Janelle Hart

In today’s world, it is easy to find information on the internet, whether it be through search engines or social media. Much of that information, however, is not reliable.

 confirms this idea by investigating the quality of information regarding recurrent urinary tract infections (UTIs) that is posted on YouTube. In this interview, coauthors 

, discuss the findings of this study and why it is important for urologists to understand where the sources of misinformation are coming from. This study was presented at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction 2022 Winter Meeting. Huang is a urology resident and Kim is a clinical assistant professor of urology at Stony Brook Medicine in New York.

Please discuss the background for this study.

 As we all know, social media is becoming more and more important in everyone's life. There's TikTok, YouTube, Instagram, [and] really a wide array of medical information available out there on the social media. In the urology literature, we actually have quite a few studies looking at some of the urologic topics, such as prostate cancer, overactive bladder, [and] erectile dysfunction, to [investigate] the quality of those medical information on social media and found that some sources could present as a major source of misinformation for a lot of our patients. So, we turned our attention to urinary tract infections. It's fairly common in my patients, especially female patients. About 50% to 80% of female patients had a history of UTI, and up to 40% of them had recurrent UTIs. So, we were curious to look at the quality of the medical information on UTIs on YouTube. Hopefully, we can have a better understanding of what patients are learning from online materials before they come to the doctor's office. That's where the idea of this study was coming from.

What were the notable findings of this study? Were any of them surprising to you or your coauthors?

 We looked at the top 200 most-viewed videos on YouTube. I think it was interesting that a lot of the videos had relatively poor quality, based on the standardized instruments that we used to evaluate the quality of the material. Only 11% of the videos featured a urologist, which is a very small portion. Less than half of the videos actually featured a medical provider, so a majority of videos are being produced by non-medical providers, commercial media, or individual YouTubers with no medical experience. Then, we found that, very importantly, videos produced by medical providers have better content quality compared to those that did not feature any medical professionals. I thought those were interesting findings. This is consistent with other similar studies looking at online materials on medical information. We found that those that come from a medical institution or medical source or [were] produced by a physicianhad a better quality, with more accurate information.

 And didn't our results also show that most of the videos were actually about home remedies for UTIs and not necessarily other medical advice?

 Absolutely. Another very interesting finding was that a majority of the videos were featuring some kind of homeopathic supplements, such as herbal supplements or certain dietary remedies, to prevent and treat urinary infection. Some of the regimens, such as vitamin C, probiotics, or cranberries, do have scientific evidence—especially cranberries—featured in the [American Urological Association (AUA)] guidelines, but a lot of the other supplements, such as the herbal supplements or certain random dietary remedies, did not really have much of the scientific 

n the literature. Those can pose as potential misinformation for a lot of our patients who are seeking for treatments for UTIs.

With an increase in digital media use around the world, how can physicians combat misinformation?

 Ideally, if we can increase the presence of physicians on social media platforms, I think that can help deliver more accurate and more accessible information for the general public. I know that some physicians, some urologists in our field are making an effort to contribute to higher quality of online patient education material, but for those of us who are really busy with clinics, with the work in the hospital, I think another way to combat misinformation is to have a better idea of what is available on the internet so that we can provide better patient counseling when we see them in office.

 I'll add [that] every day when patients come to the office, everyone has done their "research" on urinary tract infections or other things, and we really need to understand where this information is coming from. I think this study shows us that a lot of the information out there isn't necessarily sound medical advice or given by non-medical professionals. So, I think it's essential to understand where information is coming from so that we can counsel the patients appropriately.

What is the take-home message for the practicing urologist?

 From my perspective, the main take-home message would be [that] social media is obviously very important, and it plays a very big role in impacting [the] patient’s decision to seek proper care and make their medical decision. So, as a urologist, as a practicing physician, we should be aware of the online content so we can properly guide our patients and provide proper care and counseling.

 I'll also add that I know all physicians are extremely busy, but I think it's very important to have a bigger social media presence with sound medical advice. I think it's tremendously helpful for patients, and also for counseling. So, I think in the future, physicians should try to take the time to invest some more energy in this realm. I think it's an area that we've done poorly in, and hopefully, if we increase our presence on social media, it'll help the patients and it'll help the physicians.

Is there anything else you feel our audience should know about this topic?

 I think some of these videos may actually lead to patient frustration, because they're giving some of these home remedies for UTIs. In some cases, they may work, but in a lot of cases they don't. Patients come in extremely frustrated, saying things like, "I don't know what's wrong with me. I've done my research on the internet, I've watched YouTube, and I've done everything they said, and nothing's working. What's wrong with me?" So, I think patients need to understand [that] they don't always work.

1. Huang Z, Jeong R, Lee E, et al. Urinary Tract Infection on Social media: Examining YouTube content as a source of patient educational information. Paper presented at: Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction 2022 Winter Meeting; San Diego, California. February 22-26, 2022. Poster #OM8

Articles

In this interview, coauthors Connie Huang, MD, and Jason M. Kim, MD, discuss the findings of their recent study, "Urinary Tract Infection on social media: Examining YouTube content as a source of patient educational information."

YouTube spreads low-quality medical information on recurrent UTIs, study finds

The InterStim X system, a sacral nerve stimulation therapy, has been recently approved by the FDA to help patients who suffer bladder and bowel control issues. In the following interview, 

, discusses why InterStim has been so “lifestyle-changing” for patients with overactive bladder (OAB) and gives some tips as to how clinicians can best implement the system in their practice. Law was recently awarded a Center of Excellence Designation by Medtronic, the manufacturer of InterStim. He is the chief of surgery at Oakwood Southshore Medical Center in Trenton, Michigan, and clinical professor in the department of urology at the Michigan State University Medical School in East Lansing.

What does being awarded Medtronic's Center of Excellence designation mean to you?

Well, it's been a company that I've been affiliated with since 1997, and they've made tremendous progress in terms of developing a much more improved way of not only capturing the patients that need help, but [also] assisting them. I was quite surprised and honored, obviously, because I'm a firm believer that this is an alternative and a solution to a lot of the patients that have life problems, in terms of their incontinence [and] their ability to socialize. [It] brings them out of the house and gets them sociable again, and it's a life changer. So, I was really honored that they even considered me. But, then again, I'm happy to be a part of this organization.

What is your caseload like in terms of patients treated with InterStim?

We probably address 10 to 12 patients every month with the unit. It's a trial period for 1 week and if they get the results that they want, we go forward. The way we've been doing stage 1 has been so successful that at least 95% of the people go forward with stage 2. I'm no longer doing the [peripheral nerve evaluation] PNE in the office because sometimes that doesn't capture the area that I'm looking for, so I'll do stage 1 in the OR with fluoroscopy, making sure that I have a good placement of the neural probe, and then connect that to an external lead wire. For 1 week, they just trial it, and because of that, I've been much more successful in moving forward with stage 2.

How has the use of InterStim improved your care of patients with OAB?

It's been a lifestyle-changer. I mean, there are people [who] were wearing pads, [who] were socially embarrassed, [who] were actually afraid to socialize or be out in public because of the urgency, frequency, and leakage. And then there's the other segment of patients that were in retention and had to cath themselves or wear a catheter. That group of people have also been successfully treated, not to the same degree that the urgency frequency patients in my practice are, but still there's a significant improvement in being able to urinate without cathing themselves or without using a catheter. But, like I said, the biggest improvement in my patients has been the urgency frequency and urgency incontinence, and even some of the patients with irritable bowel. Some of those patients have actually been able to improve their voiding and their bowel movements, so it's not so socially embarrassing. To me, it's a big game-changer, and they don't have the medications [where] they have to worry about the side effects of dry mouth, constipation, memory loss, and some of the other issues that come along with the anticholinergics. I'm excited. I don't go to it as a first choice; I usually trial the medicines at first. Those patients that don't successfully complete what they consider to be acceptable will go forward then with the trial of the InterStim.

Do you have any pointers or tips/tricks you've picked up along the way regarding the InterStim that you can pass on to other clinicians?

I think the main thing is placement of the neural probe on the first go around. To me, I tried [the PNE] in the office, I tried placing a wire, and many times it wasn't exactly where I wanted to be. One of the reps years ago said to me, "Why don't we just do this in the 1-day surgery center?" And I thought, "Well, that defeated the purpose," but when I started doing the stage 1 in the 1-day surgery center under fluoroscopy, and [placed] the neural probe in the proper position, my conversion rate to stage 2 jumped from about 75% up to about 95%. So, I think that's the tip—if you want to really get involved with InterStim, I'm not a big fan of the PNE, but I'm a big fan of placement of the neural probe initially in the right place so that [the] 1-week trial encourages patients to go forward with stage 2.

Is there anything else you would like to say about receiving this designation?

Just thank you. It's very much appreciated. The company has been very solid, and alternative companies have come around and I think they've only made them better. They went up to the challenge and they improved. We've now got an MRI-compatible unit, which is a huge improvement where patients—especially the MS patients that need their MRIs—can keep the unit in. So, I'm just very excited that the company would even recognize, reach out, and give me that designation and that honor. It's just very exciting to be a part of a company that's made such an improvement in patients' lives. That's what I've always tried to do as a physician—just making people happier, making people more comfortable. This company has allowed me to do that, and I thank them for the recognition and the honor.

"The biggest improvement in my patients has been the urgency frequency and urgency incontinence, and even some of the patients with irritable bowel," says David W. Law, DO.

Dr. David Law discusses the benefits of InterStim for patients with OAB

The increased prevalence of radiopharmaceuticals has provided the opportunity for patients with prostate cancer to preserve their quality of life. Although not many of these therapies are FDA approved, there is a lot of promise that they will be paradigm-changing in the future, according to 

 Interdisciplinary Prostate Cancer Congress® and Other Genitourinary Malignancies (NY GU 2022), Tagawa presented a talk on the evolution of therapeutic radiopharmaceuticals in prostate cancer.

, he discusses the main points of this presentation as well as other innovations in this space. Tagawa is a professor of medicine and urology and medical director of the Genitourinary Oncology Research Program at Weill Cornell Medicine in New York City. He is also an attending physician on the Cornell campus at New York-Presbyterian Hospital.

Please discuss the main points of your presentation.

At NY GU 2022, I was able to provide a review on therapeutic radiopharmaceuticals, titled, "The Past, the Present, and the Future," [which] really focused on 2 main ones: Radium-223 and PSMA-targeted radionuclides. The background for both is that radiation is one of the cornerstones in the treatment for prostate cancer—most traditionally, either shooting it in with external beam or putting it in with brachytherapy. We use it [to] both cure [patients] as well as [for] palliation, and then more recently, we've had a couple of drugs that have been able to be administered systemically to radiate certain compartments. Radium-223 is a calcium mimetic, meaning that we put into the blood, it circulates around, and lands in bone like calcium and specifically binds to hydroxyapatite. It's an alpha emitter, so a very potent piece of radiation with a very short penetration—just a few cells. [In] the ALSYMPCA trial [NCT00699751], which was in patients with at least 2 bone metastases [who] had symptomatic disease, radium-223 with best supportive care vs best supportive care led to a survival improvement.

Since that time, we've looked at a number of different [possibilities], such as, should we give more, meaning higher dose or more than 6 cycles? That's a no, answered by my colleague Cora Sternberg[, MD]. Should we combine? There are a couple of ongoing phase 2 and 3 trials. One combination that we know to not give is for patients with non-symptomatic or minimally symptomatic metastatic [castration-resistant prostate cancer (CRPC)]. Starting radium-223 with abiraterone, the ERA 223 trial [NCT02043678] showed us that it did not work, [and this combination] lead to increased toxicity in terms of fractures.

 Bone health agents, which we should be using anyway for patients with metastatic CRPC to bone, decrease that chance of a fracture and other skeletal related events. There are [also] 2 ongoing phase 3 trials assessing radium-223 combinations. So, a similar combination in PEACE III [NCT02194842],

 but rather than in combination with abiraterone [Zytiga], it is with enzalutamide [Xtandi] in men with chemo-naïve mCRPC. The investigators in Europe had the advantage of knowing ERA 223 and were able to institute early bone health agents. We've seen data at ASCO a couple of times, including last year, that shows that with the bone health agents, this looks safe, although we do not yet know efficacy. The DORA study [NCT03574571] is the combination of docetaxel and radium versus docetaxel alone in men with metastatic CRPC including bone metastases based on a positive randomized, phase 2 by Michael Morris[,MD] and colleagues. That is enrolling now for men with metastatic CRPC, and we hope to see a benefit from that combination.

We also learned to target PSMA with radioactive particles. PSMA is a cell-surface antigen expressed on the majority of, but not all, prostate cancers. We know that we can label small molecules or antibodies with either alpha emitters or beta emitters and maybe the future would be auger emitters. But for now, what is furthest along are the small molecules (although 1 antibody is in phase 3) radio-labeled with a beta emitter lutetium-177. In the last year or so, 2 randomized trials have read out. A randomized, phase 2 [trial involving] highly selected patients tested lutetium PSMA 617 vs cabazitaxel [Jevtana] in patients with metastatic CRPC after docetaxel. [A] majority happened to receive an AR pathway inhibitor as well, and there were PSA outcome measures that were improved. And then the VISION trial [NCT03511664] examined lutetium PSMA 617 in combination with best standard of care versus best standard of care alone, which led to an improvement in both overall as well as radiographic progression free survival.

Overall, this type of therapy is reasonably well tolerated. There are some specific adverse events that we do associate with these drugs, such as myelosuppression (including thrombocytopenia). There is also dry mouth and nausea, likely having to do with the PSMA-positive sites that these small molecules can reach in the salivary gland and small intestine, as well as the possibility of renal toxicity, although we haven't seen that to a significant degree. Despite the increase in some adverse events, there is a prolongation of time to deterioration of quality of life in the VISION trial, likely because of better disease control. So, these are the radionuclides that are either in practice right now, or likely soon to come, and we look forward to the optimization of these drugs.

Which radiopharmaceuticals are currently the most effective in this space?

Radiopharmaceuticals are clearly effective. We have 2 drugs that have proven overall survival advantages, [but] we have no head-to-head trials. So, we cannot say that one is better than another. These drugs are complementary. We have an alpha that targets bone. The advantage of an alpha is that it's very potent, with very short penetration and bone is a great target for prostate cancer because many men with advanced prostate cancer have bone metastasis. That is an advantage, as there's not a lot of other toxicity. The disadvantage is it goes to only bone and patients without bone metastasis we don't think will benefit, as well as patients with bone metastasis and other sites of extra-osseous metastasis are less likely to benefit in these sites of metastases. PSMA-targeted radionuclide therapy goes to all sites of PSMA positivity. Most of the drugs—in fact, all of the drugs in phase 3—are labeled with lutetium-177, which is a beta emitter. The advantage of a beta emitter is it has a longer path length, so it can go many, many cells. But the disadvantage is a longer path length and a weaker energy level, so there can be the potential for additional toxicity.

[Overall,] there's no known advantage or disadvantage in a head-to-head trial of either one of these, but I do think they're complementary. A relatively common question that I'll hear is, “Can we use both?” We do not know about the combination together, meaning concurrently. We do have some prospective data about sequential use. Most of the data have to do with radium-223 first, followed by one of the lutetium agents. That is 20% or so of many of the prospective trials. There are also data for patients that got radium-223 after these lutetium PSMA agents in some of the prospective, randomized trials, including VISION.

What are some other innovations that are on the horizon in this space?

With the existing drugs, we are looking to make them better. One way, which we've done with many different drugs, whether you're talking about docetaxel, abiraterone, enzalutamide, etc, [is] we made them better by treating a more optimal patient population, and that is early. We think that, particularly for the PSMA-targeted radionuclides, that is going to lead to more major improvements. So, hopefully [that means] translating a median of months to a median of years with a larger hazard ratio. We hope that we can better identify in whatever subset of patient population better patient selection. Imaging appears to be one way that we're able to do that. Hopefully, we'll be able to look at additional factors as well as potential from things like genomics. We're now looking at combinations. An obvious combination to me is in combination with [androgen receptor (AR)] or hormonal therapy, where we might be able to modulate both PSMA expression as well as radio sensitivity. There are a number of other combinations that are ongoing, not limited to but including PARP inhibitors as well as immune checkpoint inhibitors.

What I'm quite hopeful for are PSMA-targeted alpha emitters. We know that alpha emitters work in terms of radium-223, but that's bone-targeted rather than tumor-targeted. So, with these very potent radionuclides, we've seen anecdotes of some very impressive responses with now at least 3 prospective trials that are ongoing. One that is read out with an antibody called J591 radio-labeled actinium-225. There is another antibody radio-labeled with thorium-227 that is also ongoing that I expect to read out later this year. And then, even though the first one published anecdotally was PSMA 617, radio-labeled with actinium-225 because that was retrospective with the first prospective trial being initially last year. So, I think that there is a lot of hope that if we're able to safely administer these targeted alphas, that there is hopefully going to be an even bigger bang for our buck.

With the approved agent radium-223, as well as and probably even more importantly, with what we expect to be the soon-to-be-approved agent lutetium PSMA 617, besides the adverse events that may happen to the patient, we should be aware that there is some exposure to the public. The patient's immediate family and caregivers are likely to be the most effected. Lutetium has a low gamma emission rate, but when we give it at a therapeutic dose, there is a reasonably significant gamma emission where people can be exposed. For the most part, short exposures, especially being feet away from the patient, is not that big of a deal. But, particularly in the first couple of days after a therapeutic dose, we need to be mindful of other living beings. I suppose that could include pets, we generally think about family, so partners, kids, grandkids, etc. [It is] okay to interact, but in the first couple of days, not many, many hours of very close contact.

1. Tagawa ST. Therapeutic radiopharmaceuticals: Past, present, and future. Presented at: 

 Interdisciplinary Prostate Cancer Congress® and Other Genitourinary Malignancies; New York City, New York. March 11-12

2. Hoskin P, Sartor O, O’Sullivan JM, et al. Efficacy and safety of radium-223 dichloride in patients with castration-resistant prostate cancer and symptomatic bone metastases, with or without previous docetaxel use: a prespecified subgroup analysis from the randomised, double-blind, phase 3 ALSYMPCA trial. 

2014;15(12):1397-1406. doi:10.1016/S1470-2045(14)70474-7

3. Smith M, Parker C, Saad F, et al. Addition of radium-223 to abiraterone acetate and prednisone or prednisolone in patients with castration-resistant prostate cancer and bone metastases (ERA 223): A randomised, double-blind, placebo-controlled, phase 3 trial. 

. 2019 March;20(3):408-419. doi: 10.1016/S1470-2045(18)30860-X. Epub 2019 Feb 6

4. Phase III radium 223 mCRPC-PEACE III (PEACE III). ClinicalTrials.gov. Updated July 31, 2020. Accessed March 22, 2022. https://clinicaltrials.gov/ct2/show/NCT02194842

5. Sartor O, de Bono J, B CH, et al. Lutetium-177-PSMA-617 for metastatic castration-resistant prostate cancer. 

2021;385(12):1091-1103. doi:10.1056/NEJMoa2107322

"With the existing drugs, we are looking to make them better," said Scott T. Tagawa, MD. 

Dr. Tagawa recaps breakthroughs with therapeutic radiopharmaceuticals in prostate cancer

Microaggressions are subtle discriminatory actions or statements made towards another person or group. Correcting them has always been a difficult task because the aggressors often do not know that what they are doing is wrong.

The medical field is no stranger to microaggressions, and because they occur so frequently, it is important to continue to educate trainees and physicians on how to identify and handle them, and what their long-term effects can have on a person’s psyche. 

, dives into this topic further in a recent presentation given at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction 2022 Winter Meeting.

Enemchukwu is a pelvic reconstruction surgeon at Stanford Health Care, and an assistant professor of urology and obstetrics and gynecology at the Stanford University School of Medicine in California.

Please summarize the main points of your presentation.

This session was really meant to give people experiencing microaggressions some tools for mitigating the impact and the negative effects of microaggressions.

1. Microaggressions are pervasive. Be prepared and be empowered.

2. You must protect yourself psychologically.

3. You must persevere. Do not allow them to damage you psychologically.

The “micro” in microaggressions, in my opinion, is a misnomer because they can have a significant impact on the individual, and ultimately, on your institution and on society as a whole because we all make up part of that team. There is data that shows that these microaggressions, actions or words that display bias or insensitivity towards a marginalized group, can cause some real psychological damage. Although they can be subtle and unintentional in some cases, they ultimately impact the entire team.

Individuals who are experiencing a microaggression must feel empowered. Feeling empowered means, at the moment of the aggression, pausing and stopping to take a minute and take inventory of your feelings do determine if you are feeling triggered. If you're feeling triggered at that point, it may not be a good time to respond to what just happened. There is a term for this, and it is the called the “90-second rule”. During this time, there is a fight or flight response, a biological instinct that floods us with adrenaline. It typically lasts about 90 seconds. As it pertains to microaggressions, these 90 seconds are not a good time to respond when you're in that fight or flight stage. You really want to stop, pause, take a moment, and collect yourself to see if it is a good time to respond.

At the end of the day, the goal is to protect yourself psychologically. Do not internalize what has been said and recognize your own value. You also want to decide, based on the relationship with the individual or the issue, whether you want to address it now, later, or never. But, again, you want to feel empowered and at peace with your decision, regardless of what your decision was.

It is important to seek support from your trusted peers and loved ones. These are the folks that will reinforce your value and help preserve your confidence. Allies are certainly important, but they may not always be present, so you need to have a contingency plan. On the other hand, if you're in the position where you're witnessing a microaggression, it's really important to speak up and say something on the behalf of that person experiencing it.

Depending on how egregious the incident was, or if there is a repeat offender ignoring your feedback, then the microaggressions could be intentional. In that case, you may want to keep a contemporaneous log of what's going on in these incidents, and potentially ask for assistance from HR, from your supervisor, your program director, or your chair.

When microaggressions occur, we often freeze and that is a natural instinct. And so, it's great to anticipate these events and think about how you want to respond ahead of time so that you're prepared when they do.

How you respond to microaggressions can vary based on the individual or the situation. There are different ways to respond. You can ask a clarifying question, you can acknowledge that the intent was not meant to be harmful, but the impact was harmful, or you can be direct and really state your discomfort. Some people like to use humor, but the goal here is to protect yourself psychologically, in that moment.

Finally, my last point was making sure that we are recognizing our own biases as well. Anyone can commit a microaggression. We have all been socialized by television, movies, social media, [and] society, to have biases and stereotypes. It is just like Pavlov's dogs. We see something, we hear something, we have this automatic reaction, and we make assumptions. And so, we certainly need to avoid being part of the problem and to make sure we speak up for others. It certainly takes practice, but we cannot give up.

Can you describe a time when you personally experienced a microaggression? How did you react and how did it make you feel?

Microaggressions are so pervasive, and worst of all, they are often invisible to the person committing them. For me, what I have learned in my experience is that it is really important to remember that anyone can commit microaggression. They can come from friends, family, colleagues, supervisors, subordinates, they can come from people of your same gender, race, ethnicity, social class, and many of us have experienced them, due to some element of our identity. But they are really dangerous because, most of the time, they're subtle and unintentional. Their impact is significant on our well-being, our confidence, our performance, and our integration into teams. Studies have shown that they can cause anxiety, depression, isolation, and post-traumatic stress disorder (PTSD). My personal response to microaggressions is dependent on the individual and my relationship with that person and the situation.

Having witnessed and experienced microaggressions, I've learned that they are one of the largest barriers to building inclusive teams and environments. They damage that sense of belonging. Imagine that one of the largest barriers to achieving greatness is something invisible to most people. That's really challenging. But it can be addressed by creating environments where we can learn from each other, so we can avoid the same subtle, often unintentional but harmful, destructive behaviors. We can achieve this by not being defensive, and by being open to learning and by checking our own biases. Also, [it is important to recognize] that threats to inclusion may not come directly from your own internal team or department. They may be come from outside. Having these discussions and having them frequently are help us recognize where these threats are coming from and help us address them. Without inclusive teams and environments, we all miss out on the unique talents of the individuals on our teams. 

Lastly, in medicine, we are often seeking to create inclusive environments, not only for our colleagues, but we must create inclusive environments with strong senses of belonging for our trainees, our medical students and other learners who may not be in a position to speak up for themselves due to the power dynamics.

What advice would you give to fellow urologists or physicians on accepting and addressing their biases?

We can mitigate bias and the effects of microaggressions by being open to continuously learning. I've learned through leading our department's diversity, equity, and inclusion (DEI) efforts that one of the best ways to learn is by sharing our experiences. It helps us to identify our blind spots. Someone may hear something that they've said or done, or something that they've witnessed in the past, but may not have known that it was offensive. So, creating environments where we feel comfortable being vulnerable, and sharing those experiences, and where other folks are open to learning is important.

How has the world of medicine evolved in terms of DEI? What work is there still to do?

Most of all, I am very happy to see people take a genuine interest in improving diversity, equity and inclusion. I think there are still segments of society who think it's only about increasing numbers and representation of women, minorities, and other marginalized groups. Improving representation is a very important part of the mission, but DEI is also about creating systems where everyone currently here and those coming in the future thrive and are able to contribute in a meaningful way by making new discoveries, making things better, making things more efficient, and more productive for everyone’s benefit. Microaggressions, gaslighting, downplaying someone else's experience, or treating people differently based on their identity really works against this common goal. So, in urology, and really medicine as a whole, we are all striving to build that championship caliber team, and we're looking at recruiting diverse talent, but if we don't take the time to create the environments where all the team members can feel that they belong and can reach their full potential, then we as a whole may never reach our full potential in medicine.

1. Enemchukwu E. Microaggressions 2.0 – How to survive and thrive. Presented at: Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction 2022 Winter Meeting; San Diego, California. February 22-26, 2022.

Ekene Enemchukwu, MD, MPH, highlights her presentation, "Microaggressions 2.0 – How to survive and thrive," from the 2022 SUFU winter meeting. 

Janelle Hart

Articles

YouTube spreads low-quality medical information on recurrent UTIs, study finds

Dr. David Law discusses the benefits of InterStim for patients with OAB

Dr. Tagawa recaps breakthroughs with therapeutic radiopharmaceuticals in prostate cancer

How to handle microaggressions and be aware of your own biases