Rachel Levine, MD, Reflects on Her Years at Mount Sinai and Her Historic Confirmation

Updated on Jun 30, 2022 | Diversity and Inclusion, Featured, Public Health

Rachel Levine, MD, was sworn in as Assistant Secretary for Health on March 26, 2021.

Rachel Levine, MD, a longtime leader in public health, was sworn in as Assistant Secretary for Health in the Department of Health and Human Services in March 2021—making history as the first openly transgender federal official to be confirmed by the U.S. Senate. Dr. Levine, who began her medical career at Mount Sinai, recently took part in an interview with Mount Sinai Today about her years of training and the road ahead.

Dr. Levine took on her new post after nearly 40 years in adolescent health and public health, most recently serving as Pennsylvania’s Secretary of Health. At her confirmation, she said, “I am both humbled by the opportunity and ready for the job.”

 

As a young physician at Mount Sinai, was becoming a national leader in public health one of your goals?

I received fantastic training in pediatrics and adolescent medicine at Mount Sinai, and at the time I really saw my career in academic medicine. I did my residency program at Mount Sinai from 1983 to 1986. I was chief resident from 1986 to 1987. I did my fellowship from 1987 to 1988, and then I was part of the voluntary faculty and kept my association with Mount Sinai through 1993, when I left to go to the Penn State College of Medicine. It was 10 years of association with Mount Sinai, and I found it to be absolutely wonderful. But I actually did not see myself in the type of role that I have now.

Were there experiences at Mount Sinai that you found especially formative?

Serving as Chief Resident of Pediatrics at The Mount Sinai Hospital was really one of the formative leadership experiences of my life. I had a tremendous amount of responsibility in terms of leading 25 to 30 residents, helping them with all the patients on all the floors, dealing with emergencies, and taking on administrative responsibilities for the unit—all under the mentorship of Kurt Hirschhorn, MD, then the Chair of Pediatrics, and Alexander Hyatt, MD, the Vice Chair. In years since, I think the job has been divided among two or three people, so the Chief Resident in 1986 had a lot of responsibility. I kind of joke that only now have I finally found a job that equals being Chief Resident of Pediatrics at The Mount Sinai Hospital.

Dr. Levine was the keynote speaker at Mount Sinai’s White Coat Ceremony in 2015.

Could you talk about a few of your mentors at Mount Sinai?

Probably the biggest mentor I have had in medicine is Dr. Hirschhorn, Professor Emeritus of Pediatrics, Genetics, and Medicine, and Chairman Emeritus of Pediatrics.  He is just an outstanding academic medicine physician, and he was a great chair and mentor. One of my most vivid memories of Mount Sinai was morning reports, where we would present the cases that came in the night before, and Dr. Hirschhorn was always there. We would discuss the admissions and then the diagnoses and the challenges, and it was a fantastic formative learning experience.

There are so many other mentors I could name, including Dr. Hyatt; Scott Barnett, MD; Les Jaffe, MD, who was head of the adolescent program during my entire time at Mount Sinai, and Angela Diaz, MD, PhD, MPH, Director of the Mount Sinai Adolescent Health Center. Dr. Diaz was a third-year resident when I was an intern and an attending in the adolescent clinic when I was a fellow. That may not seem like much of a difference, but she was senior to me, always a couple of years ahead. What I remember most from those days was her great compassion and dedication. Then and now, she is passionate about adolescent medicine and taking care of teens in the community.

The COVID-19 response was one of your top priorities as Pennsylvania’s Secretary of Health and in your federal position now. What are the biggest challenges in the pandemic now?

Our main focus now is the vaccination program. For months it was supply and the challenge of distribution and administration. But I think we are exactly at that tipping point where the most important challenge is vaccine hesitancy. Through the efforts of the Biden-Harris administration, we now have adequate supply of three safe and effective vaccines, but we now need to work past people’s hesitancy about the vaccines. One role that I hope to play is helping with this messaging as the vaccines receive Emergency Use Authorization for adolescents and perhaps younger children.

What are your other top priorities as Assistant Secretary for Health?

Addressing the continuing issue of the opioid crisis and overdoses is an important priority. We are also focusing on the public health impacts of environmental health and climate change. In an executive order, President Biden has created a new Office for Climate Change and Health Equity, and that is part of my office. As our climate changes and we look at the public health impacts, we want to make sure that we’re looking at vulnerable communities—African American communities, Latino communities, and American Indian and Native Alaskan communities. We know that there are significant health disparities, and we’re concerned that these communities are bearing the brunt of the impacts of climate change. We want to study these disparities and develop policies to address them.

What does the historic nature of your appointment mean to you?

I like to say that I may be the first transgender federal official to be confirmed by the Senate, but I won’t be the last. And here I’m building on a quote from Vice President Harris, who said that as a Black and South Asian woman, “I may be the first to hold this office, but I won’t be the last.” We’ve come a long way in the LGBTQ community, but we certainly have a long road ahead. We need to raise awareness, and we need to work in terms of health equity for LGBTQ individuals, particularly LGBTQ youth.

You were confirmed by a bipartisan vote of 52-48, but in your hearing you faced some opposition and adverse reactions. How do you handle this kind of situation?

I really think that any hostility comes from a place of fear—that people fear what they don’t understand, and so I want to educate people. Even my being the Assistant Secretary for Health shows people that transgender individuals and LGBTQ individuals are like everyone else. We’re physicians; we’re teachers; we’re lawyers; we are everywhere in society and in our government as well. And I want to show LGBTQ youth that with hard work and perseverance you can be anyone, and you can be anything.

Colleagues Salute Rachel Levine, MD:

“Dr. Levine’s appointment is both historic and emblematic of how far we have come in recognizing the accomplishments and the contributions of LGBTQI people to making our health care and our society more equitable, inclusive, and compassionate for all. Mount Sinai gave Dr. Levine a powerful foundation to build on, and today it is meaningful that during Pride Month 2021, we celebrate one of our alumni and acknowledge our ongoing commitment to enhancing and expanding service, education, and advocacy for the diverse LGBTQI communities we serve.” -Barbara Warren, PsyD, CPXP, Senior Director, LGBT Programs and Policies, Mount Sinai Office for Diversity and Inclusion

“I could not be more thrilled for Dr. Levine, or more proud of her. She is enormously accomplished and a fierce proponent of health equity, adolescent medicine, and transgender health—all critical issues that are close to my heart. We worked together when she did her pediatric training and Adolescent Medicine fellowship at Mount Sinai. I could see even then just how talented, dedicated, and compassionate she was. Dr. Levine’s confirmation is a truly historic moment, and I cannot think of anyone more deserving.” – Angela Diaz, MD, PhD, MPH, Director of the Mount Sinai Adolescent Health Center

“During her confirmation hearing, Dr. Levine never lost protocol. She remained very strong and confident in where she was coming from, and that resonated with what I remember about her back at the Adolescent Health Clinic. I never ever saw her get upset about anything; she was always so competent, calm, and confident, and the patients really liked her as their physician. I’ve enjoyed following her career, and she is a perfect fit for the position.” – Leslie Jaffe, MD, Director of Mount Sinai Adolescent Health Center, 1982-1989

”Dr. Levine is a great communicator with a passion for public health, and she will do a great amount of good in her areas of focus, which include opioid addiction and the COVID-19 response. That she has also been willing as a trans woman to stand up and be so visible is very important for other trans people to see for reassurance and for cisgender people to see as we break down barriers. It is an honor for us at Mount Sinai to be associated with a pioneer in an area where we now take a leadership role.” – Joshua D. Safer, MD, Executive Director of the Mount Sinai Center for Transgender Medicine and Surgery

Read more featured stories about Mount Sinai.

Living With Vision Challenges During the Pandemic

Updated on Jun 30, 2022 | Community, Diversity and Inclusion, Ophthalmology

Large-type keyboards help improve accessibility.

Lighthouse Guild, an organization dedicated to providing services that inspire and support people who are visually impaired to attain their goals, was the featured organization during a virtual talk hosted by the Mount Sinai Office for Diversity and Inclusion (ODI). The organization provides coordinated care for eye health, vision, and rehabilitation, as well as behavioral health services. The talk entitled, “Living With Vision Challenges During COVID-19,” is available here.

Janet Weinstein, Director of Outreach for Lighthouse Guild.

“During the COVID-19 pandemic, people with low vision have had increased difficulties with the restrictions and safety precautions we have all been taking, especially as people are getting out more,” said Janet Weinstein, Director of Outreach for Lighthouse Guild. “We specialize in vision rehabilitation—that is, equipping people to resume their activities of daily living with the vision that they have, or for those who are blind, developing alternative techniques.”

In the educational session, Ms. Weinstein described the various types of vision loss, including macular degeneration, diabetic retinopathy, glaucoma, and cataracts. The talk was part of the Raising Disability Awareness Virtual Talk Series. The series, launched by ODI in 2020 for Disability Awareness Month, featured speakers from around the Mount Sinai Health System and the community to raise awareness and promote an inclusive and equitable workplace and health care environment for people with disabilities.

Lisa Beth Miller, LCSW-R, Outreach and Referral Coordinator for Lighthouse Guild.

Lisa Beth Miller, LCSW-R, Outreach and Referral Coordinator for Lighthouse Guild, discussed how the COVID-19 pandemic affected changes in lifestyle for people with vision impairments. While social distancing and wearing masks became the norm, Ms. Weinstein stressed the importance of navigating cautiously when away from home, using gloves or tissues when touching handrails, and embracing technology, such as apps with audio description and magnification features to help maintain social distance.

During the pandemic, telephones and personal computers became even more important for people with vision loss, allowing them to access telehealth and stay connected with friends, family, classes, and work, Ms. Miller said.

Lighthouse Guild is dedicated to providing resources to those who may need eye exams, education or rehabilitation services, including technology assessments and training, to address vision challenges. Ms. Miller said that “it makes a huge difference in someone’s life to know they’re not alone,” and encouraged participants to consider themselves ambassadors for those who may have vision problems, to support them in their needs. More information on the organization can be found at the Lighthouse Guild site.

Additional disabilities-related resources are available on the Mount Sinai Office for Diversity and Inclusion site.

Read more about Diversity and Inclusion at Mount Sinai.

Noted Historian Lonnie G. Bunch, III, PhD, Discusses COVID-19, the Death of George Floyd, and Combating Racism in Health Care

May 26, 2021 | Community, Diversity and Inclusion, Featured

During the week leading up to the Icahn School of Medicine at Mount Sinai’s 52nd Annual Commencement on Friday, May 14, medical student Rachel Wilkinson held a virtual “fireside chat” with historian and educator Lonnie G. Bunch, III, PhD, Secretary of the Smithsonian Institution. At Icahn Mount Sinai’s Commencement, Ms. Wilkinson received her medical degree, and Dr. Bunch—Founding Director of the Smithsonian’s National Museum of African American History and Culture, which opened in 2016—was awarded an honorary Doctorate of Humane Letters.

Their 50-minute discussion centered on race and history and how the COVID-19 pandemic and the death of George Floyd will be remembered by future generations. Without a doubt, Dr. Bunch said, the past 18 months mark one of the most important periods in American history.

Dr. Wilkinson: How will the story of 2020-2021 be told in years to come?

Dr. Bunch: George Floyd’s murder, the insurrection at the Capitol on January 6, the devastation of COVID-19 on Americans generally and on people of color specifically—that is something historians will be writing about for generations to come. There are many moments in history that are an inflection point, where it illuminates all the dark corners of our experience, and that’s what these last two years have done: they’ve forced us to confront so many things etched by racism.

The challenge for historians is what will happen. Is this going to be a sprint that ends or a long wave that allows us to be a more transformative and fairer nation? Are we a country that lives up to our ideals or the country that realizes fairness is limited and only certain people have access to the American dream?

Dr. Wilkinson: Is there something missing that people are getting wrong about the past year and a half?

Dr. Bunch: You want people to realize this is not someone else’s story, but their story too, regardless of race, regardless of how long their family has been in this country. If we can get people to realize we’re in this together then there’s hope for a future.

Dr. Wilkinson: Thousands of us are graduating this year as doctors and biomedical scientists, and we’re trying to understand what our role should be in combating racism. What do you see as the role of health care providers?  

Dr. Bunch: The fundamental challenge is that the public health profession has used people of color as subjects rather than patients, and there is concern about fairness within the health care system. Your profession needs to embrace its history. Your profession needs to understand that it has contributed to some of the best and some of the worst outcomes in health care. Understand it, own it, and begin to look internally at what that means—a broader, more inclusive group of people going through medical school. Your job is to master your profession and to recognize that it’s not enough to be a good doctor; you’ve got to be a good person and fight the good fight.

Dr. Wilkinson: Where does medical education fit into confronting racism or injustice, overall?

Dr. Bunch: I hear many doctors say it’s a personal choice how you live your life, eat, and exercise. But it’s also a fact that if you live in Princeton, New Jersey, versus living in Trenton, New Jersey, you have a much longer life expectancy. We have to confront these issues and make sure we create a culture where health care is accessible and given fairly to all. It means you’re going to have to confront structural racism and assumptions, and when people of color come into an emergency room you’re going to have to think about them a little differently than what your initial reaction might be, that you’re being fair in giving them the treatments they need.

Dr. Wilkinson: How can health systems push the envelope on racial justice?

Dr. Bunch: I don’t want to hear doctors saying, “I can’t get out of my lane.” Your lane is really the whole system of health care. The health care community has a lot of power, a lot of resources. John Lewis (the late politician and civil rights leader), used to say to me, “Despair slows you down.” For the medical profession it’s time to own the challenge.

Dr. Wilkinson: What are you most proud of in terms of our nation’s progress toward racial justice? 

Dr. Bunch: As a historian, what’s clear to me is that America has moved in dramatic ways. What I take from history is the sense that change is possible but change is not permanent. We’ve seen moments of great leaps forward and moments of moving back. What concerns me the most is the belief that success for an individual means success for all, and that’s not true. There are people of all genders and races who you can point at and say, “Look, we have a woman CEO of a Fortune 500 company, or we have an African American.” Individual success is key, but until that trickles down to the entire community it really is just an anomaly, not the way it should be. You’re only successful if the group furthest removed from success is beginning to reap the benefit of that success.

Dr. Wilkinson: Where do we find sources of hope?

Dr. Bunch: I find hope in history. History is a reservoir I dip into and I see (the abolitionist and statesman) Frederick Douglass and Madam C.J. Walker (the first Black female millionaire in America). People who didn’t give up, people who should have given up. I also get hope from people like you and my daughter (an emergency medicine physician), people who are doing things I could never have imagined, people who say, “I will be the best in my profession and the best person of color I can be.” When I talk to people around the world—from Italy and Israel and London—and I hear them saying, “Black lives matter.” I take hope from the fact that we’re now in a world where it’s harder to keep secrets. By illuminating examples of horrible moments you can change and address those.

Dr. Wilkinson: What motivated you to take on the massive challenge of building the National Museum of African American History and Culture?

Dr. Bunch: This idea of building a museum was floating around for 100 years and began with Black Civil War veterans saying, “Why not tell our story too?” I realized if we could build a national Museum of African American History and Culture on the Mall (in Washington, D.C.) as part of the Smithsonian, that would nurture the souls of my ancestors so that African Americans would not be seen as an ancillary story but central to who we are as Americans. It’s not just a story of woe is me or pain. It’s a story of resiliency.

My favorite part of the museum is helping people understand how important slavery is to all of us—that these are people whose lives dramatically altered America. Resiliency is really at the heart of the Black experience.

Watch the full discussion
Read more Featured stories at Mount Sinai

Language Services Supports Mount Sinai’s Most Vulnerable Patients

May 12, 2021 | Community, Diversity and Inclusion

Interpretation and translation services are available at the bedside and to patients’ family members.

The COVID-19 pandemic presented many challenges for the Language Services team at the Mount Sinai Health System. The team provides language translation and interpretation services to support patients with disabilities and those with limited English proficiency. Their offerings include interpretation services on the front lines and keeping family members informed. In response to COVID-19 protocols in place, the Language team developed and deployed tools and initiatives, such as video remote interpreting for meetings, clear masks, sound amplifiers, and “proactive rounding” to ask patients and families about their needs.

The session, “Better Together—Leveraging Our Values to Serve Our Most Vulnerable Patients During the Pandemic,” was hosted by the Mount Sinai Office for Diversity and Inclusion and delivered by Silvina de la Iglesia, Associate Director of Language Services at Mount Sinai. Ms. de la Iglesia highlighted Mount Sinai’s core values, which are safety, agility, creativity, empathy, teamwork, and equity, and said the pandemic had made interpreters more essential than ever. The talk can be viewed here. Click the “cc” button for closed captions.

Silvina de la Iglesia, Associate Director of Language Services at Mount Sinai.

The talk was part of a series featuring speakers from around the Mount Sinai Health System, as well as the community, to raise awareness and promote an inclusive and equitable work place and health care environment for people with disabilities. “In the pandemic, we have had the opportunity to translate our core values into action,” said Ms. de la Iglesia.

Delivering high quality interpretation services and accommodations while following COVID-19 precautions was challenging, she said. Many of the services the program provides were adapted to be offered on a remote basis, causing staff to provide interpretation and auxiliary services via Zoom, FaceTime, and other telehealth platforms. Communicating effectively is key when it comes to the patient safety and meeting the needs of patients with disabilities and other vulnerable populations. With public health measures in place to prevent the spread of COVID-19 among internal staff and external vendors, staff had to be creative in how they delivered services. This included deploying new assistive devices, as well as using clear masks for patients who are hard of hearing and require lip reading as a means of communication.

According to Ms. de la Iglesia, to elevate the patient experience means not only adapting to the pandemic with technologically advanced devices, but also remaining true to the empathetic values held by the Health System and connecting patients with their loved ones. To learn more about the services offered, please visit the Language Services webpage.

“There’s always more work to do when it comes to disabilities,” Ms. de la Iglesia said, such as, adding more services for people with limited English proficiency or health care literacy. “The spectrum is so broad that we could never cover it all, but at least with different efforts to raise awareness, engaging the community in daily operations, and listening to feedback, we do better for our patient.”

Additional disabilities-related resources are available on the Mount Sinai Office for Diversity and Inclusion site.

Read more about Diversity and Inclusion at Mount Sinai.

Living a Full Life With Hearing Loss

Updated on Jun 30, 2022 | Community, Diversity and Inclusion

Jonathan Taylor, PhD, President of the New York City Chapter of the Hearing Loss Association of America.

People with hearing loss have widely varying needs and challenges, and accommodations such as captioning, clear face masks, and general awareness can greatly improve quality of life. This was the message of Jonathan Taylor, PhD, President of the New York City Chapter of the Hearing Loss Association of America (HLAA), during a virtual talk hosted by the Mount Sinai Office for Diversity and Inclusion (ODI). The talk can be viewed here. Click the “cc” button for closed captions.

“People are always eager to help, but may not always understand the needs of those with hearing loss,” Mr. Taylor said in the session, “Living a Full Life With Hearing Loss,” which was part of the Raising Disability Awareness Virtual Talk Series. The series, launched by ODI in 2020 for Disability Awareness Month, featured speakers from around the Mount Sinai Health System as well as the community to raise awareness and promote an inclusive and equitable work place and health care environment for people with disabilities.

Mr. Taylor’s hearing loss stemmed in part from his career as a freelance classical trombonist. The loud sounds from the trombone progressively affected Mr. Taylor’s hearing abilities. Eventually, Mr. Taylor had to stop performing, but he continues his passion for music by doing administrative work with orchestras. He also earned a doctorate in developmental psychology and has built a career in educational research.

Clear masks may be used for effective communication with people who are hard of hearing. Above, Maura Cosetti, MD, Director of the Ear Institute at the New York Eye and Ear Infirmary of Mount Sinai, consults with a patient.

As a strong advocate for people living with hearing loss, Mr. Taylor discussed the social and medical effects of hearing loss. Aside from social isolation, which could lead to depression and dementia, hearing loss may have other health implications, he said. For example, older adults with hearing impairment are twice as likely to fall due to balance issues related to the inner-ear.

The COVID-19 pandemic has also presented new challenges for the hearing loss community. Many people who experience hearing loss depend on reading lips. Wearing masks to prevent the spread of COVID-19, however, has made it impossible to read lips. Mr. Taylor stressed the value in using clear masks during this time to address this issue.

The Patient Experience team at Mount Sinai did an initial distribution of Clear Masks™—approved by the FDA and Mount Sinai Infection Prevention and Control—to raise awareness at all eight hospitals, and notified nursing leaders of the availability of these masks. Materials Management made sure to keep an adequate inventory to supply units that request additional clear masks. The use of clear masks for effective communication with patients who are hard of hearing was also included in training sessions related to Patient Safety, ADA Awareness, and mandatory Annual Core Education.

Resources and Information

Establishing and fortifying partnerships with public and private programs, as well as providing closed captioning, hearing loops (a sound system that transmits to hearing aids and cochlear implants), and educating clinical staff on the importance of using transcription apps during medical visits are all ways to enhance access for people with hearing loss. The HLAA’s mission, according to Mr. Taylor, is “to serve as an extension of the national organization by promoting the philosophy of self-help while specifically addressing access advocacy, awareness, and education.” More information about the Hearing Loss Association of America can be found on its site.

The Ear Institute at New York Eye and Ear Infirmary of Mount Sinai is a close partner with the community and HLAA, says Maura Cosetti, MD, Director of the Institute, adding that staff from the Institute were recently invited to address Mr. Taylor’s chapter on the relationship between hearing and balance. More information about hearing loss support is available here.

Additional disabilities-related resources are available on the Mount Sinai Office for Diversity and Inclusion site.

Read more about Diversity and Inclusion at Mount Sinai.

Supporting People With Developmental Disabilities in the Workplace

Updated on Jun 30, 2022 | Community, Diversity and Inclusion

Ben Adler is an intern in Talent Acquisition and Retention, Human Resources, at the Mount Sinai Health System.

Providing people with developmental disabilities job and internship opportunities benefits all concerned—by allowing the employees to maximize their independence while also enhancing disability inclusiveness and diversity of thought in the workplace.

This was the message of a virtual talk by leaders of the Adaptations Job Program, a job-services program made possible with support from public and private donations and a Mount Sinai partner since 2018, to create a holistic approach to job development for adults with disabilities while allowing the participants to embrace their individuality and learn job skills. The virtual talk can be viewed here.

The session, “Best Practices for Supporting People with Autism Spectrum Disorder (ASD) and Developmental Disabilities in the Workplace,” was hosted by the Mount Sinai Office for Diversity and Inclusion. It was part of a special series featuring speakers from around the Mount Sinai Health System as well as the community to raise awareness and promote an inclusive and equitable work place and health care environment for people with disabilities.

“In order to be independent, you need the financial means to live a full and happy life, and we believe that employment is a crucial component of that life,” said Andrea Goodman, MA, M.Ed, LCSW, Director of the Adaptations Job Program, who led the event with Ilana Shachat, MSc.OT, Employment Specialist with the Program.

Neurodiversity in the workplace also leads to an overall organizational culture where all individuals are respected and feel they belong. According to Ms. Goodman, through interactions with participants, there are changes in people’s attitudes in regard to people with disabilities, to a more positive one as people learn and understand different learning styles and appreciate their differences.

Best Practices in the Office

Best practices for employers include a clear communication strategy—explaining the goal of the project, giving one instruction at a time, giving instructions in writing, and using straightforward language, Ms. Goodman said. It is also important to explain priorities, discuss how much time a project or task would take to complete, and if possible, provide examples of what a finished project looks like.

The Adaptations Job Program is an integrated social, recreational, and vocational program, Ms. Goodman said. It works with participants and employers in maximizing the participants’ strengths in the workplace so that they could be productive employees. The program has both a person-centered and business-driven approach, so that the needs of the businesses are met through the intern placements and by offering a pipeline of talent. For more information, visit the program’s site.

Additional disabilities-related resources are available on the Mount Sinai Office for Diversity and Inclusion site.

 

Read more about Diversity and Inclusion at Mount Sinai.

Pin It on Pinterest