e051. The Way Up with Errol Pierre

Including You Interview with Errol Pierre

Full Interview Transcript

Voiceover Announcer:

This is Including You, the new series from Lead at any level. Including You, feature stories from chief diversity officers and other executives who are creating inclusive cultures in their organizations. Our goal is to show what’s working in companies just like yours, to give you the tools you need to keep pushing for progress in your own workplace. We want to create belonging and opportunity for everyone including you. And now here’s your host, Amy C Waninger.

Amy C Waninger:

Welcome back to Including You. I’m your host, Amy C Waninger, the inclusion catalyst. My guest today is Errol Pierre. Errol is a highly motivated, mission-driven business executive with more than 17 years of managed care experience, thriving at some of the largest health insurance companies in America. He’s a professor and thought leader in health policy and healthcare reform. He’s also the author of The Way Up: Climbing the Corporate Mountain as a Professional of Color. Errol, welcome to the show.

Errol Pierre:

Thank you so much for having me. It’s great to be here.

Amy C Waninger:

I am so excited to talk to you. And I want to know a little bit about your career journey, because I’m betting that’s the foundation for the book that you’ve written. Can you tell us just a little bit about what attracted you to healthcare and what was your path up and through the healthcare industry?

Errol Pierre:

Yeah, it’s a great question. Thanks for asking it. Yeah, I did not know I was going to end up in health insurance. I don’t think anyone says, “I want to be in health insurance.” Totally happened accidentally, but it’s through probably things that I’m so fortunate of. And so first, as a child, my parents had union benefits. They worked for a union. My father came from Haiti, migrated to America and was washing dishes inside of a nursing home and his benefits were through the reunion. And so I remember vividly, I was probably 14 or 15 years old, going in for a root canal with my dad, and the dentist couldn’t finish the procedure, so they had to close my mouth with an unfinished tooth. And the reason was, I hit my benefit maximum for my dental plan. Yeah, it’s crazy. So my dental plan only had probably a thousand dollars of benefit usage and the root canal was more than that.

And so the dentist was like, “I can do this much now and you’re going to have to come back on January 1st so that we can restart the work. So I’m going to close the mouth and finish it.” And so as a kid, I had no idea what that meant, but I could tell my dad obviously wasn’t happy and he was mortified that his son was going through this. And then so when I went to college and I was older, and I reflect back to that moment, I was like, “How can a country that spends 2.5 times more than any country in the world, have citizens that literally can’t get their teeth fixed? How does that happen?” And that was really what spurred the sense of there’s got to be a better way to figure out healthcare. And that’s what got me into the health insurance space, which was still accidental too. I can tell that story too, but that’s really what piqued my interest to get into healthcare.

Amy C Waninger:

So when you said your dad had uni union benefits, I’m thinking this is going to be a very happy story.

And that’s horrific on so many levels. And I’m sitting here thinking, what if it had been an appendectomy, where they just left you open and walk out of the surgery room? It’s jarring and unsettling, and I’m sure a traumatic experience for you and your family. As you’re thinking about, and it’s interesting because a lot of times when I talk to people who work in health insurance, they are not interested in shaking things up. And it sounds like you’re very interested in shaking things up from the inside. Can you go on with your story and tell us how you got into the work and how do you exist in this space where you’re trying to, not dismantle, but restructure?

Errol Pierre:

Absolutely.

Amy C Waninger:

What you’re living in?

Errol Pierre:

Yeah. One, thank goodness for the Affordable Care Act. Cause once that passed, benefit maximums, lifetime limits, all those things went away, preexisting conditions went away. I don’t know if every American realizes how monumental that piece of legislation was, to remove a lot of the things that I felt and so many Americans feel were like, the health plans up, the dollars are up, come back next year. So that’s the first piece. And so I did a lot of work going back to grad school, specifically on health policy to make sure everyone knew what they’re entitled to. There’s so much we’re entitled to in terms of health benefits, preventive care, free services, that it gets bogged down in this language that no one understands. And really, trying to say it in a very simplistic way, so that people can understand what they have. How I bumped into health insurance was another interesting story.

I worked part-time in college in the warehouse of a beauty supply store, and so I would deliver bottles of shampoo and hairspray to the salon. And some days, I would work in the salon as well. And this woman who’s seen me probably over the past year coming in and out and working at the store, came up to me and said, “Do you do more than this?” That was her question. And I was like, “Yeah, I’m in college. I was going to Fordham University and this is my part-time job.” She said, “Send me a resume.” I’m like, “Okay.” So sent her a resume. Long behold, she was the chief operating officer for the largest health insurance company in New York.

And I stumbled upon her and she watched me. I had no idea she was watching me putting shampoo bottles away, dealing with customers, and decided to ask me for my resume. So that was my first job as an intern, and that’s how I got into health insurance. And I already knew I wanted to solve this issue about my tooth. And so started asking questions and saying, “Why is it this way? Why is it that way?” And then once the Affordable Care Act passed, I was like, “Okay, we have to make sure every American knows their full benefits that they’re eligible for.”

Amy C Waninger:

So what are some of the avenues? Because I’m guessing the people that need to know this the most are also the hardest to reach.

Errol Pierre:

Absolutely. Yeah.

Amy C Waninger:

What are some of the tools and strategies that you’re using to get this information out to the people who need to hear it most? Because healthcare is such an equity issue. We have systemic problems that cause some people to be sicker than others, poor people, communities of color, there are systemic issues that cause that. Then on top of that, there are systemic issues that prevent them from seeking care. There are systemic issues that keep that care from being available to them if they do seek it out. There are problems with them getting the right care once they find it. Really every step along the way. We’re talking about huge inequalities.

Errol Pierre:

Yes, a hundred percent.

Amy C Waninger:

What are some of the strategies that you’re using to chip away at that?

Errol Pierre:

Yeah, first let me step back and do bird’s eye view. If you look at every developed nation, they have lower healthcare costs and better outcomes. Perfect examples like maternity mortality. In America, 24 out of a hundred thousand women will die giving birth, which is just a crazy number. In European countries, that’s six out of a hundred thousand or nine out of a hundred thousand. Even though we spend so much money, we still don’t get the outcomes. And one of the reasons that is because we’re not funding social service programs. These are things like sick paid leave, child family leave, making sure people have parks so that they can work out, making sure schools are really good, so you get educated and get a job, so you have income. Making sure houses, public housing has heat, and the elevator works and it’s low crime. If you solve those things, healthcare costs go down.

What we do is we cut those services, it causes people to get sicker because they don’t have all these other things. And then we try to invest money on the sick care side. So once they’re going to the emergency room, let’s spend a million dollars as opposed to saying, “Let’s spend a little bit money upfront on a better school, on healthy food, on a safe neighborhood and we’ll never get them in emergency room because we prevented it on the front end.” So always talking about upstream things that we can do that will reduce costs on the back end. That’s the first piece. Yeah.

Amy C Waninger:

Okay. I’m going to stop you there because I want to dive into this. You said 24 women out of how many will die during childbirth?

Errol Pierre:

A hundred thousand. 100,000.

Amy C Waninger:

And that’s women overall in the US. Do you know the breakdowns for Black women in particular?

Errol Pierre:

Okay, so for Black women, it’s 44 will die out of a hundred thousand, it’s double. And for Hispanic women, it’s roughly in the thirties. And one of the reasons why it’s higher for Black women is like you said, the first piece is implicit bias. It doesn’t matter your age, your education, your income. There’s this implicit bias of not believing a Black woman’s level of pain. So when they say, “I need an epidural,” or when they say something, “I feel pressure,” they’re not believed, and it’s the subconscious rationales, they’re not believed. And then two, if you look at the research, there’s differences in treatment.

So a white woman will have the same complications and get different treatment than a Black woman who presents exactly the same. And again, that leads to implicit bias. The perfect example is pain medication. There’s this bias that, “Oh, the Black patient is using the drugs recreationally, so I’m not going to give as much.” And this is racism to assume because of the color of the skin, when you say you need pain it’s for illegitimate reasons. And so just from that perception, they get less pain medications than other patients. And so this is seeped into our system. And there’s so much research that shows the bias that exists in the medical field.

Amy C Waninger:

And so we’re talking, if we say six of a hundred thousand is the gold standard, so then we’re seeing across the US, women are four times more likely to die in childbirth than in places that are doing the right things. But for Black women, we’re talking seven to eight times that number.

Errol Pierre:

Astronomical. Yeah.

Amy C Waninger:

This is total malpractice from a society standpoint. Sorry.

Errol Pierre:

No. I’m passionate about it too.

Amy C Waninger:

And I know that this isn’t news to a lot of my listeners, just when you think about these numbers, that it’s just appalling. And okay, so back to the point about getting the information out to the people that need it. How do we do that? How do we let people know what their rights are?

Errol Pierre:

Today, what tends to happen at these companies is ivory tower thing, and they think, “What would I want to find out the information?” And this happened with the vaccinations. When we were trying to put up a website for people to get vaccinations, they started with a desktop website and the websites were in English only. That was the worst place to start because the people that needed the vaccination the most, they use a cell phone as their primary source of internet. And English is not their first language. These were immigrant populations, low income populations.

So just from that ivory tower, think we are building solutions that don’t work for the people we’re trying to reach. So what I try to do is say, “Let’s hear the voice of the consumer we’re trying to reach. Let’s go to the churches, let’s go to the barbershops, let’s go to the beauty salons. Let’s find out their fear. What is stopping them from getting the vaccination? Or what is stopping them from enrolling in Medicaid that they’re eligible for, that’s perfectly free? What’s stopping them from booking an appointment?” Here are those fears. They’re like, “I don’t want to go on Medicaid because when I put my information into the system, they may deport my cousin.”

Oh, so that’s the reason. So let’s fix that issue of your fear that you’re putting information into the system and they’re going to use it to deport your family member that’s here illegally or undocumented. That’s without talking to them, you’re trying to solve an issue that’s not the issue. It’s not that the website’s not functional. It’s not that they don’t want to enroll. It’s that they have this fear about their… “Why didn’t you book that appointment with that doctor?” “Oh, the office staff sucked their teeth when I showed my insurance card because they’re like, Ugh, Medicaid. So I don’t feel good going into the office. I don’t feel good booking appointments.”

So we sometimes in the ivory tower internalize it as these patients just don’t want to get healthy. I don’t know what’s wrong with them. I don’t know why. No, the office staff treated them like crap. Do you want to go to an office where you get treated like crap? No. So they actually make sense, but if you don’t listen to them, you start solving problems that aren’t there. And then you think about them in a very derogatory manner, like they don’t want to be healthy. Everyone wants to be healthy, but the system is not set up for them to get the care that they want.

Amy C Waninger:

And they’re already overcoming huge trust issues because we’ve had a history in this country that I think a lot of white doctors especially are not aware of. I’ve had these conversations with my children’s pediatrician around how the medical system in the United States has historically abused and tested and experimented on communities of color, especially Black women and men. And there’s so much trust issue that has to be overcome to even think, “Was I included in these trials? And if I was, was that done ethically?”

Errol Pierre:

Yeah.

Amy C Waninger:

And I think there’s so many layers of this to peel back, and I don’t want to get too far away from the book, but this is stuff I can just go on about [inaudible 00:13:51]. But as you’re doing this, you’re doing it from a place of being an other, probably being an only in the levels that you’re working in. And so as you come in and you say, “Hey, we have all these problems,” how is that received? And what kind of calculus are you doing to present things in a way that you personally will be heard in some of these spaces? Because I’m sure that’s a challenge.

Errol Pierre:

And pardon the sirens. I’m in [inaudible 00:14:21], so I apologize. No, it’s a great question. When I was younger and early in my career, I bit my tongue and I wouldn’t speak up. Now I look back and I understand why I did that because I also feel like if I did speak up back then, I wouldn’t be where I am today. I was a former chief operating officer for a large insurance company. I’m a top executive currently, at a health plan.

And I feel like I had to bite my tongue and not say things out loud to get to this position. And so I was very safe coming up the ladder. And I don’t even call it a ladder in my book, I call it a mountain. I was very safe climbing this corporate mountain. But then now that I’m in this position, it behooves me not to close my mouth. Now, silence is complicity. So I had to do some code switching and being someone that externally, would be acceptable. It’s like safe, but to get to this position, but then now I have this, I feel like this relentless pursuit to now speak up because I’m in a position of to make changes.

Amy C Waninger:

That is so heavy to think, that there’s all this talent in these organizations that has this potential. But if they’re a little too vocal about something that matters, about something that matters to them, that matters to employees, that matters to stakeholders, that matters to clients and customers, and if they make a miscalculation in that space, they may not ever get to a place where they can make a real difference.

And of course, anybody that’s worked in corporate has seen this, and you get one. But then if you do it again, some of us get one, white people get one. Some white people get a whole lot more than one. But a lot of times, you’ll get one mistake and somebody will say, “Okay, don’t ever do that again.” But some people don’t even get that grace. You say one thing, you’re done. It’s over for you. And so, tell me a little bit, I’m guessing that this is how you came to write this book, is these lessons learned as you’re climbing, when to speak up, when not to speak up. Can you talk a little bit about what is it that compelled you to write this book?

Errol Pierre:

Yeah, that’s a great question. I became a chief operating officer of a health plan, large health plan at the age of 35, really, really young. Yeah. And it’s been through mentors and it’s been through sponsors. And I’ve just had an amazing experience. And I’m very fortunate for the experience I had climbing up. And I actually thought back then, and this was 2018, I was going to write this book and say, “This is how I did it.” I got the job. And it was the worst year and a half of my life because I had external validation that said, “Errol, you made it. You walk on water, you are…” And I call it Jackie Robinson syndrome, when you’re the first of, you have to be perfect and you can do no wrong. And what people forget about Jackie Robinson is he just wasn’t the first Black person to play baseball.

He also was rookie of the year that year. He was talented. He wasn’t just first. He was talented. And so I remember feeling this pressure to not make a mistake, feeling this pressure to say, “If I mess up, I’m going to close the door to other people that look like me.” And then I wasn’t happy. I had a great title. I was making more money than I ever did.

And I literally would walk, my office was in downtown Manhattan, they call it financial district. I would literally walk around the South Street seaport in the financial district waiting to go into my office until I had a meeting. So if I got there down there early, and I didn’t have a meeting till 8:00 AM, I would just walk around the city until 7:58 and then I would walk in. That’s how dreading it was to have this job, even though I was at the pinnacle of my career. And so leaving would’ve felt like a failure and people would’ve been like, “What’s going on?” But I was not happy at all. And so it took me a year and a half to finally resign. And that’s the first chapter of the book, my resignation letter from the job that I’m supposed to be amazing, supposed to be at the top of your career, the pinnacle of success. And after 18 months, I had to resign.

Amy C Waninger:

I can feel the heaviness of that in my chest, that fear of if I take a wrong step, it’s not just me getting zapped. It’s like walking a path with an electric fence that you can’t see. And it’s not just me getting zapped, but the whole thing’s just going to shut down. The whole power grid goes down and everybody that comes after me, and wow. And so the lesson learned from that, because obviously you didn’t quit. That’s chapter one.

There’s more to the story.

You didn’t quit.

Errol Pierre:

Yeah. Yes. So the lesson learned was… So each chapter has lessons. There’s 15 lessons. That first chapter is passion and purpose. You must write down your passion and your purpose and don’t get a job and then try to retrofit your passion and purpose into that job. Make sure you choose the job because it fits into your passion and purpose. So for me, I applied to the role, I wanted the C-Suite title because that’s what I wanted to do for the sake of just saying I made it. I wanted the title and the money and the gravitas that comes with it, but it wasn’t aligned to my passion and purpose, which was health equity, which was helping people, which was getting into communities and making sure they knew what they’re afforded and speaking to them in the way they understand and giving them dignity.

And then I got this role, and I tried to do it, but the role wasn’t built for that. I shouldn’t have had the role in the first place. And so I chose it with my head and not my heart. And then I had the role and I was like, “I got to get out of here.” And so the first lesson is, please write down your passion and your purpose, and that is your GPS. That is your GPS. It’ll tell you which way to go. If I did that first, I would’ve had that C-suite title and say, “I need a different C-suite title because this one won’t allow me to pursue my passion and my purpose.”

Amy C Waninger:

I think it’s a hard lesson for people who are in corporate spaces, especially, that you have to be who you are. And it took me forever to figure this out, that there were certain things about me that were never going to change. No matter how hard I try to suppress them. No matter how many times I bite my lip, hold my tongue, no matter how many times somebody corrects me and tells me the right way of approaching this, I can’t do it because it’s not who I am. And it sounds like you got yourself, hated yourself into a corner where it was not a good fit. And so many people do that. They get to that next plateau and they look around and they go, “Oh, this is not the view I signed up for.”

Errol Pierre:

Yeah, absolutely.

Amy C Waninger:

So who is your book for? Is it for young professionals who are facing those same challenges? Is it a book for… You never want to say a book is for everyone, even though they’re always for everyone, but who is your book for?

Errol Pierre:

Yeah, so great. There’s so much unsaid rules in corporate America. I wanted to say the unsaid things out loud. So the book is specifically for people of color that feel stuck, that feel frustrated, that feel dejected, that apply for 5, 10, 15 positions, never get a call back, don’t know why. We were raised and born and taught that hard work gets you there. Meritocracy exists. Can I talk about it? I was like, “It doesn’t exist. It’s who you know and timing.” And so it’s really to just get that out. So it’s definitely for people who are entry level or mid-level, feel stuck in their careers, they feel frustrated.

I’m sick of this. One, they would see themselves in the story. So a lot of the feedback I’ve been getting is, “Wow, that chapter is me.” Or, “Wow, what you said that I’ve experienced that.” So that was the first piece. But the other audience is also business leaders in corporate America to read and understand what their employees are going through and say, “Oh my God,” because they won’t say it out loud. They’re biting their lip like I used to. And so I want them to read it too, to realize that that employee, that the who’s Black or Brown, who’s quiet and gets their work done and who studious, has the same stuff inside, but they’re just too scared to say it because it’ll mess up their path. And so it’s also for that audience as well.

Amy C Waninger:

I think this is a really important thing for people to understand. I always tell people, go to the conference that’s not for you. Read the book that’s not for you. Listen to the stories that are not for you, because that’s where the learning is going to happen. If you only take the sanitized for you version of the story, there’s no lesson there. And so I want to thank you, Errol, for putting this book out into the world, not just to help the people that need the encouragement, that need the guidance, that need the… They’ve got their own GPS, but they might need the ways instructions to get there back

Errol Pierre:

Exactly.

Amy C Waninger:

This is going to help them get up that mountain. But also taking away the excuses from would be allies that they just didn’t know or they just didn’t see. Because this is so important. And we need, especially in places where public policy is being discussed, where health equity is being discussed, where huge sweeping reforms are needed, we need a lot of different diverse creative voices at those tables to make sure that those decisions that are made, are serving the people they’re intended to serve. Thank you for that.

Errol Pierre:

Thank you. No, a hundred percent. And that’s the intent of it. And it’s raw and unvarnished, and I tell a lot of stories of things I went through and then always back it up with evidence. So it’s research based, there’s a lot of papers that are cited throughout the paper to say it’s not just an anecdotal story. This also happens to other folks. And I had the opportunity to interview 11 other executives of color from all different industries. So one was Robert Childs, he’s the head of diversity, equity inclusion at American Express. Doing those interviews was so fascinating because then it also taught me that what I went through was also similar to what these other executives went through as well.

Amy C Waninger:

Yeah, I think that’s important. And I think a lot of times, people on the inside of a problem, people who are facing a problem, see patterns, see trends, know how deep things go. Looking from the outside, it’s easy to dismiss one person’s story is anecdotal. It’s not right. But it’s easy to do. It’s very easy if you have privilege and power to say, “I know that happened to you, but that’s not typical, and that’s not what I experienced. And if you have an experience and I have an experience, and they’re different, then they’re equally valid.” What people don’t realize is no, these are multiplied over time and they’re deep and they’re typical. And so we all experience things a little bit differently depending on who we are. But then there’s similarities within those groups. And I’m sorry that you felt the need to have other people back up your story because that’s not fair. It’s not right. Yeah.

Errol Pierre:

Yeah. I agree. And it’s interesting. So the Me Too movement was fascinating in that it told folks, you don’t need someone else to back up your story. Believe the woman, she said this happened, why are you now trying to think of a thousand different scenarios where it didn’t happen? And we want that same thought process and grace and space for people of color as well to say, “Hey, they did feel slighted. This was a microaggression. This was a joke that was actually offensive.” And it’s all, “Oh, you’re too sensitive.” No, don’t wash it away with they’re too sensitive. Or they’re an angry Black woman, or they’re a mean Black man. No. Allow them to be believed. Let their story be believed.

Amy C Waninger:

Absolutely. Errol Pierre, thank you so much. The book is The Way Up” Climbing the Corporate Mountain as a Professional of Color. I hope that my audience will engage with this book from whatever perspective they start from and really put some effort behind making some real and lasting change.

Errol Pierre:

Thank you.

Voiceover Announcer:

If you’ve enjoyed this episode, follow Lead at any level on LinkedIn and YouTube, then join us for Including You video simulcast every Thursday at noon Eastern. Including You can also be enjoyed each week as part of the Living Corporate Audio podcast series available on all major podcast platforms. Learn more @living-corporate.com, Including You is brought to you in part by Lead at any level. A boutique training and consulting firm, improving employee engagement and retention for companies that promote from within. Lead at any level, leaders can be anywhere and should be everywhere. Learn More at lead@anylevel.com. Lead at any level in its logo are registered. Trademarks of Lead at any level, LLC. The views and opinions of guests on our show do not necessarily reflect in the positions of Lead at any level, living corporate or the sponsors of Including You.

Amy C Waninger:

That’s it for this week’s edition of Including You. Be sure to join me next week when my guest will be Dr. Nika White of Nika White Consulting and the author of the new book, Inclusion Uncomplicated.