In the ever-evolving landscape of healthcare, the pursuit of inclusion has become a priority for organizations seeking to address disparities, promote and sustain a sense of belonging, and unleash the talents, beliefs, and power of all their constituents.
Inclusion is not new to STS. It is a stated core value and central to who we are. Over the years, STS has been on a journey to foster a more inclusive environment within the Society and the cardiothoracic surgery specialty. While the journey has been imperfect, we continue to learn, grow, and progress.
A look back
In 2017, a Presidential Task Force on Diversity and Inclusion, conceived by STS Past President Dr. Richard Prager, was formed to better understand the depth of DEI knowledge and practice within STS and the specialty. In 2019, the Task Force transformed into the Workforce on Diversity, Equity, and Inclusion, in recognition of its enduring importance. The Workforce on DEI, currently chaired by David Tom Cooke, MD, advises Society leadership on DEI best practices; develops DEI resources; undertakes initiatives to nurture an inclusive environment; enhances the cultural competency of CT surgeons and allied health professionals; and addresses health disparities within the clinical, scientific, education, and advocacy arenas.
The Workforce’s accomplishments are numerous and span educational offerings, policy, governance recommendations, scholarly publications, and more. One of the highlights of this work was the first DEI climate survey administered to STS members in 2018. The results demonstrated a need for inclusion in the specialty, gaps in knowledge on DEI, and a roadmap for success.
Another highlight was the creation of the Vivien T. Thomas Symposium and the Vivien T. Thomas Plenary Lecture, dedicated to improving equality in the specialty, starting with the STS Annual Meeting in 2019. That was the same year Dr. Robert Higgins was named the first African American STS president. Vivien Thomas was a black surgical technician with only a high school education, who designed and tested anastomosis of the subclavian artery to the pulmonary artery, resulting in the landmark “blue baby” operation in 1944 for children with tetralogy of Fallot.
Dr. Cooke, along with Dr. Thomas Varghese, hosts the Society’s Same Surgeon, Different Light podcast, now in its fourth season. In the series, Drs. Cooke and Varghese interview STS members on what inclusion means to them and tackle related challenges and opportunities in CT surgery.
“Inclusion is occurring rapidly because of intentional efforts by the STS,” said Dr. Cooke. “More and more diverse, achieving, meritorious young people are interested in our specialty. I am proud of the way STS is walking the walk of valuing inclusion and belonging.”
Continuing to advance the cause
In his year as STS President, Dr. Thomas MacGillivray has played a pivotal role in accelerating the Society’s commitment to DEI. Recognizing the importance of leadership in effecting change, he championed conversations and initiatives to nurture a culture of inclusion and belonging.
In May 2023, Dr. MacGillivray hosted a member Town Hall to foster an open dialogue about DEI-related challenges and welcome ideas to advance meaningful change.
Key themes from the Town Hall were the need for data to understand members’ general knowledge of inclusion; a call to action for members to engage in real, meaningful conversations that result in tangible change; and a culture that elevates empathy, listening, kindness, and grace throughout this journey.
“STS came into being 60 years ago because a group of surgeons wanted a society that was welcoming to all cardiothoracic surgeons,” explained Dr. MacGillivray. “That inclusivity has been the hallmark of STS since its inception, and it continues to this day, reflecting the vision of our founders. As president, one of my priorities was to promote more dialogue about inclusivity so we can understand each other better and incorporate learnings into our everyday work.”
The Town Hall informed the development of a member survey on DEI, fielded in the summer of 2023, to seek member ideas on how to advance a culture of inclusivity and ensure that STS has the policies, practices, and structures in place to represent and support our diverse group of surgeons.
“Overall, survey respondents said they are comfortable and confident regarding inclusion and see the connection between inclusion and belonging and STS’s success,” Dr. MacGillivray said. “They believe these conversations are already happening.”
The survey revealed that members agree more work needs to be done to advance diversity inside the organization and across the field and identified opportunities for action, including leadership training and more transparency and inclusivity in the selection process for STS senior leaders.
Earlier this year, Dr. MacGillivray created a Presidential Task Force on the Nominating Process to review and potentially recommend revisions to the processes and procedures used to nominate STS officers and directors.
In 2024, STS will launch a new nominating process recommended by the Task Force to elect officers and directors. Approved by the Board in October 2023, the procedural changes will ensure greater understanding, transparency, and member engagement in the nominating process.
Dr. MacGillivray also formed a Surgeon Compensation Task Force to create an annual cardiothoracic surgeon survey to better understand workplace-related compensation issues and help US-based cardiothoracic surgeons understand their value in the market. The compensation survey was conducted in Fall 2023 and the report will be released in February 2024.
The survey reveals expected pay differences between specialty, practice, career stage, and geography, as well as gender pay disparities. “A key benefit of the survey is to support the growing number of women cardiothoracic surgeons, and to arm them with data to alleviate the gender pay disparity in the specialty,” said Dr. MacGillivray.
“STS exists for our members—to empower them with data and learning opportunities so they can be the best surgeons and leaders they can be and be recognized for the contributions they make to their patients and institutions they serve,” he added.
Also this year, STS and The Annals of Thoracic Surgery produced a special reprint collection, Unequal Treatment, which explores inequities in cardiothoracic surgery. In her introductory editorial, Editor-in-Chief Dr. Joanna Chikwe notes how cardiothoracic surgery is now generally “so safe and standardized that the greatest risk to most patients is variation from the best available care,” adding that “health disparities affect the quality of cardiothoracic patient care and research more fundamentally than many of the incremental improvements we chase in pursuit of excellence.”
This collection illustrates some of how STS and The Annals have addressed these challenges through research, beginning with the inaugural edition to the present day.
TSF’s impact on inclusion
The Thoracic Surgery Foundation (TSF), the Society’s charitable arm, has a long history of offering scholarships, awards and research opportunities focused on equity, including the AstraZeneca Reversing Health Disparities in Lung Cancer Research Award to support investigators conducting health disparity research related to lung cancer; the Every Heartbeat Matters Award to help educate, screen and treat underserved populations worldwide and reduce the global burden of heart valve disease; and the Nina Starr Braunwald Research Fellowship Award to support female residents working in cardiac surgical clinics or laboratory research programs.
Nina Starr Braunwald, MD, a thoracic surgeon and medical researcher, was the first woman certified by the American Board of Thoracic Surgeons and the first woman to perform open-heart surgery. The research fellowship award honors Dr. Braunwald for her groundbreaking developments, including experimental, artificial mitral valve prostheses and a cloth-covered mechanical valve (the Braunwald-Cutter valve), among other pioneering techniques.
At STS 2024, STS and TSF will announce the creation of the Nina Starr Braunwald Center, a virtual destination offering innovative programs, advocacy efforts, education, and scholarships aimed at issues of special interest to women CT surgeons. The Center further exemplifies Dr. Braunwald’s contributions not only as a surgeon but also as a woman who showed that balancing the challenges of work and family life is possible at a time when women were not always viewed favorably for their work outside of the home.
The Extraordinary Women Award, a collaboration between STS and Women in Thoracic Surgery, also celebrates excellence in clinical practice by female cardiothoracic surgeons. The award recognizes integrity, leadership, creativity, and expertise in carrying out day-to-day duties that support the specialty.
Looking ahead
Dr. MacGillivray notes the STS will continue to build a foundation for a more inclusive future through five key strategies:
- Education and Awareness: Implementing educational programs to raise awareness about diversity and inclusion, dismantling biases, and fostering cultural competence within the cardiothoracic surgery community.
- Collaboration: Partnering with other medical societies, institutions, and advocacy groups to leverage collective efforts in addressing systemic disparities and promoting DEI.
- Research and Innovation: Investing in research that explores the intersectionality of healthcare disparities, seeking innovative solutions, and incorporating evidence-based practices that advance equity in cardiothoracic surgery.
- Pipeline Programs: Establishing and supporting pipeline programs that encourage underrepresented groups to pursue careers in cardiothoracic surgery, ensuring a diverse and talented workforce for the future.
- Advocacy: Recognizing that systemic change requires a voice on policies that address disparities in healthcare. By engaging with policymakers, STS seeks to influence and shape a healthcare landscape that ensures equitable access and outcomes for all, without compromising the quality of care provided to patients.
“As I think about 2024 and STS’s ongoing impact on equity, inclusion and belonging, I know there is important work ahead,” added Dr. Cooke. “STS is in a great position to continue to lead healthcare into modernity where access is fair and outcomes are equitable, and members of our great specialty are better equipped to treat all members of our community.”
For more information, visit the Diversity and Inclusion Resources page.