forge ahead with determination and a vision for a better, more equitable future.
Additional Resources
For those keen to dive deeper, Dr. Aluko points to the report published by the EY Center for Health Equity, a resource that is chock full of insights and data that can guide future strategies.
He also recommends the eye-opening read "Medical Apartheid" by Harriet Washington, a book that promises to deepen your understanding and fuel your desire to be a part of the change we so dearly need.
Resource Workbook
For every podcast episode, we've meticulously curated a unique workbook to dive deeper into its themes. Download the Changing Tomorrow Episode Workbook for this episode here.
Episode Transcript
Okay, Dr. Aluko, are you ready?
Yele Aluko (00:05.154)
I am ready.
Gayathri (00:06.115)
Okay, let's do this. Before we dive into the heart of our discussion, let's kick things off with a question that I ask all of my guests. And it's a fun one. If you have a superpower or if you had a superpower, what would it be?
Yele Aluko (00:24.822)
That's an interesting question and I don't get asked that question much at all. But I would say that my superpower would be an impact maker. And by that I'm not talking about just being an individual that makes an impact, but by being a part of networks, stakeholder groups, agendas that very intentionally and purposefully seek to drive
impact in society. And by so doing, they achieve overall upliftment of human society and its people.
Gayathri (01:06.675)
a really powerful one and one that I think a lot of people will want to be part of the Impact Maker Club and the Impact Maker Superpower. Thank you for sharing that, I had never thought of it that way. Today we're talking about equity and addressing inequities, a topic that is close to our hearts and one that we discussed at length.
Yele Aluko (01:19.822)
Great.
Gayathri (01:31.847)
at the International Well-Building Institute when I was working there and where you served as a co-chair of the Health Equity Advisory. The reality is that there have been a lot of conversations over the past three years, and frankly, not a lot of change around the topic of disparities and inequities. These issues have existed for centuries. They have in fact been baked into the systems at many levels.
Dr. Luko as a clinician, as a medical leader, as a corporate executive, you have a really unique perspective. From your perspective, could you tell us what equity means?
Yele Aluko (02:14.318)
So first of all, congratulations on the work that you did with IWBI. It was a privilege to be part of that conversation and to work with you there. So Cheryl, let me first say that the word equity has become more of a mainstream conversation, as you mentioned in the past few years, due to two specific drivers. And COVID-19 is one. The other.
Gayathri (02:26.155)
Thank you.
Yele Aluko (02:42.962)
is the unfortunate murder of George Floyd and other incidents like that. So to answer that question, I think we should consider talking about equity within the broader context of inequality, equality, as well as equity, because these terms can become confusing, albeit having very important differences and different implications. So let's consider three people.
three individuals. One's a middle-aged man, the second is a young adult woman, and the third is an elderly man.
Each of them needs to be able to look over a six-foot fence to watch a local baseball game. But neither of them is over six foot tall. So therefore, neither of them can see over the fence. So they can't see the baseball game.
Therefore, they are demonstrating physical height inequalities, barring them from addressing and accessing a resource that they seek to enjoy or benefit from. So that problem can be solved in a number of ways, but let's presume that they are each given a one-foot stool to stand on. So the middle-aged man is elevated to a degree that
above the fence to watch the game. However, the woman, being shorter, despite the stool elevation, she cannot. So even though she's gotten an equal elevation, she doesn't have an equal benefit. Now the elderly man in a wheelchair, obviously he can't even get onto the stool. He's disabled.
Yele Aluko (04:35.478)
So while they have each been given an equal opportunity represented as equality, only one of these three benefits from an equal resource. So they've been treated equally. So what I've described now is inequality. Now let's consider that the woman is given a two-foot stool to stand on and the elderly man is given a ramp.
he can roll his wheelchair up and this places him on a safe horizontal bench high enough for him to see over the fence and high enough for all of them the different level of resource intervention
to benefit from seeing the game.
Yele Aluko (05:31.958)
This is equity, whereby different resources are customized to individual needs. And this is done to ensure the same outcome for all three. Does that make sense?
Gayathri (05:47.179)
Thank you very much and I want to draw a point, draw out a thread that you pointed out there. By providing the two-foot stool to the woman and the safe ramp to the elderly man and providing them access to see the baseball game, carrying on with the metaphor, the view of the middle-aged man is not spoiled. Everybody has, everybody can see the baseball game, but nobody is obstructing.
the view of anybody else because they have different resources.
Yele Aluko (06:21.368)
a very good point and that is accurate.
Gayathri (06:26.595)
I think we also need to talk a little bit about the different types of equity, the different concepts around equity that we see around us. So thank you so much for that explanation. And it sets such a strong solid foundation for the conversation that we're going to have. We see words like housing equity and social equity and health equity being used. And like you said, it's come a lot.
it's become a lot more common in our conversations and terminology right now. Would you be able or comfortable telling us about the difference between health equity and social equity? Or societal equity?
Yele Aluko (07:10.826)
most definitely. Yeah, so health equity and societal equity, social equity. Let's start with societal equity. Now, societal equity refers to equitable access to all of societal resources, such as you mentioned housing, such as good and safe housing, good and safe transportation.
a clean environment absent of environmental pollution. Another example is access to quality education, good schools, and transportation that can get you there. Access to relevant amenities like healthy food, access to grocery stores, and also access to healthcare resources.
So essentially it's a broad portfolio of resources that society leans upon to live good, healthy, productive, meaningful lives. When we talk about health equity, it's a much more specific slice within societal equity. And health equity refers to... It speaks of the ability...
of every individual to achieve their maximum life potential, irrespective of their specific social economic background or any other demographics that they bring to the table. Health equity
Yele Aluko (09:01.578)
in this societal equity conversation, access to resources in society that specifically enable good health. And this is a little more granular than what I mentioned in societal equity. It is granular within the health sector and other sectors that intersect with the health sector that leads to access to
healthcare workers and providers, access to health literacy that enables people to have informed decision making around healthy behaviors and habits, such as access to insurance coverage, health coverage, access to affordable medications, and so on and so forth.
So there are commonalities in context, but they're different in that the societal equity conversation is much broader than the health equity one.
Gayathri (10:13.195)
Thank you. And it reminds me of a conversation that you had with Gilbash. I listened to your conversation with him on his podcast Unabashed, which is amazing. So we definitely listen to it. If you have a chance, Gilbash is really great, a common friend. And you mentioned in the context of equity, a very interesting example. And that was the example of two children who are brought up
in very different situations. One in an underserved community, you know, the air quality is not great. The access to food is not that great. On the other hand, we have a child in a normal household, what I'm going to call a normal household or rather a privileged household, I would say, who has access to great food. Air quality may not be great, but has air purifiers inside.
and has all the potential or all the resources that they need for them to, in the common sense of the word, succeed.
These two children, I'm going to take that a little further, may apply to the same universities or to the same job. And they are sitting for the same interviews. They're getting, it's the same application process, largely, especially for the jobs. And it's interesting because both of them will have different ways to access the same insurance that the job provides, right?
There's nothing in place to provide them with additional support to get the job or support to access the perks that a job may provide. Am I making sense in the grand scheme of things or in the metaphor that I am using?
Yele Aluko (12:11.022)
correct.
Yele Aluko (12:19.862)
You most certainly are, and I do remember that paradigm, although I had forgotten that I discussed it with Gil on that podcast. But let me also wind the clock back a little bit on that example. Let us presume that two mothers are in the hospital at the same time. One is African-American, one is Caucasian-American, and they deliver their babies on the same day.
Gayathri (12:33.894)
Mm-hmm.
Yele Aluko (12:49.334)
and the babies are delivered by the same treating obstetricians. Successful delivery, healthy babies, both women and baby are discharged home on the same day by the same discharging team, given the same discharging instructions. And they both get in their cars. One makes a left on Fifth Avenue, the other makes a right on Fifth Avenue.
The one that you described that was brought up in a more nurturing environment that had a nurturing home environment, parental support, and so on, had access to community resources, that's the baby that made a left on Fifth Avenue. Now the baby that made a right on Fifth Avenue
was brought up in the inner city. Crowded housing, environmental pollution at times, and lack of access to resources. And these two turn up, you know, 18 years later to do an examination. So you can see that
The scenario you described, there's a accumulation of life experiences that creates a difference in how people eventually show up through their life trajectories.
Yele Aluko (14:31.792)
Thanks for pointing that out, yes.
Gayathri (14:34.539)
And that was a really powerful example because of it's the reality, right? The left and the right. And it could be the same starting circumstances, but the environment that they have access to can provide so many more opportunities and I would say take away also opportunities. So thank you. Thank you for sharing that.
I live in California in the Bay Area, and the housing inequities seen here, alongside the extreme disparities in income are sobering. California has a higher GDP than most countries in the world. And it's really unfortunate about the people who don't have access to a lot of the...
a lot of the opportunities that income can provide, or rather, as simple as shelter. Dr. Aluka, what, there are a lot of opinions on how to address this, etc. What, according to you, is an example, or what is the commonly held belief that about equity, about health equity that you disagree with?
Yele Aluko (15:56.174)
Well, maybe I should consider that question in the context of what commonly held belief do I, what commonly held belief do I disagree with that people attribute health equity to. And several people consider that there is lack of trust between Black and Brown people in America.
with the health system, doctors, the health industry in general, and there's a school of thought that that's a large contributor to unequal outcomes that black and brown people extract from the health industry and from health interactions. It is indeed true that there's historical
precedent that has resulted over generations, over decades and centuries, that has built up a body of evidence of discrimination and experimentation on discrimination against Black and brown people in the health system. But we have to understand that the discrimination is a systemic societal problem.
and interacting with health facilities and the industry, the health industry is a microcosm of society. So one should not be surprised that you see that there. But it's much more than just mistrust. Mistrust is a factor and we should avoid, we should understand that the African American community population in America
is not a monolithic or homogeneous population. There are very many, several factions, different levels of socioeconomic achievement, increasingly different lived experiences, different levels of educational attainment, much more so now than before. So I disagree with the notion that there is pervasive distrust.
Yele Aluko (18:24.63)
that has caused the degree of health disparities that we see today. Another area of pervasive, well, shall I say, another area that I disagree with is a perception that the intellectual capabilities of Black and Brown people and their genetic makeup, indeed,
is inferior to that of Caucasians. It's a very provocative statement that I've just made, but it does exist. It exists in more subtle manifestations than before, but even overt and covert manifestations as well. And that also impacts the way some health systems, some providers interact with Black and Brown people.
And a good example is, as scientists, we all understand that there is an increased need for diversity in clinical trials.
It's important to have diversity in clinical trials because the results of the clinical trials are relatable to the populations that were studied. And if you don't have a representative complexion within a clinical trial, if it's skewed to one population, we cannot assume that the benefits of the drug being tested
are applicable to all. So it's important that diversity in clinical trials should reflect the complexion of the populations being studied within which drugs and devices are going to be deployed. Now fundamentally clinical research should be for every human body, physical body, and every human biology. There are several biological differences between
Yele Aluko (20:37.798)
women and men, and trials should be designed to reflect that. So where am I going with all of this? What I'm saying is that the failure to develop successful strategies that increase the diversity of clinical trials is oftentimes said African American people
Black and brown people don't trust the health system, so don't bother trying to enroll them. It's also mentioned that, oh, they don't have transportation. They can't come for the necessary follow-up visits. They can't afford the drugs. They don't understand the complexities of clinical research. If you consider that the black and brown population, the black population is 13%.
the Hispanic population is 18%, Asian population is about 4-5%, Native American, Indian 3%. That's about 40% of US population. So if the biopharma industry essentially disregards an entire 40% of America's population and focuses on doing clinical trials in the majority
Yele Aluko (22:02.642)
almost half the US population. And that's a big mistake. That's a big mistake that has real societal consequences that are adverse.
Gayathri (22:16.679)
You brought up three very important points here, and I want to dig into each of them if that is okay with you. You just gave a behind the scenes look into how I would, medical research, almost all research that I know of is done. And in doing so, you...
explained, I think, the foundation of what inequities are or how we see inequities rise, which is blaming, and you're going to use the word blaming here, blaming the individual instead of the system. They have a mistrust of the system. They are not coming. And the reality is that
the society and the systems have failed a lot of the population. What, according to you, should the healthcare system, should the society, society be doing to make Black and Brown Americans feel safe and receive equitable healthcare?
Yele Aluko (23:39.794)
Great question. So yes, there is a renewed awareness of the gravity of disparities. And there's a renewed focus on trying to move the needle to close these gaps in healthcare outcomes.
Let me say that with COVID-19, several people in America thought that what we were seeing was something new. It shocked a lot of people. The information that was being shared about the stark differences in infection rates between black and brown people and Caucasians.
So more Black and brown people got infected. More Black and brown people got admitted to hospitals as compared to Caucasians. More Black and brown people got admitted to the intensive care unit. And more Black and brown people died. And the delta between the death rate between both demographics
was shocking in the same hospital, shall we say, in metropolitan New York City. But what I've just described is really nothing new. For those of us in the health profession, this has been an established observation that has long been validated by research. And the most seminal validation occurred.
in the year 2002 when a publication called Unequal Treatment.
Yele Aluko (25:37.87)
came out of a mission that US Congress asked the Academy of Sciences and the Institute of Medicine to methodically evaluate whether racial and ethnic disparities did indeed occur within the US health industry and its systems. So on equal.
treatment was published 23 years ago. And it scoured through 500 to 700 scientific publications related to health disparities. And it proved without any equivocation that it was not because of an inferior genetic stock that would suggest
or Black people just get more diabetes, or they tend to have more hypertension. But no, it showed that there were several factors which included interpersonal relationships, didn't include genetic background, institutional relationships in the health industry.
issues with funding, issues with process and efficiency, but it did conclude one overriding factor as the main driver, and it was systemic racism in the health industry and its associated systems as the main driver. This is 23 years ago. So this is not new, and it's a very complex problem.
Yele Aluko (27:31.378)
Now we have renewed awareness of the gravity. Like I said, it's a complex and complicated issue because it requires collaboration across a very large ecosystem of stakeholders that are in the health industry, but also outside the health industry.
Yele Aluko (27:53.346)
More attention is now being invested to be successful. It requires long-term planning. It requires empathy and acknowledgement that there are systemic drivers in society. And this problem is not relegated just to the health industry. There are systemic drivers that disproportionately position the vulnerable.
for less benefits within pretty much all aspects of US society.
It does require long-term planning, long-term investment, and realistically, long-term expectations, because what has been happening for 400 years will not be dismantled in four years, but it also will not be dismantled at all if deliberate intention is lacking, and if deliberate strategy and execution doesn't happen.
Gayathri (28:32.052)
Thank you.
Gayathri (29:01.359)
It's also to add to that there is an element of accountability and checkpoints there that is required. It is long term but the progress needs to be reported in some form and only if that progress is reported will we make progress and I'm using the word progress way too many times. What I'm trying to say is that
What is done in 400 years cannot be dismantled in four years. It may need a 40-year plan. But every four years, there can be a checkpoint where progress or what's done is reported, potentially reviewed, and a pivot is taken, if necessary, to continue the work.
Yele Aluko (29:54.446)
Well, this is very true. I did say I described the genesis of unequal treatment and I mentioned that it was published in 2002. So I'll tell you very quickly some work that my team at EY, at the EY Center for Health Equity has done. Earlier this year we published a report that looked to see how much financial investment
had been put into attempting to solve the health disparity conundrum, how much had been put since 2002 when an equal treatment was published, and now. So it was somewhat of a 20-year retrospective.
And we were able to demonstrate that over the past 20 years, almost $200 billion had been invested into this space, seeking to close gaps in health disparities. That number was obtained by very meticulous research and using data from publicly available sources.
So we know that it's more than that number of almost 200 billion, at least that. And then we looked at the disparities back in 2002 and the disparities in 2022. And the truth is that the gaps haven't closed. Now, I hope you hear me loud and clear when I say they haven't closed. So there has been some improvement in population health. For example,
There's been a gradual increase in life expectancy in America over the past 50 years, and the last 20 years is part of that. So the life expectancies between white women and black women, white men and black men, have persisted for a while, but they've both increased, improved over 20 years. But what hasn't changed is the gap, the number of years between them.
Yele Aluko (32:12.874)
So $180 to $200 billion.
invested, no gap closure, and you bring up the issue of accountability. And it is true.
There's a lot of work going on in this space, but the work we do at the US End of Health Equity has unearthed the fact that you can't conflict busyness, busy work, with action. You can be very busy doing work, but not being successful in achieving goals.
You mentioned accountability, I'll go back to that. So one of the reasons why we failed is because there hasn't been consistent development of deliberate and intentional strategies designed to close gaps in a holistic manner, the long-term view. Also there has not been accountability for strategy.
that provides periodic and necessary look-backs to see if goals are being met and to recalibrate and revisit if they aren't. So I agree 100% with you.
Gayathri (33:43.103)
That's fascinating. Is the report available for publicly?
Yele Aluko (33:49.546)
Oh it is, and I'm happy to send it to you.
Gayathri (33:51.887)
Okay, I will share it in the show notes. I think. I think
Yele Aluko (33:55.574)
And it's actually on, you can get it off the internet. If you go to ey.com, Health Equity, you will find it there.
Gayathri (33:59.59)
Okay.
Gayathri (34:09.851)
Okay, ey.com slash health equity. And I will also share the report in the link in the show notes for those who want to explore further. In addition to the accountability piece, you brought up another element that I think is important for us to pause on or spend some time on. It's about...
Yele Aluko (34:12.909)
Correct.
Yele Aluko (34:21.806)
Fantastic.
Gayathri (34:39.599)
what I'm going to say, dehumanizing people of different races or are disassociating from people of different races, assuming that they have different genetic makeup, different IQ, etc. One of the books that you recommend that people wanting to get into impact work read is Medical Apartheid by Harriet Washington. And the book
describes the atrocities that were carried out on black Americans in the name of medical research.
We've seen elements of this atrocities conducted in different parts of the world on the Jews during the Holocaust in Germany, to Indigenous Americans in Canada, to Indian soldiers during the British rule. And again, it's a way of dehumanizing people who are different in the name of saving other humans. What can you tell us why the book holds such significance?
for people looking to make a change in the world, especially if they are not in the health industry. I think this is applicable across different industries. There's a lot to learn from here, but from your perspective, Dr. Aluko.
what are the different ways we can learn from history in our daily work, but also from the book.
Yele Aluko (36:09.494)
Right, so that's a very good great question. And it requires deep introspection because Medical Apophite written by Harriet A. Washington is a book that, and I have it on my office desk now, I'm looking at it. And it states Medical Apophite, the dark history of medical experimentation on black Americans from colonial times to the present.
on the front cover and on the back it says the first full history of black america's shocking mistreatment as experimental subjects at the hands of the medical establishment. It says shocking, sobering, and immensely consequential in its implications. It's a comprehensive history of the abuse of medical experimentation on black people who have for
and unwitting subjects. I want to emphasize that it speaks to experimental subjects at the hands of the medical establishment, which speaks to societal involvement, systemic involvement. And it is a very compelling narrative of the fact that this practice
has been perpetuated for centuries and that it has not actually stopped. It has stopped in the manner that it is no longer overt, but there are more contemporary and subtle manifestations of it. A lot of people have heard about the Tuskegee experiment, where black men were subjected to...
Black men who had syphilis, as you well know, were subjected to observations over 40 years during which treatment was withheld so that medical science could understand what we call the natural history of syphilis. By natural history in medicine, we mean, what happens to a disease process if there's no intervention?
Yele Aluko (38:37.77)
upon the disease. For example, the natural history of some people that have a heart attack is death. Not all, but some that have a heart attack will die absent of intervention. The natural history of syphilis at the time was not known. So the experiment was done.
to find out why. Some people have heard about Henrietta Lacks, a woman who had ovarian cancer, cervical cancer, and her tissue, part of her tissue was cloned without her permission, and became the substrate for drug development.
that expanded into a global benefit and resource that delivered billions of dollars to the biopharma industry. There are many Tuskegee's and there are many Henrietta Lacks's. The commonality is that there has been medical experimentation. It's important to know this so that it gives
mainstream society a better understanding of the degree of experimentation and the degree of societal callousness that occurred in the past. It by no means is saying that everybody who works in the health industry today is callous. But we can't ignore the fact that
those experiences have been passed down through kitchen table dinner conversations and mistrust has occurred, not just because of those two, but because it was much more pervasive than people know. And to solve this problem, we need the acknowledgement, but more importantly, the empathy and the acceptance.
Yele Aluko (40:59.202)
that it is part of the problem that we see today. And having that acknowledgement and empathy, mainstream America can come to the table together with those impacted and others to begin to develop strategies informed by the sentiment of the impacted, informed by the vulnerabilities of the impacted, so that everybody can move together.
not with an accusatory tone, but more so with a partnership intent to begin to constructively close gaps.
Gayathri (41:45.471)
you described the process in a way that is approachable and almost relatable. What you said about it being a medical decisions made by the medical establishment, but also decisions made around the dinner table is something that is true, but also shows that there are things that can be done within
the circle of within each of our circles of influence. And I think your career is a great example of that, where you you've got a storied career. And I'm sure a lot of our listeners are wondering about the amazing journey that you've taken from cardiologist to clinical practitioner, clinical lead, head of hospitals to the amazing work that you're doing at the
as EY's Chief Medical Officer. Would you mind sharing a little bit about your journey and maybe sharing some advice that you had wished that you heard when you were younger?
Yele Aluko (42:59.686)
Yeah, so it's been a multi-decade journey. I practiced cardiology for 25 years, and I've been with EY for about six years now. But I was born in Nigeria in West Africa, and my interest in the health profession occurred on a very specific day. I was 15 years old in high school.
and I was going to, my mother asked me to come with her to visit a family friend in a university teaching hospital. And we were walking through the emergency room to get into the hospital when I actually literally saw a person die in the emergency room. A gentleman brought his wife to the hospital in a taxi and he and the taxi driver
were trying to get her into the emergency room and he was weeping and crying, please help me, my wife is dying. And they eventually mobilized her on a stretcher and she literally was dead. And I, as a young teenager, saw that. And very naively and altruistically, I said to myself, I'm going to become a doctor because I don't want this to happen to a family member of mine. But be it as it may, I was good in the required.
scientific preparation. And I went to medical school, became a physician. I came to America shortly after finishing medical school in Nigeria. And I did a residency and a fellowship and a couple of other specialty fellowships in cardiology. And I began practice. I practiced to a large degree of fulfillment.
and I would say impact. My practice was all in Charlotte, North Carolina. And when I left clinical practice, I was the senior vice president of the Heart and Vascular Institute, and I was medical director of that institute. That spanned 14 hospitals across four states, North Carolina, South Carolina, Georgia, and Northern Virginia. So the question is, why did I leave clinical medicine? Well, about,
Yele Aluko (45:21.006)
12 years ago I went to business school to do an MBA. And I never had the intent of leaving the bedside. But I went to do the MBA because I wanted to be a better prepared administrator of the governance portfolio that I had been asked to manage.
I learned a lot in business school. Doctors in general, on average, have narrow guardrails of emotional intelligence for a very simple reason. Right from medical school through residency training and fellowship and practice, it's a hamster wheel that doesn't stop. And one is flung within a very homogenous ecosystem that includes doctors and nurses and patients and families.
and a lot of work that you really don't have time to think about anything else. And there's a whole world outside of those guardrails that impact what physicians do, how patients get access, how hospitals survive, that we have no idea about. But in business school I learned that much more intuitively and realized that the training I got from business school, I could take it back to my organization.
and approach clinical care, both from a clinical perspective, from a business perspective, by introducing processes that improve patient outcomes and control costs, and were geared to drive best outcomes with patient satisfaction.
So I was able to do that after I finished business school. But having done that, I continued to get, I developed gradually an interest to go into a different type of ecosystem where I could drive broader impacts in a different way. So I was seeking a louder megaphone as well as a broader geographic footprint, which EY has afforded me.
Yele Aluko (47:35.166)
in that he was a global organization. It has tentacles into a very large portfolio of industry clients, multi-industry clients. And my industry is the health industry. And it has provided a platform for conversations with industry leaders across the health value chain, includes health systems and large physician groups.
We call those providers. Health payers, the insurance companies. And we're going to talk about the benefits of the insurance
life sciences, which is broken into bio-pharma and medical devices, as well as public health. And in addition to those, the regulatory bodies, Health and Human Services, CMS, and that's an entire ecosystem that has large implications for that impact barriers that exist.
I made that decision after a two-year reflection and took a calculated risk to leave the world that I had known and the profession that I had built successfully to engage in larger conversations on the more macroeconomic perspective. And I have no regrets. I did not leave because I was burnt out.
Yele Aluko (49:15.352)
I have no regrets of all the decisions I made during my career and no regrets that I've left my career as a practicing doctor.
You asked a second question, I believe.
it had to do with what would I advise a younger person. If I look through the rearview mirror and think about where I was when I was a younger doctor.
I would have explored earlier much more opportunities other than clinical medicine. Now I'm not suggesting that doctors should not stay in clinical medicine by any means, but I am saying that if I knew what I know now, I probably would have first of all out of stadium medicine, out of down cardiology.
I probably have practiced cardiology for 10 years and done an MBA much earlier and I might have left the bedside much earlier with the deliberate intent to do what I have done later in my career to find a platform that provided broader impact, not minimizing the individualized impact.
Yele Aluko (50:44.642)
that doctors and nurses deliver every day they go to work.
Gayathri (50:55.219)
That is an inspiring path. And I think there are a lot of lessons to be learned and a lot of things that we can learn about the opportunities and about taking what can seem to be a scary, but brave step to make larger impact in the world. So thank you for sharing that. And I think I'm inspired by it. And I hope that a lot of our listeners will also look at exploring different career parts that
is that can build upon what they have already created so far. And leaving a career that you love, leaving a job that you love is not a sign of burnout. Very often, it's because you either want to do something different or you think there is opportunity for a larger change. And truly, the work that you do at the EUI Center for Health Equity is testament to that.
Where can our listeners find you and is there anything else that you would like to share with them?
Yele Aluko (52:02.454)
I'm on LinkedIn, so that's an easy way to find me. Easy to find over there. And if anybody wants to reach me directly through LinkedIn, then we can share email addresses thereafter and maybe telephone numbers. And if there's an interest in connecting one-on-one, I'm happy to do so. So, if I close with anything.
let me just say the following that I have hope that I have hope and optimism that things will change going forward. You know, fundamentally I'm a glass full kind of person. I am not pessimistic. That doesn't mean that I am naive by any means. I am very aware of the societal structures that have created these impediments over centuries.
in regards to adverse and detrimental outcomes. I don't tend to dwell on obstacles in front of me. I like to know where they are, and I want to figure out how to navigate around them so that I can keep moving forward. Now that has worked for me in my life, and even though it isn't easy by any means, and it has not been easy.
Yele Aluko (53:30.034)
everybody has obstacles that they encounter, irrespective of their backgrounds, but maybe people like me tend to get more than others. I do, I said I was optimist, I'm an optimistic person, but and I firmly believe that fundamentally there are more good people in this country than bad. So it gives me hope that
the empathy, the resources of broader partnerships and ecosystems, over time we shall overcome these problems that we've talked about today.
Gayathri (54:15.723)
And that's a wonderful closing. Thank you so much for joining us on the inaugural season of Changing Tomorrow, Dr. Luko. And that's a wrap.
Yele Aluko (54:26.37)
Thank you very much.
Gayathri (54:28.383)
Thank you so much. This was really great. I'm...