Diversity is broadly defined as the inclusion of varied attributes or characteristics. In the medical community, diversity often refers to the inclusion of healthcare professionals, trainees, educators, researchers, and patients of varied race, ethnicity, gender, disability, social class, socioeconomic status, sexual orientation, gender identity, primary spoken language, and geographic region.Discrimination in the healthcare setting can be defined as negative actions or lack of consideration given to an individual or group that occurs because of a preconceived and unjustified opinion. It is worth noting that individuals do not need to be members of an unfairly treated group to experience discrimination against that group. Discrimination can occur based upon perceived membership. Furthermore, harm does not need to occur for discrimination to exist. A group may be discriminated against if they receive something of less value than another group solely because of their race, ethnicity, gender, disability, social class, socioeconomic status, sexual orientation, gender identity, primary spoken language, or location of residence.While people can be discriminated against for various reasons, this article focuses mainly on gender, ethnicity, and race-based discrimination in the healthcare setting, not because these are the most important, but because these areas are best represented in the literature. We hope that the next version of this article will include more information on discrimination involving other underrepresented and marginalized groups.

Diversity and Discrimination In Healthcare

Background: Over the past twenty years explicit gender bias toward women in surgery has been replaced by more subtle barriers, which represent indirect forms of discrimination and prevents equality. Objective: The aim of our scoping review is to summarize the different forms of discrimination toward women in surgery. Methods: The database search consisted of original studies regarding discrimination toward female surgeons. Results: Of 3615 studies meeting research criteria, 63 were included. Of these articles, 11 (18%) were focused on gender-based discrimination, 14 (22%) on discrimination in authorship, research productivity, and research funding, 21 (33%) on discrimination in academic surgery, 7 (11%) on discrimination in surgical leadership positions and 10 (16%) on discrimination during conferences and in surgical societies. The majority (n = 53, 84%) of the included studies were conducted in the U.S.A. According to our analysis, female surgeons experience discrimination from male colleagues, healthcare workers, but also from patients and trainees. Possible solutions may include acknowledgment of the problem, increased education of diversity and integration for the younger generations, mentorship, coaching, and more active engagement by male and female partners to support women in the surgical field. Conclusions: Gender-based discrimination toward women in the field of surgery has evolved over the past twenty years, from an explicit to a more subtle attitude. A work-environment where diversity and flexibility are valued would allow female surgeons to better realize their full potential. 

Discrimination Toward Women in Surgery

The Leadership Landscape: The Role of Gender in Current Leadership Positions in Obstetrics and Gynecology Departments.

Creating work environments where people of all genders in gynecologic oncology can thrive: An SGO evidence-based review

Interstitial cystitis/bladder pain syndrome (IC/BPS) is prevalent, difficult to treat, and has close symptom overlap with overactive bladder (OAB). A review of the pathophysiology, assessment, and treatment of IC/BPS patients with overlapping OAB symptoms has not been summarized recently in the published literature.

Pathophysiology, assessment, and treatment of overactive bladder symptoms in patients with interstitial cystitis/bladder pain syndrome

Has a critical mass of women resulted in gender equity in gynecologic surgery

Background The availability and utility of public statements and policies on gender equity from professional surgical societies has not been studied. Methods Professional surgical society websites were searched for publicly available statements and policies related to gender equity. These were compiled and assessed for critical components. Results Publicly available statements/policies were published in every surgical society, though few pertained specifically to gender. Nearly all were recently written or revised. The most common statement/policy addressed discrimination and harassment. The only policies/statements that reliably contained all four key components pertained to professional conduct at national meetings. All policies that provided consequences also contained specific reporting processes. Conclusions Gender equity statements and policies are deficient among professional surgical societies. Prioritization of publicizing statements/policies that describe the challenges and provide potential solutions to well-documented gender inequities within surgical fields allows professional societies to promote a diverse and equitable workforce.

Leading from Behind: Paucity of gender equity statements and policies among professional surgical societies

To compare the safety and durability of a single intravesical trigonal-only versus 20 trigone-sparing injections of OnabotulinumtoxinA (BTA) for refractory OAB. A chart review of all idiopathic OAB patients treated with BTA from January 2016 to December 2018 was performed. Outcomes measures included: inter-injection interval, post-void residual (PVR), urinary tract infections (UTI), urinary retention requiring catheterization, and procedure time (min). Statistical analyses were performed using independent sample t-tests. Baseline characteristics were comparable for the two groups, data on 69 treatments (19 patients trigone-only) were compared to 105 treatments (26 patients trigone-sparing). There were no differences in the inter-injection intervals or rates of UTI. The trigone-only group exhibited a lower mean PVR (113 ml vs 160 ml, p   150 ml (23% vs. 39%, p < 0.03), lower rate of urinary retention (5.3% vs. 17.4%, p < 0.02), and shorter procedure time (4.3 min vs. 5.7 min, p < 0.01). There were no cases of vesico-ureteral reflux. While interpretation remains speculative, the results of this observational study suggest that a single trigone-only injection appears to be as safe and durable as multiple trigone-sparing injections but maybe quicker to perform and appears to have a lower impact on voiding function. Larger series and adequately powered prospective randomized clinical trials are warranted to validate the findings of this pilot study.

Outcomes of a single trigone-only vs. 20 trigone-sparing injections of OnabotulinumtoxinA for refractory overactive bladder (OAB).

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Has a critical mass of women resulted in gender equity in gynecologic surgery

Leading from Behind: Paucity of gender equity statements and policies among professional surgical societies

Outcomes of a single trigone-only vs. 20 trigone-sparing injections of OnabotulinumtoxinA for refractory overactive bladder (OAB).