Surgery chair to lead national study with $2.5 million NIH grant

In the early 1960s, Dr. Martin Luther King, Jr. called disparities in access to healthcare “the most shocking and inhumane form of inequality.”

More than a half-century later, the nation continues to wrestle with making healthcare accessible to everyone. Now an EVMS expert is on a mission to find solutions — starting with the field of surgery.

L.D. Britt, MD, MPH, the Edward J. Brickhouse Chair in Surgery, the Henry Ford Professor of Surgery and Professor and Chair of Surgery, was recently awarded a $2.5 million grant from the National Institutes of Health (NIH) on behalf of the American College of Surgeons to address healthcare disparities.

The research project is ambitious. But its genesis was small, involving a focus group of one family: that of Dr. Britt, Principal Investigator for the grant. Growing up in the segregated South, the Suffolk native experienced the problem first-hand.

“When my mother, father or aunts had to go to the doctor,” Dr. Britt says, “we would pack a lunch or supper. It took eight to 12 hours to get in to the doctor and once you did, you were seen for only a few minutes. And I said to myself even back then, something is wrong with this.”

My Wonder Woman

“The clear choice for the Wonder Woman who set an example for me would be my mother, Mrs. Claretta White Britt. A teacher in the segregated Suffolk Public School System for 49 years (and an additional four years in the integrated Suffolk Public Schools System), my mother was the consummate educator, advocate and parent. I actually skipped the grade that my mother taught.

My mother (along with my father Vandious Lee Britt) raised three successful sons, who went to some of the best universities in the nation — including two sons attend Harvard Medical School. I still get comments today from some of her former students, highlighting how inspirational my mother was. If I authored a dictionary, the term ‘Wonder Woman’ would have a picture of my mother.”

— L.D. Britt. MD, MPH

Nominate your Wonder Woman

And that “wrong” divides healthcare access into two distinct camps: the haves and the have-nots. The chasm widens every year. “And more money will not fix it,” Dr. Britt says. “We already spend more on healthcare than any other nation, and yet we are 68th in health and wellness outcomes.”

The answer? “Leadership. We need a Steve Jobs in healthcare — somebody who can innovate, cut through the red tape and get things done.”

This NIH grant will facilitate just that kind of initiative. It evolved from a challenge Dr. Britt posed to the American College of Surgeons when he served as its president from 2010 to 2011. “We can’t talk quality if we don’t have access,” he told the organization. And it resonated. The ACS put together a task force called the Committee on Health Care Disparities, which Dr. Britt chaired.

Partnering with the NIH is the perfect way to tackle this enormous challenge, combining the best research minds in the country with the nation’s largest repository of surgical data. The research outcomes can then be applied anywhere in the country and eventually across all disciplines.

“Surgery is leading the charge,” Dr. Britt says. But he wants this to be a template for any specialty that wants it. “There are no patents and no copyrights — we welcome everyone. The goal is to level the playing field across the board for all patients.”

The three-year study will be conducted in phases, starting with an examination of disparities to learn who’s at risk and to what extent. The core of the study will develop a set of metrics for surgical care and access that will mitigate the disparities. Ultimately, this research will be used to develop best practices, information that can be replicated anywhere across the surgical landscape.

Dr. Britt views the project as an intrinsic part of the EVMS mission. “This school, with our integrated community focus, has addressed healthcare disparities since the beginning,” he says. “When patients have no insurance, no resources, where do they go to get healthcare? Here, to our college and our residents.” EVMS is already one of the best centers in the country for evaluating, researching and addressing healthcare disparities, he says, and this project will raise the school’s profile even higher.

Dr. Britt is quick to underscore the importance of this research by noting that more than 45,000 people die each year because they don’t have access to healthcare. And he believes that number may be low. Hence, the need for this research.

“It’s hard to be a physician and see that,” he says. “You know we are a better nation than to let that happen. So this is something I needed to do for myself, our community and this school. At the end of it, I think we’ll make a real difference, and it’ll be hard to find anybody who doesn’t know EVMS and our work in this critical area.”