Associate Vice Chair of New Global Surgery Program Looks to Advance Health Equity

The Anschutz Medical Campus has long been renowned as a hub for scientific innovation and medical advancement.

But how might this knowledge have greater impact — and save more lives — if it expanded beyond Colorado’s borders? That’s the question Children’s Hospital Colorado plastic and reconstructive surgeon Phuong Nguyen, MD, is asking and answering. Appointed in January 2024 as the first Associate Vice Chair of Global Surgery at the University of Colorado School of Medicine, Dr. Nguyen will establish a program that sends surgeons to regions around the world where they will train local providers in essential surgical practices.

“We are working on this incredible campus with a lot of resources, both intellectually and physically,” Dr. Nguyen says. “I think as human beings, we have a social responsibility to help others.”

Previously, Dr. Nguyen helped build the global surgery program at the University of Texas and has helped improve surgery infrastructure in places like Vietnam, Guatemala and Peru. In the all-new program at the School of Medicine, he plans to use his experience to facilitate meaningful knowledge-sharing between residents, students and surgeons at Children’s Colorado, and their counterparts across the world.

Building sustainable models of care

To Dr. Nguyen, helping others doesn’t just mean arriving in a place and providing care for those in need. Rather than a traditional medical mission model, he aims to establish more sustainable care models that teach and empower surgeons to provide essential services in their own communities.  

“There are a lot of different nuances to this work,” Dr. Nguyen explains. “Without setting up infrastructure for patients to follow up for surgery, who's going to take care of the patient?”

He adds that preoperative care, postoperative follow-up and patient education are all important elements to consider when creating a self-sufficient care model that furthers health equity. “If we want to elevate healthcare and execute social justice, we have to put all these pieces in place, or at least try to get to that point,” Dr. Nguyen says.

The power of partnerships

Of all the lessons Dr. Nguyen has learned in his global surgery work, he says reliable partners are the most important factor in creating a sustainable healthcare infrastructure.

“You can't help someone help themselves if they're not invested,” Dr. Nguyen adds. “Whether it be another surgeon or a hospital system, you need to find someone who has the same vision that you have, so you can help each other and align those goals.”

One guiding principle for creating sustainable partnerships is training local doctors and nurses to provide care that can have the most impact. For instance, the World Bank identified 44 disease control priorities. Of this list, six neglected surgical diseases were identified as being cost effective and relatively easy to learn while holding the greatest potential to positively transform a community. These conditions include cleft lip and palate issues, club foot, cataracts, hernias, burns and trauma, and obstetric fistula.

“The idea is to find the resources and where they are lacking, train the local personnel and then equip them to provide this care,” Dr. Nguyen says. “I don't expect everyone to do this forever, but I hope I can just open the door to change how they think of things and how they approach other human beings.”

Staying nimble

Dr. Nguyen notes that it’s also important for global surgery teams to be nimble. Health systems and services in other countries are not always static, so it’s crucial to be able to pivot and evolve.

"What may have been a need last year may be totally different next year, because they've already figured out that problem, or there's a new problem,” Dr. Nguyen says. Having a predetermined idea of what a community might need can rely too much on assumptions and miss the mark when it comes to delivering sustainable care.

Being adaptable also means having a comprehensive understanding of the many challenges people face. For instance, providers may be arriving at a care center from far away, so it’s important to consider their resources, limitations, expertise and education. Patients have varying levels of insurance, familial support, and language and cultural differences. Additionally, natural disasters and war can complicate a healthcare provider’s ability to care for people.

The role of research

In addition to bolstering surgeons’ knowledge in key areas of need, Dr. Nguyen hopes to support other countries in pediatric research endeavors. For instance, two public hospitals in Hanoi, Vietnam — both run by the Ministry of Health — experience significant patient volumes. Having more patients translates to greater expertise, which creates ample opportunities for research and discovery. While providers at these institutions are highly skilled, they don’t have the resources, funding or time to set up research projects, let alone the ability to write in English, the standard language for scientific publishing.

Dr. Nguyen is helping bridge the gap. “This year, I brought my research fellow, some of my colleagues from Wake Forest and their research fellows to Vietnam,” he says. “We sat down and conducted formal didactics on how to build a research program and a database. We're helping build the infrastructure.”

This work includes building a residency system and bolstering surgical education programs. Currently, Dr. Nguyen and his team are recruiting a global surgery fellow, who will learn and implement the core elements of a standardized surgical education program.

While he knows it’s impossible to tackle all these challenges at once, Dr. Nguyen suggests that surgeons go step-by-step, building upon each success and reflecting on setbacks to identify areas for improvement. Ultimately, he hopes that the program will help American surgeons hone a less ethnocentric viewpoint that allows them to recognize just how much there is to learn from providers in other countries.

“At the end of the day, anyone who goes into medicine, for the most part, wants to do good,” Dr. Nguyen says. “If you take away the bureaucracy and layers of how to deliver care, you have just you and another person who needs your skillset; It gets to the very crux of why we help each other out, and that's such a powerful thing.”