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The surgeon -rationalist- change agent: Stepping into our calling

      Highlights

      • Disparities in Outcomes.
      • Implicit bias.
      • Process Improvement.
      • Surgical improvement process.

      Abstract

      As a profession Surgeons are the ultimate thinkers and rationalists. Historically, we have evolved our technique and the quality of the care we deliver through evaluation of our results and the challenge to effect change to improve our patient outcomes. This same discipline and rigor should be brought to the issue of disparities in surgical outcomes. We now understand that in addition to insurance, access and social determinants of health that implicit bias plays a significant role in disparate patient outcomes. Bias is human nature. We all have biases that can be managed and will lead us to provide better care. It is the responsibility of surgeons individually and collectively to be our best selves as persons and professionals. We should be at the cutting edge of the substantive change needed in medicine and our greater society.

      Abbreviations:

      Bias (Implicit), Disparate (Care), Corrective (Action)
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      References

        • Annals of Inquiry
        Thinking it through, WHY IS IT SO HARD TO BE RATIONAL? The real challenge isn't being right but knowing how wrong you might be.
        Rothman, Joshua, New Yorker. August 23, 2021;
        • Harder A.
        • Scott V.
        • Rehman K.
        • et al.
        Racial disparities in Surgical Outcomes in the US: a Comprehensive review of patient, provider and systemic factors.
        J Am Coll Surg. 2013 March; 216: 482-492
      1. (Oct 9)
        • Willer B.
        • Mpody C.
        • Tobias J.
        • et al.
        Racial Dispariaties in Pediatric Surgical Mortality across the Spectrum of Socioeconomic Status.
        American Society of Anethesiology- Virtual meeting, 2021 (A4150)
        • Greenwood B.
        • Hardeman R.
        • Huang L.
        Physician- patient racial concordance and disparities in birthing mortality for newborns.
        Proc Natl Acad Sci USA. 2020 Sep1; 117: 21194-21200https://doi.org/10.1073/pnas.1913405117
        • Gandjiam M.
        • Sareh S.
        • Premja A.
        • et al.
        Racial disparities in surgical management and outcomes of acute limb ischemia in the US, (UCLA and UCLA Harborview).
        Surg Open Science. 2021; 6: 45-50
        • Penner L.
        • Davidio J.
        • Gonzalex R.
        • et al.
        The effects of oncologist implicit bias in racially discordant oncology interaction.
        J Clin Oncol. Aug 20,2018; 34 (Num 24)
      2. Burgess D, van Pyn M, Davideo J, Saha S, Reducing racial bias among health care providers: lessons from social cognitive Psychology, J Gen Intern Med, doi:10.1007/s11606-007-0160-1.

        • Williams D.
        Unthank lecture on implicit bias -professor of public health.
        (Harvard)
        • Verhaeghen P.
        • Aikman S.
        • VanGulick A.
        Prime and Prejudice: co-occurrence in the culture as a source of automatic stereotype priming.
        Br J Psychol. 2011 Sep; 50: 501-518https://doi.org/10.1348/014466610x524254
        • Cheryl Staats
        Implicit Racial Bias and School Discipline Disparities : Exploring the Connection.
        Kirwin Institue Special Report, 2014