Dismantling Structural Barriers: Resident Clinics Refocused on Equity.

Area of Science:

• Health equity research
• Obstetrics and Gynecology
• Academic medicine

Background:

• Health disparities by race, ethnicity, and socioeconomic status are evident in obstetrics and gynecology.
• Academic medical centers often concentrate marginalized patients in trainee clinics, raising ethical concerns about care equity.
• Structural barriers within healthcare delivery contribute to these disparities.

Purpose of the Study:

• To address structural inequities in healthcare delivery within an academic obstetrics and gynecology department.
• To improve patient access and experience.
• To convey a unified message of high-quality care for all patients, irrespective of background.

Main Methods:

• Eliminated structural inequities by removing clinics stratified by training level.
• Created an integrated patient pool for trainees and attending physicians.
• Blinded demographic and insurance information, with patient triage based on clinical acuity and preference.

Main Results:

• Implemented changes to address structural inequities in healthcare delivery.
• Aimed to improve patient access and experience.
• Fostered a unified message of commitment to high-standard care for all individuals.

Conclusions:

• Academic medical centers must identify and dismantle internal structural barriers contributing to health disparities.
• Integrating patient care across training levels is a critical step toward achieving equity in obstetrics and gynecology.
• A unified approach to patient care reinforces the commitment to serving all populations equally.