Alexander Chiu

152 statements · 4 topics

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And as opposed to just kind of laying at their feet for them, assuming that they just don't want to do it or they're forgetful, you have to really understand what's the basis behind that decision is, is there distrust? Is there a barrier to to getting the medication? Am I making it easy enough for them to get it? Am I making it easy enough for them to understand why I'm giving them the medication?

quote · Academic Leadership and Health Equity in Otolaryngology

I will, I will say that I try to be a lot more patient. I try to be a lot more understanding, especially when it comes to consent for care, consent for surgery. There are a lot of folks where you're like, oh my gosh, why wouldn't you do this? Or why wouldn't you take this medication that I gave you? Why are you not compliant?

quote · Academic Leadership and Health Equity in Otolaryngology

Faculty demographics and community poverty rates influence how otolaryngologists prioritize equity in patient care; Kansas (low poverty) versus Tucson, Arizona (33% poverty rate) produce different clinical mindsets.

opinion · Academic Leadership and Health Equity in Otolaryngology

Equity work has changed clinical practice by increasing patience and understanding in consent processes, particularly when exploring reasons for medication non-compliance or surgical hesitation.

clinical · Academic Leadership and Health Equity in Otolaryngology

Equality means giving everyone the same opportunities and access, while equity means providing different resources based on individual circumstances to achieve optimal health.

opinion · Head and Neck Cancer

There is substantial literature describing health disparities on an individual basis but almost no literature on interventions, particularly at the community or society level.

opinion · Head and Neck Cancer

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Alexander's statements about Academic Leadership and Health Equity in Otolaryngology 38 statements

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Ep. 98 Health Equity Collaborative in ENT with Dr. Alexander Chiu and Dr. Romaine Johnson

Quotation I will, I will say that I try to be a lot more patient. I try to be a lot more understanding, especially when it comes to consent for care, consent for surgery. There are a lot of folks where you're like, oh my gosh, why wouldn't you do this? Or why wouldn't you take this medication that I gave you? Why are you not compliant? Open

Statement Equity requires understanding barriers to medication compliance and surgical consent rather than assuming patients are forgetful or non-compliant. Open

Quotation And as opposed to just kind of laying at their feet for them, assuming that they just don't want to do it or they're forgetful, you have to really understand what's the basis behind that decision is, is there distrust? Is there a barrier to to getting the medication? Am I making it easy enough for them to get it? Am I making it easy enough for them to understand why I'm giving them the medication? Open

Quotation I always have to remind myself of the difference, to be honest with you, between equality and equity. And I always think, oh gosh, you know, if we're giving everyone the same opportunities and we're giving them access and we're we're being culturally aware and we're open to different people and we're colorblind, so on and so forth, that's good enough and that's not good enough. Open

Statement Equality means giving everyone the same opportunities and access, while equity means providing different resources based on individual circumstances to achieve optimal health. Open

Quotation We have to be color conscious and we have to be conscious of the circumstances that people have and the things they need in order to get to their optimal health Open

Quotation A lot of the equity work is always focused on the individual and not enough of it is focused on the community, interpersonal relationships, society as a whole, and caregiver research. Open

Statement Data from 2012 shows African American Black patients consent less to head and neck cancer surgery and have poorer outcomes when case-controlled for tumor staging. Open

Quotation There's a fair amount of literature describing the issues, especially on an individual basis, there's literally next to nothing in terms of intervention on the individual basis, but more importantly, and with broader impact from a society level, from a community level, things that really make a change for large populations of patients. Open

Statement There is substantial literature describing health disparities on an individual basis but almost no literature on interventions, particularly at the community or society level. Open

Statement The Health Equity Collaborative was founded in February 2022 and has grown to include approximately 20 academic programs. Open

Statement Many prolific health disparities researchers work at institutions that do not serve the patient populations they study. Open

Quotation There are some prolific health equity health disparities researchers in all honesty, a lot of them work at places that don't have that patient population, right? I worked at one of those places and those places did not want to see patients who had lower socioeconomic status, so they're filled with brilliant researchers, but it's a little bit of a of a shell of a card game Open

Quotation We wanted folks who are in the trenches who are actually taking care of these patients who have a true passion for it more than just a grant, more than just a publication for their CV, who really want to make an impact. Open

Statement The collaborative's initial focus is on agreeing on data metrics and implementing them at member institutions before moving to intervention studies. Open

Statement Qualitative research using structured interviews and theme extraction is difficult and requires significant discipline and talent. Open

Quotation Qualitative research is not easy. It's incredibly difficult. It is discipline to be able to pick up the themes through structured interviews of 40 people. It takes talent and effort. Open

Statement Mixed methodology papers that combine qualitative interviews with objective metrics were developed partly to satisfy editors who want hard data. Open

Statement Community participatory research requires talking to patients to understand what they want from research and how it will impact them locally. Open

Quotation If you're doing research that doesn't affect the patients you treat, who you're really helping, right? So you need to talk to your patients to understand what do they want out of your research, what do they want to see it change and how will it impact them Open

Quotation We started the collaborative paying people for their time. We put our money where our mouth is. We said this is important for us as a department. We truly believe in trying to make an impact in the community. We pay people, we pay people to show up for these sessions. We put on elaborate lunches or meals to try to get people together and we found that that probably wasn't the way to do it. Open

Statement The collaborative initially paid participants for their time and provided elaborate meals but found this approach was not effective for sustained engagement. Open

Statement The American Academy of Otolaryngology received a grant from GSK to fund a core award for health disparities studies over the next three years. Open

Quotation I want people that want to make a difference just are not doing it just to be a publication or to do it in name only. Open

Statement The collaborative plans to hold one large annual meeting at the American Academy meeting and conduct regular Zoom calls between meetings. Open

Statement The collaborative has two main initial focuses: research and professional identity/recruitment of underrepresented minorities into otolaryngology. Open

Statement Orthopedic surgery's 'Nth Dimension' program has been more successful than otolaryngology efforts at recruiting people of color over the past five years. Open

Statement The collaborative is considering developing anti-racism curricula and equity education tailored specifically to otolaryngology for residents and medical students. Open

Statement Otolaryngology has the least representation of underrepresented minorities among medical specialties. Open

Quotation Our goals is to make this to be the 1 or 1A or 1 C topic and be at the forefront of everybody. Open

Statement Faculty demographics and community poverty rates influence how otolaryngologists prioritize equity in patient care; Kansas (low poverty) versus Tucson, Arizona (33% poverty rate) produce different clinical mindsets. Open

Quotation How do we make it where the Caucasian otolaryngologists who grew up in the Midwest and lived in the Midwest their whole life, how do we make it so it's 1 1A, 1 B, 1 C in their priority list when they're seeing patients? And I think that's the ultimate goal. Open

Statement Equity work has changed clinical practice by increasing patience and understanding in consent processes, particularly when exploring reasons for medication non-compliance or surgical hesitation. Open

Quotation There are others within their places of practice and institution, failing practice, population health departments, school of medicine. They're so much more developed than we are as otolaryngology, especially in terms of this work. Public health. This is public health. Get involved with them. Open

Statement Public health departments and population health groups at academic medical centers have more developed expertise in equity research than otolaryngology and can serve as local resources. Open

Statement HPV vaccine uptake in otolaryngology (relevant to laryngeal papillomas and head/neck cancer prevention) lacks rigorous interventional studies despite frequent discussion. Open

Quotation I tell them, I want you to remain to be that badass impassioned person that has principles and high ethics. And maintain that through residency and attending hood because don't become just, you know, a regular ENT resident that all they care about is how many tubes and tonsils and neck dissections they do. That's boring. That is so boring. Open

Quotation If you maintain that, that want to make the world a little better place, then guess what, you're going to be an attending and that's going to keep that want to make this world a better place and not just do a bunch of cases, your Tesla and then go home to your family. There's more to life, right? Open