Achieving Equity and Parity in Otolaryngology Care

How to Make a Difference

There are several ways physicians can help close the gap on healthcare outcomes. Dr. Thompson said that it starts with acknowledging the problem and the historical factors behind disparities, understanding the impact of the social determinants of health on outcomes, and actively integrating resources to help patients overcome their negative influence on health and well-being.

Dr. Thompson recommends physicians take the Harvard implicit bias online test (implicit.harvard.edu/implicit/takeatest.html) to become aware of biases they may not even consciously know they have, and work to overcome these biases to better understand patients. This growth leads to building trust and more effective relationships with patients, and becoming true partners in care, she said.

Creating a diverse workforce is also part of the solution. Dr. Thompson said working in diverse groups not only helps physicians see their biases, but also allows people from disparate backgrounds to educate each other about how their perceptions and biases may impact their interactions with patients. Additionally, they can also point out how social determinants of health impact specific communities and share possible solutions.

“Educating the next generation of diverse physicians is essential to achieving parity,” Dr. Thompson said. “Minority patients are more likely to seek care from and trust a racially concordant physician. Minority physicians are more likely to return to their communities and serve vulnerable populations. And diverse physicians will ask relevant scientific questions about how race and other social determinants of health impact outcomes.”

Unfortunately, according to an ACGME report, otolaryngology is behind other specialties when it comes to diversity (JAMA Intern Med. 2015;175:1706–1708). “We still have a gap that can be filled through awareness, mentoring, sponsorship, pipeline programs, and advocacy,” Dr. Thompson said.

Dr. Thompson acknowledged her many mentors in the audience for supporting her in her path and acknowledged the recent passing of Thomas McDonald, MD, who was her chair at the Mayo Clinic when she was a resident and who made Dr. Thompson her first job offer. As an Irish Catholic immigrant from Northern Ireland, she said, he had his own pathway with discrimination and, as such, could empathize with her and understand some of her challenges. “What has helped me along the way has been mentors, sponsors, and colleagues who have either been color blind or gender blind or able to see potential beyond a bias,” she said.   

Renée Bacher is a freelance medical writer based in Louisiana.