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International Dots

A decade ago, if he were asked to name 10 Black vascular surgeons, says one African American vascular chief, he could have come up with six or seven, writes Beth Bales

TODAY AFTER BEING PART OF THE creation and formation of the Society of Black Vascular Surgeons (SBVS), Vincent Rowe, MD, thinks he could list “60, 70, 80” vascular surgeons who are Black. That’s a far cry from 10 years ago, when he thinks could perhaps name just “six or seven.” At a basic level, that’s what the Society has done for him personally, said the chief of vascular surgery at the University of California, Los Angeles (UCLA). “It’s made me feel like I have a lot of colleagues with similar interests, and who have similar challenges to those I have had to face in this profession.”

The SBVS was formed in spring of 2021, after an exploratory meeting in late 2020 discovered enthusiasm and interest in creating such a group, said Edwin Kendrick, MD. It “promotes fellowship amongst members through networking, mentorship and professional development. … [and] has a core mission of education, research, advocacy and provider pipeline development

Diversity Disparities

to advance health equity. The Society seeks to support policies that improve care and overall outcomes by addressing health[care] disparities in underserved patients.”

“Each one of us saw a need,” said Rowe, noting that just 2% of SVS membership is African American. “We felt it necessary to form a collegial networking environment for ourselves, future trainees and colleagues. There’s kind of a dearth of networking systems.”

Kendrick said he has always had “an urgent call to make an impact on improving the pipeline for people entering healthcare.” In 2017 and 2018, he read a report about challenges Black doctors were facing in California. He touched base with Rowe with the idea of trying to create additional opportunities in healthcare for Black physicians in the state.

Rowe began contacting people around the country to gauge interest and discovered “a lot of people who felt they wanted to feel connected,” said Kendrick, who is president of a health equity and technology company. Both men’s visions had a lot of overlap. Kendrick’s long-standing interest was in what he wanted to do for Black physicians, whereas he, Rowe said, was more focused on vascular surgeons specifically.

In late 2020, they met for the first time, and over the next months began forming a potential group. The Society was formed in May 2021, and thanks to the dedication of a diverse board, chaired by Kenneth Simon, MD, the SBVS has continued to flourish and slowly grow. The Society started small, with perhaps 20 to 30 members, but now counts approximately 140 people. “The most revealing and beautiful thing is that the talent pool is so diverse and so strong,” said Kendrick.

“We have a mix of everything in terms of interests—advocacy, entrepreneurship, general surgery, mission work, mentoring, research, a complete coverage of all these different talents.”

It remains a work in progress, both said. They want to be sure not to overreach, but they have ambitions for future projects.

And connections are being formed, to unexpected results. Rowe said he met a surgeon who has been practicing for 20-odd years in West Virginia who regularly travels to Nigeria to train vascular surgeons. A few months ago, Rowe met another doctor who was going to Nigeria. Rowe put the two in contact, and they plan to connect and possibly expand that work.

“We’re doing a lot of this, putting people together because of our network,” Rowe said. “Without it, these two people wouldn’t have connected—and I did not know either one of them a year ago.”

Both Rowe and Kendrick said they feel the SBVS works in parallel with SVS. Their first in-person gathering was at the Vascular Annual Meeting (VAM), and they plan a reception at this year’s meeting outside Washington, D.C. They noted both 2022 vice presidential candidates talked with their members. “We outvoted our percentage,” in terms of demographics, noted Rowe. “Blacks make up 2% of SVS membership and we were 4% of the vote.”

SVS leaders also have made a concerted effort to add diversity to its committees and task forces, which has led to more engagement between SVS and its Black members. One SVS member, in fact, reached out to Rowe to seek a recommendation for an SBVS member to put on a particular task force.

The new SBVS, they noted, is helping build the support required to bring people together, to work to improve healthcare in general and mentor Black surgeons in particular, and to advocate for increased opportunities. It also wants to address the existence of healthcare disparities. Rowe wants SVS members to “remember we are parallel. We’re trying to accomplish some of the same things together. Don’t be afraid to utilize some of our expertise.

“Reach out,” he added. “I know many of our members would say they don’t have a bridge to get involved with SVS. Without that bridge, it’s hard to get places. All of us will help to get people involved where they can and help them get that opportunity.” Interested parties can learn more about the SBVS at blackvascular.org

Tackling health insecurity ‘from the top down and the bottom up’

Texas-based vascular surgeon outlines strategies that can be deployed to tackle problems threatening a patient’s health security, and highlights an example of outreach in San Antonio tackling problems in high-risk population zones head on. By Bryan

The feeling of being “uncertain, anxious and vulnerable” defines a creeping health insecurity problem riddling parts of the U.S. patient population—demographics who are underserved and at higher risk of outcomes such as amputation. And they can be a barrier to obtaining healthcare, according to Rana Afifi, MD, an associate professor of vascular surgery at McGovern Medical School, University of Texas Health Houston. Afifi was speaking during an invited presentation on strategies that can be used to tackle health insecurities during the 2023 Society for Clinical Vascular Surgery (SCVS) Annual Symposium in Miami (March 25–29). “There [are] plenty of data in the literature [showing] that there is a significant increase in the number of publications that show the relationship between social determinants of health and outcomes,” she told attendees. “However, what is lacking is the data regarding how we do any strategies to improve, implement or actually have any intervention...”

Afifi spoke of health policy reforms that “incentivize healthcare systems to respond to social determinants of health and improve population health as a strategy for reducing excessive costs.” She also focused on strategies already available that can be applied locally. Afifi dealt with health security issues as they relate to such areas of life as housing, finance, transportation and food. “You can work with food banks,” Afifi said. “There have been studies showing their role in care for patients and mitigating some of the health insecurities at risk for this.”

She turned to the example of the SAVE (San Antonio Vascular and Endovascular) Clinic in San Antonio, Texas,

Kay

founded and run by vascular surgeon Lyssa Ochoa, MD, as a case in point. Ochoa based her work on identifying the zones where, for example, there are high amputation rates and low socioeconomic status—high-risk populations, observed Afifi. “That’s basically where she based her outreach clinics,” she said. Her network is equipped with vascular care-equipped mobile units that head out into the heart of these communities, “assisting with some of the transportation options.” Ochoa and her team also partner with community healthcare workers to navigate wider needs, such as screening and trust-building. Going forward, the health insecurity issue necessitates a cultural change, and needs to be addressed at multiple levels, Afifi added. “The way to address it is from the top down and the bottom up at the same time—we can’t just wait for policy to change.”

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