Achieving health equity – a driving mission at UTHealth Houston – requires investigating all aspects of patient interaction: teaching methods, residency application review processes, research practices, and clinical care encounters, concluded a panel of UTHealth Houston faculty during a Feb. 23 Webex discussion.
The virtual talk was the final installment of a series of discussions that were a part of the Department of Pediatrics at McGovern Medical School at UTHealth Houston’s inaugural Health Equity Week which ran Feb. 20-23, through virtual panel discussions and presentations.
“Championing Health Equity at UTHealth Houston” was moderated by Syed S. Hashmi, MD, MPH, PhD, professor and vice chair for diversity and inclusion in the Department of Pediatrics, who played a key role in organizing the event.
Viewing patients and students as whole persons is central to a number of practices to improve equity and inclusion at the university, said Sandra McKay, MD, associate professor in the Department of Pediatrics at McGovern Medical School.
For example, setting the tone at the beginning of a clinical visit by asking the patient what name they liked to be called, she said, can allow the health care provider to see more than the patient’s age, sex, race, or illness.
“They become a person to you, not just a disease process,” McKay said. “It can help you build trust with them. We want to develop that trust and that rapport with them.”
Trust is critical to building a more equitable and inclusive learning environment as well, said Asia McCleary-Gaddy, PhD, assistant professor and director of Diversity and Inclusion Office at McGovern Medical School.
“When it comes to DEI work,” McCleary-Gaddy said, “sometimes our students know more than our faculty, but they are reluctant to say something because of power dynamics. And from faculty, we hear, ‘I want to know.’ Faculty development is key to moving that work forward.”
Research initiatives can be improved as well to help achieve more equitable health outcomes, the panel agreed.
Researchers and volunteers can have a meaningful impact on building trust with underserved communities by investing back in those communities once the studies or surveys are complete.
Once findings are published, the participants in the study are left to find and purchase access to the literature, which is written for other academics and not easily understood outside of the research community.
“We need to see our community members as equal stakeholders in this space. Not just when we need them for research — that is key,” said Jemima C. John, PhD, assistant professor of epidemiology, human genetics, and environmental sciences at UTHealth Houston School of Public Health. “Their lived experience carries as much weigh as our intellect.”
Practices can also be implemented to improve equity in admission into UTHealth Houston programs.
One example is in the resident application review process for the pediatric residency applications. The process has been revamped to achieve a more holistic review of the applicants, said Michelle Barratt, MD, MPH, professor in the Division of Community and General Pediatrics and the Division of Adolescent Medicine at McGovern Medical School.
“The person interviewing doesn’t know scores,” Barratt said. “The interviewer judges on the applicant’s ability to sell themselves. I think that makes for a much better opportunity for people who are coming out of poverty, for example, to be placed in our residency.”
Economic status can affect patient access to health care as well, said Paulina Filipek, MD, professor and director of the Developmental Neurology Clinic with UT Physicians, the clinical practice of McGovern Medical School.
Filipek said telemedicine visits are often not able to be completed because in some rural areas where Wi-Fi signals are not strong.
John said many of these barriers to health equity can be overcome with genuine efforts to build trust between health care providers, instructors, and their patients and students.
“At the end of the day, trust comes from true collaboration,” John said.
Previous topics during the Health Equity Week were:
- “The Color of Care”
- “Breaking Barriers to Health Equity: Addressing Structural and Systemic Challenges in the Academic Workforce”
- “Health Disparities and Health Equity Research Symposium”