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>> GOOD AFTERNOON,
EVERYONE.

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THANK YOU FOR COMING.

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I'M STEPHANIE GOFF, ONE OF THE

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MEMBERS OF THE GREAT TEACHERS

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COMMITTEE HERE AT THE CLINICAL

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CENTER.

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I'VE GOT SOME SORT OF

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INTRODUCTORY REMARKS ABOUT THE

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PROGRAM FIRST, AND THEN ABOUT

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OUR INVITED SPEAKER, DR.

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CAMPBELL. 

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WELCOME TO TODAY'S GROUND

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ROUNDS, THE ACTIVITY CODE IS

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57874, YOU CAN TEXT THIS TO THE

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PHONE NUMBER ON THE SLIDE TO GET

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CME CREDIT FOR THIS LECTURE. 

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WE INVITE YOU TO PROVIDE

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FEEDBACK BY SCANNING THE QR

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CODE. 

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FOR THOSE APPLYING YOU'LL

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RECEIVE A LINK I HAVE E-MAIL, TO

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PROVIDE FEEDBACK AND SUBMIT

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SUGGESTIONS FOR FUTURE GRAND

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ROUNDS TOPICS.

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FOLLOWING THE PRESENTATION, WE

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WILL TAKE QUESTIONS FROM THE

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MICROPHONES IN THE AISLES BUT WE

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WILL ALSO HAVE QUESTIONS

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AVAILABLE DURING THE LECTURE IF

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YOU'RE WATCHING ONLINE, THOSE

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WILL FEED DIRECTLY TO ME AND

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WE'LL ASK DR. CAMPBELL AS TIME

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PERMITS AT THE CONCLUSION OF THE

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PRESENTATION.

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THE GRAND ROUNDS IS A SPECIAL

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PROGRAM WITHIN OUR CLINICAL

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CENTER GRAND ROUNDS PROGRAM, AS

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CONCEIVED BY THE FIRST COMMITTEE

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CHAIR OF THE GREAT TEACHERS

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COMMITTEE, DR. PAUL PLOTS TO

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INVITE LEADERS TO PRESENT ON

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TOPICS AND IDEAS ABOUT WHICH

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THEY ARE PASSIONATE, TO SHARE

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REFLECTIONS AND INSPIRE YOUNG

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INVESTIGATORS IN PURSUIT OF

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CAREERS OF BIOMEDICAL RESEARCH.

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SPEAKER IS ANDRE CAMPBELL, WHOM

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I KNOW FROM OUR SHARED HISTORY

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AT COLUMBIA, A PROFESSOR AT

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UNIVERSITY OF CALIFORNIA, SAN

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FRANCISCO, BACHELOR OF ARTS

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DEGREE IN BIOLOGY FROM HARRD

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 HARVARD,

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MEDICAL DEGREE FROM UNIVERSITY

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OF CALIFORNIA, SAN FRANCISCO,

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GENERAL SURGERY AT COLUMBIA

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UNIVERSITY MEDICAL CENTER, PART

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OF THE UCSF FACULTY BASED AT THE

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SAN FRANCISCO GENERAL HOSPITAL

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FOR 30 YEARS, AN ADJUNCT

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PROFESSOR OF SURGERY AT USU

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ACROSS THE STREET, SERVICING

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WALTER REED.

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DR. CAMPBELL IS ONE OF THE MOST

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DECORATED SURGICAL EDUCATORS AT

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UCSF, RESEARCH INCLUDES ICU CARE

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OF TRAUMA PATIENTS, ACUTE LUNG

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INJURY AFTER TRAUMA, ABDOMINAL

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COME 

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COMPARTMENT SYNDROME, HE

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DIRECTED SURGICAL CRITICAL CARE

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FELLOWSHIP AT UCSF FOR 24 YEARS,

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TRAINED MANY FELLOWS WHO

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PRACTICE TOM, SURGICAL CRITICAL

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CARE, ACUTE CARE SURGERY AROUND

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THE WORLD.

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HIS EDUCATIONAL ACCOMPLISHMENTS

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HAVE BEEN CELEBRATED LOCALLY AND

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NATIONALLY.

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HE WAS RECOGNIZED AS A FOUNDING

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MEMBER OF THE HAILEY DEBOSS

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ACADEMY OF MEDICAL EDUCATORS,

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ENDOWED CHAIR OF SURGICAL

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EDUCATION AT UCSF, AWARDED SAN

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FRANCISCO GENERAL HOSPITAL HEART

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AND HEROES AWARD FOR

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CONTRIBUTIONS TO THE HOSPITAL,

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AND THE CITY AND COUNTY OF SAN

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FRANCISCO.

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HE WAS RECIPIENT OF THE

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ZUCKERBERG SAN FRANCISCO GENERAL

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HOSPITAL EQUITY AWARD, DR. ANDRE

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CAMPBELL AWARD NAMED IN HIS HIS

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FOR THE PRINCIPLES OF EQUITY AT

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THE HOSPITAL.

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MEMBER OF THE MERGE COLLEGE OF

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SURGEONS COMMITTEE ON TRAUMA FOR

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15 YEARS, CENTRAL COMMITTEE FOR

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FIVE, AMERICAN COLLEGE OF

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SURGEONS BOARD OF GOVERNORS,

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SECRETARY OF THE BOARD OF

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GOVERNORS ON THE EXECUTIVE

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COMMITTEE.

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CURRENTLY PRESIDENT OF THE

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NORTHERN CALIFORNIA CHAPTER OF

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AMERICAN COLLEGE OF SURGEONS,

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ALSO PRESIDENT OF THE UCSF GOLD

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HEADED CANE SOCIETY, MEMBER OF

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THE AMERICAN COLLEGE OF SURGEONS

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ACADEMY OF MASTER SURGICAL

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EDUCATORS.

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RECENTLY WAS AWARDED HONORARY

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FELLOWSHIP IN BRAZILIAN COLLEGE

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OF SURGEONS, RECOGNIZED BY THE

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GOVERNOR OF CALIFORNIA,

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CALIFORNIA STATE LEGISLATURE,

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STATE CONTROLLER, MAYOR OF SAN

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FRANCISCO WHO PROCLAIMED THAT

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NOVEMBER 2, 2023, WAS DR. ANDRE

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CAMPBELL DAY IN SAN FRANCISCO,

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IN ADDITION HE HAS WRITTEN OVER

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100 MANUSCRIPTS, ABSTRACTS,

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BOOKS CHAPTER.

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THE TITLE TODAY IS "DISPARITIES

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IN TRAUMA CARE" AND I'M THRILLED

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TO PRESENT OUR SPEAKER TODAY DR.

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ANDRE CAMPBELL.

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[APPLAUSE]

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>> IT'S GREAT TO BE HERE
THIS

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MORNING, THANK YOU SO MUCH.

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I REALLY APPRECIATE THAT

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GENEROUS INTRODUCTION, DR. GOFF.

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THAT'S ABSOLUTELY AMAZING.

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SO, I'VE NEVER THOUGHT I WOULD

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BE IN THE HALLOWED HALLS OF NIH

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DURING MY CAREER, IT'S A

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TREMENDOUS HONOR TO BE HERE AND

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TO BE TALKING TO YOU ABOUT

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SOMETHING NEAR AND DEAR TO MY

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HEART, TRAUMA CARE AND

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DISPARITIES IN TRAUMA CARE.

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I'LL GO THROUGH A TOUR OF WHAT

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I'M GOING TO TALK ABOUT IN A BIT

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BUT IT'S AN HONOR.

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THANK YOU FOR INVITING.

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NO DISCLOSURES, YOU'VE HAD A LOT

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OF GREAT TEACHERS, I'LL SAY A

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COUPLE THINGS.

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ONE IS MY CURRENT CHAIR OF

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SURGERY, SO WHEN I GO BACK, YOU

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DID IT, I DID IT, I COULD HAVE

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AN EYEBALL TO EYEBALL WITH HER

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ABOUT THAT, AND DR. BERTAGNOLLI

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HAS BEEN ONE OF THE GREAT NIH

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TEACHERS OVER A NUMBER OF YEARS.

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I THANK DR. GOFF, I GOT TO KNOW

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HER, SHE AND I TRAINED AT

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COLUMBIA UNIVERSITY MEDICAL

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CENTER IN NEW YORK, ALSO KNOWN

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AS COLUMBIA PRESBYTERIAN IN THE

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PAST, WE GOT TO KNOW EACH OTHER

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THROUGH THE SURGICAL SOCIETY, A

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GROUP OF SURGEONS WHO HAD

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COMPLETED THEIR TRAINING AT

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COLUMBIA OVER THE YEARS, SHE

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FINISHED IN A DIFFERENT ERA THAN

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I DID, BUT WE'RE ALL BOUND TO

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TREMENDOUS EXPERIENCE WE HAD

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TAKING CARE OF PEOPLE IN

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MANHATTAN DURING THOSE MANY

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FORMATIVE YEARS, SO IT'S REALLY

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AN HONOR.

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AGAIN, THANK YOU SO MUCH FOR

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INVITING ME HERE TO SPEAK TODAY.

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I'M GOING TO GO THROUGH A LITTLE

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BIT.

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I WORK AT SAN FRANCISCO GENERAL,

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DOESN'T LOOK LIKE THAT ANYMORE,

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SOME BUILDINGS ARE STILL UP,

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I'LL SHOW YOU PICTURES.

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SAN FRANCISCO GENERAL HAS BEEN

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AFFILIATED WITH UNIVERSITY OF

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CALIFORNIA, SAN FRANCISCO FOR

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150 YEARS.

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I'M ON THE FACULTY BUT BASED AT

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SAN FRANCISCO GENERAL HOSPITAL.

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IT'S AN IMPORTANT PART OF THE

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PUBLIC HEALTH MISSION OF CITY

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AND COUNTY OF SAN FRANCISCO, WE

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CARE FOR 100,000 PATIENTS, WHICH

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IS ABOUT 1/8 THE SIZE OF SAN

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FRANCISCO, NUMBER OF SAN

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FRANCISCO IS 800,000, WE HAVE

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100,000 PEOPLE WHO ARE CARED AT

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AT OUR CLINICS AND MAIN

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HOSPITAL.

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THIS IS THE 1940s, THE MAIN

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STREET THERE, THE BUILDINGS IN

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THE FRONT IS THE OLD HOSPITAL,

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BACK IS TUBERCULOSIS, AND THEN A

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NURSING FACILITY, IN THE 1940s

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AND '50s.

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HOSPITAL CURB DOESN'T EXIST

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BECAUSE 101 WAS NOT BUILT AT

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THAT TIME THERE.

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THIS IS WHAT WE LOOK LIKE NOW.

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THIS IS ABOUT 20 YEARS AGO

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BEFORE WE BUILT THE NEW

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BUILDING.

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THE GRAY BUILDING IS THE NEW OLD

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HOSPITAL, AND THAT'S THE OLD,

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OLD HOSPITAL THAT DATES AFTER

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THE FIRE IN SAN FRANCISCO, EARLY

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1900s, THAT'S WHAT IT LOOKED

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LIKE.

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201 WE OPENED UP THE

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STATE-OF-THE-ART HOSPITAL, YOU

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MAY REMEMBER THAT CALIFORNIA HAS

219
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ABOUT 500 EARTHQUAKES A YEAR SO

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WHAT HAPPENS AFTER THE GREAT

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EARTHQUAKE IN SOUTHERN

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CALIFORNIA, NORTH RIDGE, THEY

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HAD TO REDESIGN MAJOR HOSPITALS

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IN CALIFORNIA, OUR HOSPITAL WAS

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BUILT ON 115 BALL BEARINGS, A

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BUILDING INSIDE A BUILDING, CAN

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MOVE THREE FEET IN ANY

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DIRECTION, ENOUGH RESOURCES TO

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KEEP FOR THREE DAYS, IT'S A

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PRETTY AMAZING FACILITY.

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IT LOOKS GREAT, LIKE A

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SPACESHIP, LOOKS WONDERFUL, BUT

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THE PROBLEM IS THAT ALL THAT

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SPACE, WE LOST THAT SPACE, WE

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WON ARCHITECTURAL AWARDS, BUT

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THERE'S NOT A LOT OF SPACE FOR

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PATIENTS.

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I KNOW WE HAVE THE CEO HERE

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TODAY SO HE'S ALL ABOUT

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PATIENTS, WE HAVE GREAT AWARDS

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BUT DON'T HAVE SPACE FOR PEOPLE

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OR US THERE. 

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THIS IS NOW WITH WITH THE

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EXCEPTION OF THE RESEARCH

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BUILDING BECAUSE OF THE RULES,

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THEY HAD TO BUILD AGAIN, ALL

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RESEARCHERS ARE THERE.

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YOU MAY NOTICE UCSF IS THE

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NUMBER ONE -- RECEIVED THE

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LARGEST AMOUNT OF MONEY FROM NIH

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OTHER THAN ANY OTHER PUBLIC

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INSTITUTION IN THE UNITED

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STATES, WE'RE NUMBER 2 BEHIND

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HARVARD IN TERMS OF MONEY FROM

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NIH, FORTUNATE TO HAVE A LOT OF

256
00:09:16,828 --> 00:09:19,130
GREAT RESEARCHERS AT OUR PLACE

257
00:09:19,130 --> 00:09:19,330
THERE.

258
00:09:19,330 --> 00:09:26,204
THAT'S WHAT PRIDE HALL LOOKS

259
00:09:26,204 --> 00:09:28,940
LIKE, I'M GOING TO TALK A LOT

260
00:09:28,940 --> 00:09:32,544
ABOUT AT FIRST COVID AND HOW THE

261
00:09:32,544 --> 00:09:33,378
DISPARITIES OF COVID AFFECTED

262
00:09:33,378 --> 00:09:34,779
POPULATION IN THE UNITED STATES,

263
00:09:34,779 --> 00:09:35,880
AROUND THE WORLD.

264
00:09:35,880 --> 00:09:38,349
I'M GOING TO THEN TALK ABOUT

265
00:09:38,349 --> 00:09:40,151
OUTCOMES IN TRAUMA CARE, AND

266
00:09:40,151 --> 00:09:43,154
TALK A BIT ABOUT DIVERSITY IN

267
00:09:43,154 --> 00:09:45,523
MEDICINE, ALSO PATHWAY ISSUES IN

268
00:09:45,523 --> 00:09:46,624
MEDICINE, PIPELINE ISSUES IN

269
00:09:46,624 --> 00:09:48,259
MEDICINE, THAT'S WHAT I'M GOING

270
00:09:48,259 --> 00:09:49,661
TO TALK ABOUT TODAY.

271
00:09:49,661 --> 00:09:51,162
THESE ARE TOPICS NEAR AND DEAR

272
00:09:51,162 --> 00:09:52,964
TO MY HEART, THEY HAVE HAD

273
00:09:52,964 --> 00:09:53,965
TREMENDOUS IMPACT ON MY PATIENTS

274
00:09:53,965 --> 00:09:55,900
AS I CARE FOR THEM IN THE CITY

275
00:09:55,900 --> 00:09:58,536
AND COUNTY OF SAN FRANCISCO.

276
00:09:58,536 --> 00:09:59,738
WHAT COVID TAUGHT US, I THINK

277
00:09:59,738 --> 00:10:02,774
THAT WE SORT OF HAVE TO REVISIT

278
00:10:02,774 --> 00:10:05,877
THIS EVERY TIME THERE'S A MAJOR

279
00:10:05,877 --> 00:10:06,978
EPIDEMIC OR PANDEMIC OR, YOU

280
00:10:06,978 --> 00:10:09,280
KNOW, TRAUMA, WHICH IS NOW

281
00:10:09,280 --> 00:10:10,515
DECLARED, THANK GOD, BY THE

282
00:10:10,515 --> 00:10:13,785
SURGEON GENERAL AS A PUBLIC

283
00:10:13,785 --> 00:10:15,320
HEALTH EMERGENCY THAT THERE'S

284
00:10:15,320 --> 00:10:16,187
CERTAINLY DISPARITIES THAT EXIST

285
00:10:16,187 --> 00:10:18,022
IN TERMS OF OUTCOMES.

286
00:10:18,022 --> 00:10:20,859
SO, FIRST WHAT WE NOTICE IS THAT

287
00:10:20,859 --> 00:10:22,660
A LARGE PART OF THE PATIENTS

288
00:10:22,660 --> 00:10:24,295
BEING AFFECTED BY COVID WERE

289
00:10:24,295 --> 00:10:25,630
PEOPLE OF COLOR, IN TERMS OF

290
00:10:25,630 --> 00:10:28,700
PEOPLE DYING BOTH IN NEW YORK

291
00:10:28,700 --> 00:10:30,568
AND OTHER PLACES, AT THE

292
00:10:30,568 --> 00:10:32,737
BEGINNING OF THE PANDEMIC THERE.

293
00:10:32,737 --> 00:10:34,372
THERE WAS A LOT OF -- WE DIDN'T

294
00:10:34,372 --> 00:10:36,341
HAVE A LOT OF DATA AT FIRST BUT

295
00:10:36,341 --> 00:10:38,743
THEN THE DATA STARTED COMING IN.

296
00:10:38,743 --> 00:10:41,246
THEN WHAT HAPPENED WAS THE

297
00:10:41,246 --> 00:10:43,548
AWAKENING AROUND THE GEORGE

298
00:10:43,548 --> 00:10:45,116
FLOYD MURDER, WHAT HAPPENED AT

299
00:10:45,116 --> 00:10:46,217
THE BEGINNING OF THE PANDEMIC,

300
00:10:46,217 --> 00:10:48,153
AND WHAT HAPPENED WITH THAT.

301
00:10:48,153 --> 00:10:49,988
YOU KNOW, STUDENTS IN MANY CASE

302
00:10:49,988 --> 00:10:52,857
LED THE WAY WITH WHITE COATS FOR

303
00:10:52,857 --> 00:10:55,827
BLACK LIVES, AND A LOT OF

304
00:10:55,827 --> 00:10:57,061
PHYSICIANS STOOD UP FOR

305
00:10:57,061 --> 00:10:58,396
SOMETHING THAT WAS REALLY

306
00:10:58,396 --> 00:11:00,265
IMPORTANT TO MAKE SURE WE KNEW

307
00:11:00,265 --> 00:11:03,168
THAT EVERYBODY WAS GETTING CARED

308
00:11:03,168 --> 00:11:04,435
FOR THE SAME WAY.

309
00:11:04,435 --> 00:11:05,970
SO INITIALLY DIDN'T HAVE ANY

310
00:11:05,970 --> 00:11:07,539
DATA ABOUT COVID BUT BEGAN TO

311
00:11:07,539 --> 00:11:10,441
COME IN, AS WE SAW THERE WAS A

312
00:11:10,441 --> 00:11:12,343
HUGE DISPARITY IN AMOUNT OF

313
00:11:12,343 --> 00:11:14,445
PEOPLE GETTING AFFECTED AND

314
00:11:14,445 --> 00:11:16,948
AMOUNT OF PEOPLE WHO WERE NATIVE

315
00:11:16,948 --> 00:11:19,150
AMERICAN, LATINX, AND AFRICAN

316
00:11:19,150 --> 00:11:20,852
AMERICAN WHO WERE GETTING COVID

317
00:11:20,852 --> 00:11:23,888
AND IN FACT DYING.

318
00:11:23,888 --> 00:11:27,158
THIS WAS DATA COUPLE YEARS OLD,

319
00:11:27,158 --> 00:11:29,360
1 IN 900 BLACK AMERICANS DIED

320
00:11:29,360 --> 00:11:30,829
FROM COVID, THAT NUMBER HOVERS

321
00:11:30,829 --> 00:11:34,532
AROUND WHAT IT IS STILL TODAY,

322
00:11:34,532 --> 00:11:35,900
TWICE THE AVERAGE IN WHITE

323
00:11:35,900 --> 00:11:36,768
NATION POPULATIONS.

324
00:11:36,768 --> 00:11:38,036
MY INTRODUCTION TO THE COVID

325
00:11:38,036 --> 00:11:40,271
PANDEMIC IS ONE OF MY FRIENDS

326
00:11:40,271 --> 00:11:41,706
CALLED ME, A SURGEON NOW

327
00:11:41,706 --> 00:11:44,108
RETIRED, HIS WIFE WAS A NURSE.

328
00:11:44,108 --> 00:11:49,981
THIS HAPPENED JUST AFTER MARDI

329
00:11:49,981 --> 00:11:53,151
GRAS, HAD GONE TO A PARTY FOR --

330
00:11:53,151 --> 00:11:55,153
IT WAS A PARTY FOR THE BIRTH OF

331
00:11:55,153 --> 00:11:57,188
A CHILD, AND SHE CAME BACK AND

332
00:11:57,188 --> 00:11:58,623
THERE WAS FOUR PEOPLE GOT SICK,

333
00:11:58,623 --> 00:12:00,758
SHE WAS THE ONE WHO WENT TO THE

334
00:12:00,758 --> 00:12:02,393
HOSPITAL AND DIED IN THE

335
00:12:02,393 --> 00:12:03,695
HOSPITAL WHEN HER HUSBAND WAS

336
00:12:03,695 --> 00:12:05,630
TRYING TO GET TO HER, FROM

337
00:12:05,630 --> 00:12:05,964
COVID.

338
00:12:05,964 --> 00:12:07,498
SHE JUST DIED BEFORE THEY COULD

339
00:12:07,498 --> 00:12:10,835
FIGURE OUT WHAT TO DO WITH HER,

340
00:12:10,835 --> 00:12:14,639
WHICH THAT HAPPENED IN

341
00:12:14,639 --> 00:12:15,940
LOUISIANA, RIGHT AFTER THE MARDI

342
00:12:15,940 --> 00:12:16,608
GRAS, IN 2020.

343
00:12:16,608 --> 00:12:20,511
SHE THIS IS SOME DATA HERE, A

344
00:12:20,511 --> 00:12:21,846
BIG EFFECT ON CHILDREN.

345
00:12:21,846 --> 00:12:27,986
AND A LOT OF THE CONFIRMED CASES

346
00:12:27,986 --> 00:12:29,187
WERE CHILDREN, SO TREMENDOUS

347
00:12:29,187 --> 00:12:32,624
IMPACT ON UNDERREPRESENTED

348
00:12:32,624 --> 00:12:34,626
POPULATION, THAT'S HOW I GOT

349
00:12:34,626 --> 00:12:37,395
INVOLVED AS PART OF ADVOCATING

350
00:12:37,395 --> 00:12:38,096
FOR MAKING SURE PEOPLE KNEW THIS

351
00:12:38,096 --> 00:12:44,535
WAS SOMETHING THAT WAS A BIG

352
00:12:44,535 --> 00:12:48,139
PROBLEM AND IN COMMUNITIES OF

353
00:12:48,139 --> 00:12:58,182
COLOR, BUT AS WE FOUND OUT THAT

354
00:12:58,182 --> 00:12:58,716
IT WAS DISPROPORTIONATELY

355
00:12:58,716 --> 00:13:00,418
AFFECTING PEOPLE OF COLORS IN

356
00:13:00,418 --> 00:13:01,986
MEDICINE, WHEN IT CAME TO

357
00:13:01,986 --> 00:13:03,554
VACCINE RECIPIENTS, THE VACCINE

358
00:13:03,554 --> 00:13:04,722
WAS NOT BEING DISTRIBUTED IN

359
00:13:04,722 --> 00:13:06,090
EQUITABLE FASHION IN THE UNITED

360
00:13:06,090 --> 00:13:07,058
STATES WHICH WAS SOMETHING THAT

361
00:13:07,058 --> 00:13:09,961
TOOK A WHILE TO REMEDY THAT

362
00:13:09,961 --> 00:13:10,428
SITUATION.

363
00:13:10,428 --> 00:13:14,866
WE KNOW COVID IS A SYSTEMIC

364
00:13:14,866 --> 00:13:17,368
DISEASE, THROMBOSIS AFFECTS

365
00:13:17,368 --> 00:13:19,604
HEART, LUNGS, KIDNEY, GI TRACT.

366
00:13:19,604 --> 00:13:23,341
MY FRIENDS WROTE ARTICLES, THIS

367
00:13:23,341 --> 00:13:25,176
IS ONE ABOUT THE VASCULITIS THAT

368
00:13:25,176 --> 00:13:26,044
GOES WITH IT.

369
00:13:26,044 --> 00:13:26,778
SOMETHING THAT WAS QUITE

370
00:13:26,778 --> 00:13:28,346
IMPORTANT AS WE BEGAN TO

371
00:13:28,346 --> 00:13:30,315
UNDERSTAND WHAT WAS GOING ON.

372
00:13:30,315 --> 00:13:31,416
YOU PROBABLY REMEMBER EVERYBODY

373
00:13:31,416 --> 00:13:34,886
WAS ASKED TO LEAVE THE HOSPITAL

374
00:13:34,886 --> 00:13:36,921
EXCEPT FOR MORE SENIOR PEOPLE

375
00:13:36,921 --> 00:13:38,523
WHICH I DIDN'T QUITE UNDERSTAND

376
00:13:38,523 --> 00:13:40,625
THAT BECAUSE WE WERE MOST

377
00:13:40,625 --> 00:13:41,926
VULNERABLE, BUT DID WHAT WE HAD

378
00:13:41,926 --> 00:13:45,430
TO DO TO TAKE CARE OF FOLKS WITH

379
00:13:45,430 --> 00:13:45,630
THAT.

380
00:13:45,630 --> 00:13:48,499
AND WE SAW THERE WAS TREMENDOUS

381
00:13:48,499 --> 00:13:48,766
DISPARITY.

382
00:13:48,766 --> 00:13:53,638
THIS CAME OUT A COUPLE YEARS

383
00:13:53,638 --> 00:13:54,505
AGO, STILL DISPROPORTIONATELY

384
00:13:54,505 --> 00:13:56,074
AFFECTING PATIENTS OF COLOR.

385
00:13:56,074 --> 00:13:59,744
YOU REMEMBER ALL THE

386
00:13:59,744 --> 00:14:02,046
REFRIGERATION TRUCKS OUTSIDE

387
00:14:02,046 --> 00:14:02,981
BUILDINGS, DIFFERENT HOSPITALS,

388
00:14:02,981 --> 00:14:03,848
HOW TERRIBLE THAT WAS.

389
00:14:03,848 --> 00:14:07,852
WE DIDN'T LEARN A LOT FROM OUR

390
00:14:07,852 --> 00:14:10,621
FIRST PANDEMIC, INFLUENZA NOW

391
00:14:10,621 --> 00:14:12,924
100 YEARS AGO, THERE ARE

392
00:14:12,924 --> 00:14:17,261
MULTIPLE DIPS, PRIMARY, DELTA,

393
00:14:17,261 --> 00:14:19,464
OMICRON WAVE.

394
00:14:19,464 --> 00:14:23,134
I WENT TO A REUNION LAST WEEK, A

395
00:14:23,134 --> 00:14:25,837
FRIEND SAID, I HAVE COVID.

396
00:14:25,837 --> 00:14:26,637
I SAID, OKAY.

397
00:14:26,637 --> 00:14:29,240
I SAID, WELL, YOU KNOW, IT WAS

398
00:14:29,240 --> 00:14:30,074
ONLY THE SECOND TIME.

399
00:14:30,074 --> 00:14:32,777
I HAD IT FOUR TIMES EVEN THOUGH

400
00:14:32,777 --> 00:14:34,212
I WEAR MASKS AND PROTECTION, SIX

401
00:14:34,212 --> 00:14:36,581
VACCINES, I STILL HAVE IT, SO

402
00:14:36,581 --> 00:14:37,849
THINGS WE'RE STILL LEARNING

403
00:14:37,849 --> 00:14:38,216
ABOUT THAT.

404
00:14:38,216 --> 00:14:40,218
A NUMBER OF PEOPLE HAVE LONG

405
00:14:40,218 --> 00:14:41,786
COVID, PROBLEMS WITH IT.

406
00:14:41,786 --> 00:14:43,021
SO WE'RE STILL TRYING TO

407
00:14:43,021 --> 00:14:44,188
UNDERSTAND ITS IMPACT.

408
00:14:44,188 --> 00:14:45,723
WE DIDN'T LEARN A LOT OF LESSONS

409
00:14:45,723 --> 00:14:49,861
I THINK FROM 100 YEARS AGO BUT

410
00:14:49,861 --> 00:14:52,463
HAVE THE TECHNOLOGIES BETTER,

411
00:14:52,463 --> 00:14:53,998
THE VACCINE, THE VACCINE DENIERS

412
00:14:53,998 --> 00:14:56,434
AND EVERYTHING ELSE, AS PEOPLE

413
00:14:56,434 --> 00:14:57,535
APPRECIATE SCIENCE WE NEED TO

414
00:14:57,535 --> 00:14:58,669
MAKE SURE WE SPREAD THE WORD

415
00:14:58,669 --> 00:15:01,472
THIS IS SO IMPORTANT THAT PEOPLE

416
00:15:01,472 --> 00:15:02,507
GET VACCINATED WHEN THEY CAN AND

417
00:15:02,507 --> 00:15:06,144
AS SOON AS I GET BACK I'LL GET

418
00:15:06,144 --> 00:15:08,813
MY VACCINE, MY  7th VACCINE

419
00:15:08,813 --> 00:15:10,748
FOR COVID AND I'LL GIVE AS MANY

420
00:15:10,748 --> 00:15:12,216
AS THEY GIVE OUT WITH MY FLU

421
00:15:12,216 --> 00:15:13,785
SHOT WHICH I ALWAYS GET.

422
00:15:13,785 --> 00:15:15,153
THIS CAME OUT WITH RACIAL

423
00:15:15,153 --> 00:15:17,188
DISPARITIES, PROBLEMS IN THE

424
00:15:17,188 --> 00:15:20,825
UNITED STATES, AND ALL OVER THE

425
00:15:20,825 --> 00:15:21,025
WORLD.

426
00:15:21,025 --> 00:15:22,326
THIS IS INDIA, BRAZIL, MASSIVE

427
00:15:22,326 --> 00:15:23,961
AMOUNT OF DEATH ASSOCIATED WITH

428
00:15:23,961 --> 00:15:27,131
THAT, A SCARY TIME FOR ALL OF

429
00:15:27,131 --> 00:15:30,234
US. 

430
00:15:30,234 --> 00:15:32,804
THOSE WHO CAME IN, PRACTICING

431
00:15:32,804 --> 00:15:35,606
MEDICINE IN COVID, ISOLATED.

432
00:15:35,606 --> 00:15:36,207
MEDICAL STUDENTS BASICALLY

433
00:15:36,207 --> 00:15:37,975
COULDN'T COME TO SCHOOL WITH

434
00:15:37,975 --> 00:15:38,276
THAT.

435
00:15:38,276 --> 00:15:40,511
I THINK IT TAKES THE LESSON, I'M

436
00:15:40,511 --> 00:15:42,780
GOING TO TRANSITION FROM LESSONS

437
00:15:42,780 --> 00:15:44,248
WE LEARNED FROM COVID TO SOME OF

438
00:15:44,248 --> 00:15:46,951
THE THINGS I'VE LEARNED FROM

439
00:15:46,951 --> 00:15:47,452
ADVOCACY.

440
00:15:47,452 --> 00:15:49,687
WE'LL TALK ABOUT ADVOCACY A BIT,

441
00:15:49,687 --> 00:15:50,755
SURGICAL PRACTICE.

442
00:15:50,755 --> 00:15:53,491
THIS IS SOMETHING, BECAUSE OF MY

443
00:15:53,491 --> 00:15:54,625
PRACTICE OF SURGERY, I'M A

444
00:15:54,625 --> 00:15:55,726
TRAUMA SURGEON, THAT MEANS I

445
00:15:55,726 --> 00:15:57,662
TAKE CARE OF PEOPLE INJURED ALL

446
00:15:57,662 --> 00:15:58,429
THE TIME.

447
00:15:58,429 --> 00:16:00,965
I BASICALLY TRAINED DURING THE

448
00:16:00,965 --> 00:16:03,000
1990s, AND THE AMOUNT OF

449
00:16:03,000 --> 00:16:03,968
MURDERS AND KILLINGS IN NEW YORK

450
00:16:03,968 --> 00:16:05,970
WHERE I TRAINED WAS QUITE HIGH.

451
00:16:05,970 --> 00:16:07,572
WE HAD OVER 2,000 MURDERS IN NEW

452
00:16:07,572 --> 00:16:09,307
YORK THE LAST YEAR I WAS THERE,

453
00:16:09,307 --> 00:16:11,142
AND I WENT TO SAN FRANCISCO AND

454
00:16:11,142 --> 00:16:12,243
THE MURDER RATE WAS THERE QUITE

455
00:16:12,243 --> 00:16:12,443
HIGH.

456
00:16:12,443 --> 00:16:16,147
A IRED THAT OF THE -- A THIRD OF

457
00:16:16,147 --> 00:16:18,616
PEOPLE I TOOK CARE OF WERE

458
00:16:18,616 --> 00:16:19,117
VICTIMS OF VIOLENCE.

459
00:16:19,117 --> 00:16:21,652
I WANT TO SHARE WITH YOU AN

460
00:16:21,652 --> 00:16:23,187
EXPERIENCE RELATED TO A MASS

461
00:16:23,187 --> 00:16:24,655
SHOOTING THAT HAPPENED.

462
00:16:24,655 --> 00:16:26,591
THIS WAS THE YouTube

463
00:16:26,591 --> 00:16:27,992
SHOOTING, PART BECAUSE OF THE

464
00:16:27,992 --> 00:16:28,926
RESPONSE TO WHAT HAPPENED

465
00:16:28,926 --> 00:16:31,062
BECAUSE I WENT VIRAL WHEN THIS

466
00:16:31,062 --> 00:16:31,629
HAPPENED WITH THAT.

467
00:16:31,629 --> 00:16:33,364
THIS IS A PICTURE OF THE YOUNG

468
00:16:33,364 --> 00:16:35,666
WOMAN, HAD BEEN MAKING MONEY ON

469
00:16:35,666 --> 00:16:38,202
YouTube, BASICALLY THEN SHE

470
00:16:38,202 --> 00:16:40,171
GOT UPSET BECAUSE THEY CUT HER

471
00:16:40,171 --> 00:16:42,640
INCOME STREAM, SHE WENT TO THE

472
00:16:42,640 --> 00:16:43,741
HEADQUARTERS AND STARTED

473
00:16:43,741 --> 00:16:45,109
SHOOTING PEOPLE INCLUDING

474
00:16:45,109 --> 00:16:46,611
HERSELF.

475
00:16:46,611 --> 00:16:47,812
I WAS DOING ELECTIVE SURGERY

476
00:16:47,812 --> 00:16:51,082
THAT DAY, THERE WAS A MASS

477
00:16:51,082 --> 00:16:51,349
CASUALTY.

478
00:16:51,349 --> 00:16:52,950
WE HAVE NOTES SAYING MASS

479
00:16:52,950 --> 00:16:53,618
CASUALTY COMING IN, EVERYBODY

480
00:16:53,618 --> 00:16:54,118
RUNS DOWN.

481
00:16:54,118 --> 00:16:56,154
OF COURSE I TRIED TO CALL MY

482
00:16:56,154 --> 00:17:00,558
PARTNER, AND MY PARTNER IS NOT

483
00:17:00,558 --> 00:17:02,126
AVAILABLE BECAUSE HE'S AT THE

484
00:17:02,126 --> 00:17:02,460
MASS CASUALTY.

485
00:17:02,460 --> 00:17:05,563
SO THEN I WENT DOWN THERE.

486
00:17:05,563 --> 00:17:10,501
WE HAD MULTIPLE VICTIMS.

487
00:17:10,501 --> 00:17:12,069
CHEST INJURIES, SOME INJURED NOT

488
00:17:12,069 --> 00:17:13,638
SO BAD, READY TO DO LIKE WE

489
00:17:13,638 --> 00:17:14,739
ALWAYS ARE WITH THAT.

490
00:17:14,739 --> 00:17:16,374
SHOOTER WAS DEAD AT THE SCENE.

491
00:17:16,374 --> 00:17:20,077
MEDIA PRESENT IN LARGE NUMBERS.

492
00:17:20,077 --> 00:17:22,413
IT STRUCK ME HOW THERE WERE SO

493
00:17:22,413 --> 00:17:24,182
MANY MEDIA PEOPLE THERE, JUST

494
00:17:24,182 --> 00:17:25,183
ALL OF THEM, HUNDREDS OF THEM

495
00:17:25,183 --> 00:17:27,084
ALL OVER THE PLACE.

496
00:17:27,084 --> 00:17:28,819
THERE WAS MEDIA TRUCKS AND

497
00:17:28,819 --> 00:17:29,720
EVERYTHING ELSE.

498
00:17:29,720 --> 00:17:31,856
WE JUST HAD A MASS SHOOTING THE

499
00:17:31,856 --> 00:17:35,059
WEEK BEFORE THAT HAPPENED AT A

500
00:17:35,059 --> 00:17:35,726
BARBERSHOP, SIX VICTIMS.

501
00:17:35,726 --> 00:17:37,828
AFTER THAT I DIDN'T SEE ANYBODY

502
00:17:37,828 --> 00:17:38,129
THERE.

503
00:17:38,129 --> 00:17:41,866
SO THEY ASKED ME TO SPEAK TO THE

504
00:17:41,866 --> 00:17:43,734
MEDIA, AND AS I WALKED OUT OF

505
00:17:43,734 --> 00:17:44,769
THE DRIVEWAY, THEY SAID YOU

506
00:17:44,769 --> 00:17:47,138
CAN'T SAY THIS, YOU CAN'T SAY

507
00:17:47,138 --> 00:17:51,142
THAT, YOU CAN'T SAY THIS, SORT

508
00:17:51,142 --> 00:17:55,146
OF SAID, OKAY, CARRIED LIVE ON

509
00:17:55,146 --> 00:17:57,148
CNN, MSNBC, BBC, OF COURSE THEY

510
00:17:57,148 --> 00:17:58,316
SAID FOX NEWS, I SAID I DIDN'T

511
00:17:58,316 --> 00:18:00,218
WANT TO BE CARRIED ON FOX NEWS.

512
00:18:00,218 --> 00:18:01,385
I DIDN'T MIND ANYTHING ELSE BUT

513
00:18:01,385 --> 00:18:03,120
DIDN'T WANT TO BE CARRIED ON

514
00:18:03,120 --> 00:18:03,321
THAT.

515
00:18:03,321 --> 00:18:05,489
I'M GOING TO SHOW YOU THE VIDEO

516
00:18:05,489 --> 00:18:07,758
NOW AND WE CAN TALK ABOUT THE

517
00:18:07,758 --> 00:18:18,336
IMPACT AS THAT HAD -- LET'S SEE 

518
00:18:19,604 --> 00:18:24,508
DO YOU WANT TO HIT IT FOR ME? 

519
00:18:24,508 --> 00:18:26,110
>> THIS IS A TERRIBLE DAY
IN THE

520
00:18:26,110 --> 00:18:28,379
UNITED STATES, ONCE AGAIN WE

521
00:18:28,379 --> 00:18:30,181
HAVE A MULTIPLE CASUALTY

522
00:18:30,181 --> 00:18:32,817
SITUATION THAT'S CONFRONTED US

523
00:18:32,817 --> 00:18:34,285
HERE AT THE ZUCKERBERG SAN

524
00:18:34,285 --> 00:18:35,920
FRANCISCO GENERAL HOSPITAL.

525
00:18:35,920 --> 00:18:36,821
WHEN SOMETHING LIKE THIS

526
00:18:36,821 --> 00:18:38,889
HAPPENS, THEN YOU GUYS COME OUT.

527
00:18:38,889 --> 00:18:39,957
REALITY IS WE HAVE TO DEAL WITH

528
00:18:39,957 --> 00:18:41,492
THIS ALL THE TIME, WITH THE

529
00:18:41,492 --> 00:18:42,693
FAMILIES, THE INJURIES, WE HAVE

530
00:18:42,693 --> 00:18:46,931
TO DEAL WITH THIS CONSTANTLY.

531
00:18:46,931 --> 00:18:47,531
GUN VIOLENCE HAPPENS EVERY DAY

532
00:18:47,531 --> 00:18:48,833
IN THE UNITED STATES, SAN

533
00:18:48,833 --> 00:18:50,735
FRANCISCO, BAY AREA, HAPPENS ALL

534
00:18:50,735 --> 00:18:51,402
OVER THE COUNTRY.

535
00:18:51,402 --> 00:18:53,371
I DON'T SEE YOU GUYS OUT HERE

536
00:18:53,371 --> 00:18:54,672
BECAUSE I'D LIKE TO MAKE SURE

537
00:18:54,672 --> 00:18:56,707
PEOPLE KNOW THAT WE GOT A

538
00:18:56,707 --> 00:18:58,242
SERIOUS PROBLEM THAT WE NEED TO

539
00:18:58,242 --> 00:18:58,476
ADDRESS.

540
00:18:58,476 --> 00:19:00,845
I DON'T HAVE ALL THE ANSWERS BUT

541
00:19:00,845 --> 00:19:02,613
I CAN SAY AT LEAST WE'RE HAVING

542
00:19:02,613 --> 00:19:04,048
A DISCUSSION ABOUT IT NATIONALLY

543
00:19:04,048 --> 00:19:06,017
WHICH IS A GOOD THING BUT THIS

544
00:19:06,017 --> 00:19:08,219
IS A REAL PROBLEM.

545
00:19:08,219 --> 00:19:10,054
>> I DON'T THINK I SAID
ANYTHING

546
00:19:10,054 --> 00:19:10,655
CONTROVERSIAL THERE, RIGHT?

547
00:19:10,655 --> 00:19:12,556
I THOUGHT WHAT I SAID WAS LEVEL

548
00:19:12,556 --> 00:19:12,823
HEADED.

549
00:19:12,823 --> 00:19:15,993
OF COURSE I GOT HATE MAIL, DEATH

550
00:19:15,993 --> 00:19:17,762
THREATS, PEOPLE SCREAMING SAYING

551
00:19:17,762 --> 00:19:19,263
I WANT TO TAKE THEIR GUNS AWAY.

552
00:19:19,263 --> 00:19:20,564
I DIDN'T SAY ANY OF THAT.

553
00:19:20,564 --> 00:19:21,799
I SAID WE HAVE A PROBLEM AND WE

554
00:19:21,799 --> 00:19:25,002
NEED TO THINK ABOUT IT, RIGHT? 

555
00:19:25,002 --> 00:19:26,304
IN A MATURE FASHION.

556
00:19:26,304 --> 00:19:29,473
I WAS DESCRIBED AT WEARY, ILL

557
00:19:29,473 --> 00:19:37,481
ITEM PEFERRED,  -- ILL TEMPEREDG

558
00:19:37,481 --> 00:19:38,316
ON INTENSE MEDIA PRESENCE THAT I

559
00:19:38,316 --> 00:19:39,617
DON'T SEE EVERY DAY.

560
00:19:39,617 --> 00:19:41,319
EVERY DAY WHEN PEOPLE ARE

561
00:19:41,319 --> 00:19:43,054
INJURED, I DIDN'T REALLY SEE

562
00:19:43,054 --> 00:19:45,089
THAT, AND THAT STRUCK ME ABOUT

563
00:19:45,089 --> 00:19:46,757
THAT.

564
00:19:46,757 --> 00:19:49,827
OTHER PICTURES WERE LIKE, 30 OR

565
00:19:49,827 --> 00:19:51,495
40 PEOPLE SURROUNDING ME ASKING

566
00:19:51,495 --> 00:19:52,630
ME QUESTIONS.

567
00:19:52,630 --> 00:19:53,731
THAT'S SOMETHING THAT REALLY

568
00:19:53,731 --> 00:19:54,865
STRUCK ME.

569
00:19:54,865 --> 00:19:56,167
I DIDN'T SAY ANYTHING

570
00:19:56,167 --> 00:19:56,734
CONTROVERSIAL.

571
00:19:56,734 --> 00:19:58,569
BUT THEN THEY DID.

572
00:19:58,569 --> 00:20:00,638
NOW, I HAVE A LOT OF EXPERIENCE

573
00:20:00,638 --> 00:20:01,839
TALKING TO THE MEDIA, I'VE BEEN

574
00:20:01,839 --> 00:20:03,140
DOING IT A LONG TIME.

575
00:20:03,140 --> 00:20:05,810
IN THE LAST FEW YEARS I'VE BEEN

576
00:20:05,810 --> 00:20:08,245
ON NATIONAL MEDIA LIKE, YOU

577
00:20:08,245 --> 00:20:10,481
KNOW, ABOUT 90 TIMES OR SO.

578
00:20:10,481 --> 00:20:13,984
I ALSO GOT INVITED TO THE WHITE

579
00:20:13,984 --> 00:20:15,553
HOUSE DURING THE SAFER

580
00:20:15,553 --> 00:20:16,420
COMMUNITIES ACT SIGNING BECAUSE

581
00:20:16,420 --> 00:20:19,156
OF SOME OF THE WORK I'VE DONE

582
00:20:19,156 --> 00:20:20,725
WITH THAT.

583
00:20:20,725 --> 00:20:21,625
I HAVE A LOT OF EXPERIENCE

584
00:20:21,625 --> 00:20:23,661
DEALING WITH THESE THINGS.

585
00:20:23,661 --> 00:20:26,230
THIS WAS SOMETHING THAT

586
00:20:26,230 --> 00:20:27,131
SURPRISED ME, HOW DIFFICULT THEY

587
00:20:27,131 --> 00:20:29,066
WERE IN TERMS OF THE WAY THEY

588
00:20:29,066 --> 00:20:30,334
ADDRESSED WHAT I SAID.

589
00:20:30,334 --> 00:20:33,804
AND THIS IS ME VENTING MY

590
00:20:33,804 --> 00:20:35,740
SPLEEN, BUT THERE WAS A LOT OF

591
00:20:35,740 --> 00:20:37,641
RACIAL OVERTONES BECAUSE I'M

592
00:20:37,641 --> 00:20:40,044
OUTSPOKEN AFRICAN AMERICAN MAN,

593
00:20:40,044 --> 00:20:41,779
AND I WAS BASICALLY SAYING WHAT

594
00:20:41,779 --> 00:20:43,080
THE TRUTH WAS BECAUSE PEOPLE

595
00:20:43,080 --> 00:20:44,482
DIDN'T WANT TO HEAR WHAT I HAD

596
00:20:44,482 --> 00:20:44,715
TO SAY.

597
00:20:44,715 --> 00:20:46,617
FOR ME IT WAS A MOMENT WHERE I

598
00:20:46,617 --> 00:20:49,553
STEPPED UP AND SAID I HAD TO SAY

599
00:20:49,553 --> 00:20:51,956
SOMETHING, AND THIS IS WHAT I

600
00:20:51,956 --> 00:20:53,057
SAID, THE RESULT I CREATED

601
00:20:53,057 --> 00:20:54,992
SOMETHING THAT WENT VIRAL SO I

602
00:20:54,992 --> 00:20:56,260
HAD HUNDREDS OF THOUSANDS OF

603
00:20:56,260 --> 00:20:58,295
VIEWERS ALL OVER THE WORLD, MY

604
00:20:58,295 --> 00:21:02,066
FRIENDS ALL CALLING ME BASICALLY

605
00:21:02,066 --> 00:21:03,801
SAYING GREAT JOB, THEN GETTING

606
00:21:03,801 --> 00:21:05,603
NASTY E-MAILS AND LETTERS AND

607
00:21:05,603 --> 00:21:06,404
CALLS, YOU'RE TALKING ABOUT

608
00:21:06,404 --> 00:21:07,938
THINGS YOU SHOULDN'T BE TALKING

609
00:21:07,938 --> 00:21:09,607
ABOUT, GO BACK TO THE OPERATING

610
00:21:09,607 --> 00:21:10,941
ROOM, THAT'S JUST THE LEAST OF

611
00:21:10,941 --> 00:21:12,176
SOME THINGS I HAD.

612
00:21:12,176 --> 00:21:14,211
THIS IS SOME OF THE MEDIA THAT

613
00:21:14,211 --> 00:21:15,780
WENT ALONG WITH THE FIRESTORM

614
00:21:15,780 --> 00:21:18,382
THAT HAPPENED WITH THAT.

615
00:21:18,382 --> 00:21:19,850
I DO THAT TO SAY NO MATTER WHERE

616
00:21:19,850 --> 00:21:21,852
YOU'RE DOING IF YOU GET A CHANCE

617
00:21:21,852 --> 00:21:25,122
TO SPEAK UP TO DO SOMETHING

618
00:21:25,122 --> 00:21:28,159
SOMETHING NEAR AND DEAR TO YOUR

619
00:21:28,159 --> 00:21:30,294
HEART, FINALLY WE'RE BEGINNING

620
00:21:30,294 --> 00:21:31,128
TO 9/11 MAKE SOME CHANGES IN

621
00:21:31,128 --> 00:21:32,163
TERMS OF TRAUMA.

622
00:21:32,163 --> 00:21:33,497
I'LL TALK LATER ABOUT

623
00:21:33,497 --> 00:21:34,432
DISPARITIES AND OUTCOME IN

624
00:21:34,432 --> 00:21:36,967
TRAUMA, SOME THINGS YOU CAN DO

625
00:21:36,967 --> 00:21:37,234
ABOUT IT.

626
00:21:37,234 --> 00:21:38,869
THIS IS SOMETHING THAT HAS BEEN

627
00:21:38,869 --> 00:21:43,240
OUT FOR A LONG TIME, JUST SAID

628
00:21:43,240 --> 00:21:45,543
ABOUT ISSUES, DISPARITIES ACROSS

629
00:21:45,543 --> 00:21:47,812
ALL CLINICAL SETTINGS, CANCER,

630
00:21:47,812 --> 00:21:49,413
TRAUMA, WHATEVER AREA IT IS, IN

631
00:21:49,413 --> 00:21:51,482
TERMS OF, YOU KNOW, ISSUES

632
00:21:51,482 --> 00:21:52,750
RELATED TO ASTHMA AND CHILDREN

633
00:21:52,750 --> 00:21:53,884
AND SO FORTH.

634
00:21:53,884 --> 00:21:56,520
SO MANY AREAS THAT THERE'S BEEN

635
00:21:56,520 --> 00:21:57,555
UNEQUAL TREATMENT, IT'S

636
00:21:57,555 --> 00:21:58,722
ASSOCIATED WITH HIGHER

637
00:21:58,722 --> 00:21:59,123
MORTALITY.

638
00:21:59,123 --> 00:22:00,758
SO THAT'S BEEN AROUND FOR OVER

639
00:22:00,758 --> 00:22:03,461
20 YEARS THAT WE'VE BEEN TALKING

640
00:22:03,461 --> 00:22:04,662
ABOUT THAT.

641
00:22:04,662 --> 00:22:08,566
I SUGGEST RECOMMENDATIONS, THIS

642
00:22:08,566 --> 00:22:13,070
WAS A PROCESS, LOOKING AT

643
00:22:13,070 --> 00:22:13,704
STRUCTURAL VARIABLES, OUTCOME

644
00:22:13,704 --> 00:22:14,905
VARIABLES, STRUCTURED WAY OF

645
00:22:14,905 --> 00:22:16,106
DOING THINGS.

646
00:22:16,106 --> 00:22:22,146
SO PART INVOLVES PATIENT

647
00:22:22,146 --> 00:22:23,080
EDUCATION, INTEGRATING

648
00:22:23,080 --> 00:22:23,614
CROSS-CULTURE EDUCATION,

649
00:22:23,614 --> 00:22:25,082
INCREASING PROPORTION OF

650
00:22:25,082 --> 00:22:26,784
UNDERREPRESENTED PHYSICIANS AND

651
00:22:26,784 --> 00:22:28,819
ETHNIC MINORITIES IN THE HEALTH

652
00:22:28,819 --> 00:22:31,021
POPULATION, THINGS THAT WE CAN

653
00:22:31,021 --> 00:22:32,756
DO, ORGANIZED FASHION, THIS CAME

654
00:22:32,756 --> 00:22:40,631
OUT ABOUT 20 YEARS AGO IN THE

655
00:22:40,631 --> 00:22:41,098
LITERATURE.

656
00:22:41,098 --> 00:22:43,033
WHY DOES DIVERSITY MATTER FOR

657
00:22:43,033 --> 00:22:43,834
HEALTH?

658
00:22:43,834 --> 00:22:44,969
I ALLUDED EARLIER TO THIS,

659
00:22:44,969 --> 00:22:46,504
PHYSICIANS OF COLOR CAN HAVE

660
00:22:46,504 --> 00:22:48,939
MAJOR IMPACT ON PATIENTS OF

661
00:22:48,939 --> 00:22:50,841
COLOR, BLACK DOCTORS MORE LIKELY

662
00:22:50,841 --> 00:22:52,676
TO WRITE ADDITIONAL NOTES ABOUT

663
00:22:52,676 --> 00:22:58,282
THEIR SUBJECTS, OUTCOMES IN

664
00:22:58,282 --> 00:22:59,083
CARDIOVASCULAR DISEASE REDUCE

665
00:22:59,083 --> 00:23:01,819
REDUCTION AND GAP IN DEATH FROM

666
00:23:01,819 --> 00:23:02,353
CARDIOVASCULAR DISEASE.

667
00:23:02,353 --> 00:23:05,222
CHOLESTEROL SCREENINGS GO UP,

668
00:23:05,222 --> 00:23:07,157
FLU SHOTS MORE LIKELY, SO IT

669
00:23:07,157 --> 00:23:07,625
DOES MATTER.

670
00:23:07,625 --> 00:23:09,260
THIS IS EVIDENCE THAT CAME OUT

671
00:23:09,260 --> 00:23:11,996
OF A PAPER PUBLISHED A COUPLE

672
00:23:11,996 --> 00:23:14,198
YEARS AGO SO DIFFERENCE,

673
00:23:14,198 --> 00:23:17,668
DIVERSITY DOES MATTER WITH THAT.

674
00:23:17,668 --> 00:23:20,337
DISPARITIES, SHORTER LIFE

675
00:23:20,337 --> 00:23:21,205
EXPECTANCIES, THERE'S INCREASED

676
00:23:21,205 --> 00:23:23,140
HIGHER INCIDENTS OF CANCER,

677
00:23:23,140 --> 00:23:25,543
BIRTH DEFECTS, CARDIOVASCULAR

678
00:23:25,543 --> 00:23:27,845
DISEASE, ASTHMA, DIABETES,

679
00:23:27,845 --> 00:23:28,879
STROKE, SEXUALLY TRANSMITTED

680
00:23:28,879 --> 00:23:30,781
DISEASE AND MENTAL ILLNESS,

681
00:23:30,781 --> 00:23:32,416
SOMETHING WE KNOW, SOMETHING WE

682
00:23:32,416 --> 00:23:34,385
WILL TALK LATER ON ABOUT THAT.

683
00:23:34,385 --> 00:23:36,921
ISSUES RELATED TO LOW INCOME,

684
00:23:36,921 --> 00:23:39,924
POOR EDUCATION, SOME BIOLOGICAL

685
00:23:39,924 --> 00:23:41,358
DIFFERENCES, CULTURAL ISSUES,

686
00:23:41,358 --> 00:23:41,959
QUALITY CARE, RACIAL

687
00:23:41,959 --> 00:23:43,027
DISCRIMINATION, WHICH ARE ALL

688
00:23:43,027 --> 00:23:43,460
THINGS.

689
00:23:43,460 --> 00:23:45,796
IN ORDER TO BEGIN TO APPROACH

690
00:23:45,796 --> 00:23:48,032
THIS THERE HAS TO BE A

691
00:23:48,032 --> 00:23:48,899
MULTI-FACETED APPROACH.

692
00:23:48,899 --> 00:23:50,901
I'LL TALK ABOUT STRUCTURAL

693
00:23:50,901 --> 00:23:52,670
RACISM IN A LITTLE BIT.

694
00:23:52,670 --> 00:23:54,305
THINGS LIKE IMPROVING ACCESS,

695
00:23:54,305 --> 00:23:55,439
THAT DOES WORK.

696
00:23:55,439 --> 00:23:57,441
THINGS LIKE INCREASING PUBLIC

697
00:23:57,441 --> 00:24:01,378
HEALTH FUNDING, DIVERSIFYING THE

698
00:24:01,378 --> 00:24:03,180
WORKFORCE IS ANOTHER APPROACH.

699
00:24:03,180 --> 00:24:04,648
MORE TARGETED RESEARCH SO WE CAN

700
00:24:04,648 --> 00:24:07,484
UNDERSTAND WHY IS THERE A

701
00:24:07,484 --> 00:24:08,586
DIFFERENCE IN THE OUTCOMES, YOU

702
00:24:08,586 --> 00:24:09,987
KNOW, WE THINK WE TREAT

703
00:24:09,987 --> 00:24:11,088
EVERYBODY THE SAME WAY, AND WE

704
00:24:11,088 --> 00:24:12,756
DO WHEN THEY HIT THE DOOR BUT

705
00:24:12,756 --> 00:24:15,125
WHY IS THERE A DIFFERENCE IN

706
00:24:15,125 --> 00:24:16,927
TERMS OF OUTCOMES WITH THAT

707
00:24:16,927 --> 00:24:17,595
RELATED TO PREEXISTING

708
00:24:17,595 --> 00:24:19,229
CONDITIONS, WHAT IS IT RELATED

709
00:24:19,229 --> 00:24:20,531
TO, MAKING SURE WE'RE TREAT

710
00:24:20,531 --> 00:24:22,032
PEOPLE IN A CULTURALLY COMPETENT

711
00:24:22,032 --> 00:24:22,266
FASHION.

712
00:24:22,266 --> 00:24:23,467
MAKE SURE YOU'RE ABLE TO

713
00:24:23,467 --> 00:24:25,970
COMMUNICATE WHEN YOU GO IN, IN A

714
00:24:25,970 --> 00:24:27,137
LANGUAGE THAT YOU HAVE.

715
00:24:27,137 --> 00:24:29,373
SAN FRANCISCO GENERAL WE SPEAK

716
00:24:29,373 --> 00:24:31,542
30 OR 40 LANGUAGES EVERY DAY,

717
00:24:31,542 --> 00:24:33,344
MAKING SURE WE HAVE ADEQUATE

718
00:24:33,344 --> 00:24:34,278
TRANSLATION TO MAKE SURE

719
00:24:34,278 --> 00:24:38,148
PATIENTS UNDERSTAND SO THEY CAN

720
00:24:38,148 --> 00:24:39,583
BASICALLY GET BETTER CARE.

721
00:24:39,583 --> 00:24:44,755
THIS IS A PAPER THAT CAME OUT

722
00:24:44,755 --> 00:24:47,091
LOOKING AT OUTCOMES AND TRAUMA

723
00:24:47,091 --> 00:24:48,392
CENTERS DESIGNATED, RIGHT, IN

724
00:24:48,392 --> 00:24:49,994
TERMS OF PATIENTS WITH BRAIN

725
00:24:49,994 --> 00:24:51,929
INJURY AND FOUND LATINX AND

726
00:24:51,929 --> 00:24:54,031
BLACK PATIENTS LESS LIKELY TO BE

727
00:24:54,031 --> 00:24:57,768
DISCHARGED TO REHAB, RELATIVE TO

728
00:24:57,768 --> 00:25:00,237
WHITE PATIENTS, FUNCTIONAL

729
00:25:00,237 --> 00:25:01,872
DIFFERENCE IN ASIAN PATIENTS,

730
00:25:01,872 --> 00:25:04,441
LIKELY TO GO TO REHAB, PROPERLY

731
00:25:04,441 --> 00:25:05,209
INSURED, DIFFERENCE IN OUTCOMES

732
00:25:05,209 --> 00:25:06,777
THE WAY PEOPLE ARE DISCHARGED,

733
00:25:06,777 --> 00:25:08,245
WE HAVE TO KEEP WORKING ON

734
00:25:08,245 --> 00:25:10,514
TRYING TO MAKE SURE THAT WE MAKE

735
00:25:10,514 --> 00:25:11,982
STRIDES FORWARD IN TERMS OF

736
00:25:11,982 --> 00:25:14,018
CARING FOR PATIENTS WHO HAVE

737
00:25:14,018 --> 00:25:15,386
BEEN INJURED OR WHO HAVE SOME

738
00:25:15,386 --> 00:25:16,487
OTHER DISEASE PROCESS.

739
00:25:16,487 --> 00:25:19,123
THESE ARE SOME OTHER AREAS OF

740
00:25:19,123 --> 00:25:20,190
THINGS, TALKING ABOUT BREAST

741
00:25:20,190 --> 00:25:21,859
CANCER, I THINK YOU KNOW THIS

742
00:25:21,859 --> 00:25:24,328
AREA, I JUST HEARD A GREAT TALK

743
00:25:24,328 --> 00:25:28,332
BY LISA NEWMAN, WHO IS A SURGEON

744
00:25:28,332 --> 00:25:29,933
WHO LOOKED AT LINKED BETWEEN

745
00:25:29,933 --> 00:25:31,769
GENES IN WEST AFRICAN PATIENTS

746
00:25:31,769 --> 00:25:32,503
WITH TRIPLE-NEGATIVE BREAST

747
00:25:32,503 --> 00:25:34,038
CANCER AND BREAST CANCER IN THE

748
00:25:34,038 --> 00:25:35,139
UNITED STATES, AND OUTCOMES

749
00:25:35,139 --> 00:25:36,674
RELATED TO THAT.

750
00:25:36,674 --> 00:25:40,377
SHE'S BEEN SPENDING 20 YEARS

751
00:25:40,377 --> 00:25:41,979
WORKING ON THAT, RESEARCH

752
00:25:41,979 --> 00:25:44,815
RELATED TO THAT, DIFFERENCES IN

753
00:25:44,815 --> 00:25:46,550
PANCREATIC CANCER OUTCOMES FOR

754
00:25:46,550 --> 00:25:48,852
PATIENTS, DIVERSE PATIENTS TOO.

755
00:25:48,852 --> 00:25:49,820
AND WE BASICALLY CONTRIBUTED

756
00:25:49,820 --> 00:25:50,154
SOME OF THIS.

757
00:25:50,154 --> 00:25:52,356
THIS IS A THING WE DID A COUPLE

758
00:25:52,356 --> 00:25:54,191
YEARS AGO LOOKING AT OUTCOMES,

759
00:25:54,191 --> 00:25:55,426
SOCIAL DETERMINANTS OF HEALTH,

760
00:25:55,426 --> 00:25:57,995
WHERE YOU LIVE, WHERE YOU GREW

761
00:25:57,995 --> 00:25:59,196
UP, WHETHER OR NOT YOU'RE

762
00:25:59,196 --> 00:26:02,566
EMPLOYED, ARE YOU IN A FOOD

763
00:26:02,566 --> 00:26:04,635
DESERT, EVEN RECOGNIZING NOW

764
00:26:04,635 --> 00:26:07,838
THAT EVEN WITHIN A CITY, YOU

765
00:26:07,838 --> 00:26:10,641
KNOW, LIKE WASHINGTON, IF YOU

766
00:26:10,641 --> 00:26:13,811
LIVE IN AN AREA HEAVILY

767
00:26:13,811 --> 00:26:14,578
UNDERREPRESENTED PATIENTS, THAT

768
00:26:14,578 --> 00:26:15,612
TRANSIT TIMES TO THE HOSPITAL

769
00:26:15,612 --> 00:26:17,648
ARE LONGER THAN OTHER PLACES,

770
00:26:17,648 --> 00:26:19,216
WITH THAT, MAYBE IT'S ALSO THEY

771
00:26:19,216 --> 00:26:20,217
ARE WORKING ON TRYING TO FIGURE

772
00:26:20,217 --> 00:26:21,919
OUT WHETHER OR NOT IT'S RELATED

773
00:26:21,919 --> 00:26:23,654
TO OUTCOMES TOO WITH THAT.

774
00:26:23,654 --> 00:26:26,523
NOW, WE'VE BEEN TALKING ABOUT

775
00:26:26,523 --> 00:26:28,892
FIREARM VIOLENCE BEING DECLARED

776
00:26:28,892 --> 00:26:30,160
A PUBLIC HEALTH EMERGENCY FOR

777
00:26:30,160 --> 00:26:32,296
MANY YEARS, ME AND MANY OTHERS,

778
00:26:32,296 --> 00:26:34,798
THE SURGEON GENERAL CAME OUT

779
00:26:34,798 --> 00:26:36,433
WITH A REPORT WITH THAT.

780
00:26:36,433 --> 00:26:38,802
I WAS FORTUNATE TO BE INVITED TO

781
00:26:38,802 --> 00:26:40,437
WHITE COATS AT THE WHITE HOUSE A

782
00:26:40,437 --> 00:26:42,940
FEW WEEKS AGO, WHERE WE TALKED

783
00:26:42,940 --> 00:26:44,241
ABOUT -- A FEW MONTHS AGO NOW,

784
00:26:44,241 --> 00:26:45,876
WHERE WE TALKED ABOUT THAT, I

785
00:26:45,876 --> 00:26:47,111
GOT A CHANCE TO TALK TO HIM

786
00:26:47,111 --> 00:26:47,978
ABOUT THAT.

787
00:26:47,978 --> 00:26:49,580
I DIDN'T REALIZE HE WAS WORKING

788
00:26:49,580 --> 00:26:52,015
ON THIS BUT IT CAME OUT JUST A

789
00:26:52,015 --> 00:26:53,484
FEW MONTHS AFTER THAT, A MONTH

790
00:26:53,484 --> 00:26:56,687
OR TWO AFTER WE DID THAT.

791
00:26:56,687 --> 00:26:58,655
ALSO REGIONAL FACTORS, GUN

792
00:26:58,655 --> 00:26:59,757
OWNERSHIP, LARGE IMPACT, AFRICAN

793
00:26:59,757 --> 00:27:02,559
AMERICAN POPULATION.

794
00:27:02,559 --> 00:27:03,961
THIS IS SOMETHING THAT'S

795
00:27:03,961 --> 00:27:05,028
REALLY -- THAT WE'LL HAVE TO

796
00:27:05,028 --> 00:27:06,463
COME TO GRIPS WITH THIS ISSUE.

797
00:27:06,463 --> 00:27:09,566
THERE'S A LOT OF STUFF GOING ON,

798
00:27:09,566 --> 00:27:10,667
LOCAL LEVEL, BECAUSE OF THE

799
00:27:10,667 --> 00:27:13,470
BRADY GROUP AND THE OTHER GROUPS

800
00:27:13,470 --> 00:27:15,272
THAT ARE GOING ON, GABY

801
00:27:15,272 --> 00:27:16,206
GIFFORDS' GROUP AND OTHERS

802
00:27:16,206 --> 00:27:18,308
TRYING TO CHANGE THE LAWS

803
00:27:18,308 --> 00:27:21,545
LOCALLY, WE'VE DONE A LOT OF

804
00:27:21,545 --> 00:27:26,683
THINGS LOCALLY BUT NATIONALLY

805
00:27:26,683 --> 00:27:27,584
REMAINS A PROBLEM WITH AVAILABLE

806
00:27:27,584 --> 00:27:30,220
GUNS FOR PEOPLE IN THE ITS.

807
00:27:30,220 --> 00:27:33,157
A LITTLE BIT ABOUT THIS, THIS IS

808
00:27:33,157 --> 00:27:37,094
NOW ON A GRANULAR LEVEL LIKE DO

809
00:27:37,094 --> 00:27:40,197
SURGEONS FEEL THAT THERE'S

810
00:27:40,197 --> 00:27:40,964
DISPARITY IN HEALTHCARE

811
00:27:40,964 --> 00:27:41,431
OUTCOMES?

812
00:27:41,431 --> 00:27:44,034
THE ANSWER IS ABOUT A THIRD OF

813
00:27:44,034 --> 00:27:45,002
US SEE THAT.

814
00:27:45,002 --> 00:27:47,404
ONLY 4% REPORT THEY WITNESS SUCH

815
00:27:47,404 --> 00:27:48,172
DISPARITIES.

816
00:27:48,172 --> 00:27:49,473
NOW, IT'S CLEAR FROM LITERATURE

817
00:27:49,473 --> 00:27:51,108
I SHOWED AND OTHERS YOU KNOW

818
00:27:51,108 --> 00:27:52,743
ABOUT DISPARITIES ARE REAL.

819
00:27:52,743 --> 00:27:54,144
I'LL GO THROUGH SOME THINGS JUST

820
00:27:54,144 --> 00:27:56,446
TALKING ABOUT THAT IN A BIT BUT

821
00:27:56,446 --> 00:27:58,549
RECOGNIZING IT HAPPENED, IT'S A

822
00:27:58,549 --> 00:27:59,983
REAL PROBLEM, WE NEED TO MAYBE

823
00:27:59,983 --> 00:28:01,185
CHANGE OUR PRACTICE, ADDRESS OUR

824
00:28:01,185 --> 00:28:03,120
PRACTICE TO FIGURE OUT HOW WE

825
00:28:03,120 --> 00:28:04,488
CAN MAKE A DIFFERENCE.

826
00:28:04,488 --> 00:28:07,224
THIS IS MORE STUFF RELATED TO

827
00:28:07,224 --> 00:28:08,592
ISSUES RELATED TO MORTALITY, YOU

828
00:28:08,592 --> 00:28:10,861
CAN SEE THE HOMICIDE RATE HERE

829
00:28:10,861 --> 00:28:12,229
IS MUCH HIGHER.

830
00:28:12,229 --> 00:28:15,032
GUN VIOLENCE DEATH RATE IS ABOUT

831
00:28:15,032 --> 00:28:16,800
40,000 A YEAR OR SO.

832
00:28:16,800 --> 00:28:18,902
THERE'S A LARGE PART THAT ARE

833
00:28:18,902 --> 00:28:22,639
SUICIDE, BUT THEN THE SIDE THAT

834
00:28:22,639 --> 00:28:24,341
GETS THE -- THE HOMICIDE RATE

835
00:28:24,341 --> 00:28:26,009
GETS MORE ATTENTION BUT

836
00:28:26,009 --> 00:28:27,277
DISPROPORTIONATELY AFFECTS

837
00:28:27,277 --> 00:28:28,045
AFRICAN AMERICANS IN THE UNITED

838
00:28:28,045 --> 00:28:31,148
STATES, YOU KNOW, OVERALL.

839
00:28:31,148 --> 00:28:32,916
SO THIS IS JUST HOMICIDE, HIV

840
00:28:32,916 --> 00:28:34,651
DISEASE, DISEASE OF THE HEART.

841
00:28:34,651 --> 00:28:36,420
THIS IS IN YOUNG PEOPLE, WHAT

842
00:28:36,420 --> 00:28:39,289
THE CAUSE OF DEATH IS.

843
00:28:39,289 --> 00:28:42,759
YOU CAN SEE WHAT CAUSES OF DEATH

844
00:28:42,759 --> 00:28:45,429
ARE IN WHITE VERSUS BLACK

845
00:28:45,429 --> 00:28:45,762
PATIENTS HERE.

846
00:28:45,762 --> 00:28:48,298
THERE ARE A LOT OF TRENDS IN

847
00:28:48,298 --> 00:28:50,400
TERMS OF RACIAL DISPARITIES,

848
00:28:50,400 --> 00:28:53,203
TRAUMA CENTERS, THIS IS TEN-YEAR

849
00:28:53,203 --> 00:28:55,439
STUDY AND THEY FOUND WITH PROVEN

850
00:28:55,439 --> 00:28:57,474
OUTCOMES THE GAP IN QUALITY HAS

851
00:28:57,474 --> 00:29:00,611
NOT NARROWED OVER TEN YEARS, SO

852
00:29:00,611 --> 00:29:01,845
EVEN THOUGH WE'RE RECOGNIZING,

853
00:29:01,845 --> 00:29:03,814
TRYING TO DO THINGS, THERE'S NOT

854
00:29:03,814 --> 00:29:06,083
A LOT OF NARROWING OF THE GAP.

855
00:29:06,083 --> 00:29:07,784
BUT THERE'S AWARENESS THAT'S

856
00:29:07,784 --> 00:29:08,018
GROWING.

857
00:29:08,018 --> 00:29:11,855
THIS IS A SURVEY HERE, AWARENESS

858
00:29:11,855 --> 00:29:14,291
OF ETHNIC, RACIAL DISPARITIES,

859
00:29:14,291 --> 00:29:15,158
OUTCOMES, FACTORS ACKNOWLEDGING

860
00:29:15,158 --> 00:29:17,160
ACTION, A SURVEY OF GENERAL

861
00:29:17,160 --> 00:29:18,228
SURGEONS, LESS THAN 50%

862
00:29:18,228 --> 00:29:19,863
INSTITUTIONAL EFFORTS TO ADDRESS

863
00:29:19,863 --> 00:29:21,398
THIS ISSUE, LESS THAN 25%

864
00:29:21,398 --> 00:29:23,066
REPORTED ADDRESSING IT IN THEIR

865
00:29:23,066 --> 00:29:23,400
PRACTICE.

866
00:29:23,400 --> 00:29:24,902
SO I THINK THAT THIS NUMBER,

867
00:29:24,902 --> 00:29:27,437
THIS IS AN OLDER PAPER NOW BUT

868
00:29:27,437 --> 00:29:28,639
THIS IS SOMETHING THAT WE'RE

869
00:29:28,639 --> 00:29:30,807
BEGINNING TO ADDRESS IN OUR

870
00:29:30,807 --> 00:29:31,408
PRACTICE BECAUSE WE'RE

871
00:29:31,408 --> 00:29:32,643
UNDERSTANDING THERE'S

872
00:29:32,643 --> 00:29:33,877
DIFFERENCES IN OUTCOMES, WE'RE

873
00:29:33,877 --> 00:29:35,078
DOING IT, YOU KNOW, AT OUR

874
00:29:35,078 --> 00:29:36,480
PLACE, AS MANY OF YOU ARE DOING

875
00:29:36,480 --> 00:29:38,081
IT AROUND THE COUNTRY ALSO.

876
00:29:38,081 --> 00:29:40,083
SO THIS IS SOMETHING THAT WHEN

877
00:29:40,083 --> 00:29:43,854
THIS CAME OUT, THIS WAS REALLY

878
00:29:43,854 --> 00:29:45,689
QUITE CONTROVERSIAL BECAUSE

879
00:29:45,689 --> 00:29:46,957
THESE ARE KIDS, KIDS GET

880
00:29:46,957 --> 00:29:50,627
STRAITED  -- TREATED THE SAME BT

881
00:29:50,627 --> 00:29:56,533
THEY FOUND THE BLACK CHILDREN

882
00:29:56,533 --> 00:29:57,968
HAD SIGNIFICANTLY INCREASED

883
00:29:57,968 --> 00:29:58,802
PREMORBIDTIES, TRAUMA AND

884
00:29:58,802 --> 00:30:00,037
VIOLENCE, I THINK YOU KNOW, IF

885
00:30:00,037 --> 00:30:01,805
YOU DON'T KNOW YOU SHOULD KNOW,

886
00:30:01,805 --> 00:30:03,640
NUMBER ONE CAUSE OF DEATH IN

887
00:30:03,640 --> 00:30:05,876
CHILDREN IN THE UNITED STATES IS

888
00:30:05,876 --> 00:30:08,045
GUN VIOLENCE.

889
00:30:08,045 --> 00:30:09,046
NUMBER ONE CAUSE.

890
00:30:09,046 --> 00:30:10,347
NOW, THAT SHOULD GIVE US PAUSE.

891
00:30:10,347 --> 00:30:11,315
IT'S NOT INFECTIOUS DISEASE.

892
00:30:11,315 --> 00:30:13,083
IT'S NOT COVID.

893
00:30:13,083 --> 00:30:13,417
IT'S NOT THAT.

894
00:30:13,417 --> 00:30:14,384
IT IS GUN VIOLENCE.

895
00:30:14,384 --> 00:30:15,953
I THINK THIS IS SOMETHING THAT

896
00:30:15,953 --> 00:30:18,121
WE NEED TO LOOK AT OURSELVES AND

897
00:30:18,121 --> 00:30:21,425
SAID ARE WE WILLING TO ACCEPT A

898
00:30:21,425 --> 00:30:22,392
SOCIETY WHERE CHILDREN DIE AT

899
00:30:22,392 --> 00:30:23,894
HIGHER RATE THAN ANY OTHER

900
00:30:23,894 --> 00:30:29,833
COUNTRY IN THE WORLD.

901
00:30:29,833 --> 00:30:32,202
THAT'S SOMETHING THAT YOU THINK

902
00:30:32,202 --> 00:30:34,638
EVEN AFTER PARKLAND, SANDY HOOK,

903
00:30:34,638 --> 00:30:39,042
LAS VEGAS, IT GOES DOWN, TEXAS,

904
00:30:39,042 --> 00:30:39,876
YOU KNOW, EVERY DAY WHEN YOU

905
00:30:39,876 --> 00:30:43,146
HEAR ABOUT IT YOU THINK THERE

906
00:30:43,146 --> 00:30:44,948
WOULD BE AN OUTCRY WITH THAT BUT

907
00:30:44,948 --> 00:30:45,482
THERE'S NOT.

908
00:30:45,482 --> 00:30:48,352
I THINK WE HAVE TO KEEP ON

909
00:30:48,352 --> 00:30:49,052
WORKING ON RAISING

910
00:30:49,052 --> 00:30:50,153
CONSCIOUSNESS, MAKING SURE

911
00:30:50,153 --> 00:30:51,254
PEOPLE ARE AWARE, SPEAKING OUT

912
00:30:51,254 --> 00:30:52,622
WHEN WE CAN.

913
00:30:52,622 --> 00:30:54,658
NO DIFFERENCE IN DEATH BUT

914
00:30:54,658 --> 00:30:58,095
BLACKS MORE LIKELY GO TO

915
00:30:58,095 --> 00:30:58,862
INPATIENT REHAB, QUITE

916
00:30:58,862 --> 00:31:00,564
CONTROVERSIAL, HIGHER LENGTH OF

917
00:31:00,564 --> 00:31:02,366
STAY, ICU COST, THE WHOLE THING

918
00:31:02,366 --> 00:31:04,201
WITH THAT, MORE FUNCTIONAL

919
00:31:04,201 --> 00:31:07,137
DEFICITS IN TERMS OF WALKING,

920
00:31:07,137 --> 00:31:10,073
FREEDING, EXPRESSIONAL DEFECTS.

921
00:31:10,073 --> 00:31:12,743
THIS WAS SOMETHING PEOPLE WERE

922
00:31:12,743 --> 00:31:14,044
QUITE UPSET ABOUT WHEN PRESENTED

923
00:31:14,044 --> 00:31:16,346
BY A GROUP AT THE AMERICAN

924
00:31:16,346 --> 00:31:17,681
ASSOCIATION OF SURGERY AND

925
00:31:17,681 --> 00:31:19,082
TRAUMA, OUR BIGGEST TRAUMA

926
00:31:19,082 --> 00:31:24,121
MEETING IN THE COUNTRY EVERY

927
00:31:24,121 --> 00:31:24,788
YEAR.

928
00:31:24,788 --> 00:31:29,493
THIS IS LOOKING AT INSURANCE

929
00:31:29,493 --> 00:31:31,661
RATES, PREDICTING DISPARITIES,

930
00:31:31,661 --> 00:31:33,163
AFTER TRAUMA, AND AFRICAN

931
00:31:33,163 --> 00:31:36,833
AMERICAN, HISPANICS, UNINSURED

932
00:31:36,833 --> 00:31:39,536
HAD WORSE OUTCOMES, INSURANCE

933
00:31:39,536 --> 00:31:40,737
HAD STRONGER ASSOCIATE WITH

934
00:31:40,737 --> 00:31:42,639
MORTALITY, THINGS WE KNOW ARE

935
00:31:42,639 --> 00:31:43,373
HAPPENING.

936
00:31:43,373 --> 00:31:47,744
THIS IS WHAT HAPPENS AFTER

937
00:31:47,744 --> 00:31:50,347
TRIAGE, IT CONTINUES THAT WE SEE

938
00:31:50,347 --> 00:31:51,281
THERE'S DIFFERENT THINGS THAT

939
00:31:51,281 --> 00:31:51,948
RELATED TO THAT.

940
00:31:51,948 --> 00:31:53,417
IF YOU STEP BACK AND LOOK AT THE

941
00:31:53,417 --> 00:31:54,885
PROBLEM THERE IS, THERE ARE A

942
00:31:54,885 --> 00:31:59,056
LOT OF WAYS TO LOOK AT IT,

943
00:31:59,056 --> 00:32:02,959
ACCESS TO CARE, PATIENT FACTORS,

944
00:32:02,959 --> 00:32:09,166
SOME YOU CAN CONTROL, PROVIDER

945
00:32:09,166 --> 00:32:09,833
THINGS, WHY DO DISPARITIES

946
00:32:09,833 --> 00:32:11,001
HAPPEN LIKE THIS.

947
00:32:11,001 --> 00:32:12,436
YOU HAVE TO THINK IN GLOBAL

948
00:32:12,436 --> 00:32:13,670
TERMS TRYING TO FIGURE OUT WHEN

949
00:32:13,670 --> 00:32:15,539
YOU TRY TO GET TO SOLUTIONS TO

950
00:32:15,539 --> 00:32:16,640
THIS, YOU KNOW, WITH THAT.

951
00:32:16,640 --> 00:32:18,975
SO IN TERMS OF SOLUTIONS, I'LL

952
00:32:18,975 --> 00:32:21,945
GO THROUGH SOME THINGS TALKING

953
00:32:21,945 --> 00:32:24,648
ABOUT SOLUTIONS THAT CAN MAKE A

954
00:32:24,648 --> 00:32:25,882
DIFFERENCE, GOING INTO SOME

955
00:32:25,882 --> 00:32:26,650
ISSUES RELATED TO TRAINING,

956
00:32:26,650 --> 00:32:28,652
TALKING ABOUT THE LAST SIX IN MY

957
00:32:28,652 --> 00:32:29,186
TALK THERE.

958
00:32:29,186 --> 00:32:31,588
IN TERMS OF LOOKING AT IMPROVED

959
00:32:31,588 --> 00:32:33,623
OUTCOMES, LOOK AT ISSUES RELATED

960
00:32:33,623 --> 00:32:34,591
TO SOCIAL DETERMINANTS OF

961
00:32:34,591 --> 00:32:36,760
HEALTH, SOME OF WHICH WE CANNOT

962
00:32:36,760 --> 00:32:38,562
AND CAN CONTROL, MORBIDITY, RISK

963
00:32:38,562 --> 00:32:39,496
FACTORS WITH THAT.

964
00:32:39,496 --> 00:32:41,832
THERE ARE POSITIVE TRENDS IN

965
00:32:41,832 --> 00:32:43,333
TERMS OF OUTREACH PROGRAMS,

966
00:32:43,333 --> 00:32:45,335
SOCIAL PROGRAMS TO HELP WITH

967
00:32:45,335 --> 00:32:46,069
THAT, INVESTMENT IN EDUCATION,

968
00:32:46,069 --> 00:32:47,304
OVER THE LONG TERM.

969
00:32:47,304 --> 00:32:50,140
MAKING SURE PEOPLE OF COLOR

970
00:32:50,140 --> 00:32:52,642
PARTICIPATE IN THE POLICY AND

971
00:32:52,642 --> 00:32:55,145
DECISIONS, HAVE ACCESS TO CARE,

972
00:32:55,145 --> 00:32:56,079
WHEN THEY DO THINGS.

973
00:32:56,079 --> 00:32:58,882
SO THINGS THAT HAPPEN WITH

974
00:32:58,882 --> 00:33:00,851
MEDICAID EXPANSION, THIS WAS

975
00:33:00,851 --> 00:33:03,954
SOMETHING THAT WE ALL WERE QUITE

976
00:33:03,954 --> 00:33:04,988
EXCITED ABOUT, WHEN THE

977
00:33:04,988 --> 00:33:06,890
AFFORDABLE CARE ACT CAME WITH

978
00:33:06,890 --> 00:33:08,125
THAT.

979
00:33:08,125 --> 00:33:10,327
MY PATIENT POPULATION IN SAN

980
00:33:10,327 --> 00:33:10,894
FRANCISCO GENERAL BEFORE THE

981
00:33:10,894 --> 00:33:13,597
AFFORDABLE CARE ACT CAME OUT WE

982
00:33:13,597 --> 00:33:16,666
HAD 50% OF PATIENTS NO PAY, AND

983
00:33:16,666 --> 00:33:19,169
THAT NUMBER WENT FROM 50% DOWN

984
00:33:19,169 --> 00:33:24,207
TO 5%, AND THE REST HAD MEDICAL,

985
00:33:24,207 --> 00:33:25,675
OUR VERSION OF MEDICAID, THAT

986
00:33:25,675 --> 00:33:30,480
MADE IMPROVEMENTS IN THE WAY

987
00:33:30,480 --> 00:33:31,414
PEOPLE SOUGHT CARE, CANCER

988
00:33:31,414 --> 00:33:33,984
SCREENINGS, ET CETERA, THAT MADE

989
00:33:33,984 --> 00:33:37,187
A DIFFERENCE IN MAKING CHANGES.

990
00:33:37,187 --> 00:33:38,555
OTHER SYSTEMS WERE DISPARITIES

991
00:33:38,555 --> 00:33:41,591
HAVE BEEN WORKED ON, AS THE

992
00:33:41,591 --> 00:33:44,227
ISSUES AND THE TRICARE SYSTEM

993
00:33:44,227 --> 00:33:46,096
FOR MILITARY, IN TERMS OF

994
00:33:46,096 --> 00:33:47,664
IMPROVED SCREENING, THAT

995
00:33:47,664 --> 00:33:49,466
BASICALLY EQUAL ACCESS BASICALLY

996
00:33:49,466 --> 00:33:51,134
BEGAN TO BRING DOWN DISPARITIES

997
00:33:51,134 --> 00:33:52,736
THAT EXISTED THAT I REPORTED ON

998
00:33:52,736 --> 00:33:53,837
A LITTLE BIT EARLIER AND THAT

999
00:33:53,837 --> 00:33:55,605
YOU KNOW ALREADY.

1000
00:33:55,605 --> 00:33:56,473
THAT'S ANOTHER WAY, ANOTHER

1001
00:33:56,473 --> 00:33:58,675
SYSTEM WAY TO LOOK AT THINGS TO

1002
00:33:58,675 --> 00:34:00,377
TRY TO IMPROVE.

1003
00:34:00,377 --> 00:34:02,145
SO THIS IS A CALL TO ACTION.

1004
00:34:02,145 --> 00:34:05,348
THIS IS RESEARCH, ROAD MAP TO

1005
00:34:05,348 --> 00:34:06,483
TARGETING AND LIMITING HEALTH

1006
00:34:06,483 --> 00:34:08,585
CARE, IDENTIFYING THINGS,

1007
00:34:08,585 --> 00:34:11,121
GETTING DATA, DEFINING THINGS,

1008
00:34:11,121 --> 00:34:12,155
CONDUCTING RESEARCH, ANALYZING

1009
00:34:12,155 --> 00:34:15,559
DATA, TRYING TO SCALE UP AND

1010
00:34:15,559 --> 00:34:15,825
SUSTAIN.

1011
00:34:15,825 --> 00:34:17,394
WHAT THE COLLEGE OF SURGEONS IS

1012
00:34:17,394 --> 00:34:18,995
GETTING READY TO DO WHICH IS A

1013
00:34:18,995 --> 00:34:21,598
GOOD PLACE TO BE, AND I'M ON

1014
00:34:21,598 --> 00:34:24,601
WHAT'S CALLED NOW THE -- USED TO

1015
00:34:24,601 --> 00:34:27,337
BE CALLED ANTI-RACISM TASK FOR,

1016
00:34:27,337 --> 00:34:31,441
BUT IT'S NOW CALLED THE

1017
00:34:31,441 --> 00:34:34,344
INCLUSIVE ACCESS COMMITTEE,

1018
00:34:34,344 --> 00:34:35,612
WE'RE BEGINNING TO EMBED OUTCOME

1019
00:34:35,612 --> 00:34:38,548
IN TERMS OF TRAUMA CENTER

1020
00:34:38,548 --> 00:34:40,951
VERIFICATION, IN TERMS OF OTHER

1021
00:34:40,951 --> 00:34:45,121
VERIFICATIONS FOR CANCER, AND

1022
00:34:45,121 --> 00:34:46,156
THE LIKE, CONVERTING QUALITY

1023
00:34:46,156 --> 00:34:47,023
INDICATORS RELATED TO

1024
00:34:47,023 --> 00:34:48,758
DISPARITIES SO YOU ARE THEN

1025
00:34:48,758 --> 00:34:49,559
MAKING SURE WE'RE COLLECTING

1026
00:34:49,559 --> 00:34:52,162
DATA TO MAKE SURE THAT WE CAN

1027
00:34:52,162 --> 00:34:53,396
MAKE A DIFFERENCE NATIONWIDE TO

1028
00:34:53,396 --> 00:34:54,097
DO THAT.

1029
00:34:54,097 --> 00:34:55,966
THERE'S SOME TALK THE JOINT

1030
00:34:55,966 --> 00:34:58,668
COMMISSION WILL BEGIN TO EMBED

1031
00:34:58,668 --> 00:34:59,669
THINGS INTO THEIR STANDARDS

1032
00:34:59,669 --> 00:35:00,937
ALSO, WITH DOING THAT.

1033
00:35:00,937 --> 00:35:02,172
AND THIS WAS ANOTHER PAPER THAT

1034
00:35:02,172 --> 00:35:04,674
JUST CAME OUT A COUPLE YEARS AGO

1035
00:35:04,674 --> 00:35:06,943
LOOKING AT WHAT YOU CAN DO IN

1036
00:35:06,943 --> 00:35:09,613
TERMS OF WHY THEY EXIST, WE KNOW

1037
00:35:09,613 --> 00:35:11,982
WHY THEY EXIST BUT INCREASING

1038
00:35:11,982 --> 00:35:15,452
DIVERSITY THE HEALTHCARE WORK

1039
00:35:15,452 --> 00:35:16,720
FORCE, THE COMMUNITY AROUND THEM

1040
00:35:16,720 --> 00:35:18,421
IS ANOTHER WAY TO DO THAT,

1041
00:35:18,421 --> 00:35:20,991
REALLY BEING AWARE OF WHAT THE

1042
00:35:20,991 --> 00:35:22,759
SOCIAL DETERMINANTS OF HEALTH.

1043
00:35:22,759 --> 00:35:24,961
PLACES NOW WHEN THEY PRESENT

1044
00:35:24,961 --> 00:35:26,363
MORBIDITY AND MORTALITY THEY

1045
00:35:26,363 --> 00:35:27,130
LOOK AT ISSUES RELATED TO SOCIAL

1046
00:35:27,130 --> 00:35:28,965
DETERMINANTS OF HEALTH, WHAT ARE

1047
00:35:28,965 --> 00:35:30,066
THE ACCESS POINTS THE PATIENTS

1048
00:35:30,066 --> 00:35:32,535
HAVE, WHAT THEY CAN DO,

1049
00:35:32,535 --> 00:35:33,703
BASICALLY THEN CREATE MEANINGFUL

1050
00:35:33,703 --> 00:35:36,573
CHANGE, WHEN YOU'RE LOOKING AT

1051
00:35:36,573 --> 00:35:37,974
THE OUTCOMES WITH THAT.

1052
00:35:37,974 --> 00:35:39,509
I'M GOING TO TURN TO THE PATIENT

1053
00:35:39,509 --> 00:35:40,510
FOR THE POPULATION IN THE UNITED

1054
00:35:40,510 --> 00:35:46,616
STATES AND TALK ABOUT ISSUES

1055
00:35:46,616 --> 00:35:47,917
RELATED TO TRAINING MODEL IN

1056
00:35:47,917 --> 00:35:48,351
SURGERY.

1057
00:35:48,351 --> 00:35:49,019
THIS IS THE STATE OF THE

1058
00:35:49,019 --> 00:35:50,120
POPULATION IN THE UNITED STATES,

1059
00:35:50,120 --> 00:35:52,355
YOU'RE AWARE OF THESE NUMBERS,

1060
00:35:52,355 --> 00:35:53,623
BUT THINGS ARE CHANGING WITH

1061
00:35:53,623 --> 00:35:56,059
THAT. 

1062
00:35:56,059 --> 00:35:58,328
THIS IS THE PERCENTAGE OF

1063
00:35:58,328 --> 00:35:59,462
RACIAL/ETHNIC BREAK DOWN OF THE

1064
00:35:59,462 --> 00:36:02,565
PATIENTS SO YOU CAN SEE AFRICAN

1065
00:36:02,565 --> 00:36:06,202
AMERICANS ARE 12% OF THE

1066
00:36:06,202 --> 00:36:08,605
POPULATION, ONLY 3% OF

1067
00:36:08,605 --> 00:36:09,539
PHYSICIANS.

1068
00:36:09,539 --> 00:36:11,875
THIS IS AN EXAMPLE NOW WHAT'S

1069
00:36:11,875 --> 00:36:14,077
GOING ON IN TERMS OF TENURED

1070
00:36:14,077 --> 00:36:14,744
FACULTY.

1071
00:36:14,744 --> 00:36:19,149
THE REPORT CAME OUT TWO YEARS

1072
00:36:19,149 --> 00:36:19,883
AGO, THERE WERE 10 TENURED

1073
00:36:19,883 --> 00:36:21,418
AFRICAN AMERICAN WOMEN FULL

1074
00:36:21,418 --> 00:36:22,585
PROFESSORS IN THE WHOLE UNITED

1075
00:36:22,585 --> 00:36:23,053
STATES.

1076
00:36:23,053 --> 00:36:25,355
I KNOW MOST OF THEM.

1077
00:36:25,355 --> 00:36:26,756
IN TERMS OF MEN, FULL

1078
00:36:26,756 --> 00:36:28,758
PROFESSORS, PEOPLE OF MY RANK,

1079
00:36:28,758 --> 00:36:30,794
THERE'S ABOUT 80.

1080
00:36:30,794 --> 00:36:34,564
I KNOW PROBABLY 3/4 OF THEM

1081
00:36:34,564 --> 00:36:36,566
BECAUSE OF THE THINGS, PROGRAMS

1082
00:36:36,566 --> 00:36:38,635
I'VE BEEN INVOLVED WITH THAT.

1083
00:36:38,635 --> 00:36:39,703
SMALL NUMBERS OF TENURED FACULTY

1084
00:36:39,703 --> 00:36:41,204
WHO FACE A BIGGER BURDEN WITH

1085
00:36:41,204 --> 00:36:43,139
THAT, WHETHER OR NOT IT'S BLACK,

1086
00:36:43,139 --> 00:36:45,642
HISPANIC, OR OTHERWISE.

1087
00:36:45,642 --> 00:36:48,645
RESIDENT NUMBERS, SLOWLY

1088
00:36:48,645 --> 00:36:49,045
INCREASING.

1089
00:36:49,045 --> 00:36:50,914
WE BASICALLY HAVE -- WE'VE MADE

1090
00:36:50,914 --> 00:36:52,415
SOME CHANGES, WE MADE SOME

1091
00:36:52,415 --> 00:36:54,317
INROADS, I'LL SHOW YOU THINGS

1092
00:36:54,317 --> 00:36:55,685
WE'RE DOING TO CHANGE THINGS IN

1093
00:36:55,685 --> 00:36:57,354
OUR PLACE AND OTHER PLACES ARE

1094
00:36:57,354 --> 00:36:58,855
DOING THE SAME THING.

1095
00:36:58,855 --> 00:37:00,290
YOU'VE SEEN THE LEAKY PIPELINE

1096
00:37:00,290 --> 00:37:03,860
HERE, THE OTHER TERM FOR IT,

1097
00:37:03,860 --> 00:37:08,098
BECAUSE PIPELINE HAS NEGATIVE

1098
00:37:08,098 --> 00:37:11,935
CONNOTATION, NEGATIVE PATHWAY TO

1099
00:37:11,935 --> 00:37:13,203
LEADERSHIP, THESE ARE REAL

1100
00:37:13,203 --> 00:37:14,270
NUMBERS OF PEOPLE CHAIRS IN THE

1101
00:37:14,270 --> 00:37:16,439
UNITED STATES.

1102
00:37:16,439 --> 00:37:20,210
THAT NUMBER HAS CHANGED.

1103
00:37:20,210 --> 00:37:22,479
IN SURGERY, I KNOW ALL OF THEM.

1104
00:37:22,479 --> 00:37:25,115
THAT NUMBER IS QUITE SMALL WITH

1105
00:37:25,115 --> 00:37:25,615
THAT.

1106
00:37:25,615 --> 00:37:27,984
SO THE OTHER THING THAT'S GOING

1107
00:37:27,984 --> 00:37:30,286
ON WITH THAT IS THAT WE HAVE A

1108
00:37:30,286 --> 00:37:31,688
PROBLEM IN SURGERY.

1109
00:37:31,688 --> 00:37:33,490
THE PROBLEM WITH SURGERY IS THAT

1110
00:37:33,490 --> 00:37:35,959
WE HAVE AN ATTRITION RATE THAT'S

1111
00:37:35,959 --> 00:37:37,260
QUITE HIGH.

1112
00:37:37,260 --> 00:37:38,862
AT BASELINE WE DO NOT FINISH 20%

1113
00:37:38,862 --> 00:37:40,530
OF PEOPLE WHO START IN OUR

1114
00:37:40,530 --> 00:37:40,930
PROGRAM.

1115
00:37:40,930 --> 00:37:44,200
NOW, IF WE WERE RUNNING A

1116
00:37:44,200 --> 00:37:45,802
COMPANY LIKE AMAZON OR WHATEVER

1117
00:37:45,802 --> 00:37:48,104
COMPANY THERE WAS, AND WE SAID

1118
00:37:48,104 --> 00:37:49,806
20% OF PEOPLE FAILED, AT A

1119
00:37:49,806 --> 00:37:53,443
BASELINE, THAT WOULD BE A REAL

1120
00:37:53,443 --> 00:37:53,676
PROBLEM.

1121
00:37:53,676 --> 00:37:54,844
NOW, WHAT'S EVEN WORSE,

1122
00:37:54,844 --> 00:37:56,179
ATTRITION RATE FOR PEOPLE OF

1123
00:37:56,179 --> 00:37:57,547
COLOR IS MUCH HIGHER.

1124
00:37:57,547 --> 00:38:03,787
THAT NUMBER IS CLOSER TO 35% IN

1125
00:38:03,787 --> 00:38:05,955
TERMS OF NOT FINISHING FIVE OR

1126
00:38:05,955 --> 00:38:06,823
SEVEN YEAR PROGRAM.

1127
00:38:06,823 --> 00:38:08,425
ATTRITION RATE IS HIGHER IN

1128
00:38:08,425 --> 00:38:10,326
ORTHOPEDICS, 12 TIMES THE NORM.

1129
00:38:10,326 --> 00:38:13,563
GENERAL SURGERY IT'S 6 OR 7

1130
00:38:13,563 --> 00:38:14,197
TIMES.

1131
00:38:14,197 --> 00:38:18,334
THIS IS A REAL PROBLEM THAT'S

1132
00:38:18,334 --> 00:38:19,702
THERE.

1133
00:38:19,702 --> 00:38:20,837
THERE'S NOT ENOUGH STUDENTS, AND

1134
00:38:20,837 --> 00:38:23,773
HOW DO WE TURN THE DRIBBLE INTO

1135
00:38:23,773 --> 00:38:24,073
MORE.

1136
00:38:24,073 --> 00:38:25,475
I THINK MORE, THESE ARE THINGS

1137
00:38:25,475 --> 00:38:26,709
THAT CAN BE DONE.

1138
00:38:26,709 --> 00:38:29,345
IT'S JUST TO LET YOU KNOW WHAT

1139
00:38:29,345 --> 00:38:32,582
PEOPLE ARE DOING.

1140
00:38:32,582 --> 00:38:34,651
MORE LIKELY TO PRACTICE IN

1141
00:38:34,651 --> 00:38:37,187
PRIMARY CARE, WORKING IN

1142
00:38:37,187 --> 00:38:39,923
IMPOVERISHED AREA THAN WHITE

1143
00:38:39,923 --> 00:38:41,825
PHYSICIANS, LIKELY TO PRACTICE

1144
00:38:41,825 --> 00:38:46,663
IN UNDERSERVED HEAR.

1145
00:38:46,663 --> 00:38:47,430
BLACK PHYSICIANS, AMERICAN

1146
00:38:47,430 --> 00:38:48,898
INDIAN, HISPANIC AND WHITE.

1147
00:38:48,898 --> 00:38:50,166
NUMBERS OF STUDENTS IN MEDICAL

1148
00:38:50,166 --> 00:38:51,734
SCHOOLS HAVE GONE UP

1149
00:38:51,734 --> 00:38:54,637
SIGNIFICANTLY WHICH IS GREAT

1150
00:38:54,637 --> 00:38:55,772
OVERALL, RECOGNIZING WE'LL NEED

1151
00:38:55,772 --> 00:38:58,374
MORE OF A WORKFORCE GOING

1152
00:38:58,374 --> 00:39:00,577
FORWARD BUT THE NUMBERS OF BLACK

1153
00:39:00,577 --> 00:39:02,779
AND LATINO NUMBERS OF STUDENTS

1154
00:39:02,779 --> 00:39:04,547
HAVE GONE DOWN, YOU KNOW, OVER

1155
00:39:04,547 --> 00:39:05,815
THIS PERIOD OF TIME.

1156
00:39:05,815 --> 00:39:07,383
THIS IS NOW 13-YEAR PERIOD.

1157
00:39:07,383 --> 00:39:11,621
THIS IS DATA FOR THE AAMC.

1158
00:39:11,621 --> 00:39:13,656
ONE OF THE FACTORS ACCOUNTING

1159
00:39:13,656 --> 00:39:16,593
FOR THAT FAMILY INCOME, IT'S

1160
00:39:16,593 --> 00:39:16,860
EXPENSIVE.

1161
00:39:16,860 --> 00:39:18,094
I THINK IT'S $90,000 A YEAR AT

1162
00:39:18,094 --> 00:39:20,897
OUR PLACE FOR MEDICAL SCHOOL,

1163
00:39:20,897 --> 00:39:22,866
MAY BE MORE WHERE SOME STUDENTS

1164
00:39:22,866 --> 00:39:25,535
IN THE AUDIENCE ARE FROM.

1165
00:39:25,535 --> 00:39:26,936
NOW NEW SCHOOLS NOW COMING OUT

1166
00:39:26,936 --> 00:39:30,573
THAT ARE FREE OF TUITION BUT

1167
00:39:30,573 --> 00:39:31,908
THAT TAKES A $1 BILLION

1168
00:39:31,908 --> 00:39:32,775
INVESTMENT, IT'S HUGE, AND

1169
00:39:32,775 --> 00:39:34,143
THAT'S NOT GOING TO REALLY

1170
00:39:34,143 --> 00:39:35,078
HAPPEN WITH THAT.

1171
00:39:35,078 --> 00:39:37,180
ONE OF THE THINGS MORE STRIKING

1172
00:39:37,180 --> 00:39:39,148
HERE, THIS STATEMENT, TAKES A

1173
00:39:39,148 --> 00:39:40,383
BACHELOR'S DEGREE TO MAKE A

1174
00:39:40,383 --> 00:39:44,087
MEDICAL STUDENT, WE KNOW THAT.

1175
00:39:44,087 --> 00:39:45,555
READING PROFICIENCY AT AGE 8 TO

1176
00:39:45,555 --> 00:39:47,457
MAKE A DOCTOR AT AGE 28A

1177
00:39:47,457 --> 00:39:48,324
PROFOUND STATEMENT.

1178
00:39:48,324 --> 00:39:50,860
IT GOES RIGHT TO THE HEART OF

1179
00:39:50,860 --> 00:39:52,495
WHAT'S GOING ON, THAT THERE'S A

1180
00:39:52,495 --> 00:39:55,031
BREAKDOWN IN THE WAY THAT

1181
00:39:55,031 --> 00:39:59,802
EDUCATION GOES IN DIFFERENT

1182
00:39:59,802 --> 00:40:00,670
COMMUNITIES, PARTICULARLY

1183
00:40:00,670 --> 00:40:01,871
AFRICAN AMERICAN COMMUNITIES.

1184
00:40:01,871 --> 00:40:04,340
RATIONALE IS INCREASING OF U.S.

1185
00:40:04,340 --> 00:40:07,110
POPULATION OVERALL, INCREASE

1186
00:40:07,110 --> 00:40:09,145
NUMBER OF PEOPLE

1187
00:40:09,145 --> 00:40:10,547
UNDERREPRESENTED IN MEDICINE,

1188
00:40:10,547 --> 00:40:11,748
PROBLEMS OF HEALTH DISPARITIES I

1189
00:40:11,748 --> 00:40:17,220
TALKED ABOUT ACROSS THE BOARD,

1190
00:40:17,220 --> 00:40:18,855
INCREASED NEED FOR PHYSICIANS,

1191
00:40:18,855 --> 00:40:21,791
URM ACCOUNT FOR SIGNIFICANT

1192
00:40:21,791 --> 00:40:25,562
FRACTION OF 18 TO 24 YEARS OLDS,

1193
00:40:25,562 --> 00:40:27,330
THERE'S CLEARLY A RATIONALE FOR

1194
00:40:27,330 --> 00:40:27,597
THAT.

1195
00:40:27,597 --> 00:40:29,999
THIS PAPER CAME OUT BY SOCIETY

1196
00:40:29,999 --> 00:40:30,934
OF BLACK ACADEMIC SURGEONS, WHAT

1197
00:40:30,934 --> 00:40:35,138
IT WAS, IT WAS A COHORT STUDY

1198
00:40:35,138 --> 00:40:36,906
LOOKING AT PEOPLE PROGRESSING

1199
00:40:36,906 --> 00:40:39,943
FROM PROFESSOR UP TO CHAIR.

1200
00:40:39,943 --> 00:40:42,011
WHAT THEY IDENTIFIED FACTORS,

1201
00:40:42,011 --> 00:40:43,346
INTERSECTIONAL, RECRUITMENT AND

1202
00:40:43,346 --> 00:40:45,014
RETENTION OF TRAINEES, IT'S

1203
00:40:45,014 --> 00:40:47,116
IMPORTANT THAT WE RETAIN

1204
00:40:47,116 --> 00:40:48,785
TRAINEES AS WE BEGIN TO IMPROVE

1205
00:40:48,785 --> 00:40:51,187
THIS PIPELINE ISSUE THAT WE HAVE

1206
00:40:51,187 --> 00:40:51,888
WITH THAT.

1207
00:40:51,888 --> 00:40:53,890
THIS IS A STUDY LOOKING AT

1208
00:40:53,890 --> 00:40:56,993
BENCHMARKS IN TERMS OF SUCCESS.

1209
00:40:56,993 --> 00:40:58,728
THEY LOOKED AT CVs, PEOPLE IN

1210
00:40:58,728 --> 00:41:01,064
SOCIETY OF ACADEMIC SURGEONS,

1211
00:41:01,064 --> 00:41:04,133
AND OTHER SOCIETIES, THEY FOUND

1212
00:41:04,133 --> 00:41:08,338
THAT THEY ATTAINED THINGS,

1213
00:41:08,338 --> 00:41:09,339
ATTAINED GOALS AND SUCCESS RIGHT

1214
00:41:09,339 --> 00:41:10,907
JUST AS MUCH AS EVERYONE ELSE,

1215
00:41:10,907 --> 00:41:13,443
SO THAT WAS SOMETHING THAT WAS

1216
00:41:13,443 --> 00:41:13,743
INTERESTING.

1217
00:41:13,743 --> 00:41:16,279
THIS IS, AGAIN, REFLECTING THE

1218
00:41:16,279 --> 00:41:16,546
PIPELINE.

1219
00:41:16,546 --> 00:41:21,117
I'LL DRILL DOWN LOOKING AT THAT.

1220
00:41:21,117 --> 00:41:26,522
SO 3%, ALL ORTHOPEDIC RESIDENTS

1221
00:41:26,522 --> 00:41:32,028
BLACK, 5.9% OF PEDIATRIC, AND

1222
00:41:32,028 --> 00:41:34,397
THIS TALKS ABOUT DISMISSAL RATE,

1223
00:41:34,397 --> 00:41:38,134
QUITE HIGH, BOTH IN SURGERY AND

1224
00:41:38,134 --> 00:41:39,902
ORTHOPEDICS OVERALL SO YOU START

1225
00:41:39,902 --> 00:41:42,538
AT A SMALL NUMBER, ANOTHER

1226
00:41:42,538 --> 00:41:45,975
GRAPHIC FROM DR. McDADE, AAMC,

1227
00:41:45,975 --> 00:41:49,779
RATES ON THE RIGHT WITH THAT.

1228
00:41:49,779 --> 00:41:51,347
SO LESSER IN OTHER AREAS BUT

1229
00:41:51,347 --> 00:41:53,816
MUCH HIGHER IN OTHERS WITH THAT,

1230
00:41:53,816 --> 00:41:57,687
AND IN SURGERY WE'RE SIX TIMES,

1231
00:41:57,687 --> 00:41:59,422
ORTHOPEDICS, YOU CAN SEE 15

1232
00:41:59,422 --> 00:42:00,923
TIMES THE RATE, SO THIS IS A

1233
00:42:00,923 --> 00:42:03,459
REAL PROBLEM WE HAVE.

1234
00:42:03,459 --> 00:42:05,595
PART OF WHAT WE'VE BEEN DOING

1235
00:42:05,595 --> 00:42:07,130
WITH SOCIETY FOR BLACK ACADEMIC

1236
00:42:07,130 --> 00:42:09,799
SURGEONS WHERE I HAD THE HONOR

1237
00:42:09,799 --> 00:42:10,633
TO SERVE AS PRESIDENT MAKING

1238
00:42:10,633 --> 00:42:14,537
SURE WE REACH OUT TO MAKE SURE

1239
00:42:14,537 --> 00:42:18,708
WE SUPPORT ALL OF OUR RESIDENT

1240
00:42:18,708 --> 00:42:22,879
TRAINEES ALONG THE WAY WITH

1241
00:42:22,879 --> 00:42:23,079
THAT.

1242
00:42:23,079 --> 00:42:26,015
THIS IS GIVING AN IDEA OF THE

1243
00:42:26,015 --> 00:42:29,886
NUMBERS IN TERMS OF BLACK FOLKS,

1244
00:42:29,886 --> 00:42:31,788
BLACK FACULTY WHO ARE GOING UP

1245
00:42:31,788 --> 00:42:38,394
THE FOOD CHAIN AND BECOMING FULL

1246
00:42:38,394 --> 00:42:39,295
PROFESSORS.

1247
00:42:39,295 --> 00:42:40,797
THE SUPREME COURT DECISION SORT

1248
00:42:40,797 --> 00:42:45,668
OF BANNED AFFIRMATIVE ACTION, IN

1249
00:42:45,668 --> 00:42:46,669
CALIFORNIA THEY BANNED IT 27

1250
00:42:46,669 --> 00:42:49,872
YEARS AGO, WE'VE BEEN ABLE TO

1251
00:42:49,872 --> 00:42:51,307
CONTINUE THE WORK WE'RE DOING

1252
00:42:51,307 --> 00:42:52,175
EVEN THOUGH IT TOOK A LITTLE

1253
00:42:52,175 --> 00:42:55,178
WHILE TO FIGURE IT OUT, LOOKING

1254
00:42:55,178 --> 00:42:56,879
MORE HOLISTICALLY AT WAYS TO

1255
00:42:56,879 --> 00:42:59,382
RECRUIT PEOPLE TO MAKE SURE.

1256
00:42:59,382 --> 00:43:03,820
BUT I THINK THERE ARE A LOT OF

1257
00:43:03,820 --> 00:43:08,758
STATEMENTS, THIS IS KETANJI

1258
00:43:08,758 --> 00:43:10,760
BROWN JACKSON, BUT WE BANNED IT

1259
00:43:10,760 --> 00:43:11,828
IN CALIFORNIA BUT WE'VE BEEN

1260
00:43:11,828 --> 00:43:13,896
ABLE TO WORK THROUGH THAT AS WE

1261
00:43:13,896 --> 00:43:14,197
MOVE ALONG.

1262
00:43:14,197 --> 00:43:18,668
THERE ARE A LOT OF FORCES OUT

1263
00:43:18,668 --> 00:43:22,238
THERE DOING THINGS.

1264
00:43:22,238 --> 00:43:23,806
WE PUBLICIZE THE GREAT, WE'RE SO

1265
00:43:23,806 --> 00:43:27,243
HAPPY ABOUT INTERNS COMING IN,

1266
00:43:27,243 --> 00:43:30,179
SO EXCITED ABOUT THAT.

1267
00:43:30,179 --> 00:43:32,715
THE NUMBER ONE MEDIA INFLUENCE

1268
00:43:32,715 --> 00:43:37,220
IN THE WHOLE WORLD, ELON MUSK,

1269
00:43:37,220 --> 00:43:38,621
ZERO PERCENT, THAT GETS TWEETED

1270
00:43:38,621 --> 00:43:40,790
MILLIONS OF TIMES WITH THAT,

1271
00:43:40,790 --> 00:43:41,791
ENDING WOKENESS, THERE'S A

1272
00:43:41,791 --> 00:43:44,761
PUSHBACK IN TERMS OF DOING

1273
00:43:44,761 --> 00:43:45,428
THINGS.

1274
00:43:45,428 --> 00:43:46,863
INSTEAD OF CELEBRATING HOW

1275
00:43:46,863 --> 00:43:48,598
WONDERFUL THAT PICTURE IS,

1276
00:43:48,598 --> 00:43:50,333
THERE'S A HUGE PUSHBACK EVEN BY

1277
00:43:50,333 --> 00:43:51,467
SOMEONE WHO HAS NO BUSINESS

1278
00:43:51,467 --> 00:43:53,202
DRAWING ON THAT ISSUE WITH THAT.

1279
00:43:53,202 --> 00:43:57,006
SO THIS IS WHAT WE'VE DONE AT

1280
00:43:57,006 --> 00:43:59,542
OUR PLACE, 27 YEARS AFTER PROP

1281
00:43:59,542 --> 00:44:00,443
2, WE'VE BEEN ABLE TO BRING IN

1282
00:44:00,443 --> 00:44:02,345
THE BEST OF THE BEST, THE BEST

1283
00:44:02,345 --> 00:44:04,580
OF THE BEST LOOKS LIKE THE

1284
00:44:04,580 --> 00:44:05,848
POPULATION IN CALIFORNIA.

1285
00:44:05,848 --> 00:44:07,917
BUT IT TAKES A LOT OF WORK, A

1286
00:44:07,917 --> 00:44:10,853
LOT OF SUPPORT TO DO THIS.

1287
00:44:10,853 --> 00:44:12,255
WE NOW HAVE MORE AFRICAN

1288
00:44:12,255 --> 00:44:14,157
AMERICANS AND LATINOS THAN EVER

1289
00:44:14,157 --> 00:44:16,793
IN OUR PROGRAM, IN THE HISTORY,

1290
00:44:16,793 --> 00:44:18,895
THEY ARE ALL UNBELIEVABLY

1291
00:44:18,895 --> 00:44:19,962
OUTSTANDING PEOPLE, DOING GREAT

1292
00:44:19,962 --> 00:44:21,364
WORK WITH THAT.

1293
00:44:21,364 --> 00:44:23,132
THIS IS THE CALL TEAM AT SAN

1294
00:44:23,132 --> 00:44:23,833
FRANCISCO GENERAL HOSPITAL.

1295
00:44:23,833 --> 00:44:26,803
THIS WAS THE FIRST TIME THIS

1296
00:44:26,803 --> 00:44:27,937
EVER HAPPENED, IN THE 150 YEARS

1297
00:44:27,937 --> 00:44:29,205
OF THE HOSPITAL WHERE THE

1298
00:44:29,205 --> 00:44:32,141
ATTENDING ON THE RIGHT, FELLOW

1299
00:44:32,141 --> 00:44:34,510
IS NEXT, SENIOR RESIDENT, JUNIOR

1300
00:44:34,510 --> 00:44:35,511
RESIDENT, THEY ARE ALL AFRICAN

1301
00:44:35,511 --> 00:44:37,446
AMERICAN WOMEN, SO WE HAD TO

1302
00:44:37,446 --> 00:44:38,815
JUST CELEBRATE HOW WONDERFUL

1303
00:44:38,815 --> 00:44:39,749
THAT IS.

1304
00:44:39,749 --> 00:44:42,518
THAT WE'RE BEGINNING TO CHANGE,

1305
00:44:42,518 --> 00:44:45,021
THINGS THAT NEVER HAPPENED

1306
00:44:45,021 --> 00:44:46,222
BEFORE WITH THAT.

1307
00:44:46,222 --> 00:44:48,224
ARE WE GOING TO LOSE MOMENTUM

1308
00:44:48,224 --> 00:44:49,659
BECAUSE WE'RE WORRIED ABOUT

1309
00:44:49,659 --> 00:44:51,127
THIS, YOU KNOW, AS WE GO

1310
00:44:51,127 --> 00:44:53,462
FORWARD, AND WHAT WE HAVE TO

1311
00:44:53,462 --> 00:44:54,564
UNDERSTAND THIS IS A FIGHT MANY

1312
00:44:54,564 --> 00:44:58,434
OF US HAVE BEEN DEALING WITH FOR

1313
00:44:58,434 --> 00:45:00,369
30 OR 40 YEARS OF OUR CAREER

1314
00:45:00,369 --> 00:45:02,004
MAKING SURE WE PUSH FORWARD.

1315
00:45:02,004 --> 00:45:03,005
THERE WILL BE ROAD BLOCKS,

1316
00:45:03,005 --> 00:45:04,173
PEOPLE SAY NO, YOU CAN'T DO

1317
00:45:04,173 --> 00:45:06,142
THIS, BUT YOU FIGURE OUT A WAY

1318
00:45:06,142 --> 00:45:08,811
TO DO IT THE RIGHT WAY.

1319
00:45:08,811 --> 00:45:12,548
I THINK I MAY HAVE MENTIONED

1320
00:45:12,548 --> 00:45:14,350
EARLIER, TALKING TO STUDENTS,

1321
00:45:14,350 --> 00:45:16,252
ENTIRE 90-YEAR HISTORY OF UCSF

1322
00:45:16,252 --> 00:45:19,088
SURGERY THERE'S BEEN 16 AFRICAN

1323
00:45:19,088 --> 00:45:20,223
AMERICANS GRADUATED, THERE'S

1324
00:45:20,223 --> 00:45:22,658
EIGHT RESIDENTS A YEAR WE

1325
00:45:22,658 --> 00:45:25,061
GRADUATE, THAT'S GOING BACK TO

1326
00:45:25,061 --> 00:45:26,829
THE 1930s AND '40s WHEN WE

1327
00:45:26,829 --> 00:45:27,330
STARTED.

1328
00:45:27,330 --> 00:45:28,865
SO WE'RE BEGINNING TO MAKE

1329
00:45:28,865 --> 00:45:30,333
INROADS BUT THIS IS SOMETHING

1330
00:45:30,333 --> 00:45:31,667
THAT'S GOING TO TAKE A LOT OF

1331
00:45:31,667 --> 00:45:36,305
WORK WITH DOING THAT.

1332
00:45:36,305 --> 00:45:37,540
THIS IS SURGICAL SPECIALTIES,

1333
00:45:37,540 --> 00:45:41,210
THE CONCLUSION THERE'S MINIMAL

1334
00:45:41,210 --> 00:45:43,713
POSITIVE PROGRESS, GENERAL

1335
00:45:43,713 --> 00:45:44,413
DIVERSITY, SPECIALTIES,

1336
00:45:44,413 --> 00:45:46,282
CONTINUING TO ADVOCATE WITH

1337
00:45:46,282 --> 00:45:46,916
MENTORSHIP, SCHOLARSHIP

1338
00:45:46,916 --> 00:45:48,618
PROGRAMS, SUPPORTING PEOPLE.

1339
00:45:48,618 --> 00:45:50,019
THIS CAME OUT OF THE JOURNAL OF

1340
00:45:50,019 --> 00:45:51,120
SURGICAL RESEARCH.

1341
00:45:51,120 --> 00:45:52,255
THIS IS A FRAMEWORK BECAUSE WHAT

1342
00:45:52,255 --> 00:45:54,490
YOU DO IS BRING PEOPLE IN, YOU

1343
00:45:54,490 --> 00:45:56,626
WANT TO MAKE SURE THEY ARE

1344
00:45:56,626 --> 00:45:56,926
SUCCESSFUL.

1345
00:45:56,926 --> 00:45:59,629
AND THAT REQUIRES A FAIR AMOUNT

1346
00:45:59,629 --> 00:46:02,465
OF SUPPORT BECAUSE THERE'S A

1347
00:46:02,465 --> 00:46:03,933
NUMBER OF INSTITUTIONAL ELEMENTS

1348
00:46:03,933 --> 00:46:07,803
THAT PUSH BACK ON SUCCESS WITH

1349
00:46:07,803 --> 00:46:11,040
THAT SO THINGS ACGME HAS DONE,

1350
00:46:11,040 --> 00:46:12,441
ENSURING THAT LEADERSHIP

1351
00:46:12,441 --> 00:46:14,410
APPOINTEES ARE DIVERSE, PROGRAM

1352
00:46:14,410 --> 00:46:15,745
LEADERSHIP, MAKING SURE THEY ARE

1353
00:46:15,745 --> 00:46:18,414
REPRESENTED IN TERMS OF

1354
00:46:18,414 --> 00:46:18,915
UNDERREPRESENTED GROUPS.

1355
00:46:18,915 --> 00:46:19,615
PROVIDE SAFE SPACE FOR

1356
00:46:19,615 --> 00:46:21,117
DISCUSSION AND ISSUES THAT COME

1357
00:46:21,117 --> 00:46:22,585
UP WITH THAT.

1358
00:46:22,585 --> 00:46:26,722
FACULTY AND HOUSE STAFF, MAKE

1359
00:46:26,722 --> 00:46:29,492
SURE YOU BE AWARE OF

1360
00:46:29,492 --> 00:46:30,760
GASLIGHTING.

1361
00:46:30,760 --> 00:46:34,897
IN SURGERY AT LEAST, IF SOMEONE

1362
00:46:34,897 --> 00:46:35,865
IS MAYBE STRUGGLING WHAT HAPPENS

1363
00:46:35,865 --> 00:46:38,134
THERE TENDS TO BE A GROUP THING

1364
00:46:38,134 --> 00:46:39,402
PROCESS WITH THEM, MAKING SURE

1365
00:46:39,402 --> 00:46:42,204
YOU WORK TO GET RID OF THAT.

1366
00:46:42,204 --> 00:46:43,839
MAKE SURE YOU BASICALLY HELP

1367
00:46:43,839 --> 00:46:46,008
SUPPORT THEM SO THAT THEY ARE

1368
00:46:46,008 --> 00:46:46,542
SUCCESSFUL.

1369
00:46:46,542 --> 00:46:48,978
MAKE SURE FOR THE BLACK TRAINEES

1370
00:46:48,978 --> 00:46:50,212
THEY PROTECT PERSONAL

1371
00:46:50,212 --> 00:46:51,747
WELL-BEING, SEEK MENTORSHIP AND

1372
00:46:51,747 --> 00:46:53,716
SUPPORT AS THEY GO ALONG,

1373
00:46:53,716 --> 00:46:56,819
SOMETHING WE WORKED ON THERE,

1374
00:46:56,819 --> 00:46:58,554
CLEARLY DEFINED MISSION, IN

1375
00:46:58,554 --> 00:47:00,189
TERMS OF EACH DEPARTMENT WAS

1376
00:47:00,189 --> 00:47:02,758
DOING THAT.

1377
00:47:02,758 --> 00:47:03,392
TARGETING MENTORSHIP,

1378
00:47:03,392 --> 00:47:04,660
SPONSORSHIP, SUPPORT, GETTING

1379
00:47:04,660 --> 00:47:05,528
PEOPLE INVOLVED IN NATIONAL

1380
00:47:05,528 --> 00:47:06,963
GROUPS, IF YOU DON'T HAVE ENOUGH

1381
00:47:06,963 --> 00:47:08,397
SUPPORT WHERE YOU'RE AT.

1382
00:47:08,397 --> 00:47:10,633
THIS IS SOMETHING WE PUBLISHED

1383
00:47:10,633 --> 00:47:12,902
LAST YEAR, JUST AS A WAY, IT'S A

1384
00:47:12,902 --> 00:47:15,671
TOOLKIT, IF YOU WILL, TO MAKE

1385
00:47:15,671 --> 00:47:16,906
SURE PEOPLE ARE SUPPORTED.

1386
00:47:16,906 --> 00:47:18,908
AT OUR PLACE WE'VE BEEN

1387
00:47:18,908 --> 00:47:20,943
OUTSTANDING IN TERMS OF

1388
00:47:20,943 --> 00:47:21,644
RECRUITING WOMEN IN SURGERY

1389
00:47:21,644 --> 00:47:23,646
BECAUSE WE'VE HAD A WOMAN CHAIR.

1390
00:47:23,646 --> 00:47:25,281
I MENTIONED THAT EARLIER.

1391
00:47:25,281 --> 00:47:27,183
ABOUT 55% OF OUR SURGICAL

1392
00:47:27,183 --> 00:47:28,617
RESIDENTS ARE WOMEN.

1393
00:47:28,617 --> 00:47:29,885
NATIONALLY THAT NUMBER IS 30%

1394
00:47:29,885 --> 00:47:31,053
BUT WE'RE FORTUNATE BECAUSE

1395
00:47:31,053 --> 00:47:34,457
WE'VE HAD OUTSTANDING WOMEN

1396
00:47:34,457 --> 00:47:35,057
LEADERS, OUTSTANDING DIVISION

1397
00:47:35,057 --> 00:47:38,060
CHIEFS THAT ARE WOMEN, PROVIDING

1398
00:47:38,060 --> 00:47:41,530
A TREMENDOUS AMOUNT OF ROLE

1399
00:47:41,530 --> 00:47:42,865
MODELING FOR THE RESIDENTS WHO

1400
00:47:42,865 --> 00:47:44,300
ARE IN TRAINING.

1401
00:47:44,300 --> 00:47:45,468
I'M GOING TO CONCLUDE THINGS AND

1402
00:47:45,468 --> 00:47:47,803
I'M HAPPY TO ANSWER QUESTIONS

1403
00:47:47,803 --> 00:47:48,104
AFTERWARDS.

1404
00:47:48,104 --> 00:47:51,941
I USE COVID AS A FRAMEWORK ABOUT

1405
00:47:51,941 --> 00:47:53,542
DISPARITIES AND WHAT HAPPENED,

1406
00:47:53,542 --> 00:47:54,977
SO FRESH IN OUR MIND AND STILL

1407
00:47:54,977 --> 00:47:59,715
CONTINUES AS WE DO THAT.

1408
00:47:59,715 --> 00:48:00,750
AMPLIFIED PREEXISTING

1409
00:48:00,750 --> 00:48:02,451
DISPARITIES IN TRAUMA, CANCER,

1410
00:48:02,451 --> 00:48:03,986
OTHER AREAS WITH THAT, BUT

1411
00:48:03,986 --> 00:48:05,454
PIPELINE ISSUES IN MEDICINE ARE

1412
00:48:05,454 --> 00:48:07,857
SERIOUS BUT THERE ARE WAYS TO

1413
00:48:07,857 --> 00:48:10,826
BEGIN TO APPROACH THE PIPELINE

1414
00:48:10,826 --> 00:48:12,995
PATHWAY ISSUES, IMPERATIVE TO

1415
00:48:12,995 --> 00:48:15,131
HAVE A DIVERSE WORKFORCE BUT I

1416
00:48:15,131 --> 00:48:16,599
THINK THE CHALLENGES ARE REALLY

1417
00:48:16,599 --> 00:48:18,501
BIG BUT THEY ARE WITHIN REACH.

1418
00:48:18,501 --> 00:48:20,903
WE HAVE TO BE CREATIVE AS WE GO

1419
00:48:20,903 --> 00:48:22,238
FORWARD WITH THINGS, AND WITH

1420
00:48:22,238 --> 00:48:23,272
THAT I'LL JUST THANK YOU FOR

1421
00:48:23,272 --> 00:48:24,640
YOUR TIME TODAY.

1422
00:48:24,640 --> 00:48:27,476
IT'S BEEN A TREMENDOUS HONOR TO

1423
00:48:27,476 --> 00:48:29,311
SPEAK TODAY AT NIH AT GREAT

1424
00:48:29,311 --> 00:48:30,379
TEACHERS CONFERENCE.

1425
00:48:30,379 --> 00:48:32,148
THANK YOU SO MUCH.

1426
00:48:32,148 --> 00:48:41,223
[APPLAUSE] 

1427
00:48:41,223 --> 00:48:42,525
>> THANKS FOR THE TALK,
DR.

1428
00:48:42,525 --> 00:48:42,858
CAMPBELL.

1429
00:48:42,858 --> 00:48:44,727
MY QUESTION HAS TO DO WITH THE

1430
00:48:44,727 --> 00:48:47,730
NUMBER OF MEDICAL SCHOOL

1431
00:48:47,730 --> 00:48:49,031
APPLICATIONS, SO I DIDN'T SEE

1432
00:48:49,031 --> 00:48:54,437
THAT COVERED IN THE TALK.

1433
00:48:54,437 --> 00:48:56,639
I'M AWARE THAT MEDICAL SCHOOLS

1434
00:48:56,639 --> 00:49:01,277
HAVE TAKEN SOME STEPS TO TRY TO

1435
00:49:01,277 --> 00:49:03,813
CREATE MORE DIVERSITY IN THE

1436
00:49:03,813 --> 00:49:06,115
CLASSES, BUT AS I TALK WITH THE

1437
00:49:06,115 --> 00:49:08,984
FOLKS ACROSS THE STREET, FROM

1438
00:49:08,984 --> 00:49:10,486
SERVICES UNIVERSITY WHERE YOU

1439
00:49:10,486 --> 00:49:12,755
AND I BOTH SHARE ADJUNCT

1440
00:49:12,755 --> 00:49:15,024
PROFESSORSHIPS, AND ALSO --

1441
00:49:15,024 --> 00:49:20,329
>>  I'M NOT A TWO STAR
GENERAL. 

1442
00:49:20,329 --> 00:49:21,330
I WISH I WAS.

1443
00:49:21,330 --> 00:49:22,531
>> AND THEN ALSO AT THE
PLACE

1444
00:49:22,531 --> 00:49:25,868
WHERE I WENT TO MEDICAL SCHOOL,

1445
00:49:25,868 --> 00:49:27,970
INDIANA UNIVERSITY, IT WAS --

1446
00:49:27,970 --> 00:49:30,940
THERE WAS JUST INCREASING

1447
00:49:30,940 --> 00:49:32,241
COMPETITION OVER RELATIVELY

1448
00:49:32,241 --> 00:49:34,810
SMALL GROUP OF STUDENTS.

1449
00:49:34,810 --> 00:49:38,414
AND SO THE MEDICAL SCHOOLS WERE

1450
00:49:38,414 --> 00:49:40,116
A LITTLE BIT FRUSTRATED IN THEIR

1451
00:49:40,116 --> 00:49:43,452
EFFORTS TO TRY TO INCREASE

1452
00:49:43,452 --> 00:49:45,087
DIVERSITY.

1453
00:49:45,087 --> 00:49:46,255
SO TELL ME, TELL US, WHAT THE

1454
00:49:46,255 --> 00:49:49,458
STATUS IS OF THE NUMBER OF

1455
00:49:49,458 --> 00:49:51,093
MEDICAL SCHOOL APPLICANTS FROM

1456
00:49:51,093 --> 00:49:52,461
UNDERREPRESENTED MINORITIES NOW.

1457
00:49:52,461 --> 00:49:53,796
>> AT OUR PLACE -- THANK
YOU FOR

1458
00:49:53,796 --> 00:49:54,930
THAT QUESTION, SIR.

1459
00:49:54,930 --> 00:49:56,765
AT OUR PLACE WE'VE ACTUALLY HAD

1460
00:49:56,765 --> 00:49:58,501
THE OPPOSITE EFFECT.

1461
00:49:58,501 --> 00:50:00,636
WE'VE INCREASED THE NUMBER OF

1462
00:50:00,636 --> 00:50:02,071
UNDERREPRESENTED IN MEDICINE,

1463
00:50:02,071 --> 00:50:04,039
THAT'S BEEN INTENTIONAL.

1464
00:50:04,039 --> 00:50:06,342
WE'VE BEEN AGGRESSIVE WITH

1465
00:50:06,342 --> 00:50:07,076
RECRUITMENT, OUTREACH, REACHING

1466
00:50:07,076 --> 00:50:09,612
OUT TO HBCUs AND OTHER PLACES.

1467
00:50:09,612 --> 00:50:10,713
HAVE TO BE EXTREMELY INTENTIONAL

1468
00:50:10,713 --> 00:50:12,081
WHEN DOING THAT.

1469
00:50:12,081 --> 00:50:13,115
OUR NUMBERS, EVEN THOUGH ALL

1470
00:50:13,115 --> 00:50:15,818
THESE THINGS ARE GOING ON

1471
00:50:15,818 --> 00:50:17,686
NATIONALLY, WE'VE INCREASED THE

1472
00:50:17,686 --> 00:50:18,387
NUMBERS.

1473
00:50:18,387 --> 00:50:20,189
BUT IT IS SOMETHING WE HAVE TO

1474
00:50:20,189 --> 00:50:20,356
DO.

1475
00:50:20,356 --> 00:50:22,892
OUR DEAN OF ADMISSIONS IS REALLY

1476
00:50:22,892 --> 00:50:23,325
PROGRESSIVE.

1477
00:50:23,325 --> 00:50:25,694
SHE'S JUST PRESIDENT OF THE

1478
00:50:25,694 --> 00:50:26,328
AMERICAN HEART ASSOCIATION, YOU

1479
00:50:26,328 --> 00:50:29,431
KNOW, YOU MAY KNOW HER BUT SHE'S

1480
00:50:29,431 --> 00:50:30,232
TERRIFIC.

1481
00:50:30,232 --> 00:50:31,433
SHE'S REALLY BEEN DEDICATED TO

1482
00:50:31,433 --> 00:50:33,602
THE MISSION, AS OUR DEAN WITH

1483
00:50:33,602 --> 00:50:36,005
THAT, THE WHOLE FACULTY WITH

1484
00:50:36,005 --> 00:50:36,205
THAT.

1485
00:50:36,205 --> 00:50:38,574
THIS PERMEATES WITH THE FACULTY,

1486
00:50:38,574 --> 00:50:40,176
MEDICAL SCHOOL, THROUGH

1487
00:50:40,176 --> 00:50:40,776
ADMISSIONS PROCESS, THAT'S ONE

1488
00:50:40,776 --> 00:50:42,311
WAY TO CONTINUE TO DO THAT.

1489
00:50:42,311 --> 00:50:44,613
IT IS A STRUGGLE BECAUSE THE

1490
00:50:44,613 --> 00:50:45,281
NUMBERS OF APPLICATIONS HAVE

1491
00:50:45,281 --> 00:50:45,981
GONE UP.

1492
00:50:45,981 --> 00:50:47,816
IT GOES UP AND DOWN EACH YEAR.

1493
00:50:47,816 --> 00:50:49,718
SOMETIMES IT GOES UP, SOMETIMES

1494
00:50:49,718 --> 00:50:51,420
DOWN, DEPENDING HOW LONG PEOPLE

1495
00:50:51,420 --> 00:50:53,355
WANT TO TRAIN TO BE DOCTORS.

1496
00:50:53,355 --> 00:50:55,124
BUT IT IS A CHALLENGE.

1497
00:50:55,124 --> 00:50:57,359
YOU HAVE TO BE INTENTIONAL ABOUT

1498
00:50:57,359 --> 00:50:59,028
DOING THAT AT THE STUDENT LEVEL.

1499
00:50:59,028 --> 00:51:02,998
WE HAVE AS A MEDICAL SCHOOL UCSF

1500
00:51:02,998 --> 00:51:05,134
BEEN SUCCESSFUL IN TERMS OF

1501
00:51:05,134 --> 00:51:05,768
DIVERSIFYING THE STUDENT

1502
00:51:05,768 --> 00:51:08,037
POPULATION BUT WE'VE NOT BEEN

1503
00:51:08,037 --> 00:51:09,271
SUCCESSFUL WITH THE RESIDENCY

1504
00:51:09,271 --> 00:51:10,339
TRAINING PROGRAM.

1505
00:51:10,339 --> 00:51:13,209
WE'RE NOW BEGINNING TO WORK ON

1506
00:51:13,209 --> 00:51:13,709
THAT ALSO.

1507
00:51:13,709 --> 00:51:15,611
AND OUR GME OFFICE HAS BEEN

1508
00:51:15,611 --> 00:51:17,980
HELPING US WITH TECHNIQUES TO DO

1509
00:51:17,980 --> 00:51:18,214
THINGS.

1510
00:51:18,214 --> 00:51:19,481
WE HAVE DIFFERENT SUBCOMMITTEES

1511
00:51:19,481 --> 00:51:21,584
TO HELP WITH THAT.

1512
00:51:21,584 --> 00:51:25,721
GOING TO THE PLACES WHERE WE

1513
00:51:25,721 --> 00:51:29,158
COULD GET STUDENTS ATTRACTED SO

1514
00:51:29,158 --> 00:51:30,693
SMA, LATINO ELEMENTS WE'VE BEEN

1515
00:51:30,693 --> 00:51:33,195
TRYING TO DO OUTREACH TO

1516
00:51:33,195 --> 00:51:33,963
CONFERENCES NATIONALLY TO LET

1517
00:51:33,963 --> 00:51:36,966
STUDENTS KNOW WHERE TO COME FOR

1518
00:51:36,966 --> 00:51:38,367
GME, BUT CERTAINLY IN MEDICAL

1519
00:51:38,367 --> 00:51:40,703
LEVEL THERE'S CHALLENGES WITH

1520
00:51:40,703 --> 00:51:41,637
THAT.

1521
00:51:41,637 --> 00:51:43,772
THANK YOU.

1522
00:51:43,772 --> 00:51:51,180
 

1523
00:51:51,180 --> 00:51:53,582
 

1524
00:51:53,582 --> 00:51:54,383
>> ONE QUESTION FOR YOU,

1525
00:51:54,383 --> 00:51:56,452
BUILDING OFF OF WHAT HE JUST

1526
00:51:56,452 --> 00:52:02,891
ASKED, I FEEL LIKE BEING LATINO

1527
00:52:02,891 --> 00:52:05,194
IN MEDICINE, I FEEL LIKE IT

1528
00:52:05,194 --> 00:52:06,428
STARTS LIKE YOU'RE SAYING PEOPLE

1529
00:52:06,428 --> 00:52:07,496
APPLYING TO MEDICAL SCHOOL BUT

1530
00:52:07,496 --> 00:52:08,931
WHEN YOU APPLY TO MEDICAL SCHOOL

1531
00:52:08,931 --> 00:52:10,666
IT'S ABOUT LIKE WHO IS ON THE

1532
00:52:10,666 --> 00:52:12,434
ADMISSION BOARD, WHO IS

1533
00:52:12,434 --> 00:52:14,069
REVIEWING APPLICATION THAT CAN

1534
00:52:14,069 --> 00:52:15,704
HELP YOU GET THERE, AND SO LIKE

1535
00:52:15,704 --> 00:52:17,673
WHEN IT COMES TO WHEN WE DO GET

1536
00:52:17,673 --> 00:52:19,408
TO MEDICAL SCHOOL AND THINK

1537
00:52:19,408 --> 00:52:20,676
ABOUT CAREERS, HOW WE CONTINUE

1538
00:52:20,676 --> 00:52:24,446
TO PUSH FOR MORE OF US,

1539
00:52:24,446 --> 00:52:26,148
UNDERREPRESENTED, TO PURSUE

1540
00:52:26,148 --> 00:52:28,384
ACADEMICS, LEADERSHIP IN

1541
00:52:28,384 --> 00:52:30,786
ACADEMIA, EVEN MORE SO PURSUE

1542
00:52:30,786 --> 00:52:32,221
FIELDS OF PRIMARY CARE,

1543
00:52:32,221 --> 00:52:33,956
PASSIONATE ABOUT WHATEVER YOU'RE

1544
00:52:33,956 --> 00:52:35,124
PASSIONATE ABOUT, A LOT OF TIMES

1545
00:52:35,124 --> 00:52:36,659
YOU MENTIONED THE PRIME PROGRAM

1546
00:52:36,659 --> 00:52:39,595
IN CALIFORNIA, U.C. SYSTEMS, WE

1547
00:52:39,595 --> 00:52:42,231
PUSH FOR PRIMARY CARE A LOT OF

1548
00:52:42,231 --> 00:52:44,199
TIMES AS UNDERREPRESENTEDS, WHAT

1549
00:52:44,199 --> 00:52:45,968
WE CARE ABOUT, WE'RE ALSO NEEDED

1550
00:52:45,968 --> 00:52:49,371
IN SPACES OF SURGICAL

1551
00:52:49,371 --> 00:52:51,440
SPECIALTIES, ACADEMIA, SPACES OF

1552
00:52:51,440 --> 00:52:52,007
LEADERSHIP.

1553
00:52:52,007 --> 00:52:53,275
CAN YOU TALK MORE HOW WE

1554
00:52:53,275 --> 00:52:54,843
CONTINUE TO PUSH OUR PEOPLE TO

1555
00:52:54,843 --> 00:52:56,178
GO INTO THOSE SPACES BECAUSE WE

1556
00:52:56,178 --> 00:52:58,714
NEED TO SIT ON THOSE COMMITTEES,

1557
00:52:58,714 --> 00:53:00,182
ON THAT LEADERSHIP, CREATE

1558
00:53:00,182 --> 00:53:02,918
CHANGE FROM INSIDE.

1559
00:53:02,918 --> 00:53:03,352
THANK YOU.

1560
00:53:03,352 --> 00:53:04,486
>> IS THERE A QUESTION?

1561
00:53:04,486 --> 00:53:06,755
>> HOW DO WE DO THAT, HOW
DO WE

1562
00:53:06,755 --> 00:53:08,057
PUSH MORE OF US?

1563
00:53:08,057 --> 00:53:09,792
>> OKAY, I GOT YOU.

1564
00:53:09,792 --> 00:53:13,329
THANK YOU, I APPRECIATE THAT.

1565
00:53:13,329 --> 00:53:16,632
I THINK THIS IS -- I THINK THAT

1566
00:53:16,632 --> 00:53:18,033
I JUST READ SOMETHING THEY

1567
00:53:18,033 --> 00:53:20,169
ESTIMATED IT WOULD TAKE BY 2050

1568
00:53:20,169 --> 00:53:23,505
AT THE RATE WE'RE GOING TO

1569
00:53:23,505 --> 00:53:25,541
BASICALLY HAVE THE DIVERSITY AND

1570
00:53:25,541 --> 00:53:26,542
MEDICINE MATCH THE GENERAL

1571
00:53:26,542 --> 00:53:28,744
POPULATION BECAUSE THE

1572
00:53:28,744 --> 00:53:29,812
POPULATION IS SLOWLY BECOMING

1573
00:53:29,812 --> 00:53:31,280
MUCH MORE DIVERSE AND CERTAINLY

1574
00:53:31,280 --> 00:53:33,982
CALIFORNIA WILL PROBABLY LEAD

1575
00:53:33,982 --> 00:53:37,553
THE WAY.

1576
00:53:37,553 --> 00:53:42,958
WE NEED  TO TAKE IN MIND AS WE O

1577
00:53:42,958 --> 00:53:43,359
FORWARD.

1578
00:53:43,359 --> 00:53:44,827
THE CHALLENGES, THE THING THAT

1579
00:53:44,827 --> 00:53:48,697
IMPRESSED ME, I HAD A COFFEE

1580
00:53:48,697 --> 00:53:49,531
HOUR WITH STUDENTS, DIVERSE

1581
00:53:49,531 --> 00:53:53,669
STUDENTS YOU HAVE HERE AT NIH,

1582
00:53:53,669 --> 00:53:54,403
YOU'RE PRETTY AMAZING, I'LL

1583
00:53:54,403 --> 00:53:56,038
COMPLIMENT YOU BECAUSE YOU'RE

1584
00:53:56,038 --> 00:53:58,207
THE BOSS, RIGHT?

1585
00:53:58,207 --> 00:54:00,409
FOR SUPPORTING THE PROGRAM.

1586
00:54:00,409 --> 00:54:01,877
I SENT STUDENTS TO THE PROGRAM

1587
00:54:01,877 --> 00:54:03,512
THAT MANY OF YOU ARE IN, THAT'S

1588
00:54:03,512 --> 00:54:05,514
A GOOD WAY BECAUSE YOU GET A

1589
00:54:05,514 --> 00:54:06,648
CHANCE TO SEE WHAT IT'S LIKE

1590
00:54:06,648 --> 00:54:13,856
NONE  -- WHAT IT'S LIKE TO BE A

1591
00:54:13,856 --> 00:54:14,990
RESEARCHER IN MEDICINE, THE ROLE

1592
00:54:14,990 --> 00:54:16,024
MODEL THING IS IMPORTANT, SEE

1593
00:54:16,024 --> 00:54:17,359
SOMEONE LIKE YOU, CAN YOU

1594
00:54:17,359 --> 00:54:19,161
POTENTIALLY DO THAT.

1595
00:54:19,161 --> 00:54:21,797
WE TALKED ABOUT I'M FIRST

1596
00:54:21,797 --> 00:54:24,900
GENERATION, I KNOW WHAT THAT'S

1597
00:54:24,900 --> 00:54:27,870
LIKE, THE STRUGGLES, YOU DON'T

1598
00:54:27,870 --> 00:54:30,906
SEE ANYBODY WHO LOOKS LIKE YOU,

1599
00:54:30,906 --> 00:54:31,874
OCCASIONALLY YOU DO, REACH OUT

1600
00:54:31,874 --> 00:54:34,376
AND TALK TO THEM AND SEE IF THEY

1601
00:54:34,376 --> 00:54:35,477
CAN SUPPORT YOU BUT THERE'S A

1602
00:54:35,477 --> 00:54:39,581
LOT OF YOU AND THERE'S NOT A LOT

1603
00:54:39,581 --> 00:54:42,050
OF US, SO -- WE JUST HAVE TO

1604
00:54:42,050 --> 00:54:43,485
KEEP MOVING FORWARD TRYING TO

1605
00:54:43,485 --> 00:54:50,659
MAKE A POSITIVE IMPACT ON

1606
00:54:50,659 --> 00:54:51,160
THINGS.

1607
00:54:51,160 --> 00:54:53,395
>> I HAD A QUESTION
SPECIFICALLY

1608
00:54:53,395 --> 00:54:54,530
ABOUT ONE FIGURE THAT REALLY

1609
00:54:54,530 --> 00:54:55,431
SHOOK ME.

1610
00:54:55,431 --> 00:54:57,232
I TOOK A PICTURE SO I COULD LOOK

1611
00:54:57,232 --> 00:54:58,267
UP THE ARTICLE LATER.

1612
00:54:58,267 --> 00:55:01,603
IT WAS THE ONE ABOUT UNINTENDED

1613
00:55:01,603 --> 00:55:03,038
ATTRITION IN SURGICAL RESIDENTS

1614
00:55:03,038 --> 00:55:06,675
AND THERE ARE ARROWS POINTING TO

1615
00:55:06,675 --> 00:55:07,376
SPECIFICALLY ORTHO, THORACIC,

1616
00:55:07,376 --> 00:55:11,647
VASCULAR, AS COMPARED TO OTHER

1617
00:55:11,647 --> 00:55:13,182
SURGICAL SUBSPECIALITIES LIKE

1618
00:55:13,182 --> 00:55:14,082
ENT OR PLASTICS.

1619
00:55:14,082 --> 00:55:16,785
WONDERING YOUR TAKE WHY THAT IS

1620
00:55:16,785 --> 00:55:21,223
SO HIGH IN ORTHO, THORACIC,

1621
00:55:21,223 --> 00:55:24,526
VASCULAR, DO YOU HAVE HYPOTHESES

1622
00:55:24,526 --> 00:55:25,594
WHETHER THAT'S CULTURE,

1623
00:55:25,594 --> 00:55:28,664
FELLOWSHIP MATCH, ANY OTHER

1624
00:55:28,664 --> 00:55:37,206
FACTORS YOU MIGHT THINK? 

1625
00:55:37,206 --> 00:55:40,909
>> SO THOSE AREAS IN
SURGERY

1626
00:55:40,909 --> 00:55:42,578
ARE -- FOR LACK OF BETTER WORD

1627
00:55:42,578 --> 00:55:45,247
THERE'S MORE HAZING THAT GOES ON

1628
00:55:45,247 --> 00:55:47,816
IN THOSE SUBSPECIALITIES.

1629
00:55:47,816 --> 00:55:48,884
AND CERTAINLY IN ORTHOPEDICS

1630
00:55:48,884 --> 00:55:50,519
THEY BRING YOU IN BUT THEY MAY

1631
00:55:50,519 --> 00:55:52,788
NOT WANT TO FINISH YOU, YOU

1632
00:55:52,788 --> 00:55:53,889
KNOW, WITH THAT.

1633
00:55:53,889 --> 00:55:56,558
THE ATTRITION RATE I THINK IS

1634
00:55:56,558 --> 00:55:59,161
RELATED TO THE FACT THAT THEY DO

1635
00:55:59,161 --> 00:56:00,229
NOT CREATE A SUPPORTIVE

1636
00:56:00,229 --> 00:56:01,630
ENVIRONMENT FOR THE RESIDENTS TO

1637
00:56:01,630 --> 00:56:02,064
BE IN.

1638
00:56:02,064 --> 00:56:04,166
IF YOU DON'T FEEL SUPPORTED, IF

1639
00:56:04,166 --> 00:56:06,835
YOU'RE WORKING HARD I MEAN I

1640
00:56:06,835 --> 00:56:10,439
THINK MANY OF US IN RESIDENCY

1641
00:56:10,439 --> 00:56:12,875
TRAINING IS NOT EASY.

1642
00:56:12,875 --> 00:56:14,009
SURGEONS KNOW THAT.

1643
00:56:14,009 --> 00:56:16,345
YOU KNOW, IT'S NOT EASY AT ALL.

1644
00:56:16,345 --> 00:56:17,779
IT TAKES A LOT OUT OF YOU.

1645
00:56:17,779 --> 00:56:20,782
IF YOU FEEL LIKE YOU'RE THERE BY

1646
00:56:20,782 --> 00:56:22,384
YOURSELF BECAUSE A LOT OF THE

1647
00:56:22,384 --> 00:56:23,452
RESIDENTS WHO GET INTO TROUBLE

1648
00:56:23,452 --> 00:56:25,020
FEEL LIKE THEY ARE NOT

1649
00:56:25,020 --> 00:56:26,488
SUPPORTED, FEEL LIKE THEY ARE BY

1650
00:56:26,488 --> 00:56:29,057
THEMSELVES, AS A RESULT OF THAT

1651
00:56:29,057 --> 00:56:31,527
THEN YOU'LL HEAR ABOUT THEM

1652
00:56:31,527 --> 00:56:32,327
BEING DISMISSED AFTERWARDS

1653
00:56:32,327 --> 00:56:34,463
BECAUSE THEY DON'T FEEL

1654
00:56:34,463 --> 00:56:36,265
SUPPORTED.

1655
00:56:36,265 --> 00:56:37,633
THERE'S SEVERAL FOLKS NATIONALLY

1656
00:56:37,633 --> 00:56:38,667
TRYING TO ADDRESS THIS.

1657
00:56:38,667 --> 00:56:40,669
THE PROBLEM IS THAT YOU BRING

1658
00:56:40,669 --> 00:56:42,771
PEOPLE IN, YOU KNOW, THE WHOLE

1659
00:56:42,771 --> 00:56:44,072
THING ABOUT D.E.I. EFFORTS, YOU

1660
00:56:44,072 --> 00:56:45,674
SORT OF BRING THEM IN BUT YOU

1661
00:56:45,674 --> 00:56:46,909
HAVE TO MAKE SURE THEY ARE

1662
00:56:46,909 --> 00:56:47,342
COMFORTABLE.

1663
00:56:47,342 --> 00:56:49,745
IF YOU SAY THINGS TO THEM THAT

1664
00:56:49,745 --> 00:56:50,879
ARE RACIST OR THINGS THAT ARE

1665
00:56:50,879 --> 00:56:52,748
SEXIST OR THINGS THAT DON'T

1666
00:56:52,748 --> 00:56:54,616
INCLUDE THEM, MAKE YOU FEEL

1667
00:56:54,616 --> 00:56:56,351
OTHER THAN, YOU'RE LIKE WELL,

1668
00:56:56,351 --> 00:56:57,686
I'M WORKING THIS HARD, WHY

1669
00:56:57,686 --> 00:56:58,687
SHOULD I CONTINUE?

1670
00:56:58,687 --> 00:57:00,289
YOU START DOUBTING YOURSELF WITH

1671
00:57:00,289 --> 00:57:00,489
THAT.

1672
00:57:00,489 --> 00:57:01,757
THERE'S ENVIRONMENTAL THINGS.

1673
00:57:01,757 --> 00:57:04,426
THE ENVIRONMENTAL THINGS, THOSE

1674
00:57:04,426 --> 00:57:07,763
CAN BE FIXED BECAUSE IF THEY

1675
00:57:07,763 --> 00:57:09,898
CREATE ENVIRONMENT THAT'S

1676
00:57:09,898 --> 00:57:11,900
SUPPORTIVE YOU'LL BE SUCCESSFUL,

1677
00:57:11,900 --> 00:57:12,901
THEY ARE NOT CREATING THAT

1678
00:57:12,901 --> 00:57:14,503
ENVIRONMENT, IN FACT THEY ARE

1679
00:57:14,503 --> 00:57:16,104
MAKING IT HOSTILE AND NEED TO BE

1680
00:57:16,104 --> 00:57:16,972
CALLED OUT.

1681
00:57:16,972 --> 00:57:21,944
DR. McDADE IS AT THE AAMC, HE

1682
00:57:21,944 --> 00:57:23,211
SHARED THAT SLIDE, HE SAID SHARE

1683
00:57:23,211 --> 00:57:23,745
IT WIDELY.

1684
00:57:23,745 --> 00:57:25,380
YOU LOOK AT THAT, THIS IS A REAL

1685
00:57:25,380 --> 00:57:25,614
PROBLEM.

1686
00:57:25,614 --> 00:57:26,882
YOU DON'T HAVE TO BE A

1687
00:57:26,882 --> 00:57:29,284
STATISTICIAN TO SAY THAT NUMBER

1688
00:57:29,284 --> 00:57:34,323
IS WAY MORE, IT STICKS OUT Y  --

1689
00:57:34,323 --> 00:57:35,357
AND WHY IS THAT?

1690
00:57:35,357 --> 00:57:37,292
WE HAVE TO STOP THE HAZING,

1691
00:57:37,292 --> 00:57:39,828
CHANGE THE CULTURE.

1692
00:57:39,828 --> 00:57:40,829
THINGS HAVE GOTTEN BETTER BUT WE

1693
00:57:40,829 --> 00:57:44,466
STILL HAVE A LONG WAY TO GO.

1694
00:57:44,466 --> 00:57:45,767
>> THANK YOU AGAIN, DR.

1695
00:57:45,767 --> 00:57:46,034
CAMPBELL.

1696
00:57:46,034 --> 00:57:47,669
I THINK NOT A LOT OF US HERE ARE

1697
00:57:47,669 --> 00:57:49,071
SURGEONS BUT I THINK ANYTHING

1698
00:57:49,071 --> 00:57:50,539
THAT YOU'RE IN, WHETHER IT'S A

1699
00:57:50,539 --> 00:57:52,140
LAB OR BRANCH, THERE'S A

1700
00:57:52,140 --> 00:57:53,575
HIERARCHY INVOLVED.

1701
00:57:53,575 --> 00:57:56,211
THERE ARE PROBABLY DIFFERENT

1702
00:57:56,211 --> 00:57:59,314
OPPORTUNITIES FOR ALLYSHIP AS

1703
00:57:59,314 --> 00:58:01,316
YOU MOVE FROM JUNIOR TO SENIOR

1704
00:58:01,316 --> 00:58:01,516
STAGE.

1705
00:58:01,516 --> 00:58:05,621
CAN YOU TALK ABOUT MORE WAYS

1706
00:58:05,621 --> 00:58:07,155
PEOPLE CAN PROMOTE EQUITY AT

1707
00:58:07,155 --> 00:58:10,726
DIFFERENT LEVELS IN THEIR

1708
00:58:10,726 --> 00:58:10,959
CAREER?

1709
00:58:10,959 --> 00:58:12,628
>> I THINK ONE OF THE
THINGS

1710
00:58:12,628 --> 00:58:13,762
THAT'S INTERESTING THAT'S

1711
00:58:13,762 --> 00:58:15,897
HAPPENING, AT LEAST IN SURGERY,

1712
00:58:15,897 --> 00:58:16,965
WE'RE BEGINNING TO FORM --

1713
00:58:16,965 --> 00:58:18,800
THERE'S A LOT OF AFFINITY

1714
00:58:18,800 --> 00:58:20,636
GROUPS, THE OLDEST ONE IS

1715
00:58:20,636 --> 00:58:23,972
ASSOCIATION OF WOMEN SURGEONS,

1716
00:58:23,972 --> 00:58:25,273
WHICH A FANTASTIC GROUP, SOCIETY

1717
00:58:25,273 --> 00:58:28,577
OF BLACK ACADEMIC SURGEONS, A

1718
00:58:28,577 --> 00:58:31,346
NEW ONE, WE'VE BEEN OUT 35

1719
00:58:31,346 --> 00:58:35,417
YEARS, THAT WE'VE BEEN IN

1720
00:58:35,417 --> 00:58:36,685
EXISTENCE, LATINO SURGICAL

1721
00:58:36,685 --> 00:58:37,486
ASSOCIATION, ASIAN ACADEMIC

1722
00:58:37,486 --> 00:58:41,123
SURGEONS ASSOCIATION, AND NOW

1723
00:58:41,123 --> 00:58:43,025
THERE'S A NEW SURGERY

1724
00:58:43,025 --> 00:58:43,392
ASSOCIATION.

1725
00:58:43,392 --> 00:58:45,761
WE FOUND THERE'S A LOT OF

1726
00:58:45,761 --> 00:58:46,395
INTERSECTIONALITY BETWEEN

1727
00:58:46,395 --> 00:58:47,829
STRUGGLES WE ALL FACE, AND WE

1728
00:58:47,829 --> 00:58:49,431
NEED TO WORK TOGETHER AND WE'VE

1729
00:58:49,431 --> 00:58:51,900
BEEN DOING THAT IN TERMS OF

1730
00:58:51,900 --> 00:58:52,467
DOING RECRUITMENT SESSIONS.

1731
00:58:52,467 --> 00:58:54,536
YOU KNOW, WE HAD A BOOTH FOR A

1732
00:58:54,536 --> 00:58:56,071
NUMBER OF YEARS, ALL OF US WERE

1733
00:58:56,071 --> 00:58:59,574
REPRESENTED, WE WERE ABLE TO

1734
00:58:59,574 --> 00:59:05,313
REACH OUT AND HELP EACH OTHER.

1735
00:59:05,313 --> 00:59:07,749
THE STRUGGLES EVERYONE FACES,

1736
00:59:07,749 --> 00:59:11,953
WHATEVER YOUR ETHNIC BACKGROUND

1737
00:59:11,953 --> 00:59:14,289
IS, OR YOUR SEXUALLY

1738
00:59:14,289 --> 00:59:14,990
PREFERENCES, WE'RE STILL

1739
00:59:14,990 --> 00:59:15,957
FIGHTING THE SAME ISSUES.

1740
00:59:15,957 --> 00:59:18,193
AND I THINK IF WE WORK TOGETHER,

1741
00:59:18,193 --> 00:59:18,960
WE WORK BETTER.

1742
00:59:18,960 --> 00:59:20,495
I THINK IT'S BEEN GREAT WE'VE

1743
00:59:20,495 --> 00:59:22,698
BEEN WORKING TOGETHER AS A GROUP

1744
00:59:22,698 --> 00:59:24,232
TO HELP SUPPORT, YOU KNOW, THE

1745
00:59:24,232 --> 00:59:25,767
STRUGGLE BECAUSE THE STRUGGLE

1746
00:59:25,767 --> 00:59:27,736
DOESN'T JUST AFFECT ONE GROUP.

1747
00:59:27,736 --> 00:59:30,272
IT AFFECTS ONE, IT AFFECTS ALL

1748
00:59:30,272 --> 00:59:31,306
OF US.

1749
00:59:31,306 --> 00:59:33,809
THE ALLYSHIP STARTED A LOT WHERE

1750
00:59:33,809 --> 00:59:35,510
WE'RE NOW WORKING TOGETHER,

1751
00:59:35,510 --> 00:59:37,546
HELPING EACH OTHER, PARTICIPATE

1752
00:59:37,546 --> 00:59:39,247
IN EACH OTHER'S MEETINGS, DOING

1753
00:59:39,247 --> 00:59:41,116
THOSE KIND OF THINGS.

1754
00:59:41,116 --> 00:59:43,051
THAT'S A BIG PLUS BECAUSE IF YOU

1755
00:59:43,051 --> 00:59:45,721
SEE THERE'S NOW A GROWING GROUP

1756
00:59:45,721 --> 00:59:47,823
OF PEOPLE, THAT WILL SUPPORT

1757
00:59:47,823 --> 00:59:51,159
YOU, THAT'S SOMETHING THAT'S

1758
00:59:51,159 --> 00:59:52,461
IMPORTANT.

1759
00:59:52,461 --> 01:00:02,971
THANK YOU FOR THAT QUESTION. 

1760
01:00:02,971 --> 01:00:06,108
 

1761
01:00:06,108 --> 01:00:07,576
>> ONE MORE QUESTION.

1762
01:00:07,576 --> 01:00:08,510
>> THANK YOU AGAIN, DR.

1763
01:00:08,510 --> 01:00:10,612
CAMPBELL, FOR MAKING IT ALL THE

1764
01:00:10,612 --> 01:00:14,316
WAY WE'RE AND SPEAKING TO US

1765
01:00:14,316 --> 01:00:14,783
STUDENTS.

1766
01:00:14,783 --> 01:00:18,386
I WANT TO ASK IF YOU HAVE ANY

1767
01:00:18,386 --> 01:00:20,989
ADVICE ON HOW TO GO AROUND THIS

1768
01:00:20,989 --> 01:00:23,258
RECENT ISSUE LIKE SINCE THE

1769
01:00:23,258 --> 01:00:25,193
AFFIRMATIVE ACTION HAS BEEN

1770
01:00:25,193 --> 01:00:26,695
REVERSED ON SCHOOLS, AREN'T EVEN

1771
01:00:26,695 --> 01:00:28,997
PROVIDING US DATA WHAT THE

1772
01:00:28,997 --> 01:00:31,466
LATINO ADMISSION RATES ARE,

1773
01:00:31,466 --> 01:00:32,901
BLACK ADMISSION RATES, I WANTED

1774
01:00:32,901 --> 01:00:39,941
TO ASK LIKE WHAT CAN WE DO AS

1775
01:00:39,941 --> 01:00:42,277
STUDENTS TO INCREASE THE

1776
01:00:42,277 --> 01:00:42,878
ADMISSION RATES BECAUSE JUST

1777
01:00:42,878 --> 01:00:44,412
FROM SEEING LIKE WITH OUR OWN

1778
01:00:44,412 --> 01:00:47,382
EYES LIKE THERE HAS BEEN A

1779
01:00:47,382 --> 01:00:49,217
SIGNIFICANT DECREASE IN

1780
01:00:49,217 --> 01:00:50,418
ADMISSION RATES OF MINORITY

1781
01:00:50,418 --> 01:00:53,822
GROUPS, EVEN AT MY OWN SCHOOL,

1782
01:00:53,822 --> 01:00:55,824
I'VE SEEN A DRASTIC DECREASE,

1783
01:00:55,824 --> 01:00:56,992
WONDERING IF THERE'S A WAY WE

1784
01:00:56,992 --> 01:00:58,560
CAN GO AROUND THIS ISSUE, WHAT

1785
01:00:58,560 --> 01:01:00,295
ADVICE DO YOU HAVE FOR US AS

1786
01:01:00,295 --> 01:01:06,601
STUDENTS TO FIGHT FOR THIS

1787
01:01:06,601 --> 01:01:07,035
PROBLEM?

1788
01:01:07,035 --> 01:01:07,302
THANK YOU.

1789
01:01:07,302 --> 01:01:09,437
>> I THINK AS STUDENTS YOU
SORT

1790
01:01:09,437 --> 01:01:11,439
OF FEEL SOMETIMES YOU'RE

1791
01:01:11,439 --> 01:01:12,407
POWERLESS BUT THE REALITY IS

1792
01:01:12,407 --> 01:01:13,375
YOU'RE VERY EMPOWERED.

1793
01:01:13,375 --> 01:01:15,944
WE HAD A GROUP OF STUDENTS

1794
01:01:15,944 --> 01:01:19,214
STARTED WHITE COATS FOR BLACK

1795
01:01:19,214 --> 01:01:19,447
LIVES.

1796
01:01:19,447 --> 01:01:21,349
BASICALLY STARTED WHAT WAS A

1797
01:01:21,349 --> 01:01:25,187
NATIONAL MOVEMENT, IN TERMS OF

1798
01:01:25,187 --> 01:01:26,888
SETTING OF RACIAL INJUSTICES,

1799
01:01:26,888 --> 01:01:28,056
WITH THE WAY THAT AFRICAN

1800
01:01:28,056 --> 01:01:30,759
AMERICANS WERE TREATED BY THE

1801
01:01:30,759 --> 01:01:31,560
POLICE AND OTHERS, AND I THINK

1802
01:01:31,560 --> 01:01:33,261
THAT WAS A HUGE THING.

1803
01:01:33,261 --> 01:01:34,663
THEY GOT RECOGNIZED BY THE STATE

1804
01:01:34,663 --> 01:01:37,199
OF CALIFORNIA BECAUSE OF WHAT

1805
01:01:37,199 --> 01:01:38,633
THEY DID BY THE ASSEMBLY GROUP.

1806
01:01:38,633 --> 01:01:41,670
SO I THINK WHAT YOU CAN DO IS

1807
01:01:41,670 --> 01:01:43,338
YOU CAN REACH BACK TO DO THINGS.

1808
01:01:43,338 --> 01:01:45,106
I THINK ABOUT THIS, YOU ASKED

1809
01:01:45,106 --> 01:01:46,341
THAT QUESTION, I THOUGHT ABOUT

1810
01:01:46,341 --> 01:01:47,776
WHEN I WAS AT HARVARD, I WOULD

1811
01:01:47,776 --> 01:01:49,377
GO TO NEW YORK AND VISIT HIGH

1812
01:01:49,377 --> 01:01:50,579
SCHOOLS TO TRY TO GET MORE

1813
01:01:50,579 --> 01:01:54,983
STUDENTS , WHEN I WAS MEDICAL

1814
01:01:54,983 --> 01:01:57,485
SCHOOL I TRIED TO GET TO

1815
01:01:57,485 --> 01:01:58,887
MEETINGS, WE FORMED A GROUP, I

1816
01:01:58,887 --> 01:02:01,990
WAS ONE OF THE FOUNDING MEMBERS

1817
01:02:01,990 --> 01:02:05,460
TO TRY TO HELP INCREASE THEIR

1818
01:02:05,460 --> 01:02:08,129
AWARENESS AND ISSUES RELATED TO

1819
01:02:08,129 --> 01:02:09,030
AFRICAN AMERICANS THERE.

1820
01:02:09,030 --> 01:02:12,367
NOW I'M SORT OF NOW PART OF THE

1821
01:02:12,367 --> 01:02:13,568
COMMITTEE THAT SELECTS

1822
01:02:13,568 --> 01:02:16,438
RESIDENTS, I'M TRYING TO

1823
01:02:16,438 --> 01:02:19,374
BASICALLY MAKE SURE THAT PEOPLE

1824
01:02:19,374 --> 01:02:21,443
HEAR THE ISSUES THAT FOLKS HAD

1825
01:02:21,443 --> 01:02:22,811
BECAUSE THERE'S A LOT OF -- I'VE

1826
01:02:22,811 --> 01:02:26,681
DONE A LOT OF TRAINING, IMPLICIT

1827
01:02:26,681 --> 01:02:32,888
BIAS, WE HAVE A LOT OF IMPLICIT

1828
01:02:32,888 --> 01:02:33,989
BIASES, RECOGNIZING YOU HAVE

1829
01:02:33,989 --> 01:02:35,223
THESE ISSUES, MAYBE WE CAN

1830
01:02:35,223 --> 01:02:37,025
CHANGE THINGS IN TERMS OF

1831
01:02:37,025 --> 01:02:37,425
ATTITUDES.

1832
01:02:37,425 --> 01:02:38,627
GOING OUT.

1833
01:02:38,627 --> 01:02:40,262
TRYING TO BE AGGRESSIVE.

1834
01:02:40,262 --> 01:02:42,564
WE FOUND WE WOULD INTERVIEW

1835
01:02:42,564 --> 01:02:43,598
PEOPLE, SELECT PEOPLE,

1836
01:02:43,598 --> 01:02:44,599
INTERVIEWED, WHEN IT CAME TIME

1837
01:02:44,599 --> 01:02:46,768
TO RANKING WERE NOT DOING THINGS

1838
01:02:46,768 --> 01:02:47,702
THE RIGHT WAY.

1839
01:02:47,702 --> 01:02:49,137
AND BASICALLY KEPT BEATING A

1840
01:02:49,137 --> 01:02:49,471
DRUM.

1841
01:02:49,471 --> 01:02:50,839
YOU'VE GOT TO MAKE SURE IF WE'RE

1842
01:02:50,839 --> 01:02:52,707
GOING TO DO IT LET'S LOOK AT THE

1843
01:02:52,707 --> 01:02:53,441
WHOLE SPECTRUM.

1844
01:02:53,441 --> 01:02:56,611
YOU HAVE TO BE WITHIN, YOU KNOW,

1845
01:02:56,611 --> 01:02:58,146
THE RANK RANGE TO BRING PEOPLE

1846
01:02:58,146 --> 01:02:58,880
IN.

1847
01:02:58,880 --> 01:03:00,148
BY DOING THAT WE BASICALLY WERE

1848
01:03:00,148 --> 01:03:02,317
ABLE TO CHANGE THE WAY THAT WE

1849
01:03:02,317 --> 01:03:06,454
DO THINGS BUT GOING OUT DOING

1850
01:03:06,454 --> 01:03:07,222
THINGS, STUDENTS, RECRUITMENT,

1851
01:03:07,222 --> 01:03:09,124
AT OUR LEVEL THINGS WE CAN DO

1852
01:03:09,124 --> 01:03:11,526
BUT I HAVE TO BE MINDFUL THAT I

1853
01:03:11,526 --> 01:03:13,628
THINK IF YOU THINK ABOUT THIS,

1854
01:03:13,628 --> 01:03:15,063
DIVERSITY MAKES THINGS BETTER.

1855
01:03:15,063 --> 01:03:17,465
AND PEOPLE JUST HAVE TO

1856
01:03:17,465 --> 01:03:19,100
UNDERSTAND THAT BECAUSE EVEN

1857
01:03:19,100 --> 01:03:19,935
GROUPS IN CORPORATE AMERICA

1858
01:03:19,935 --> 01:03:21,603
UNDERSTAND THAT WHEN YOU HAVE

1859
01:03:21,603 --> 01:03:23,571
DIVERSE GROUPS THEY WORK BETTER

1860
01:03:23,571 --> 01:03:26,741
BUT MAKING SURE WE KEEP BRINGING

1861
01:03:26,741 --> 01:03:30,145
MORE PEOPLE INASMUCH AS WE CAN

1862
01:03:30,145 --> 01:03:30,946
WHEREVER YOU'RE AT, DOING WHAT

1863
01:03:30,946 --> 01:03:35,617
YOU CAN AT THE SCHOOL YOU'RE AT

1864
01:03:35,617 --> 01:03:38,386
TO MAKE A DIFFERENCE.

1865
01:03:38,386 --> 01:03:40,655
 

1866
01:03:40,655 --> 01:03:42,290
>> THANK YOU ALL FOR
COMING.

1867
01:03:42,290 --> 01:03:43,725
>> THANK YOU.

1868
01:03:43,725 --> 01:03:46,328
[END OF PROGRAM]

1869
01:03:46,328 --> 01:03:52,334
 

1870
01:03:52,334 --> 01:04:02,377