KK: Leon, what are your thoughts on leadership and limitations that you’ve overcome but maybe others haven’t?

LH: I think there’s a challenge for people because there are people who don’t want the extra burden they may have to deal with because there are, when you become an administrative leader or clinical leader, a lot of tasks that come with those roles. I think the art of mentorship has gone away for many folks. There aren’t as many mentors out there that are available to spend the time necessary. I think trying to find enough people who want to be mentors, particularly to women, African-Americans, and underrepresented minorities, is harder.

KK: I read an article that was very intriguing to me in JAMA.¹ The concept was the minority tax. Your thoughts?

LR: I think there’s a psychological burden in terms of this tax, and I think that it is carrying the hopes and expectations of a whole people with you and knowing that, if you fail, the failure will be blamed upon your inferiority as a member of an inferior race. That does add a lot of pressure. There’s also a very tangible aspect to this black/minority tax thing. It is that very well-intentioned people who have a genuine desire to have diversity in various situations will seek out those few of us who actually are of a certain rank in a certain field. This is something that I talk about very explicitly to minority faculty that I mentor because you’re really torn. When you get invited to sit on the admissions committee, you know how important it is that an admissions committee has diverse faculty on it. There’s tension between doing what you know is important, doing what you want to do, and really staying on track to make sure those things don’t derail your career goals.

KK: I assume these “well-intentioned people” believe they are providing opportunity that you and others want, but it may be more of an obligation than an opportunity because if you’re more interested in faculty development or ultrasound or EMS, now you may not pursue those things because you are the appointed diversity and inclusion person at your facility.

LR: For some people, it is a wonderful opportunity, but does that then marginalize you in ways that pursuing other avenues might not? Every individual has to struggle with lots of choices, and there are lots of things to weigh as you make these professional decisions.