Themes of inequity and injustice are woven through the history of medicine. The national and specialty-wide conversation about these problems has become more open in the past two years, in parallel with major social movements around the world. In combination with the COVID-19 pandemic, these conversations have shed light on ways in which privilege, disadvantage, and systemic bias have contributed to diminished quality and value of medical care, particular among historically marginalized populations. We as otolaryngologists may wonder about what kinds of bias, whether implicit or explicit, may be affecting our patients or may be perpetuated in our own practices. This panel, hosted by members of the PSQI committee, including a former committee chair and national leaders in diversity/equity/inclusion in otolaryngology, will complement other PSQI committee panels addressing inequities in health care, with a specific focus on how systemic bias directly affects our patients and practices on a daily basis, and how individual practitioners can begin to address those biases. We will focus on racism, sexism, anti-LGBTQ+ and ableism bias, providing a review of current knowledge on the effects of these biases on surgical care in the United States, including effects on provider-patient interaction, treatment recommendations, and adherence to these recommendations. We will also address issues of diversity, where inequities in the pathway of physician training, recruitment, hiring, and promotion can influence the providers a patient may see. These issues will be examined for both academic and non-academic practice settings. We will connect quality to costs of care in order to discuss how systemic bias affects the value of surgical care delivered to patients of different privilege, and how this difference in value perpetuates injustice in health care.