Beyond the Knife Hosts Pioneering Dean, Surgeon

By Keith Gillogly

After reviewing his case, Hayes-Dixon began discussing surgery and a chemotherapy treatment plan for his stage 2 cancer.

Treatment plan? The patient looked confused. He’d been told his cancer was stage 4, incurable — hospice was his best bet.

Now Hayes-Dixon was the one surprised.

“This was not the first time that I had heard this story," Hayes-Dixon recalled. “I’ve had other medical oncologists tell me the same thing. They see patients that because they don’t have insurance or they have Medicaid insurance or Medicare insurance, they’re told, ‘you won’t be able to make it through the treatment. Just go home and live the rest of your life.’”

“These are the types of inequities that we must end.”

Hayes-Dixon, dean of Howard University College of Medicine, was the keynote speaker at the Beyond the Knife lecture, which took place at the Jacobs School of Medicine and Biomedical Sciences on Feb. 5.

A trailblazing surgeon, scientist, and educator, Hayes-Dixon became the first Black woman to serve as dean of the College of Medicine in 2022 in Howard University’s 154-year history. In 2004, she became the first African American woman in the U.S. to earn board certification in pediatric surgery.

In its sixth year, the annual Beyond the Knife endowed lecture, hosted by the Jacobs School’s Department of Surgery, aims to spotlight and mitigate the effects of systemic racism and inequality in health care. 

Steven D. Schwaitzberg, MD, SUNY Distinguished Service Professor and chair of surgery, welcomed the audience of students, faculty, physicians, and community members in a packed Jacobs School M&T Auditorium. After thanking all the guests and the team members behind the event, he reflected on the many challenges affecting health equity today.

“What we are seeing today is that you can change the words, change the signs, you can even change the laws, but none of that will change the fundamental problems of fairness, justice, equity and equality,” he said.

In attendance was U.S. Rep. Tim Kennedy, who spoke about the Buffalo community’s longstanding and ongoing health equity leadership and how it led to the creation of the UB Community Health Equity Research Institute.   

“Coming together here tonight to talk about equity, to talk about inclusion, and to talk about health care and saving lives and making sure that everybody has an opportunity to receive equitable health care in their lives, nothing is more important,” he said.

While addressing the crowd, Allison Brashear, MD, MBA, UB’s vice president for health sciences and dean of the Jacobs School, talked about how inequity is a product of systems and choices and about how UB and the Jacobs School are working to eliminate these inequities and transform the health of Western New York. She also further reflected on the lectureship’s importance.

“This lecture has been much more than just tradition. Beyond the Knife challenges us to face inequity and to confront the truths that are uncomfortable but essential and to recognize that these inequities are daily realities for many in our community,” she said.

Beginning her talk, Hayes-Dixon provided her own definition of health equity: “having the opportunity to achieve the same health outcomes no matter your ZIP code, your race, your ethnicity, your gender, your gender decision, or your religious beliefs.”

She then shared several real examples of inequitable care that she’s witnessed in her more than 20 years in academic medicine and health care, including the young man with abdominal cancer.

While some people have believed that health equity affects only those unable to afford insurance or better care, Hayes-Dixon has worked to shine the light on how these problems lead to hospital closures and fewer doctors and resources, which affects everyone. “This is our problem. This is everyone’s problem. This is not just the problem of the disenfranchised and the disadvantaged,” she said.

Hayes-Dixon suggested that it’s up to the health care providers themselves to promote health equity best practices, as they’re the ones directly interacting with patients. She also pointed to evidence and data about how people better trust physicians and providers when they look like them.

As a historically Black college and university, Howard University and its College of Medicine have played a pivotal role educating and training Black physicians throughout American history, Hayes-Dixon discussed. Yet, to graduate more Black physicians, we need more universities to fill education and training gaps, not just HBCUs she said.

She also cited recent data showing that Black trainees are much more likely to be dismissed from their residency training programs than Caucasian ones. Black surgeons in training are six times more likely, while Black anesthesiologists are 10 times more likely. “We can’t invest that much of our time and effort and get to a place where we have this much dismissal. It’s inequitable,” she said.

Long before training programs begin, fueling the physician pipeline early is equally important. As one example, Hayes-Dixon talked about Howard University’s outreach efforts to elementary schools to teach basics of medicine and spark interest in careers in medicine and science.

Still, she said that we’ll need more effort and metrics to really determine how and when we’ve achieved better health equity and representation. “We have many challenges and opportunities ahead of us,” she said.

Before her lecture, Hayes-Dixon met with a group of Jacobs School medical students. She talked about her surgical career and overcoming obstacles to treat abdominal cancerous tumors, particularly desmoplastic small round cell tumors (DSRCT), a rare cancer that’s particularly aggressive in African Americans.

When developing novel ideas and techniques to combat these tumors, Hayes-Dixon was asked if she encountered pushback. Her response, and reality, were blunt. “I’m Black and I’m a woman. So, my ideas were not even close to being accepted the first time I mentioned them.”

Over time, Hayes-Dixon pioneered techniques to successfully remove the hundreds and even thousands of abdominal and pelvic tumors that can appear in a single DSRCT patient. Using these methods, surgical operations to remove the tumors — without removing organs — and applying heated chemotherapy have successfully reduced mortality rates.

Following Hayes-Dixon’s talk, a speaker panel discussed a range of health equity topics, among them retention strategies, equitable leadership pathways, inclusion of community voices, teaching about health equity, and historical perspectives on health equity.

The discussion was moderated by Claudine Ewing, Channel 2 News anchor, and the panel included Allison Brashear, MD, MBA; Andrea Hayes-Dixon, MD; Thomas J. Ward Jr., PhD, dean of the School of Arts and Sciences at Farmingdale State College; Jamal B. Williams, PhD, assistant professor of psychiatry at the Jacobs School; and Rhonda Wilson, founder and president of Buffalo Black Nurses.