Health Equity Collaborative in ENT w/ Dr. Alexander Chiu & Dr. Romaine Johnson | ENT Podcast Ep. 98

Equity requires providing different levels of support based on individual circumstances to achieve optimal health, unlike equality which provides the same resources to all.

Current otolaryngology literature focuses heavily on documenting disparities (e.g., Black children having more severe sleep apnea and higher revision rates) but lacks intervention studies to reduce these disparities.

Language barriers contribute to increased emergency room visits and phone calls after pediatric tonsillectomy when post-operative instructions are not provided in the patient's preferred language.

Implementing language-preference tracking and providing instructions in preferred languages reduced emergency room visits and phone calls after tonsillectomy at Children's Hospital Dallas.

The Health Equity Collaborative was founded in February 2022 with six initial institutions including University of Mississippi, Henry Ford, Atlanta Georgia, University of Maryland Baltimore, and University of Kansas.

High-impact journals show reluctance to publish qualitative studies despite their value in understanding patient and trainee experiences.

Qualitative research using structured interviews is difficult and requires discipline to identify themes across 40 participants.

Mixed methodology papers combining qualitative and quantitative data were developed partly as a response to editorial preferences for hard data.

Structured interview questions used in residency applicant selection can assess work ethic, communication skills, problem-solving ability, and resilience to adversity better than board scores and letters of recommendation.

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

The collaborative's initial funding strategy of paying participants for their time and providing elaborate meals was not effective.

The American Academy of Otolaryngology received a grant from GSK to fund a core award for three years of health disparities research.

The collaborative now includes approximately 20 academic programs with varying degrees of involvement.

Orthopedic surgery's Nth Dimension program has been more successful than otolaryngology initiatives in recruiting people of color over the past five years.

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

Patient non-compliance with medications or treatment recommendations often stems from distrust, access barriers, or inadequate explanation rather than forgetfulness or unwillingness.

Public health departments and family medicine have more developed infrastructure for equity work than otolaryngology and can provide expertise in participatory research methods.