Disability Inclusion In The Workplace: Margaret Larkins-Pettigrew Of Highmark Health and Allegheny Health Network On How Businesses Make Accommodations For Customers and Employees Who Have A Disability

An Interview With Eric Pines

Eric L. Pines
Authority Magazine
13 min readJul 6, 2022

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Good leaders are also good followers: Know when to take the back seat, and let others show you the path.

As we all know, over the past several years there has been a great deal of discussion about inclusion and diversity in the workplace. One aspect of inclusion that is not discussed enough, is how businesses can be inclusive of people with disabilities. We know that the Americans With Disabilities Act (ADA) requires businesses to make reasonable accommodations for people with disabilities. What exactly does this look like in practice? What exactly are reasonable accommodations? Aside from what is legally required, what are some best practices that can make a business place feel more welcoming and inclusive of people with disabilities? To address these questions, we are talking to successful business leaders who can share stories and insights from their experience about the “How Businesses Make Accommodations For Customers and Employees Who Are Disabled “.

As a part of this series, we had the pleasure of interviewing Dr. Margaret Larkins-Pettigrew.

As an obstetrician/gynecologist caring for high-risk women, Margaret Larkins-Pettigrew, MD, MEd, MPPM, FACOG, has developed tremendous respect for the opportunities and challenges faced by marginalized populations. As a global health strategist, academia, and veteran, Dr. Larkins-Pettigrew leverages her experience to shape inclusive workplace culture, advancing its commitment to workforce diversity, cultural humility, equitable health care delivery and outcomes for all patients and communities. Dr. Larkins-Pettigrew is the senior vice president and chief clinical officer of Diversity, Equity and Inclusion for Allegheny Health Network and Highmark Health as well as a professor of obstetrics and gynecology at Drexel University and Regional Dean of Students.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you ended up where you are?

I was a nurse for 16 years before I decided to go back to medical school. I wanted to make sure that everyone had equitable care, especially those who had been minoritized. I realized that to be a voice that people would pay attention to in the space of obstetrics and gynecology (OBGYN), I needed to become a doctor. Since then, I’ve spent the past 28 years as an OBGYN. I’ve always had a passion for diversity, equity and inclusion (DEI) and read everything I could get my hands on. I wanted to make a change in the health industry. In 2014, I became the endowed chair for clinical excellence and diversity for University Hospitals/Case Western Reserve University, which was a first-of-its-kind position for a physician. This required assessing and implementing DEI strategies in corporate, clinical and academic settings.

In September 2021, Highmark Health, a national blended health organization, created the Enterprise Equitable Health Institute, and appointed me as the leader to drive our comprehensive internal and external strategy to promote a culture of equity and inclusion for our employees, patients and members.

You are a successful leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?

  • Honesty: I believe transparency equates to honesty especially in this area of diversity, equity, and inclusion. It takes courage to really embrace DEI as a central part of our existence. To make strides in the right direction, it’s going to take everyone — black, white, people living with disabilities and the LGBTQ+ population, etc. It really requires intentional, uncomfortable but honest and transparent conversations.
  • Leadership: Leadership can take a lot of forms, but the best leaders lead with humility. Leaders need to be strategic thinkers, have insight and vision about where they want to take an institution and understand where the institution comes from. No matter what you aim to accomplish, leading with humility sets you apart from others.
  • Self-Reflection: Self-reflection is the ability to give yourself grace. We’re all going to stumble but none of us will be failures. We each go through situations where we may not rise to our initial expectations in all that we do, but I think having the ability to self-reflect and pivot is critical. Every leader should look for opportunities for do-overs, asking “if I had the opportunity to choose a different path, what would I do?”

Can you share a story about one of your greatest work related struggles? Can you share what you did to overcome it?

My greatest work-related struggle has been patience, and it’s a challenge I still strive to improve. For me, this means allowing my team the time to do the work and see the results of their efforts. I’ve had to overcome many challenges of sitting back, watching for progress and trusting that change takes time.

What are some of the most interesting or exciting projects you are working on now?

There are three things that really differentiate the work Highmark Health is doing. The first is data. Data is one of the most important elements of how people will embrace change. Data tells the story, and if you don’t have the right data, you may unintentionally cause harm. At Highmark Health, we’re having serious conversations about the data we have and mapping out plans to capture the data we need. Data is where we’re going to see significant support for programs that we are currently running and those that we want to create that will make a difference in the lives of our employees and our community members. I’m excited about having these open conversations about why data justice is one of the priorities we should focus on.

The second space I’m really excited about is this whole universe of health equity. Over the course of my career in DEI, I developed the “Pillars of Organizational Equity for Social Justice,” a framework that convenes corporate and hospital leadership, practitioners, researchers, and caregivers from various disciplines to identify practical and novel ways to understand, explain, and solve the seemingly intractable problems of racial inequity and injustice. I’ve implemented this at other institutions and now at Highmark Health. I built a team to foster exhaustive research, research-based policies and innovative practices, data-driven education, advocacy campaigns, and narrative-change initiatives.

Thirdly, we want to make sure we can see a significant difference from our DEI efforts, not only in our system but also in our city and community. A country is defined by the health of its infant population, and a comprehensive study on regional equity revealed that fetal deaths are two times more likely among Pittsburgh’s Black women compared to white women. Through our First Steps and Beyond program, we’re working to reduce racial inequity, address extreme prematurity, eliminate sleep-related infant deaths and provide fourth trimester support. These interventions will decrease the death of all babies.

Fantastic. Let’s now shift to our discussion about inclusion. Can you tell our readers a bit about your experience working with initiatives to promote Diversity and Inclusion? Can you share a story with us?

Diversity, equity and inclusion is a challenging but rewarding space to work in. When you see that change in behavior, when people begin to understand why we’re having conversations about diversity, when you witness folks embracing empathy — it makes it all worthwhile. In my memoir, Colors of the Heart, I talk about my history, family, fear and faith. I could not live in this space without having folks of all ethnicities and races in my family. This journey has been a long and interesting one for me considering my family’s African roots as slaves to now moving to a space of freedom of mind, thought and economic empowerment. What I’ve learned in my personal and professional life is that most people do not want to hurt others. Their intention is to do what’s right. Though, this issue of bias and discrimination happens on a regular basis for people of color, especially African Americans.

I can tell you a story of this bias that resonated with me. In a previous role, I was in a meeting with C-suite executives, and we were discussing the shortage in our clinical space — needing more nurses, specialists, environmental service workers, etc. They went around the room and asked people about how we can recruit. The leader said to me, “Margaret, can you go back to your community? Can you talk to your churches?” He said to tell my parishioners that we’re hiring — he didn’t say anything about nurses, doctors or lawyers, but he said we’re hiring environmental service workers. See how divisive that language is? Everyone has a community, and he had no idea what my community was made of geographically. He assumed that I lived in a predominantly Black neighborhood and attended a predominantly Black church. Think about how that would translate to someone in my position who has lived in marginalized communities and is now in a place where you think you’re a part of the C-suite? This was a discouraging experience. I knew he didn’t mean any harm and it was really unconscious bias.

I could have been direct and said that was inappropriate, but I wanted to show him that we needed to change those assumptions to be a really great organization, and to be a better world we have to do this together. So, instead, I drafted a letter about the role and shared it with that leader. It indicated our organization was a phenomenal place to work and grow and outlined the duties of the role. I sent this letter to all the synagogues, all the Catholic churches, all the mosques, and the community recreation centers. I am hopeful that he noted the diversity in his broad pool of applicants.

This may be obvious to you, but it will be helpful to spell this out. Can you articulate to our readers a few reasons why it is so important for a business or organization to have an inclusive work culture?

With more than 90,000 hours of a person’s lifetime spent at the job site, integrating DEI across the entire enterprise is key. At Highmark Health, we want to create a place where people want to stay, build trust, and partner with us. By starting with basics — dignity, respect, compassion, humility and empathy, we create a space for team members to bring their authentic selves to work. When this happens internally, the outcomes are going to be what’s best for the people being taken care of externally.

The Enterprise Equitable Health Institute (EEHI) is an enterprise-wide effort dedicated to advancing a comprehensive internal and external strategy to promote a culture of equity and inclusion. From the organization’s recruitment, hiring, professional development and workplace culture practices and standards, to the quality of care and service it provides to every patient, member, customer, and community, the EEHI is engaged. In health care, unchecked biases — whether unconscious or implicit — can hurt someone physically or mentally. We need to take the time to meet people where they are.

The Americans with Disabilities Act (ADA) requires businesses to make reasonable accommodations for people with disabilities. For the benefit of our readers, can you help explain what this looks like in practice? What exactly are reasonable accommodations? Can you please share a few examples?

For our organization, we look at disability accommodations through a patient/member and employee lens. At our facilities, we want to make it easy for patients to navigate their way around, following universal design principles. One of those examples includes having a lower information desk so that people in a wheelchair can easily access it when at our hospitals or clinics.

For our employees, we invest in making, supporting, and enhancing the tools and resources needed to help individuals to excel in our organization. That could be technology like unique software or hardware, physical equipment like a customized desk or alternative workstation, adjusting work schedules, medical accommodations or allotting extra time to complete a project.

Aside from what is legally required, what are some best practices that can make a business place feel more welcoming and inclusive of people with disabilities? If you can, please share a few examples.

The most significant best practice for being inclusive of people with disabilities is bringing that community — patients, members, employees, neighbors, and partners — into the conversation. A common mistake is implementing what we believe is important for people living with disabilities and not listening to the voices of those who are navigating these differences. At Highmark Health, we have an advisory board that informs us how individuals have been treated in our system and how we can improve. One of those board members includes the Honorable Anthony Coelho, former U.S. Congressman and Vice President, National Task Force on Employment of Adults with Disabilities. He was instrumental in passing the American Disabilities Act. To have someone of his experience level on our National Advisory Committee is a phenomenal move for our organization to progress in the right direction. We’re in the space of trying to make sure that we are hearing our employee and community voices and that we’re responding to them.

We invest from an employee and community standpoint as well. We work with Bender Consultants to connect people living with disabilities to great job opportunities. We give our employees the opportunity to be the best they can be through accommodations and give them a wraparound environment of support.

Can you share a few examples of ideas that were implemented at your workplace to help promote disability inclusion? Can you share with us how the work culture was impacted as a result?

At Highmark Health, we’re really engaging the community of folks that have disabilities to consider us as an employer — and we recently surpassed our benchmark. We really encourage people to come as they are and bring their whole selves to work — that means bringing your talents and expertise that will help us grow as an organization. On our own EEHI team, we have several folks with disabilities, some seen and unseen, but everyone is very focused on making sure we’re inclusive.

We’re really proud that Highmark Health has been rated a “Best Place to Work for People With Disabilities” for the past seven years by the Disability Equality Index.

This is our signature question that we ask in many of our interviews. What are your “5 Things I Wish Someone Told Me When I First Started My Career”?

  1. You can never disappoint yourself: People will disappoint you, but you can never disappoint yourself. If you hold on to your values, your ethics stay disciplined.
  2. Everybody wants to be an expert: One of my colleagues once told me that everybody wants to be an expert. What sets us apart is taking expertise to significance and making a difference in the lives of others. If you find yourself in that space, you have truly reached Maslow’s hierarchy. That is what I try to do as a servant leader each day.
  3. You’re going to make mistakes along the way: The resilient leaders recognize they make mistakes, pivot and move in a direction that lifts you up.
  4. Good leaders are also good followers: Know when to take the back seat, and let others show you the path.
  5. “For what I do is me and for this is why I came” This is a quote my husband and I live by. It’s my mantra for keep forging ahead despite challenges.

Can you please give us your favorite “Life Lesson Quote”? Can you share a story about how that was relevant in your own life?

A quote that really stands out to me that has been attributed to a few different changemakers, including Malcolm X is, “If you take the ‘I’ out of illness and add ‘we’, you end up with wellness.”

The philosophy that I live by is that it has to be all of us. It takes all of us to navigate wellness — and you can’t do that without understanding DEI as a leader.

You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

For me, that movement would be bringing compassionate empathy, dignity, respect, and fair governance through a social justice lens. There you can get comfortable having uncomfortable conversations and map out how we move forward. It doesn’t matter where we start, we just need to continue growing and moving forward on the journey of DEI.

How can our readers further follow your work online?

Readers can follow the Enterprise Equitable Health Institute’s efforts through the Highmark Health digital magazine.

This was very inspiring. Thank you so much for the time you spent with this. We wish you continued success and good health!

About the Interviewer: Eric L. Pines is a nationally recognized federal employment lawyer, mediator, and attorney business coach. He represents federal employees and acts as in-house counsel for over fifty thousand federal employees through his work as a federal employee labor union representative. A formal federal employee himself, Mr. Pines began his federal employment law career as in-house counsel for AFGE Local 1923 which is in Social Security Administration’s headquarters and is the largest federal union local in the world. He presently serves as AFGE 1923’s Chief Counsel as well as in-house counsel for all FEMA bargaining unit employees and numerous Department of Defense and Veteran Affairs unions.

While he and his firm specialize in representing federal employees from all federal agencies and in reference to virtually all federal employee matters, his firm has placed special attention on representing Veteran Affairs doctors and nurses hired under the authority of Title. He and his firm have a particular passion in representing disabled federal employees with their requests for medical and religious reasonable accommodations when those accommodations are warranted under the Rehabilitation Act of 1973 (ADA). He also represents them with their requests for Federal Employee Disability Retirement (OPM) when an accommodation would not be possible.

Mr. Pines has also served as a mediator for numerous federal agencies including serving a year as the Library of Congress’ in-house EEO Mediator. He has also served as an expert witness in federal court for federal employee matters. He has also worked as an EEO technical writer drafting hundreds of Final Agency Decisions for the federal sector.

Mr. Pines’ firm is headquartered in Houston, Texas and has offices in Baltimore, Maryland and Atlanta, Georgia. His first passion is his wife and five children. He plays classical and rock guitar and enjoys playing ice hockey, running, and biking. Please visit his websites at www.pinesfederal.com and www.toughinjurylawyers.com. He can also be reached at eric@pinesfederal.com.

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Eric L. Pines
Authority Magazine

Eric L. Pines is a nationally recognized federal employment lawyer, mediator, and attorney business coach