Geolani W. Dy, M.D., chose to practice urology to impact social justice. Her goal: advocate for children born with differences of sexual development (intersex conditions) on the frontier of the specialty. She ultimately focused her career on caring for trans and gender diverse communities through gender-affirming surgery.
For Casey A. Seideman, M.D., the breadth of disease processes, procedures and technology used in urology attracted her and, once in, she was drawn to working on diversity, equity and inclusion.
Dy and Seideman are assistant professors of urology in the Oregon Health & Science University School of Medicine.
According to the American Urological Association, 10% of practicing urologists are women, an improvement in the last decade. Only 2.2% of urologists identify as Black and 3.9% identify as Hispanic.
Given significant disparities, for example, in prostate cancer death rates among Black men and a growing body of literature — including a recent paper by Somnath Saha, M.D., M.P.H., professor of medicine (general internal medicine and geriatrics), OHSU School of Medicine, suggesting that Black patients may prefer the care they receive from physicians of their own race, Dy and Seideman saw an opportunity to join and amplify efforts to examine disparities in the urologic provider workforce as one step towards addressing health disparities.
“We need to start representing the patients we care for,” said Dy. “Until we make a change in who urologists are, we aren’t going to make change.”
By-passing the talking points
In the wake of George Floyd’s death at the hands of police in late May, they teamed up with Shannon Cannon, M.D., a fellow in pediatric urology at Seattle Children’s Hospital and University of Washington, and formed Urologists for Equity.
“As our nation confronts systemic racism, we must all reflect upon our own contributions to the current crisis, and on actions we must take to create sustainable change,” they wrote in June in an open letter to their profession also signed by a dozen colleagues across the country.
“Many organizations, including the American Urologic Association and Urology Care Foundation, have made statements condemning racism. As the AUA looks ahead for ways to promote equity in our society, encouraging members to speak out against racism, and committing to engage in advocacy against racial discrimination, it is imperative that members of our profession look within.
“While pledging to fight for health care equity for our patients, we must consider: what does it mean to truly support diversity in our own field?” they continued. “As a urologic community, we need to critically evaluate the scope of the problem, identify barriers to diversity and inclusion, including those that we tacitly uphold, create a blueprint for impacting change, and engage in continuous self-assessment.”
Areas of activity
This national network is active in four areas:
- Advocacy — Specific initiatives and actions that all urologists can pursue, including partnering with organizations that seek to fight systemic injustices in urology and metrics for self-evaluation and monitoring.
- Sponsorship — Create a list of mentors, coaches and sponsors for underrepresented minority faculty and trainees in urology.
- Scholarship — Promote research that exposes structural barriers and highlights DEI needs in urology and develop a list of studies and resources for self-education.
- Engagement — Harness the creativity and energy of a diverse community of urologists, including medical students, department chairs, community urologists, researchers and all who are committed to creating meaningful change in urology.
“Our goal is to bypass the talking points and start working on some action,” Seideman said.
An important aspect of change, said Dy and Seideman, is the ability to talk about both the positive and the alienating experiences that women and members of underrepresented groups have had in the specialty in order to encourage welcoming practices.
Chris Amling, M.D., professor and chair of urology in the OHSU School of Medicine, is supporting their efforts and their colleagues are leaning in.
“It’s energizing to see the direction and expansion of ideas that Drs. Dy and Seideman are bringing to the department and the profession,” said Amling, who led a department town hall on anti-racism in June. “Their dedication to this cause is inspiring to all of us. In the midst of so much tragedy, it is incredibly hopeful that we acknowledge these disparities and embrace this work together.”
Dy and Seideman feel moved and excited.
“We are inspired by our community of urologists at OHSU, nationally and internationally who are dedicated to this work and know that for all of us it will be career-long,” Dr. Seideman said.