From
Dr. Alexander Chiu
Ep. 98 Health Equity Collaborative in ENT with Dr. Alexander Chiu and Dr. Romaine Johnson
With Dr. Alexander Chiu & Dr. Romaine Johnson · hosted by Dr. Gopi Shaw
Chapter 1 of 7 · Fundamentals
Defining equity
Introduction and defining health equity
Expert statements on this page
No expert statements were drawn from this page.
Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
Only a few other public items share this diagnosis — go deeper there →
Video
Health Equity Collaborative in ENT w/ Dr. Alexander Chiu & Dr. Romaine Johnson | ENT Podcast Ep. 98
Alexander Chiu · 41 min · Published Jun 2026
Video
Dr. Alexander Chiu, an Elsevier author
Alexander Chiu · 5 min · Published Jun 2026
Video
Understanding Health Equity Research w/ Kevin Sykes, PhD, MPH | BackTable ENT Podcast Ep. 152
Alexander Chiu · 61 min · Published Jun 2026
What the experts said
Equality means giving everyone the same opportunities and access; equity means providing different supports so everyone can reach optimal health.
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).
Much equity work focuses on the individual, but not enough on community, interpersonal relationships, society, and caregiver research.
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.
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.
After implementing language-preference tracking and better communication, the Dallas team saw fewer emergency room visits and phone calls for simple post-tonsillectomy questions.
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.
A University of Kansas resident is conducting a qualitative study to understand why patients in Kansas City resist head and neck cancer surgery.
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.
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.
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.
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.
Qualitative research is rigorous and difficult: it requires discipline to extract themes from structured interviews of 40 people.
Mixed methodology (qualitative + quantitative metrics) may have emerged partly to satisfy traditional journal expectations for 'hard data.'
Community participatory research means doing research that affects the patients you treat, informed by what patients themselves want to see changed.
The collaborative initially paid people to attend sessions and provided elaborate meals, but that approach 'fell flat.'
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.
The collaborative now includes about 20 academic programs with varying degrees of involvement.
The collaborative meets via Zoom and plans one large in-person meeting annually at the American Academy of Otolaryngology meeting.
The master plan is for the American Academy of Otolaryngology to eventually adopt and support the collaborative.
Dr. Johnson has been tasked with working with the Academy's Regent registry (mostly private practitioners, some universities) to extract data and create an 'equity scorecard' to assess whether care is equitable.
Building good data infrastructure and achieving measurable outcomes takes time; early wins for the collaborative included convening stakeholders and gaining Academy support.
The collaborative has two main foci: research and professional identity/recruitment of underrepresented minorities into otolaryngology.
Orthopedic surgery's Nth Dimension program has been more successful than otolaryngology efforts at recruiting people of color over the past 5 years.
Financial hurdles remain a barrier to replicating the Nth Dimension model in otolaryngology; larger societies need to fund this work.
The collaborative is considering developing anti-racism and equity curricula tailored to otolaryngology for residents and medical students.
Otolaryngology has the least representation of underrepresented minorities among surgical specialties.
The ultimate goal is to make health equity a top-three priority (1, 1A, or 1B) for all otolaryngologists, not just those in diverse or high-poverty communities.
Dr. Chiu tries to be more patient and understanding when patients appear non-compliant, exploring whether there is distrust, a barrier to obtaining medication, or insufficient explanation.
When a patient gives 'that look' suggesting they may not follow through, Dr. Chiu now explores the underlying reason rather than assuming forgetfulness or lack of motivation.
Local practitioners can partner with population health departments, schools of medicine, and public health groups at their institutions, which are more developed in equity work than otolaryngology.
Public health networks established for COVID vaccination studies use techniques (participatory research, community engagement) applicable to otolaryngology topics like HPV vaccine uptake.
Dr. Chiu tells medical students he wants them to remain 'badass, impassioned people with principles and high ethics' through residency and into attending practice, not just focus on case volume.
Medical students interviewing for otolaryngology residency often express interest in global health, equity, and justice, but those values can be lost during training.
Research on elite achievers (e.g., top law school students) shows they become more interested in maintaining elite status over time, potentially losing early idealism.