Journal articles on the topic 'Physicians Salaries'
To see the other types of publications on this topic, follow the link: Physicians Salaries.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Physicians Salaries.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Leigh, J. Paul. "International Comparisons of Physicians' Salaries." International Journal of Health Services 22, no. 2 (April 1992): 217–20. http://dx.doi.org/10.2190/8524-35wh-ey0v-6m7a.
Full textAbstract:
Data from recent international publications are used to analyze physician incomes across countries. U.S. incomes are the highest among 14 countries, even after adjusting for the average standard of living within each country.
2
ANDERSON, JANE. "Demand, Salaries Up for Primary Care Physicians." Internal Medicine News 42, no. 14 (August 2009): 59. http://dx.doi.org/10.1016/s1097-8690(09)70552-9.
Full text
3
Rosenthal, Lisa J., and John Joseph-Peter Sabuco. "Salaries in Psychosomatic Medicine: A Cross-Sectional Survey of Practicing Physicians." Psychosomatics 58, no. 1 (January 2017): 92–94. http://dx.doi.org/10.1016/j.psym.2016.07.003.
Full text
4
Junkes, Maria Bernadete, and Valdir Filgueiras Pessoa. "Financial expense incurred by medical leaves of health professionals in Rondonia public hospitals, Brazil." Revista Latino-Americana de Enfermagem 18, no. 3 (June 2010): 406–12. http://dx.doi.org/10.1590/s0104-11692010000300016.
Full textAbstract:
The study investigates the additional payroll expense caused by absenteeism due to illness among nursing professionals and physicians at two public hospitals at Cacoal, Rondonia, Brazil. Non-programmed absences of up to 15 days which occurred at the hospital units between 2004 to 2007 were verified in the database of the institutions’ human resource sector. From 1,704 non-programmed absences, 1,486 were justified by medical declarations. It was verified that absenteeism caused by illness was responsible for 87.2% of all non-programmed absences. When these data are grouped by professional categories, it was observed that the nurse absenteeism due to illness reached 83.3%, when compared with 16.7% for physicians. The general absenteeism index, adding up nurses and physicians, corresponded to 0.85%, resulting in an additional payroll expense of 5.2% and 7.4% in the salaries of nursing professionals and physicians, respectively.
5
Nedic, Olesja. "Restoring dignity and respect to health care workers." Medical review 59, no. 11-12 (2006): 515–21. http://dx.doi.org/10.2298/mpns0612515n.
Full textAbstract:
Introduction. This year, the World Health Organization focuses on restoring dignity and respect to health care workers. The aim of this study was to investigate the workplace stressors in physicians. Material and Methods. The present study was performed in the period 2002-2004, among physicians treated in the Health Center Novi Sad. The examinees were asked to fill out a questionnaire - a workplace survey - to identify workplace stressors by using a self-evaluation method. The physicians were divided into three groups: those practicing surgery (S), internal medicine (IM) and preventive-diagnostics (PD). Statistical analysis was done using SPSS and STATISTICA software. The sample included 208 physicians with an average age of 40 years (SD=7,1); average work experience of 22 years (SD=8,1). Results. 65 physicians from group S and 108 physicians from group IM, identified the following workplace stressors: treating patients in life-threatening situations (47.7%, 30.6%, respectfully); on-call duty (13.8%, 12%); low salary (10.8%, 10.2%); limited diagnostic and therapeutic resources in the IM group. 35 physicians from the DP group identified the following stressors: low salary (25%), treating patients in life-threatening situations and a great number of patients (16%). The analysis of all examined physicians revealed the following workplace stressors: treating patients in life-threatening situations (34.6%), low salary (13%), on-call duty and overtime, and too many patients per physician (11.5%). Conclusion. Restoring the reputation of health workers can be done by providing new equipment to resolve life-threatening situations, by increasing salaries, reducing on-call time, as well as the number of patients. Generally speaking, this should help to improve the quality of work in the health care system, in accordance with the recommendations of the WHO. .
6
Stewart, F. Marc, Robert L. Wasserman, Clara D. Bloomfield, Stephen Petersdorf, Robert P. Witherspoon, Frederick R. Appelbaum, Andrew Ziskind, et al. "Benchmarks in Clinical Productivity: A National Comprehensive Cancer Network Survey." Journal of Oncology Practice 3, no. 1 (January 2007): 2–8. http://dx.doi.org/10.1200/jop.0712001.
Full textAbstract:
Purpose Oncologists in academic cancer centers usually generate professional fees that are insufficient to cover salaries and other expenses, despite significant clinical activity; therefore, supplemental funding is frequently required in order to support competitive levels of physician compensation. Relative value units (RVUs) allow comparisons of productivity across institutions and practice locations and provide a reasonable point of reference on which funding decisions can be based. Methods We reviewed the clinical productivity and other characteristics of oncology physicians practicing in 13 major academic cancer institutions with membership or shared membership in the National Comprehensive Cancer Network (NCCN). The objectives of this study were to develop tools that would lead to better-informed decision making regarding practice management and physician deployment in comprehensive cancer centers and to determine benchmarks of productivity using RVUs accrued by physicians at each institution. Three hundred fifty-three individual physician practices across the 13 NCCN institutions in the survey provided data describing adult hematology/medical oncology and bone marrow/stem-cell transplantation programs. Data from the member institutions participating in the survey included all American Medical Association Current Procedural Terminology (CPT®) codes generated (billed) by each physician during each organization's fiscal year 2003 as a measure of actual clinical productivity. Physician characteristic data included specialty, clinical full-time equivalent (CFTE) status, faculty rank, faculty track, number of years of experience, and total salary by funding source. The average adult hematologist/medical oncologist in our sample would produce 3,745 RVUs if he/she worked full-time as a clinician (100% CFTE), compared with 4,506 RVUs for a 100% CFTE transplant oncologist. Results and Conclusion Our results suggest specific clinical productivity targets for academic oncologists and provide a methodology for analyzing potential factors associated with clinical productivity and developing clinical productivity targets specific for physicians with a mix of research, administrative, teaching, and clinical salary support.
7
Sayed, Nawid, Craig Rodrigues, Victoria Reedman, and Sydney McQueen. "A Call to Action Against Rising Medical Student Tuition." University of Ottawa Journal of Medicine 9, no. 1 (May 17, 2019): 28–32. http://dx.doi.org/10.18192/uojm.v9i1.3840.
Full textAbstract:
There is growing concern among medical students regarding the unprecedented increases in medical school tuition fees, which has been far exceeding inflation. One consideration is how these increasing fees and resulting debt may be impacting student demographics, particularly with respect to socioeconomic status, as well the types of clinical careers that medical students are pursuing, given the lower average salaries earned by primary caregivers. This second point is concerning given the shortage of primary care physicians in Canada.
8
Novikov, Denis. "LEGAL REGULATION OF MEDICAL ACTIVITY IN RUSSIAN EMPIRE BY MEDICAL CHARTER." Inter Collegas 4, no. 2 (July 22, 2017): 52–56. http://dx.doi.org/10.35339/ic.4.2.52-56.
Full textAbstract:
Novikov D.O.The article is devoted to the study of legal regulation of county physicians’ work in zemstvo medicine. The author determined that the Medical Charter, adopted in 1905, was the first legislative framework regulating medical activities, training, salaries, labour discipline and material responsibility of physicians.Key Words: zemstvo medicine, medical activity, physicians, the Medical Charter, legal regulation, duties. ПРАВОВЕ РЕГУЛЮВАННЯ МЕДИЧНОЇ ДІЯЛЬНОСТІ В РОСІЙСЬКІЙ ІМПЕРІЇ ЗА ЛІКАРСЬКИМ СТАТУТОМНовіков Д.O.Стаття присвячена дослідженню правового регулювання праці повітових лікарів в земській медицині. Автор визначив, що прийнята в 1905 році Медична хартія була першою законодавчою базою, яка регулює медичну діяльність, підготовку, зарплату, трудову дисципліну і матеріальну відповідальність лікарів.Ключові слова: земська медицина, медична діяльність, лікарі, Медична хартія, правове регулювання, обов'язки. ПРАВОВОЕ РЕГУЛИРОВАНИЕ МЕДИЦИНСКОЙ ДЕЯТЕЛЬНОСТИ В РОССИЙСКОЙ ИМПЕРИИ ПО ВРАЧЕБНОМУ УСТАВУНовиков Д.А.Статья посвящена исследованию правового регулирования труда уездных врачей в земской медицине. Автор определил, что принятая в 1905 году Медицинская хартия была первой законодательной базой, регулирующей медицинскую деятельность, подготовку, зарплату, трудовую дисциплину и материальную ответственность врачей.Ключевые слова: земская медицина, медицинская деятельность, врачи, Медицинская хартия, правовое регулирование, обязанности.
9
Noy, Shlomo, and Ran Lachman. "Physician hospital conflict among salaried physicians." Health Care Management Review 18, no. 4 (1993): 60–61. http://dx.doi.org/10.1097/00004010-199301840-00008.
Full text
10
Noy, Shlomo, and Ran Lachman. "Physician—hospital conflict among salaried physicians." Health Care Management Review 18, no. 4 (1993): 60–69. http://dx.doi.org/10.1097/00004010-199323000-00008.
Full text
11
Vakil, R., L. D. Bosserman, C. Presant, W. McNatt, A. Der, A. Greenburg, A. Estrella, G. Upadhyaya, and M. Vakil. "Overhead costs (OC) associated with quality oncology care (QOC) monitoring to ensure compliance with national treatment guidelines (TG)." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 6637. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.6637.
Full textAbstract:
6637 Background: QOC is a goal of all oncology practices (op), healthcare insurance plans (hip), HMOs, and payers for health insurance. In order to ensure compliance with TG and maintain QOC in a multi-site op, we adapted an electronic medical record (EMR) to evaluate tumor and stage specific compliance in oncology treatments. This report evaluates the OC associated with development and operation of that monitoring system and its application to an HMO patient population of 75,000 covered lives. Methods: OC included 25% (proportion of HMO to total patients )of the emr system developmental costs (DC) and operational costs (OpC). Personnel time included entering data and treatments, training, data coordination, and data analysis. Salaries were based on regional averages for physicians, administrators, clerks, and nurses. Time estimates were made for monitoring quality data only, excluding standard patient care. Compliance data is reported separately. Results: 1,250 patients over 18 months were treated by 5 of the op physicians. DC for this program included computer hardware $25,000, personnel training $10,900, and EMR licensing $12,500. Annualized operational costs (OpC) included emr maintenance fees $1000, IT consultants $4500, physician time to enter individual patient data at first consultation and follow up visits $58,000, nursing time to enter treatment data and continued training $7650, physician continued training $11,250, senior administrator coordination $30,000, administrative supervision $17,900, clerical data analysis $22,500, and senior physician supervision $50,000. Costs per covered life for DC were $0.645 and for OC were $2.704 per year. Conclusions: The costs to maintain QOC and ensure TG compliance are substantial and must be reimbursed by hips and HMOs. Understanding these costs is essential to negotiating care contracts with hips that will monitor care appropriately. Investing in EMR methods to ensure QOC will be important to patients and op, as well as hips. Monitoring continuing OC to determine if they decrease with additional experience is essential. Standardizing EMR data sets aad op methodologies for compliance monitoring will further improve efficiencies and cost efficacy in documenting delivered QOC. No significant financial relationships to disclose.
12
Vaillancourt, Christian, Brian H. Rowe, Jennifer D. Artz, Robert Green, Marcel Émond, Venkatesh Thiruganasambandamoorthy, Grant Innes, Jeffrey J. Perry, Lisa A. Calder, and Ian G. Stiell. "CAEP 2014 Academic symposium: “How to make research succeed in your department: How to fund your research program”." CJEM 17, no. 4 (July 2015): 453–61. http://dx.doi.org/10.1017/cem.2015.58.
Full textAbstract:
ABSTRACTObjectiveWe sought to gather a comprehensive list of funding strategies and opportunities for emergency medicine (EM) centres across Canada, and make recommendations on how to successfully fund all levels of research activity, including research projects, staff salaries, infrastructure, and researcher stipends.MethodsWe formed an expert panel consisting of volunteers recognized nationally for their scholarly work in EM. First, we conducted interviews with academic leaders and researchers to obtain a description of their local funding strategies using a standardized open-ended questionnaire. Panelists then identified emerging funding models. Second, we listed funding opportunities and initiatives at the provincial, national, and international levels. Finally, we used an iterative consensus-based approach to derive pragmatic recommendations after incorporating comments and suggestions from participants at an academic symposium.ResultsOur review of funding strategies identified four funding models: 1) investigator dependent model, 2) practice plan, 3) generous benefactor, and 4) mixed funding. Recommendations in this document include approaches for research contributors and producers (seven recommendations), for local academic leaders (five recommendations), and for national organizations, such as the Canadian Association of Emergency Physicians (CAEP) (three recommendations).ConclusionsFunding for research in EM varies across Canada and is largely insecure. We offer recommendations to help facilitate funding for large and small projects, for salary support, and for local and national leaders to advance EM research. We believe that these recommendations will increase funding for all levels of EM research activity, including research projects, staff salaries, infrastructure, and researcher stipends.
13
Sabitova, Alina, Sana Zehra Sajun, Sandra Nicholson, Franziska Mosler, and Stefan Priebe. "Job morale of physicians in low-income and middle-income countries: a systematic literature review of qualitative studies." BMJ Open 9, no. 12 (December 2019): e028657. http://dx.doi.org/10.1136/bmjopen-2018-028657.
Full textAbstract:
ObjectivesTo systematically review the available literature on physicians’ and dentists’ experiences influencing job motivation, job satisfaction, burnout, well-being and symptoms of depression as indicators of job morale in low-income and middle-income countries.DesignThe review was reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for studies evaluating outcomes of interest using qualitative methods. The framework method was used to analyse and integrate review findings.Data sourcesA primary search of electronic databases was performed by using a combination of search terms related to the following areas of interest: ‘morale’, ‘physicians and dentists’ and ‘low-income and middle-income countries’. A secondary search of the grey literature was conducted in addition to checking the reference list of included studies and review papers.ResultsTen papers representing 10 different studies and involving 581 participants across seven low-income and middle-income countries met the inclusion criteria for the review. However, none of the studies focused on dentists’ experiences was included. An analytical framework including four main categories was developed: work environment (physical and social), rewards (financial, non-financial and social respect), work content (workload, nature of work, job security/stability and safety), managerial context (staffing levels, protocols and guidelines consistency and political interference). The job morale of physicians working in low-income and middle-income countries was mainly influenced by negative experiences. Increasing salaries, offering opportunities for career and professional development, improving the physical and social working environment, implementing clear professional guidelines and protocols and tackling healthcare staff shortage may influence physicians’ job morale positively.ConclusionsThere were a limited number of studies and a great degree of heterogeneity of evidence. Further research is recommended to assist in scrutinising context-specific issues and ways of addressing them to maximise their utility.PROSPERO registration numberCRD42017082579.
14
Berthelot, S., M. Mallet, L. Baril, P. Dupont, L. Bissonnette, H. Stelfox, M. Émond, et al. "P017: A time-driven activity-based costing method to estimate health care costs in the emergency department." CJEM 19, S1 (May 2017): S83. http://dx.doi.org/10.1017/cem.2017.219.
Full textAbstract:
Introduction: Poor physicians’ knowledge of health care costs has been identified as an important barrier to improving efficiency and reducing overuse in care delivery. Moreover, costs of tests and treatments estimated with traditional costing methods have been shown to be imprecise and unreliable. We estimated the cost of frequent care activities in the emergency department (ED) using the time-driven activity-based costing (TDABC) method. Methods: We conducted a TDABC study in the ED of the CHUL, Québec city (77000 visits/year). We estimated the cost of all potential care activities (e.g. triage) provided to adult patients with selected urgent (e.g. pulmonary sepsis) and non urgent (e.g. urinary tract infection) conditions frequently encountered in the ED. Following Lean management principles, process maps were developed by a group of ED care providers for each care activity to identify human resources, supplies and equipment involved, and to estimate the time required to complete each process. Resource unit cost (e.g. cost per minute of a nurse) and overhead rate were calculated using financial information from fiscal year 2015-16. Estimated cost of each care activity (e.g. chest X-ray) including physicians’ charges was calculated by summing overhead allocation and the cost of each process (e.g. disinfection of the X-ray machine) as obtained by multiplying the resource unit cost by the time for process completion. Results: Process maps were developed for 14 conditions and 68 ED care activities. We estimated the costs of activities (CAN$) related to nursing (e.g. urinalysis and culture triage ordering $14.70), clerk tasks (e.g. patient registration $3.40), physicians (e.g. FAST scan $20.90), laboratory testing (e.g. CBC $6.30), diagnostic imaging (e.g. abdominal CT scan $146.50), therapy (e.g. 5 mg of iv morphine $20.40), and resuscitation (rapid sequence intubation with ketamine and succinylcholine $146.40). Overall, emergency physicians’ charges, personnel salaries and overheads accounted for 38%, 22% and 16% of all ED care costs, respectively. Conclusion: Our results represent an important step toward increasing emergency physicians’ awareness on the real cost of their interventions and empowering them to adopt more cost-effective practice patterns.
15
Stehr, Wolfgang, and Don K. Nakayama. "Employment and Hospital Support among Pediatric Surgeons." American Surgeon 80, no. 12 (December 2014): 1256–59. http://dx.doi.org/10.1177/000313481408001229.
Full textAbstract:
Employment, either by an academic entity or a hospital, is increasingly becoming a feature of surgical practice. Independent practices receive indirect subsidies to support their revenue. A survey of the extent of employment and the forms of indirect subsidies by which hospitals support independent practices, not previously done, would be of interest to all clinicians. A 2012 Internet survey of pediatric surgeons, asking practice description, hospital support, governance and management, conditions of compensation, selected contractual obligations, and arrangements for part-time coverage was conducted. Response rate was 21.8 per cent (253 of 1,163). Employed surgeons comprised 80 per cent: 60 per cent academic (152 of 253) and 20 per cent nonacademic (51). Only eight per cent (19) were in private practice. Half (47% [106 of 226]) had administrative tasks. One-fifth (20% [45 of 223]) was in a system without physician input in governance. The rest were in practices with physicians involved in management: on boards of directors (35% [78]), in management positions (31% [69]), and entirely physician-run (14% [31]). Most salaries were independent of external benchmarks. Productivity measures, when applied to compensation (54% [117 of 218]), used relative value units (71% [83 of 117]) more often than revenue production (29% [34]). Patient contact minimums (4% [nine of 217]) and penalties were less common (20% [43 of 218]) than bonus provisions (53% [116 of 218]). Most surgeons in private practice (75% [14 of 19]) received nonsalary hospital support. Pediatric surgery reflects the current trend of physician employment and hospital subsidies. Surgeon participation in governance and strategic system decisions will be necessary as healthcare systems evolve.
16
Samokhodsky, Victor. "Diagnostic-combined groups as a personalization tool of doctor’s financial stimulation level and predictor of treatment cost." OTORHINOLARYNGOLOGY, no. 1(2) 2019 (September 3, 2019): 4–16. http://dx.doi.org/10.37219/2528-8253-2019-1-04.
Full textAbstract:
Introduction: The mechanism of formation and use of clinical-statistical groups and diagnostic-combined groups (DSG) as a tool for determining the cost of physician work, personification of the level of financial stimulation of his quality work is proposed based on the example of ENT diseases of different degrees of complexity. Purpose: As a result of the comparative characterization of physicians' work indicators management of diseases of five degrees of complexity, proposition to recommend the mechanism of substantiation of the levels of financial renumeration of the doctor and the possible options for reimbursement of a certain amount of the total cost of treatment. Material and Methods: We performed retrospective analysis of case histories and outpatient charts of otorhinolaryngological patients of the regional hospital for 10 years. Taking into account certain features of the clinical course of the disease, indicators of the average working time of the doctor for the process of examination and treatment, we recommend clinical-statistical groups, divided into four which amounted to five DCG, ie diseases of five degrees of complexity. Also, a formula is proposed in which, on the basis of official data on the amount of salaries of doctors, the terms of their regulatory expenses, the so-called "increasing" coefficients, an attempt was made to determine the cost of physicians' work according to the degree of complexity of the disease and to identify possible sources of compensation to the patient from the amount of the total cost of treatment. Results and discussion: Appropriate calculations indicated the opportunity to justify certain amounts of financial incentives for physicians, depending on the number of patients treated with varying degrees of complexity. Possible official sources of financial compensation to the patient of a certain amount of the total cost of his treatment were also identified. Conclusions: Given the creation of computer programs that would greatly simplify the corresponding calculations of the tables presented in the article, the recommended algorithm for practical implementation of the clinical-statistical groups and DCG system would be methodologically suitable for use in other (therapy, surgery, etc.) profile services of healthcare establishment.
17
KADIOGLU, FUNDA GULAY. "An Ethical Analysis of Performance-Based Supplementary Payment in Turkey’s Healthcare System." Cambridge Quarterly of Healthcare Ethics 25, no. 3 (June 27, 2016): 493–96. http://dx.doi.org/10.1017/s096318011600013x.
Full textAbstract:
Abstract:In 2003 Turkey introduced the Health Transition Program to develop easily accessible, high-quality, and effective healthcare services for the population. This program, like other health reforms, has three primary goals: to improve health status, to enhance financial protection, and to ensure patients’ satisfaction. Although there is considerable literature on the anticipated positive results of such health reforms, little evidence exists on their current effectiveness. One of the main initiatives of this health reform is a performance-based supplementary payment system, an additional payment healthcare professionals receive each month in addition to their regular salaries. This system may cause some ethical problems. Physicians have an ethical duty to provide high-quality care to each patient; however, pay-for-performance and other programs that create strong incentives for high-quality care set up a potential conflict between this duty and the competing interest of complying with a performance measure.
18
L., J. F. "HOW THE CLINTON HEALTH PROPOSAL WAS CONCEIVED AND PROPAGATED." Pediatrics 94, no. 3 (September 1, 1994): 384. http://dx.doi.org/10.1542/peds.94.3.384.
Full textAbstract:
... The working groups contained more than 1000 participants, not 511, as claimed by the Task Force. Nearly half of the members were private citizens. Large numbers worked for managed-care interests, most notably the Robert Wood Johnson Foundation and the Henry J. Kaiser Family Foundation. Both foundations have supported managed-care reform in several states. In addition, six members the White House passed off as Congressional staffers turned out to be Robert Wood Johnson fellows assigned to the staffs of four Democratic Senators; all were on the foundation's payroll. Dozens of other private interests were represented in the working groups—Aetna, Prudential, Kaiser-Permanente, health czar Ira Magaziner's former consulting company Telesis, to name a few. Conspicuously absent were physicians in private practice. The Task Force spent at least $4 million and possibly as much as $16 million on expenses, salaries, and consulting fees. In the charter it filed with the GSA in March 1993, the Task Force said expenses would total $100 000.
19
Stasenko, Marina, Christopher M. Tarney, Mitchell Veith, Kenneth Seier, Yovanni Casablanca, and Carol L. Brown. "Survey of sexual harassment and gender disparities among gynecologic oncologists." Journal of Clinical Oncology 37, no. 18_suppl (June 20, 2019): LBA10502. http://dx.doi.org/10.1200/jco.2019.37.18_suppl.lba10502.
Full textAbstract:
LBA10502 Background: Sexual harassment is a problem in the workplace, with a third of U.S. women reporting experiencing unwanted sexual advances in their careers. Moreover, gender disparities have persisted in medicine, despite over half of U.S. physicians under age 44 being female. The purpose of this study is to evaluate perceived gender biases, prevalence of sexual harassment, and how these affect physician growth and advancement in gynecologic oncology (Gyn-Onc). Methods: We conducted a survey study of U.S.-based physician members of the Society of Gynecologic Oncology: full, senior, and fellow members. Participants reported: demographics; experiences with sexual harassment in training/practice; perceptions of gender disparities in Gyn-Onc. Survey was anonymized and collected using RedCap data capture tool. Dichotomous outcomes were compared using Fisher’s exact test. Results: The survey was sent to 1,566 members; 402 responses were received (26% response rate: 255 females (F), 147 males (M)). Female responders were younger, non-white (28% F, 11% M), not married (16% F, 3% M), and had fewer years in practice than males (p≤0.001, each). Six of every 10 responders (64%) reported experiencing sexual harassment during training/practice; 7 of every 10 women (71%) experienced sexual harassment in training/practice. One in 10 responders openly reported this behavior (15% responders; 17%F, 10% M, p=0.210); most common reasons for lack of reporting were: incident did not seem important enough (40%), did not think anything would be done about it (37%), and fear of reprisal (34%). Female responders were more likely to report that they felt gender affected their career advancement (34% F, 10% M; p≤0.001) and that gender played a role in setting their salary (42% F, 6% M; p≤0.001). Of note, 91% male responders did not feel that there is a gender pay gap in Gyn-Onc, compared to 57% females (p≤0.001). Conclusions: This report is the first to show that experience of sexual harassment is common among Gyn-Onc physicians. Importantly, only few report these occurrences, often for fear of reprisal or concern that nothing will be done. Further, female Gyn-Oncologists report feeling that gender influences salaries and career advancement. Awareness and acknowledgement of sexual harassment and gender inequalities within Gyn-Onc can lead to interventions to address these disparities.
20
Everard, Kelly M., Kimberly Zoberi, and Christine Jacobs. "Factors Associated With Successfully Filling Faculty Vacancies in Family Medicine." Family Medicine 51, no. 6 (June 6, 2019): 489–92. http://dx.doi.org/10.22454/fammed.2019.313365.
Full textAbstract:
Background and Objectives: Faculty vacancies are a concern for chairs of academic family medicine departments who regularly face having to recruit new faculty. Faculty physicians who report lack of support for research and teaching or excessive time in activities that are not meaningful may experience burnout resulting in leaving academic medicine. Methods: Data were collected via a Council of Academic Family Medicine Educational Research Alliance (CERA) survey of US family medicine department chairs. To determine characteristics associated with success in hiring new physician faculty, chairs answered questions about the number of vacancies in the previous 12 months, the number of vacancies filled in the previous 12 months, the months the longest vacancy was open, starting salary, whether signing bonus was offered, and the full-time equivalent (FTE) for clinical, research, teaching, and administrative time. Results: The response rate was 52%. Chairs reported an average of 3.9 vacancies in the previous 12 months, and an average of 2.5 (66%) were filled. Chairs who didn’t offer protected time for teaching filled a higher percentage of their vacancies, but they did not fill them faster than departments that did offer teaching time. Higher salary and a signing bonus were associated with filling positions faster. Chairs who offered a signing bonus filled positions nearly 4 months sooner than those who didn’t. Conclusions: Offering protected time for teaching or research and FTE allocation for clinical, teaching, research, and administrative time were not associated with success in hiring new faculty. Chairs who offered higher salaries and signing bonuses were able to hire faculty more quickly than those who didn’t.
21
Hickson, Gerald B., William A. Altemeier, and James M. Perrin. "Physician Reimbursement by Salary or Fee-for-Service: Effect on Physician Practice Behavior in a Randomized Prospective Study." Pediatrics 80, no. 3 (September 1, 1987): 344–50. http://dx.doi.org/10.1542/peds.80.3.344.
Full textAbstract:
We used a resident continuity clinic to compare prospectively the impact of salary v fee-for-service reimbursement on physician practice behavior. This model allowed randomization of physicians into salary and fee-for-service groups and separation of the effects of reimbursement from patient behavior. Physicians reimbursed by fee-for-services scheduled more visits per patient than did salaried physicians (3.69 visits v 2.83 visits, P < .01) and saw their patients more often (2.70 visits v 2.21 visits, P < .05) during the 9-month study. Almost all of this difference was because fee-for-service physicians saw more well patients than salaried physicians (1.42 visits and .99 visits per enrolled patient, respectively, P < .01). Evaluating visits by American Academy of Pediatrics' guidelines indicated that fee-for-service physicians saw more patients for well-childcare than salaried physicians because they missed fewer recommended ommended visits and scheduled visits in excess of those recommendations. Fee-for-service physicians also provided better continuity of care than salaried physicians by attending a larger percentage of all visits made by their patients (86.6% of visits v 78.3% of visits, P < .05), and by encouraging fewer emergency visits per enrolled patient (0.12 visits v 0.22 visits, P < .01). Physicians' interest in private practice, as determined by their career plans, correlated significantly with total number of patients enrolled (r = .48, P < .05) and total clinic patients seen by each resident during the study (r = .40, P < .05): reimbursement was not significantly related to these two outcomes after correction for differences in career plans by fee-for-service and salaried physicians. A resident continuity clinic was used as a model, and it was possible to isolate the effect of reimbursement from patient/parent behavior and to demonstrate that reimbursement method and physician interest in practice motivated physicians to influence the use of outpatient services by their patients.
22
Li, Ben, Jean Jacob-Brassard, Fahima Dossa, Konrad Salata, Teruko Kishibe, Elisa Greco, Nancy N. Baxter, and Mohammed Al-Omran. "Gender differences in faculty rank among academic physicians: a systematic review and meta-analysis." BMJ Open 11, no. 11 (November 2021): e050322. http://dx.doi.org/10.1136/bmjopen-2021-050322.
Full textAbstract:
ObjectiveMany studies have analysed gender bias in academic medicine; however, no comprehensive synthesis of the literature has been performed. We conducted a pooled analysis of the difference in the proportion of men versus women with full professorship among academic physicians.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, Embase, Cochrane Central Register of Controlled Trials, Education Resources Information Center and PsycINFO were searched from inception to 3 July 2020.Study selectionAll original studies reporting faculty rank stratified by gender worldwide were included.Data extraction and synthesisStudy screening, data extraction and quality assessment were performed by two independent reviewers, with a third author resolving discrepancies. Meta-analysis was conducted using random-effects models.ResultsOur search yielded 5897 articles. 218 studies were included with 991 207 academic physician data points. Men were 2.77 times more likely to be full professors (182 271/643 790 men vs 30 349/251 501 women, OR 2.77, 95% CI 2.57 to 2.98). Although men practised for longer (median 18 vs 12 years, p<0.00002), the gender gap remained after pooling seven studies that adjusted for factors including time in practice, specialty, publications, h-index, additional PhD and institution (adjusted OR 1.83, 95% CI 1.04 to 3.20). Meta-regression by data collection year demonstrated improvement over time (p=0.0011); however, subgroup analysis showed that gender disparities remain significant in the 2010–2020 decade (OR 2.63, 95% CI 2.48 to 2.80). The gender gap was present across all specialties and both within and outside of North America. Men published more papers (mean difference 17.2, 95% CI 14.7 to 19.7), earned higher salaries (mean difference $33 256, 95% CI $25 969 to $40 542) and were more likely to be departmental chairs (OR 2.61, 95% CI 2.19 to 3.12).ConclusionsGender inequity in academic medicine exists across all specialties, geographical regions and multiple measures of success, including academic rank, publications, salary and leadership. Men are more likely than women to be full professors after controlling for experience, academic productivity and specialty. Although there has been some improvement over time, the gender disparity in faculty rank persists.PROSPERO registration numberCRD42020197414.
23
Baerlocher, Mark Otto, Jason Noble, and Allan S. Detsky. "Impact of physician income source on productivity." Clinical & Investigative Medicine 30, no. 1 (February 11, 2007): 42. http://dx.doi.org/10.25011/cim.v30i1.448.
Full textAbstract:
Based on data from the 2004 National Physician Survey, physicians whose primary payment method was fee-for-service saw more patients per week than physicians remunerated by other methods, including salary or blended payments. This result did not change when examined according to specialty or specialty grouping (Table 1), physician age (Table 2) Family physicians versus specialists, type of practice (office-based versus hospital-based; data not shown), or practice setting (urban versus rural; data not shown). Overall, fee-for-service (FFS) physicians saw approximately twice the number of patients per week as salaried physicians. These data provide convincing evidence that FFS physicians see substantially more patients.
24
Mbunya, S., C. Asirwa, and D. Felker. "Telemedicine: Bridging the Gap Between Rural and Urban Oncologic Healthcare in Kenya." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 226s. http://dx.doi.org/10.1200/jgo.18.91500.
Full textAbstract:
Background: The AMPATH Consortium has served to greatly expand healthcare in western Kenya. Gaps and limitations in care still exist, especially in oncology care in rural areas. Telemedicine provides a lower cost, practical method to maximize physician resources and limit cost and stress to families with socioeconomic limitations in rural Kenya. The following paper seeks to discuss the importance of developing a telemedicine model in western Kenya and the many advantages telemedicine can bring, as well as discuss the telemedicine model being developed by AMPATH Oncology. Aim: Integrate paper-based medical records into the AMPATH AIDS EMR; Identify sustainable telemedicine tools to integrate into the EMR; Establish networking in rural clinics; Budget in IT personnel at each clinic to assist in patient setup with central site; use solar as primary power source for devices to aid in power issues. Only 45% of Kenyans have access to power; Use cellular networks for communication; Maximize time allocated for physicians to see patients; Decrease travel time to clinics as only 32% of Kenyans live in urban environments. Methods: Cost analysis of remote clinic locations and associated costs; Clinic budget estimate for networking and telemedicine support position; Cost summary and savings Results: Estimated costs for the operations budget for the 17 rural outreach clinics include the costs of hardware, solar networking setup, and internet at a total $3400/wk. This will decrease after the first year to $1700 for maintenance costs of equipment. Personnel consists of 1 local person to support the system and will be a weekly cost of $1870. Lost time for physicians due to road travel totals ∼100 hours weekly. Estimated salaries for an oncologist at $30/h leads to a cost of $3007/wk in lost productivity. It should be noted that lodging and per diem expenses are not included in the estimated expenses that total $6114/wk. By doing telemedicine at the rural clinics in an ideal 48 workable week situation. The savings of $528,000 is a clear evidence that this is financially feasible solely based on travel savings over 5 years. For this reason, the actual savings is ∼$264,000 and still makes a strong argument for this being the right move. Conclusion: Telemedicine is a viable and necessary resource for developing oncologic care in rural Kenya. We believe that telemedicine represents a natural evolution in healthcare in Kenya to support its rural population. Telemedicine helps maximize the limited physician resources and allows them to reach a larger audience without tying up their time in lengthy commutes. Last, telemedicine should assist patients to overcome the barriers of cost and time that limit their treatment. Future challenges and gains will be made with the evolution of the newly formed national health insurance system. Gaining support and reimbursement from telemedicine visits will be crucial to ensuring the success of telemedicine.
25
Parikh, Aparna R., Nancy L. Keating, Pang-Hsiang Liu, Stacy W. Gray, Carrie N. Klabunde, Katherine L. Kahn, David A. Haggstrom, et al. "ReCAP: Oncologists’ Selection of Genetic and Molecular Testing in the Evolving Landscape of Stage II Colorectal Cancer." Journal of Oncology Practice 12, no. 3 (March 2016): 259–60. http://dx.doi.org/10.1200/jop.2015.007062.
Full textAbstract:
CONTEXT AND QUESTION ASKED: Genetic testing can be used in the diagnosis of Lynch syndrome, formerly known as hereditary nonpolyposis colorectal cancer (CRC), the most common inherited disorder that increases the risk for CRC; however, test results related to Lynch syndrome screening may also be used for predictive and prognostic purposes in patients with stage II CRC. Although national guidelines recommend the use of several genetic and molecular tests for patients with CRC, little is known about how guidelines, particularly the complex testing recommendations for Lynch syndrome, are translated into clinical practice. In this study, we asked: how does the family history of patients with stage II CRC influence medical oncologists’ selection of genetic and molecular testing, both related and unrelated to Lynch syndrome? SUMMARY ANSWER: We found that oncologists’ self-reported ordering of Lynch syndrome–related tests was strongly associated with the strength of CRC family history, but even so, not all oncologists would order germline testing for mismatch repair (MMR) genes, much less screen for Lynch syndrome by ordering microsatellite instability and/or immunohistochemistry for MMR proteins, in a patient scenario with the strongest family history of CRC ( Table 2 ). We also found overtesting of KRAS and Oncotype DX for stage II CRC associated with certain practice and provider characteristics, with graduates of non-US or non-Canadian medical schools and physicians compensated under fee-for-service or by productivity-based salaries being more likely to choose KRAS testing. Fee-for-service and productivity-based salaries were also associated with increased Oncotype DX testing. [Table: see text] METHODS: In 2012 and 2013, we surveyed medical oncologists in the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS) and evaluated their selection of microsatellite instability and/or immunohistorchemistry for MMR proteins, germline testing for MMR genes, BRAF and KRAS mutation analysis, and Oncotype DX in stage II CRC. Physicians were randomly assigned to receive one of three vignettes, varying by strength of CRC family history. We compared differences in testing by family history and provider and practice characteristics, and we used multivariate logistic regression to identify provider and practice characteristics associated with testing. BIAS, CONFOUNDING FACTOR(S), DRAWBACKS: Although we surveyed a large cohort of oncologists from diverse geographic and practice settings, there were several limitations to this study. Whereas CanCORS patients are representative of the national patient population, participants were mostly oncologists who care for patients enrolled in CanCORS and who may be slightly older than US oncologists as a whole. Furthermore, our measures of testing relied on physician self-reporting rather than direct measures of use. In addition, we did not ask oncologists to report on the sequence in which they would order the various tests, and we were unable to determine whether such respondents would have ordered simultaneous or sequential testing. Finally, our study focused on patients with stage II CRC and may not be further generalizable. REAL-LIFE IMPLICATIONS: The high lifetime risk of CRC and other cancers among affected individuals and family members and low detection rates led the Centers for Disease Control and Prevention to recommend universal Lynch syndrome screening of all patients newly diagnosed with CRC. Previous efforts to increase the identification of patients and family members with Lynch syndrome have unfortunately achieved limited success. It remains to be seen whether the recapitulation by the National Comprehensive Cancer Network of the Centers for Disease Control and Prevention recommendation to screen all incident CRC specimens for Lynch syndrome can increase diagnoses. Undertesting related to Lynch syndrome screening and overtesting involving molecular tests among surveyed oncologists highlight the need for improved implementation, targeted education, and evaluation of organizational and financial arrangements to promote the appropriate use of genetic and molecular tests.
26
Shankar, P. Ravi, Arun K. Dubey, Atanu Nandy, Burton L. Herz, and Brian W. Little. "Student perception about working in rural United States/Canada after graduation: a study in an offshore Caribbean medical school." F1000Research 3 (December 10, 2014): 301. http://dx.doi.org/10.12688/f1000research.5927.1.
Full textAbstract:
Introduction: Rural residents of the United States (US) and Canada face problems in accessing healthcare. International medical graduates (IMGs) play an important role in delivering rural healthcare. IMGs from Caribbean medical schools have the highest proportion of physicians in primary care. Xavier University School of Medicines admits students from the US, Canada and other countries to the undergraduate medical (MD) course and also offers a premedical program. The present study was conducted to obtain student perception about working in rural US/Canada after graduation. Methods: The study was conducted among premedical and preclinical undergraduate medical (MD) students during October 2014. The questionnaire used was modified from a previous study. Semester of study, gender, nationality, place of residence and occupation of parents were noted. Information about whether students plan to work in rural US/Canada after graduation, possible reasons why doctors are reluctant to work in rural areas, how the government can encourage rural practice, possible problems respondents anticipate while working in rural areas were among the topics studied.Results: Ninety nine of the 108 students (91.7%) participated. Forty respondents were in favor of working in rural US/Canada after graduation. Respondents mentioned good housing, regular electricity, water supply, telecommunication facilities, and schools for education of children as important conditions to be fulfilled. The government should provide higher salaries to rural doctors, help with loan repayment, and provide opportunities for professional growth. Potential problems mentioned were difficulty in being accepted by the rural community, problems in convincing patients to follow medical advice, lack of exposure to rural life among the respondents, and cultural issues.Conclusions: About 40% of respondents would consider working in rural US/Canada. Conditions required to be fulfilled have been mentioned above. Graduates from Caribbean medical schools have a role in addressing rural physician shortage. Similar studies in other offshore Caribbean medical schools are required as Caribbean IMGs make an important contribution to the rural US and Canadian health workforce.
27
Shankar, P. Ravi, Arun K. Dubey, Atanu Nandy, Burton L. Herz, and Brian W. Little. "Student perception about working in rural United States/Canada after graduation: a study in an offshore Caribbean medical school." F1000Research 3 (April 23, 2015): 301. http://dx.doi.org/10.12688/f1000research.5927.2.
Full textAbstract:
Introduction: Rural residents of the United States (US) and Canada face problems in accessing healthcare. International medical graduates (IMGs) play an important role in delivering rural healthcare. IMGs from Caribbean medical schools have the highest proportion of physicians in primary care. Xavier University School of Medicines admits students from the US, Canada and other countries to the undergraduate medical (MD) course and also offers a premedical program. The present study was conducted to obtain student perception about working in rural US/Canada after graduation. Methods: The study was conducted among premedical and preclinical undergraduate medical (MD) students during October 2014. The questionnaire used was modified from a previous study. Semester of study, gender, nationality, place of residence and occupation of parents were noted. Information about whether students plan to work in rural US/Canada after graduation, possible reasons why doctors are reluctant to work in rural areas, how the government can encourage rural practice, possible problems respondents anticipate while working in rural areas were among the topics studied.Results: Ninety nine of the 108 students (91.7%) participated. Forty respondents were in favor of working in rural US/Canada after graduation. Respondents mentioned good housing, regular electricity, water supply, telecommunication facilities, and schools for education of children as important conditions to be fulfilled. The government should provide higher salaries to rural doctors, help with loan repayment, and provide opportunities for professional growth. Potential problems mentioned were difficulty in being accepted by the rural community, problems in convincing patients to follow medical advice, lack of exposure to rural life among the respondents, and cultural issues.Conclusions: About 40% of respondents would consider working in rural US/Canada. Conditions required to be fulfilled have been mentioned above. Graduates from Caribbean medical schools have a role in addressing rural physician shortage. Similar studies in other offshore Caribbean medical schools are required as Caribbean IMGs make an important contribution to the rural US and Canadian health workforce.
28
Bjegovich-Weidman, Marija, Jill Kahabka, Amy Bock, Jacob Frick, Helga Kowalski, and Joseph Mirro. "Development by a Large Integrated Health Care System of an Objective Methodology for Evaluation of Medical Oncology Service Sites." Journal of Oncology Practice 8, no. 2 (March 2012): 70. http://dx.doi.org/10.1200/jop.2011.000425.
Full textAbstract:
Purpose: Aurora Health Care (AHC) is the largest health care system in Wisconsin, with 14 acute care hospitals. In early 2010, a group of 18 medical oncologists became affiliated with AHC. This affiliation added 13 medical oncology infusion clinics to our existing 12 sites. In the era of health care reform and declining reimbursement, we need an objective method and criteria to evaluate our 25 outpatient medical oncology sites. We developed financial, clinical, and strategic tools for the evaluation and management of our cancer subservice lines and outpatient sites. The key to our success has been the direct involvement of stakeholders with a vested interest in the services in the selection of the criteria and evaluation process. Methods: We developed our objective metrics for evaluation based on strategic, financial, operational, and patient experience criteria. Strategic criteria included: population trends, full-time equivalent (FTE) medical oncologists/primary care physicians, FTE radiation oncologists, FTE oncologic surgeons, new annual cases of patients with cancer, and market share trends. Financial criteria per site included: physician work relative value units, staff FTE by type, staff salaries, and profit and loss. Operational criteria included: facility by type (clinic v hospital based), hours of operation, and facility detail (eg, No. of chairs, No. of procedure and examination rooms, square footage). Patient experience criteria included: nursing model primary/nurse navigators, multidisciplinary support at site, Press Ganey (South Bend, IN; health care performance improvement company) results, and employee engagement score. Results: The outcome of our data analysis has resulted in the development of recommendations for AHC senior leadership and geographic market leadership to consider the consolidation of four sites (phase one, four sites; phase two, two sites) and priority strategic sites to address capacity issues that limit growth. The recommendations if implemented would result in significant cost savings, currently being quantified as a result of consolidation and improved efficiency. A reinvestment of these cost savings would be required to address facility expansion and program enhancement to maximize patient-centered expert care consistently across all of our remaining sites of service.
29
Smith, Darron, and Cardell Jacobson. "Differences in salaries of physician assistants in the USA by race, ethnicity and sex." Journal of Health Services Research & Policy 23, no. 1 (January 2018): 44–48. http://dx.doi.org/10.1177/1355819617738275.
Full textAbstract:
Objectives Data from the Academy of American Physician Assistants have suggested there are no differences in salaries by race and ethnic group. Our objective was to compare salaries of physician assistants for different racial and ethnic groups and sexes using another data source. Methods Data from the American Community Surveys (2010–2012) to examine pay differentials of physician assistants. Ordinary least squares regression analysis to compare the salaries of males and females, and those of racial and ethnic groups. Results The majority of physician assistants in recent decades have been women. Their salaries are substantially below those of their male counterparts. The number from racial and ethnic minorities remains low. American Community Surveys data show salaries to be lower than that reported by the American Academy of Physician Assistants. The salaries of Black and Hispanic physician assistants lag significantly behind the salaries of those who are White. Conclusions American Community Surveys data suggest that previously published Academy of American Physician Assistants survey data may have been biased with a low percentage of physician assistants from racial and ethnic minorities which suggests that the Academy of American Physician Assistants need to focus on recruiting greater numbers of minorities.
30
Palazuelos, Daniel, Ranu Dhillon, Adrianne Katrina Nelson, Kevin P. Savage, Rosabelle Conover, Joel T. Katz, and Joseph J. Rhatigan. "Training Toward a Movement: Career Development Insights From the First 7 Years of a Global Health Equity Residency." Journal of Graduate Medical Education 10, no. 5 (October 1, 2018): 509–16. http://dx.doi.org/10.4300/jgme-d-18-00213.1.
Full textAbstract:
ABSTRACT Background The Doris and Howard Hiatt Residency in Global Health Equity and Internal Medicine at Brigham and Women's Hospital provides global health training during residency, but little is known about its effect on participants' selection of a global health career. Objective We assessed the perceptions of residency graduates from the first 7 classes to better understand the outcomes of this education program, and the challenges faced by participants. Methods We interviewed 27 of 31 physicians (87%) who graduated from the program between 2003 and 2013 using a convergent mixed-methods design and a structured interview tool that included both open-ended and forced-choice questions. We independently coded and analyzed qualitative data using a case study design, and then wove together the qualitative and quantitative data at the interpretation phase using a parallel convergent mixed-methods design. Results Entering a career focused on social justice was cited as the most common motivator for selecting to train in global health. Most respondents (83%, 20 of 24) reported they were able to achieve this goal despite structural barriers, such as lower salaries compared with peers, a lack of mentors in the field, poorly structured and undersupported career pathways at their institutions, and unique work-life challenges. Conclusions A majority of graduates from 1 dedicated residency program in global health and internal medicine reported they were able to continue to engage in global health activities after graduation and, despite identified challenges, reported that they planned long-term careers in global health.
31
Relman, Arnold S. "Salaried Physicians and Economic Incentives." New England Journal of Medicine 319, no. 12 (September 22, 1988): 784. http://dx.doi.org/10.1056/nejm198809223191209.
Full text
32
&NA;. "Physician Salaries Declined over Last Decade." Oncology Times 28, no. 15 (August 2006): 30. http://dx.doi.org/10.1097/01.cot.0000293390.79865.16.
Full text
33
Snyder, Jennifer, Jennifer Zorn, and Kyle Satterblom. "Anticipated Salaries of Physician Assistant Students." Journal of Physician Assistant Education 19, no. 1 (2008): 13–17. http://dx.doi.org/10.1097/01367895-200819010-00003.
Full text
34
Okeke, E. N. "Do higher salaries lower physician migration?" Health Policy and Planning 29, no. 5 (July 26, 2013): 603–14. http://dx.doi.org/10.1093/heapol/czt046.
Full text
35
Gaidarov, G. M., S. V. Makarov, N. Yu Alekseeva, and I. V. Maevskaya. "ANALYSIS OF VACANCIES AND JOB OFFERS FOR DOCTORS IN STATE MEDICAL ORGANIZATIONS OF THE IRKUTSK REGION." Acta Biomedica Scientifica 3, no. 4 (July 28, 2018): 101–8. http://dx.doi.org/10.29413/abs.2018-3.4.14.
Full textAbstract:
The analysis of vacancies and job offers for doctors, especially information on the declared amount of wages and benefits, allows not only to study the need for personnel, but also to study the level of motivation of candidates for medical posts. The aim of the study was to analyze vacancies and job offers for doctors from state medical organizations of the Irkutsk region. The study was conducted using the method of continuous statistical analysis of job offers for physicians posted on the official website of the Ministry of Health of the Irkutsk region. The public sector of the healthcare system in the Irkutsk region provides a large number of vacancies for unemployed doctors and young professionals. Declared in job advertisements, the salary level of doctors is below the level reflected in regional state reports on the health of the population and the organization of health care. There is a lag in the salaries of medical workers from the average for the region, as well as the backlog of the Irkutsk region in this indicator from the Russian Federation. When comparing the municipalities of the region to the maximum and minimum declared wage levels, it is revealed that the difference between them is almost fourfold. Although the most demanded are doctors who provide primary health care, the need for these specialists does not correlate with the level of wages offered to them in vacancy announcements. Fourfold excess of the maximum declared wage level over the minimum in the municipal formations of the region is not a consequence of taking into account difficult working conditions in hard-to-reach areas, but is due exclusively to factors of economic nature.
36
Seeholzer, Eileen L., Marielee Santiago, Charles Thomas, Monica DeAngelis, Francesca Scarl, Anastasia Webb, Tangela Woods, and Ashwini R. Sehgal. "Prevalence of Social Determinants of Health Among Health System Employees." Journal of Primary Care & Community Health 13 (January 2022): 215013192211139. http://dx.doi.org/10.1177/21501319221113956.
Full textAbstract:
Introduction/Objectives: Many health systems screen patients for social determinants of health and refer patients with social needs to community service organizations for assistance. However, little is known about social determinants of health among health system employees. We sought to examine the prevalence of social determinants among employees of The MetroHealth System, a large safety-net health system in Cleveland, Ohio. Methods: We invited participants in an employee wellness program to answer the same screening questions that patients answer about 9 social determinants of health, including food insecurity, financial strain, transportation difficulty, inability to pay for housing or utilities, intimate partner violence, social isolation, infrequent physical activity, daily stress, and lack of internet access. We then determined the percentage of employees who met pre-defined criteria for being at risk for each social determinant. We also examined how these percentages varied across employee job categories. Results: Of 4191 full-time employees, 1932 (46%) completed the survey. The percentage of employees at risk for each social determinant were: food insecurity (11%), financial strain (12%), transportation difficulty (4%), inability to pay for housing or utilities (10%), intimate partner violence (4%), social isolation (48%), infrequent physical activity (10%), daily stress (58%), and lack of internet access (3%). Being at risk for specific social determinants was more common among support staff compared to staff physicians and nurses. For example, the survey participants included 436 administrative support staff, a job category that includes secretaries and patient service representatives. Among this group, 20% reported food insecurity, 20% financial strain, and 17% inability to pay for housing or utilities. Conclusions: Social determinants of health are common among health system employees, especially among workers in lower paid job categories. Health systems should routinely screen employees for social determinants and adjust salaries, benefits, and assistance programs to address their social needs.
37
Surdacki, Marian. "Lekarze i chirurdzy w Szpitalu Świętego Ducha w Rzymie w XVII–XVIII wieku." Medycyna Nowożytna 28, no. 1 (September 29, 2022): 11–52. http://dx.doi.org/10.4467/12311960mn.22.001.16209.
Full textAbstract:
Doctors and surgeons at the Hospital of the Holy Spirit in Rome in the 17th – 18th centuries Founded in 1198 by Pope Innocent III, Europe’s largest Hospital of the Holy Spirit in Rome, run by the Order of Regular Canons of Saint Duicha, became a model for other such institutions. It performed two functions: an asylum for foundlings (brefotrophium) and a hospital-clinic for the sick, the so-called the infirmary, in which there were about a thousand in certain periods, especially during epidemics, the sick inmates specialized in the treatment of people with fever, especially those with malaria, as well as injured and requiring surgical operations. The rank and size of the hospital was evidenced by the number of outstanding doctors and surgeons, unprecedented in other European hospitals. In some periods of the eighteenth century, there were nearly twenty of them in the hospital in total, but as a rule, there were always at least four chief physicians and two chief surgeons, as well as four assistant physicians and two deputy surgeons. Moreover, when the number of patients increased, additional doctors and surgeons were hired, often working for free in the hope of obtaining full employment. Among doctors, it was possible to meet specialists of the highest class, not only combining medical practice with teaching, but also authors of outstanding works and scientific treatises in the field of medicine, philosophy and law, written on the basis of observations and experiences as well as conducted scientific research. Many doctors and surgeons working in the hospital were also papal doctors. Engagement to work in the hospital took place through public competitions. It is interesting that most of the medical and surgical staff came from very distant places and even foreign countries. All doctors and chief surgeons were hired to work at the Holy Spirit Hospital as graduates of universities and other institutes or academies. As for the six surgeons, especially their deputies, nearly all were educated and practiced in the Holy Spirit Hospital. Chief doctors, called professors and sometimes lecturers, had a hierarchical priority and supervisory position among the medical community. The latter term mainly referred to doctors and surgeons teaching at the Hospital’s Academy of Surgery, later the School of Surgery, where the nurses working in the hospital learned the art of surgery. The most important duty of the doctors and chief surgeons was to carry out twice a day (morning and after lunch) visits to patients in their departments. The visits ended at least half an hour before lunch or dinner so that the patients could be given medicines and treatments before eating. During the morning visit, the physician and the chief surgeon were accompanied by their assistants or deputies, who were on duty around the clock in the hospital, while their superiors lived outside the hospital. The fame enjoyed by doctors and surgeons has not always translated into the reliability and effectiveness of the medical services they provide in the hospital. Many of them did not pay much attention to their work. They did not fulfill the duties entrusted to them, did not come or were late to work, handed over their tasks to doctors and lower-ranking personnel, kept employment and salaries despite reaching old age and poor physical condition, preventing them from properly performing their professional duties.
38
Jacobson, Cardell K., and Darron T. Smith. "Racial and ethnic differences in physician assistant salaries." Journal of the American Academy of Physician Assistants 28, no. 6 (June 2015): 1–6. http://dx.doi.org/10.1097/01.jaa.0000465219.19481.4d.
Full text
39
Ilic, Miroslav. "What is the knowledge of tubercular patients about risk factors contributing to development of their disease." Srpski arhiv za celokupno lekarstvo 134, Suppl. 2 (2006): 122–27. http://dx.doi.org/10.2298/sarh06s2122i.
Full textAbstract:
INTRODUCTION. Present knowledge of population on basic characteristics of tuberculosis is a significant issue of prevention of tuberculosis. OBJECTIVE. The objective of our study was to determine the level of knowledge on risk factors of tuberculosis among tubercular patients. METHOD. A total of 115 new patients with the active pulmonary tuberculosis were interviewed by means of anonymous questionnaire, who has been treated at the Institute of Pulmonary Diseases, Sremska Kamenica during six-month period (October 2003-March 2004). RESULTS. The patients fulfilled the questionnaire; 37.6 % had no or finished only elementary school, and 58.6 % considered genetics the main risk factor of tuberculosis. Every second patient believed that he could not catch tuberculosis if he suffered from diabetes mellitus or any kind of tumor. 8.7 % of patients who suffered from diabetes mellitus had been informed by their physicians that could catch tuberculosis one day. Every third patient did not possess sewage system and nearly 20% lived in moist flats. Around 85% had no regular salaries or these were significantly under the average Serbian income per capita in this period (12820 dinars-CSD). Leading risk factors that can contribute to development of tuberculosis were as follows: irregular nutrition (91.4 %), smoking (74.2 %), alcohol consumption (65.5%) and associated diseases (diabetes mellitus, tumors). Only 15% of them believed that all these risk factors (smoking, alcohol, irregular diet) could participate together in development of tuberculosis, and not as individual factors. Analyzing the patients? knowledge on risk factors of tuberculosis, in relation to their educational level and alcohol and cigarettes consumption, there was no significant difference (p<0.05). Nevertheless, analyzing the quality of life in patients? houses, in relation to salary and bad habits (alcohol, cigarettes) as risk factors of tuberculosis, significant statistical difference was found (p>0.05). CONCLUSION. Intensive and permanent education of population is necessary primarily considering the knowledge on tuberculosis that would be the basis of reducing the number of patients and leading to possible eradication of this disease.
40
Barnes, Courtney, Beverly Hayes, Gina Aranzamendez, and Laurie Kaufman. "Clinical process analysis." Journal of Clinical Oncology 30, no. 34_suppl (December 1, 2012): 157. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.157.
Full textAbstract:
157 Background: MD Anderson has been working with Harvard on a pilot project for Time Driven Activity Based Costing: a component is Clinical Process Analysis, which brings value on its own. It provides a visualization that “speaks” to those delivering the service. This brings great awareness of frontline reality for staff and leaders alike and the many “ah-ha” moments creates a urgency for improvement. As Berwick shared in his keynote speech at IHI 2011, "the quality movement will rise or fall on its success in reducing the cost of health care.” In order to make the right changes, who best to reduce the cost, than those delivering the service? According to Don Berwick and Dr. Brent James, the burden of changing the face of healthcare lies with us. Methods: When frequencies, probabilities and salaries are incorporated into processes of patient care, the cost of direct labor can be determined and opportunities for improvement visualized. Based on lessons learned, tools (data driven road maps, blueprints) and successful strategies (standardized process flow maps templates) have been developed to efficiently and effectively disseminate Clinical Process Analysis throughout clinical areas. Results: Data analysis and front-line reality are synchronized. Allows a “broader” view of the patient’s journey outside of one’s own discipline. Builds bridge between financial and clinical worlds by engaging clinicians through a patient-centered care perspective rather than a perspective of budget, variance and financial cost reduction. Identifies opportunities for improvement. Provides opportunities to build “psychological safety” in order for frontline staff to share with clinical area leadership the process realities of patient care. Based on feedback from physicians, managers, staff and financial experts, the process flow charts are useful to track patient flow, resource utilization, customer satisfaction, patient education, and on-boarding of new staff. Conclusions: Clinical Process Analysis provides an engaging first step to drive improvement in clinical quality and financial performance.
41
Gosfield, Alice G. "Is Physician Employment by Health Systems an Answer?" Journal of Oncology Practice 10, no. 1 (January 2014): 55–57. http://dx.doi.org/10.1200/jop.2013.001128.
Full textAbstract:
There are many predicates underlying the trend of hospitals and health system giving higher salaries and longer contract terms in an effort to secure oncologists for employment, demonstrated to be a money-losing proposition for hospitals.
42
Matiukha, L. F. "6 months after the start of medical reform of the primary and secondary levels: is everything ok?.." Infusion & Chemotherapy, no. 3.2 (December 15, 2020): 204–6. http://dx.doi.org/10.32902/2663-0338-2020-3.2-204-206.
Full textAbstract:
Background. The main goal of reforming the primary health care system (PHC) is to improve its quality and accessibility. At present, 30.45 million declarations have been signed in Ukraine with 23,453 primary care physicians. More than 70 % of those who signed the declaration are satisfied with their family doctor (FD). All PHC utilities have signed the agreements with the National Health Service of Ukraine. However, only 9 % of respondents considered health care reform successful.
Objective. To describe the current condition of PHC reform.
Materials and methods. Review of the available statistics and publications on this issue.
Results and discussion. High-quality transformation of PHC requires consideration of historical experience, regulatory framework, financial efficiency, organization of quality medical care, effective human resources policy, and social efficiency. The groundwork for the current reform began in 2006, when the concept of the State Program for PHC development was adopted. Since 2010, there is a separate medical specialty “General practice – family medicine”. By 2020, there should be a complete retraining of physicians and pediatricians for FD, who had to take care of 80 % of the patient’s needs. New principles of financing for real patients and the functioning of the system allowing to choose a doctor were implemented only in 2017-2020, and all the imperfections of PHC could not be eliminated. FD should be aware that their competence and the depth of services provided are now particularly important. Another task of the reform is to improve the financial efficiency of PHC: streamlining the budget, providing the feasibility and justification of costs, establishing the free package of guaranteed medical services. The disadvantages of the current financial system are that the re-indexation of doctors’ salaries has not taken place, inflation and rising drug prices have not been taken into account. Apart from that, there are no adjustment factors for rural doctors and payment for home visits. The reasons for inefficient funding are the lack of budgetary resources, the inertia of management in the context of frequent changes in the leadership of the Ministry of Health, non-transparent management of some institutions, negative lobbying by representatives of other sectors of health care. The organization of medical care also does not address a number of issues: there are no national screening programs, no criteria for the quality of work of doctors and nurses, and no mechanism of life and health insurance of medical staff. The eHealth system and the personnel aspects of PHC also need improvement. Thus, in 5 out of 6 outpatient clinics there is a shortage of medical staff. The forced retraining of long-serving physicians has provoked considerable resistance, and some of these physicians have never become FD. Among other issues that need to be addressed are the establishment of interactions between the departments of medical universities and clinical bases, legalization of scientific and pedagogical workers in the system of the National Health Service of Ukraine, payment for the work of interns. In terms of social efficiency, the benefits for the patient are the ability to choose a doctor and a PHC facility, the availability of an electronic queue, free basic services, the ability to communicate with a doctor and order medication online. Disadvantages include problems with medical care in case of temporary absence of a doctor, especially unpredicted, lack of possibility of emergency admission in some institutions, long travel distance to the PHC institution.
Conclusions. 1. The main goal of reforming the PHC system is to improve its quality and accessibility. 2. Qualitative transformation of PHC requires taking into account historical experience, regulatory framework, financial efficiency, organization of quality medical care, effective personnel policy, social efficiency. 3. The current PHC system has a number of gaps that should be gradually addressed. 4. Among other issues that need to be addressed – the establishment of interactions between the departments of medical universities with clinical bases, legalization in the system of the National Health Service of Ukraine of scientific and pedagogical workers, payment for the work of interns. 5. The advantages of the modern PHC system for the patient are the ability to choose a doctor and a PHC facility, the availability of an electronic queue, free basic services, the ability to communicate with a doctor and order medication online.
43
Vengberg, Sofie, Mio Fredriksson, Bo Burström, Kristina Burström, and Ulrika Winblad. "Money matters – primary care providers' perceptions of payment incentives." Journal of Health Organization and Management 35, no. 4 (February 2, 2021): 458–74. http://dx.doi.org/10.1108/jhom-06-2020-0225.
Full textAbstract:
PurposePayments to healthcare providers create incentives that can influence provider behaviour. Research on unit-level incentives in primary care is, however, scarce. This paper examines how managers and salaried physicians at Swedish primary healthcare centres perceive that payment incentives directed towards the healthcare centre affect their work.Design/methodology/approachAn interview study was conducted with 24 respondents at 13 primary healthcare centres in two cities, located in regions with different payment systems. One had a mixed system comprised of fee-for-service and risk-adjusted capitation payments, and the other a mainly risk-adjusted capitation system.FindingsFindings suggested that both managers and salaried physicians were aware of and adapted to unit-level payment incentives, albeit the latter sometimes to a lesser extent. Respondents perceived fee-for-service payments to stimulate production of shorter visits, up-coding of visits and skimming of healthier patients. Results also suggested that differentiated rates for patient visits affected horizontal prioritisations between physician and nurse visits. Respondents perceived that risk-adjustments for diagnoses led to a focus on registering diagnosis codes, and to some extent, also up-coding of secondary diagnoses.Practical implicationsPolicymakers and responsible authorities need to design payment systems carefully, balancing different incentives and considering how and from where data used to calculate payments are retrieved, not relying too heavily on data supplied by providers.Originality/valueThis study contributes evidence on unit-level payment incentives in primary care, a scarcely researched topic, especially using qualitative methods.
44
Katz, Paul R., Kenneth Scott, and Jurgis Karuza. "Has the Time Come for Salaried Nursing Home Physicians?" Journal of the American Medical Directors Association 13, no. 8 (October 2012): 673–74. http://dx.doi.org/10.1016/j.jamda.2012.04.014.
Full text
45
Laff, M. "FAMILY PHYSICIAN SALARIES UP, BUT STILL TRAIL THOSE OF SUBSPECIALISTS." Annals of Family Medicine 13, no. 4 (July 1, 2015): 390–91. http://dx.doi.org/10.1370/afm.1826.
Full text
46
Elston-Lafata, Jennifer, Gregory Cooper, George Divine, and Susan Flocke. "Colorectal cancer screening discussions: Maybe 3As is enough?" Journal of Clinical Oncology 30, no. 34_suppl (December 1, 2012): 7. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.7.
Full textAbstract:
7 Background: We evaluate the association of the 5A steps as recommended by the US Preventive Services Task Force (i.e., assess, advise, agree, assist and arrange) with adherence to physician-recommended colorectal cancer (CRC) screening. Methods: Audio-recordings of periodic health exams (PHEs) were joined with electronic medical record data and pre-visit patient surveys. Association of the 5A steps, as coded from audio-recordings, with CRC screening use was assessed using generalized estimating equation approaches. Results: Physician participants (n=64) were salaried primary care physicians. Patient participants (n=444) were insured, aged 50-80 years and due for CRC screening. Virtually all visits (n=415) included a discussion of CRC screening. When CRC screening was discussed, patients almost always (99%) received a physician recommendation for screening (advise). Over half were given assistance in obtaining screening (assist, 59%) and told why they were eligible for screening (assess, 56%). Few negotiated a plan (agree, 16%) or discussed follow up (arrange, 3%). Just over half (56%) of patients adhered to physician screening recommendations. Multivariable model results illustrate the importance of the assess and assist steps combined (OR=1.92 [95%CI 1.03-3.57]) for patient adherence to recommended CRC screening. Other variables significantly associated with screening use included discussion of CRC screening during history taking, and decreasing patient age and body mass index. Conclusions: A relatively simple discussion at the time of a CRC screening recommendation (Advise)—one that both describes the patient’s eligibility for screening (Assess) and provides verbal help regarding how to obtain screening (Assist)—may lead to improved adherence to CRC screening.
47
Zhang, Cindy Y., Diane M. Cole, Marci G. Adams, and Richard K. Silver. "Does Physician Gender Impact the Clinical Productivity and Salaries of Obstetrician-Gynecologists?" Current Women s Health Reviews 15, no. 3 (April 1, 2019): 223–29. http://dx.doi.org/10.2174/1573404814666181015123650.
Full textAbstract:
Background: Male medical student interest in the field of obstetrics-gynecology has significantly decreased in the last three decades. A perceived patient preference for female obstetrician- gynecologists (Ob-Gyn) and subsequent gender differences in clinical productivity and compensation may influence this trend. Objective: To explore how provider gender affects clinical productivity and salary among obstetrics- gynecology generalists. Methods: An analysis of productivity and salary data for generalist Ob-Gyns employed by an academic integrated health system was performed. Gross charges, net collections, physician payroll information, work relative value units (wRVUs), new and existing patient encounter volumes and clinical full-time equivalent (FTE) status were compared year over year by physician gender using a repeated measures ANOVA test. Results: On average, male providers earned a numerically higher salary in each year studied, but when the entire timeframe was evaluated, there was no significant difference in salary nor total productivity between women and men (p=0.19 and 0.15, respectively). There was a gender difference in how total productivity was achieved, with women seeing twice as many new patients (p= 0.0025), and men achieving higher average wRVUs per patient encounter (p=0.02). Conclusions: There was no significant difference in total productivity and there was no significant difference in salaries between male and female Ob-Gyns. However, there were differences in the type of care that contributed to productivity by gender. Female providers saw a higher proportion of new patient encounters, while male providers accrued a higher wRVU per encounter, likely as a result of higher procedure volumes. These findings are an encouraging sign that men are not disadvantaged in terms of productivity in obstetrics-gynecology and that compensation models such as the one in this system can promote fair payment in mixed-gender physician groups.</P>
48
Owens, Brian. "Work–life advantages of becoming a salaried physician may be oversold." Canadian Medical Association Journal 191, no. 4 (January 27, 2019): E113—E114. http://dx.doi.org/10.1503/cmaj.109-5699.
Full text
49
Mirica Dumitrescu, Catalina-Oana. "Professional career management and personal development for the employees of the Romanian medical system." Proceedings of the International Conference on Business Excellence 11, no. 1 (July 1, 2017): 390–97. http://dx.doi.org/10.1515/picbe-2017-0042.
Full textAbstract:
Abstract The purpose of this article is to inform as many persons as possible on the present situation of doctors in Romania, to present more theoretical and practical elements that lead to the development of a sustainable career in the Romanian medical system. So I tried to get as much information about the current situation of the medical system, to obtain a certain confirmation of what was said by those working in the system. Gradually, I found out about the hospital problems, the insufficient budget allocated annually by the mismanagement, media campaigns of doctor denigration, the increasingly precarious health conditions of Romanians, the colossal businesses of the pharmaceutical industry, the heavily discussed and postponed Health Law, that managed to pull a lot of people in the street, and many other items that are not only intended to sound an alarm regarding the condition of medical workers in Romania. Besides the researches and the relationships on the medical education status, the situation of available positions, the distribution of doctors, their salaries, the legal and ethical operating framework, I undertook also a study among physicians (especially those being at their early career) to find out the elements that led them to choose this career and what is the current situation of medical career in Romania. For this, I chose questions that reflect the doctors’ satisfaction at workplace and how performance is influenced by the satisfaction level obtained from the medical services provided in the Romanian healthcare facilities. The study had both expected results, already knowing the current situation, but also unexpected, given the expectations of doctors. In more detail, there is a large number of young doctors that before thinking about work at a prestigious hospital abroad, think to what extent the current workplace in Romania offers support for family, pension, holidays etc. Thus, we considered appropriate to bring up within the paper the current possibilities for personal development, the personal brand in various mediums of communication. This paper could be a viable support to provide the necessary elements in creating an upward career path for young doctors. This paper aims primarily to present a current situation of the medical system, more statistical data (unfortunately, statistics regarding the Romanian medical system are not very up to date, most information relates to the year 2007-2009 - 2010), but also the Romanian situation seen from outside or media. The situation is far from being optimistic, the presented data are clear signals of alarm on the present status, but we hope that in the end, this paper has managed to arouse the interest of Romanian doctors with potential on the possibilities and opportunities for a career development in the homeland.
50
Schroeder, Brett, Jerome Graber, and Emmanuel Cuevas. "NCOG-75. ESTIMATED PHYSICIAN COST OF A NEURO-ONCOLOGY MULTIDISCIPLINARY TEAM (MDT) TUMOR BOARD MEETING AT A SINGLE ACADEMIC CENTER." Neuro-Oncology 22, Supplement_2 (November 2020): ii146. http://dx.doi.org/10.1093/neuonc/noaa215.612.
Full textAbstract:
Abstract BACKGROUND Multidisciplinary teams (MDTs) to improve coordination across disciplines have become commonplace in oncology. Quantifying the impact of MDTs is challenging, and they carry significant costs. Weekly neuro-oncology tumor boards are attended by neuro-oncologists, neurosurgeons, radiation-oncologists, neuro-radiologists, neuro-pathologists, and support staff including mid-level practitioners, research coordinators, social workers, nurses and trainees. Our aim was to estimate costs associated with neuro-oncology MDTs. METHODS The estimated physician cost of MDT meetings were calculated from reported salaries of each physician specialty. Annual salaries from the Doximity 2019 Physician Compensation Report (PCR) included data for 4 neurosurgeons, 4 radiation-oncologists, 2 radiologists, 2 oncologists, and 2 neurologists. Medscape 2019 PCR data was compiled for 4 general surgeons, 2 radiologists, 2 oncologists, 2 pathologists, and 2 neurologists. The Physician Wages Across Specialties by Leigh in 2011 (JAMA) was utilized for 4 neurosurgeons, 4 radiation oncologists, 2 oncologists, and 2 neurologists. Annual salary data was divided by annual hours per specialty as reported by the Annual Work Hours Across Specialties, 2011. These values were then applied to an MDT for one patient, one hour, weekly, and annually. RESULTS The Doximity 2019 PCR yielded a per meeting cost of $2,520.84, and an annual cost of $131,083.68. The Medscape 2019 PCR produced a cost of $1,570.60 weekly, and $81,671.20 annually. JAMA data estimated a per meeting cost of $1,448.06, and $75.299.12. The mean per meeting and annual costs were $1846.50, and $96,018.00, respectively. With 6-10 cases per MDT, the mean costs per patient were $184.65 to $307.75. CONCLUSIONS Costs of MDT are not negligible. The impact of MDTs on patient outcomes are harder to quantify, but evidence exists that organized MDTs improve patient prognosis, and unorganized MDTs may negatively affect prognosis. Processes to streamline MDTs could help answer outcomes research questions, improve efficiency, and generate clinically relevant performance metrics.