It was encouraging to see collaboration embraced at this year’s Society of Gynecologic Surgeons 47th Annual Scientific Meeting. The theme, “Working Together: How Collaboration Enables Us to Better Help Our Patients,” defines how, as healthcare providers, it is our responsibility to embrace our communities and all their differences to deliver the best care possible.
Research has shown and was discussed throughout the conference that disparities exist in the prevalence, severity, and management of gynecologic diseases. Interestingly, however, were the findings of race and ethnicity of participants in various studies, and how many fail to capture our diverse patient population.
As Dr. Vivian Sung shared, most research abstracts presented at the SGS podium do not include information about race or ethnicity. And, while featured SGS manuscripts published in the American Journal of Obstetrics and Gynecology are more likely to report this data, they still do not represent the diversity of the U.S. population. We must be better.
We must strive to include data on race and ethnicity in our publications and increase minority involvement in study design, recruitment, and implementation. In addition, capturing information about our patients’ socioeconomic background, language, where they live (rural or urban environments), and even the access they have to care may help us to better understand and serve populations more representative of our surrounding communities.
With regard to our interest in gynecologic surgery, I share this observation. For many years, endometriosis was considered a middle-aged, white women’s disease. However, clinicians and researchers are now identifying disparities in time to diagnosis, the number of clinic or ER visits for pain, and time to surgical intervention for non-white patients with concerns for endometriosis. Disparities in uterine fibroid incidence, prognosis, and management, indicate similar concerns. My point is, we need to go beyond including a more diverse pool of research participants. We need to do better at leveling the playing field when it comes to the entire healthcare process, from bench to bedside.
These new options add choices for patients, enabling them to share in their health care decision-making. But they’re not available to everyone.
In the case of fibroids, they are very common, but they disproportionately affect Black women, many of whom end up with a hysterectomy rather than pursuing alternate treatment options. However, according to a study discussed during the conference, researchers found the number of Black fibroid patients who received myomectomies and hysterectomies declined after the creation of a multidisciplinary clinic. This study illustrates how the availability of new treatment options and collaborative efforts can reduce disparity in care and further highlights the need for proactive initiatives to improve overall community wellness.
At the UCI Department of Obstetrics & Gynecology, we have established a Diversity, Equity, and Inclusion Council made up of faculty, fellows, residents, and clinical staff that works to identify and mitigate issues related to DEI at UCI. We believe it is our responsibility to confront inequities in healthcare, with the goal that every patient deserves and receives high-quality, compassionate care.
Our council is accountable for the inclusivity, recruitment, and retention of diverse faculty, students, and staff. We’re also accountable for improving healthcare outcomes through health equity research and ensuring access to education on health equity and justice as a public health issue.
I’m proud to say, over the last year, we’ve made great progress toward ensuring we are a reflection of the population we serve. And, by reinforcing the values of UCI and systemwide collaboration, we aspire to be the best place to give and get care in our region.
Dr. Chuba has no conflicts of interest to report