Canada takes major step forward as a leader in inclusive dermatology
The AbbVie Chair in Ethnodermatology at the University of Toronto will support development of new curricula to train future physicians and dermatologists on diagnosis and treatment of conditions in diverse skin types. istock.com
Dermatologist Dr. Geeta Yadav tells the story of one of her patients, an Indo-Canadian man with severe eczema, who told her he had waited nine years to be correctly diagnosed. “I was able to give him treatment that made him 100 per cent better in a matter of two months,” says Dr. Yadav. “It is awful to imagine that someone would have to suffer like that because the diagnosis wasn’t made for so long and the severity wasn’t identified sooner.”
This patient’s journey through the health-care system is not unusual, says Dr. Yadav, founder of Toronto’s FACET Dermatology clinic. “Delayed diagnosis and misdiagnosis of skin diseases are more common among people of colour, and the reasons are complex and often systemic.”
One key issue is access to care, she says. “We have cultural barriers, with immigrants from minority populations who can’t necessarily access care properly because they don’t speak the same language as their care providers, and it’s harder for them to advocate for themselves.”
Another challenge is that research and medical education have for many years focused more on non-Hispanic white populations and have paid less attention to the distinct impacts of skin conditions on patients of colour.
“One factor is all the clinical trial work,” says Dr. Yadav. “Most of the large trials have been done in North America and Western Europe, so the most robust data is based on studies in which patients of colour were under-represented. And that is also an access matter – less access for certain groups to the advanced therapeutics tested in trials.”
Bringing equity and inclusion to dermatological care
A major step has been taken towards creation of more equitable, diverse and inclusive dermatological care in Canada and around the world. AbbVie, a global research and development-based biopharmaceutical company, has made a $3-million donation to establish the AbbVie Chair in Ethnodermatology at the University of Toronto’s Temerty Faculty of Medicine – one of the first positions of its kind in the world.
Endowed chairs, which are maintained in perpetuity, are among the most prestigious appointments in academia, and they are a powerful recruitment tool for top clinicians and researchers and a driver of advancement in scholarship and research.
“The inaugural AbbVie Chair in Ethnodermatology will have a broad educational and research mandate,” says Professor Vincent Piguet, director of the Division of Dermatology in U of T’s Temerty Faculty of Medicine. “This will include leading the development of curricula to ensure future physicians and dermatologists are adequately trained to diagnose and treat conditions in diverse skin types and to apply principles of inclusive dermatology. They will also undertake much-needed clinical investigations into skin disorders and diseases’ distinct impact on people of colour.”
The need for AbbVie’s sponsorship has also never been more relevant – nor more pressing – than it is today. According to Statistics Canada demographic projections, the proportion of Canadians who belong to a visible minority group will increase greatly by 2031. Visible minority groups could soon comprise 63 per cent of the population of Toronto, 59 per cent of Vancouver and 31 per cent of Montreal.
“Delayed diagnosis and misdiagnosis of skin diseases are more common among people of colour, and the reasons are complex and often systemic. ”
Expanding knowledge to deliver equitable care to patients
Dr. Yadav welcomes creation of the AbbVie Chair in Ethnodermatology. Long interested in delivering care to under-serviced communities, she completed her dermatology training at the University of Toronto and today teaches dermatology students at the Temerty Faculty of Medicine.
“Creation of this chair will expand research into the diseases in dermatology that have a disproportionate impact on people with skin of colour,” she says. “It also provides opportunities to study how various treatments work for different populations, allowing us to move closer to precision medicine.”
Having additional resources also gives dermatologists more opportunities to carve out time from their work in the clinic “to draft a manuscript or a research proposal and seek funding to support further research,” says Dr. Yadav.
“This will help dermatology build a better foundation of knowledge to guide what we do on a daily basis and help us deliver the best clinical care to all of our patients.”
To view this report on The Globe's website, visit globeandmail.com
To view the full report as it appeared in The Globe's print edition: The importance of skin health