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Academic Leadership and Health Equity in Otolaryngology

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Diversity in Academic Otolaryngology: An Update and Recommendations for Moving From Words to Action
Despite the ACGME's recent emphasis on the importance of recruiting and retaining a diverse physician workforce, the minority of otolaryngology residency programs advertise any concerted, department-level efforts toward increasing D&I at th
article · Jun 2026
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Ep. 98 Health Equity Collaborative in ENT with Dr. Alexander Chiu and Dr. Romaine Johnson
In this episode of BackTable ENT, Dr. Gopi Shah, Dr. Romaine Johnson (UT Southwestern), and Dr. Alex Chiu (University of Kansas) discuss health disparities rese
podcast41:15 · Jun 2026
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Dr Alexander Chiu Welcome-Chair
Welcome to the Otolaryngology Website
video · Jun 2026
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Dr Alexander Chiu Welcome-Chief
Welcome to the Otolaryngology Website
video · Jun 2026
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Alexander G. Chiu, MD
Head, Division of Otolaryngology-Head & Neck Surgery
video · Jun 2026
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For patients & families
Doctors who specialize in ear, nose, and throat care have come together to address a troubling pattern: patients from different backgrounds don't always receive the same quality of care or have the same health outcomes [e13230-c2, e13230-c4]. In February 2022, six medical centers started the Health Equity Collaborative to study these differences and find solutions; the group has since grown to about 20 programs [e13230-c1, e13236-c10]. Their work focuses on two main areas: conducting research to understand why disparities exist, and recruiting more doctors from underrepresented communities into the specialty . One early success came from a children's hospital in Dallas, where families who didn't speak English were struggling after their child's tonsil surgery—once the hospital improved communication in families' preferred languages, emergency room visits and worried phone calls dropped significantly [e13230-c5, e13236-c5, e13236-c6]. The collaborative is now working with the American Academy of Otolaryngology, which received a three-year grant to fund studies on health disparities [e13230-c8, e13236-c19]. Doctors are learning to ask deeper questions when patients don't follow treatment plans—sometimes the issue isn't forgetfulness but distrust, cost barriers, or unclear explanations [e13230-c12, e13236-c29, e13236-c30].
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Dr. Alexander Chiu, an Elsevier author
Chronic sinusitis affects at least 30 million people a year, and the actual numbers are probably much higher than quoted.
epidemiologicalAlexander Chiu0:27 ↗
Chronic sinusitis has a bigger detriment on quality of life than lower back pain, according to some studies.
epidemiologicalAlexander Chiu0:38 ↗
Chronic sinusitis symptoms include inability to breathe through the nose, facial pressure, loss of taste, and loss of smell, persisting for 12 weeks or longer—sometimes years or a lifetime.
clinicalAlexander Chiu0:55 ↗
In most instances chronic sinusitis can be treated with medicines, but some patients who don't respond need a surgical alternative.
clinicalAlexander Chiu1:21 ↗
Dr. Chiu and Dr. Palmer were former partners at the University of Pennsylvania with adjoining offices.
clinicalAlexander Chiu1:43 ↗
For beginners to endoscopic sinus surgery, the operative field looks like a big field of red, requiring step-by-step procedures correlating anatomy from CT/MRI scans with endoscopic views.
clinicalAlexander Chiu2:40 ↗
The atlas pairs illustrations, CT scans, and MRI scans with endoscopic pictures from cases to guide readers step-by-step from patient preparation to closure and postoperative care.
clinicalAlexander Chiu3:09 ↗
Dr. Chiu has contributed to over 20 different textbooks and written a separate textbook on his own.
clinicalAlexander Chiu4:16 ↗
The Elsevier editorial staff and artist illustrator for this atlas are superior to any Dr. Chiu has worked with before.
opinionAlexander Chiu4:01 ↗
Endoscopic sinus and skull-based surgery techniques in the U.S. are mirrored worldwide but lag 3 to 5 years behind in some developing countries.
epidemiologicalAlexander Chiu4:34 ↗
The atlas spans the spectrum from basic procedures in the first 10 chapters to advanced skull-based tumor procedures in later chapters, allowing surgeons to progress as they gain experience.
clinicalAlexander Chiu4:56 ↗
Ep. 98 Health Equity Collaborative in ENT with Dr. Alexander Chiu and Dr. Romaine Johnson
Equality means giving everyone the same opportunities and access; equity means providing different supports so everyone can reach optimal health.
opinionAlexander Chiu4:36 ↗
The apple-in-the-tree analogy: three people of different heights (6'5", 5'8", 5'3") need different-sized boxes to reach the same fruit (optimal health).
opinionAlexander Chiu5:07 ↗
Much equity work focuses on the individual, but not enough on community, interpersonal relationships, society, and caregiver research.
opinionAlexander Chiu7:40 ↗
Many current articles describe disparities (e.g., Black children have more severe sleep apnea, higher revision rates) using big data or local data, but fewer address interventions to reduce those disparities.
epidemiologicalRomaine Johnson8:29 ↗
At Children's Hospital Dallas, many families were calling or visiting the emergency room post-tonsillectomy due to a language barrier; they did not understand post-op pain medication instructions.
clinicalRomaine Johnson9:28 ↗
After implementing language-preference tracking and better communication, the Dallas team saw fewer emergency room visits and phone calls for simple post-tonsillectomy questions.
clinicalRomaine Johnson9:46 ↗
Data from 2012 (decade-old) show that African American Black patients consent less to head and neck cancer surgery and have poorer outcomes even when case-controlled for tumor stage.
epidemiologicalAlexander Chiu10:40 ↗
A University of Kansas resident is conducting a qualitative study to understand why patients in Kansas City resist head and neck cancer surgery.
clinicalAlexander Chiu10:52 ↗
There is a fair amount of literature describing health disparities on an individual basis, but almost no literature on interventions—especially at the community or societal level.
opinionAlexander Chiu11:25 ↗
The Health Equity Collaborative was started in February 2022 with six institutions: University of Mississippi, Henry Ford, Charles Moore (Atlanta), University of Maryland Baltimore, UT Southwestern, and University of Kansas.
clinicalAlexander Chiu12:07 ↗
The collaborative's initial goal was to agree on data metrics, collect local data, and present it to institutional decision-makers to effect policy change.
clinicalAlexander Chiu13:15 ↗
The collaborative now includes about 20 academic programs with varying degrees of involvement.
clinicalAlexander Chiu20:16 ↗
The master plan is for the American Academy of Otolaryngology to eventually adopt and support the collaborative.
opinionAlexander Chiu22:21 ↗
High-impact journals are reluctant to publish qualitative studies (structured interviews, theme extraction) because they are not observational trials, randomized controlled trials, or systematic reviews.
opinionRomaine Johnson14:32 ↗
Qualitative research is rigorous and difficult: it requires discipline to extract themes from structured interviews of 40 people.
opinionAlexander Chiu15:06 ↗
Mixed methodology (qualitative + quantitative metrics) may have emerged partly to satisfy traditional journal expectations for 'hard data.'
opinionAlexander Chiu16:10 ↗
Community participatory research means doing research that affects the patients you treat, informed by what patients themselves want to see changed.
opinionAlexander Chiu18:13 ↗
The collaborative initially paid people to attend sessions and provided elaborate meals, but that approach 'fell flat.'
clinicalAlexander Chiu19:01 ↗
The American Academy of Otolaryngology (Jim Denaney) has stepped up more than other national societies, recently securing a GSK grant for a 3-year core award to study health disparities.
clinicalAlexander Chiu19:27 ↗
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