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General Sessions

Friday, February 1

8:40–9:30 am

The Dynamics of Health Care Disparity and Equity: Closing the Gaps

Jo Ann Rooney, JD, LLM, EdD, President, Loyola University Chicago

The pace of change across the health care landscape can be described as “dynamic,” “unprecedented,” “innovative,” and some might even add “tumultuous.” What cannot be debated is that the rapid advances in technology are contributing significantly to changes in clinical care, to the education of health care providers and the speed at which research outcomes can be translated into clinical practice. Clinical practices and health outcomes will be increasingly influenced and supported by innovative technologies, data analytics, and informatics. Medical ethicists will continue to face new challenges as the use of artificial intelligence grows. Whether caring for neonates or the growing aging population, improving health outcomes and quality of life are essential goals.

However, we cannot have a conversation about the new or the innovative without an honest evaluation of issues surrounding health disparities, health care equity, or access to health care. Doing so will only widen the gap in what is already an alarming situation. What do we mean when we use the terms disparities, equity, and access? We may believe that living in an urban versus rural area is a factor, or that even within an urban area your zip code is a determining factor. However, do we consider a person’s status as a military veteran, a school aged child, a young adult, an immigrant, or even a grandparent caring for small children as someone who is struggling within our health care system? How does public policy and codified law impact public health and contribute to health outcomes or access?

There is significant work being done by our colleges and universities to bring together the talents of clinicians, social workers, public health professionals, lawyers, and other professionals to address these concerns as well as changing the way we educate future health care professionals. What are some of these specific examples and how can we leverage this work even further?

By the end of the session the participant will be able to:

  1. Gain a deeper baseline understanding of the issues surrounding health disparities, healthcare equity and access.
  2. Achieve a broader perspective of the various clinical and non-clinical factors that contribute to these issues
  3. Learn about some practical clinical programs, interdisciplinary work and research at the university level and about curriculum changes being implemented to prepare the future workforce in both clinical and non-clinical areas.

Jo Ann Rooney, JD, LLM, EdD, was inaugurated as Loyola University’s 24th president in 2016. She is the first lay president of Loyola University Chicago and the first woman to hold the position. President Barack Obama nominated Dr Rooney and the US Senate confirmed her as principal deputy undersecretary of defense for personnel and readiness in the U.S. Department of Defense. While at the department, she also served as acting undersecretary of defense for personnel and readiness, managing recruitment, health care, education, pay, and benefits for approximately 2.7 million active-duty personnel and their families. In 2012, Dr Rooney received the Department of Defense Medal for Distinguished Public Service, the highest award given to a civilian by the secretary of defense.

Saturday, February 2
8:35–9:30 am

Achieving Health Equity Through Medical Education

Joedrecka Brown Speights, MD, Department of Family Medicine and Rural Health, Florida State University College of Medicine

Achieving health equity through medical education presents a tremendous opportunity for academia to impact the barriers to health and improve the health of all. Health is not merely the absence of disease, but the opportunity to be well physically, mentally, emotionally, spiritually, and financially in an environment free of pollution, toxic stress, food insecurity, and the consequences of discrimination, racism, and poverty. While some individuals have the opportunity to live their healthiest life, others suffer preventable and unjust differences in health outcomes. Family physicians are the cornerstone of providing primary care to all that is preventive, holistic, culturally responsive, and patient-centered care across the life course. Family medicine educators are particularly well situated to address the health needs of populations, impact the health care workforce, engage community, and attend to personal health and wellness. Family physicians are well positioned to eliminate health disparities through awareness and action, curricular design, and implementation, scholarship and innovation, and community engagement. At times there is a fatalistic lack of hope in the health care environment that is already overwhelmed with competing priorities like billing, coding, and reimbursement, regulations, and the electronic health records. However, several exemplars exist that demonstrate health equity can be attained in many areas including infant mortality, cancer, and cardiovascular hea

By the end of the session the participant will be able to:

  1. Describe health equity and its enhancers and distractors.
  2. Demonstrate that health equity is achievable through discussion of scientific evidence and exemplars in maternal and child health equity.
  3. Mobilize medical education leaders and students to engage in activities (environmental, policy, systems, curricular, community-engaged, and/or clinical activities) in support of Health Equity.
  4. Identify at least one method or strategy to increase health equity in the curriculum.

Dr Speights will share a message of hope and lend an opportunity for participants to explore some of these examples and discuss strategies as to how they can contribute individually and as a part of systems to attain health equity. Concerted and collaborative efforts make health equity feasible. Health equity can be achieved if we are intentional, value all people, rectify injustices, monitor progress, learn from exemplars, work collaboratively across disciplines, and model methods to address health inequities for our students.

Joedrecka S. Brown Speights, MD, is professor and chair of Family Medicine and Rural Health at the Florida State University. She is the 2018 recipient of the Dr Martin Luther King, Jr, Distinguished Service Award by the Florida State University. Her experience includes serving as the medical director of the National Community Center of Excellence in Women’s Health, Office of Women’s Health, Department of Health and Human Services at Turley Family Health Center. Dr Speights is a 2017 inaugural fellow of the George Washington University Leaders for Health Equity International Fellowship, now Atlantic Fellows for Health Equity.

Sunday, February 3
8:30–9:30 am

Addressing Micro-Aggressions, Racism, and Discrimination in the Medical Workplace

Roberto Montenegro, MD, PhD, Seattle Children’s Hospital, University of Washington, Department of Psychiatry and Behavioral Medicin

Medical trainees are often mistreated within the confines of our own academic settings. This mistreatment can come directly from attendings, fellows, residents, medical students, other staff members, and patients alike. They can range from less overt forms of adversarial comments like micro-aggressions, to more overt forms of mistreatment such as racist or sexist comments, sexual harassment, derogatory comments regarding sexual orientation, refusal to see trainees of a particular ethnic or religious group, and others. There is an abundance of literature describing the impact of this mistreatment on the trainee’s learning environment as well as their personal and professional wellbeing. Faculty response to such mistreatment is variable and complicated by the lack of training in both identifying these subtle forms of discrimination and facilitating these difficult discussions where emotions can run high and individuals can become defensive. How can medical educators cultivate a positive learning environment in the face of mistreatment and how can educators help their trainees have difficult conversations that can help them address, process and confront situations of covert discrimination?  

By the end of the session the participant will be able to:

  1. Understand the historical and sociopolitical origin of race and racism in the US and how it relates to at least three forms of racism.
  2. Recognize, define and give examples of micro-aggressions.
  3. Understand how white fragility can perpetuate a negative learning environment for underrepresented trainees, faculty, staff, and patients alike.
  4. Apply practical strategies for responding to and coping with micro-aggressions at both the individual and institutional levels.

Dr Montenegro is a child and adolescent psychiatrist at Seattle Children’s Hospital and the University of Washington. His research focuses on how perceived discrimination affects both biological markers and mental health. He also specializes in cross cultural psychiatry, transgender mental health, social justice, and health disparities education curriculum development.

 

 


Copyright 2018 by Society of Teachers of Family Medicine