Operation Equity

An Introduction to the Social Determinants of Surgical Health

This curriculum is designed to provide a broad overview of the factors that drive disparities in health care and health outcomes for patients with surgical disease. This course is not intended to merely reiterate why eliminating surgical disparities are important. Rather, the curriculum focuses on engaging students in meaningful dialogue about how systems perpetuate disparities in access, care quality, experience, and outcomes for disadvantaged patient populations with surgical disease. Further, it challenges students to consider how we, as future health providers and as a health system, can create change to address these disparities.

If you’re interested in learning more about Operation Equity, please contact Cindy Zhao at cindy.zhao@pennmedicine.upenn.edu

Course Objectives 

At the end of this course, students will be able: 

  • To describe how systemic barriers perpetuate disparities in access, experience, and outcomes in surgical disease

  • To facilitate interdisciplinary dialogue about the social determinants of surgical health

  • To appraise how providers can address health care and health disparities in surgery 

  • To provide care sensitive to all aspects of a patient’s identity and lived experience

  • To advocate for marginalized surgical patient populations through clinical care, scholarship, and policy change

Course Format

 This course has ten “equity discussions” of contributing factors to disparities across the continuum of surgical care: 

  1. Access to care 

  2. Pre-operative care 

  3. Operative care

  4. Post-operative care

  5. Surgical outcomes and research

Rules of Engagement

  1. Respect

    • ​Respect all individuals, including those not present. These might be your current and future classmates, coworkers, and patients!

    • Consider an individual’s rights rather than their educational or economic value.

    • Frame discussion in terms of the value of all humans.

  2. Intentionality​

    • ​Trust intent, name impact. If someone says or does something that is hurtful or inappropriate, tell them in a respectful way trusting that they did not mean harm

    • Challenge ideas, not people

    • Consider when to call in, rather than call out* (See note for more information)

  3. Confidentiality​

    • ​Facilitators may change the topic or move a specific conversation offline to ensure that small group conversations remain productive.

    • Topics, thoughts, and experiences discussed during class should remain confidential unless explicit permission is obtained.

  4. Language​

    • ​Use I statements - speak for yourself, not for groups; avoid tokenism

    • Avoid pejorative terms (e.g. use “undocumented” instead of “alien”)

    • Use people-first language (e.g. use “person with addiction” instead of “addict”)

    • Provide context and definitions for buzzwords to encourage mutual understanding among individuals with different knowledge levels.

Guest Speakers

Cary Aarons, MD

Associate Professor of Surgery

Program Director for General Surgery

Department of Surgery

University of Pennsylvania Health System

 

Mike Ashburn, MD, MPH, MBA

Professor of Anesthesiology and Critical Care

Director, Pain Medicine

Department of Anesthesiology and Critical Care

University of Pennsylvania Health System

 

Jaya Aysola, MD, MPH

Assistant Professor of Medicine and Pediatrics

Assistant Dean of Inclusion

Executive Director, Center for Health Equity Advancement

Departments of Medicine and Pediatrics

University of Pennsylvania Health System

 

Jovan Bennett, BS

Project Manager

Penn Center for Community Healthcare Workers

University of Pennsylvania

 

Robin Canada, MD

Associate Professor of Clinical Medicine

Associate Program Director, Primary Care Track

Director of Residency Education, Puentes de Salud

Department of Medicine

University of Pennsylvania Health System

 

Daniel Dempsey, MD

Professor of Surgery

Chief, Gastrointestinal Surgery

Assistant Director of Perioperative Services

Department of Surgery

University of Pennsylvania Health System

 

Benoit Dubé, MD

Associate Professor of Psychiatry

Chief Wellness Officer, University of Pennsylvania

Department of Psychiatry

University of Pennsylvania Health System

Victoria Gershuni, MD, MS, MTR

Assistant Instructor of Surgery

Department of Surgery

University of Pennsylvania Health System

 

Julia Glaser, MD

Assistant Professor of Clinical Surgery

Department of Surgery

University of Pennsylvania Health System

 

Linda Hawkins, PhD, MSEd, LPC

Co-Director, Gender & Sexuality Development Clinic

Children’s Hospital of Philadelphia

 

Holly Fernandez Lynch, JD, MBe

John Russell Dickson, MD Presidential Assistant Professor of Medical Ethics

Assistant Faculty Director of Online Education, www.improvinghealthcare.net

Department of Medical Ethics and Health Policy

Perelman School of Medicine, University of Pennsylvania

 

Monica Llado-Farrulla, MD

Assistant Instructor of Surgery

Department of Surgery

University of Pennsylvania Health System

 

Maripat Pileggi, JD

Staff Attorney

Community Legal Services

 

Colleen Tewksbury, PhD, MPH, RD

Senior Research Investigator

Adjunct Associate Professor of Public Health in Surgery

Bariatric Program Manager

Department of Surgery

University of Pennsylvania Health System

Cheryl Garfield

Lead Community Healthcare Worker

Penn Center for Community Healthcare Workers

University of Pennsylvania

Course Outline

Equity Discussion Topic
Date
Core Students
University-Wide
#1 The Semantics of Health Equity: From Concepts to Strategic Approaches
Wednesday, January 6
X
X
#2 Legal Challenges in Accessing Healthcare and the Role of the Safety Net Hospital
Tuesday, January 19
X
#3 Addressing Patient Health and Obesity Prior to Elective Surgery
Tuesday, February 2
X
#4 The Additional Challenges of Navigating Stigma Against LGBTQIA Patients
Tuesday, February 16
X
X
#5 Considerations for the Patient: The Social Determinants of Surgical Health Not Taught in School
Wednesday, March 3
X
X
#6 Gender-Affirming Surgery
Tuesday, March 16
X
#7 Considerations for the Provider: Addressing Bias and Promoting Diversity in Surgery
Tuesday, March 30
X
X
#8 Post-operative Pain
Tuesday, April 13
X
#9 The Lack of Diversity in Research and the History of Research on Vulnerable Subjects
Wednesday, April 28
X
X
#10 Post-operative Care Coordination and Patient-Centered Outcomes
Tuesday, May 11
X