Gap In Medicine Research Articles

The Person's Care Requires a Sex and Gender Approach.

There is an urgent need to optimize pharmacology therapy with a consideration of high interindividual variability and economic costs. A sex–gender approach (which considers men, women, and people of diverse gender identities) and the assessment of differences in sex and gender promote global health, avoiding systematic errors that generate results with low validity. Care for people should consider the single individual and his or her past and present life experiences, as well as his or her relationship with care providers. Therefore, intersectoral and interdisciplinary studies are urgently required. It is desirable to create teams made up of men and women to meet the needs of both. Finally, it is also necessary to build an alliance among regulatory and ethic authorities, statistics, informatics, the healthcare system and providers, researchers, the pharmaceutical and diagnostic industries, decision makers, and patients to overcome the gender gap in medicine and to take real care of a person in an appropriate manner.

Advancing leadership in medical radiation sciences: Incorporating systematic leadership education in pre-registration curricula

Advancing leadership in medical radiation sciences: Incorporating systematic leadership education in pre-registration curricula

Women in healthcare

British Journal of Healthcare AssistantsVol. 15, No. 9 Not so equal | Editor's PageWomen in healthcareBradley PeterBradley PeterSearch for more papers by this authorBradley PeterPublished Online:18 Oct 2021https://doi.org/10.12968/bjha.2021.15.9.421AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Dacre J, Woodhams C. Mend the gap: the independent review into the gender pay gap in medicine. 2020. https://tinyurl.com/4hk9m543 (accessed 7 October 2021) Google ScholarMansey K, Powell M. Royal College of Nursing secretly paid former boss a £135,000 payoff after she was investigated over her links to Prince Charles’ donor George Farha. Mail on Sunday. 18 September 2021. https://tinyurl.com/r5j3xrtn (accessed 7 October 2021) Google ScholarNHS Employers. Gender in the NHS infographic. 2019. https://tinyurl.com/ydcxsb67 (accessed 7 October 2021) Google Scholar FiguresReferencesRelatedDetails 2 October 2021Volume 15Issue 9ISSN (print): 1753-1586ISSN (online): 2052-4420 Metrics History Published online 18 October 2021 Published in print 2 October 2021 Information© MA Healthcare LimitedPDF download

THE GENDER PAY GAP IN NON-PROCEDURAL CARDIOLOGY - EVIDENCE FROM A POPULATION-BASED STUDY

<h3>BACKGROUND</h3> The gender pay gap in medicine is well documented. Frequently cited drivers of gender-based billings disparities are women entering lower-remunerated specialties and fewer hours worked. To date, there has not been a population-based analysis of the gender pay gap and gender-based practice differences in a highly remunerated specialty like cardiology in a fee-for-service system (FFS). Our objectives were to assess differences in billings, practice patterns, and patient outcomes between male and female non-procedural cardiologists in a FFS system. <h3>METHODS AND RESULTS</h3> We used linked population-based administrative health databases to conduct a retrospective cohort study of cardiologists practicing in Ontario, Canada between April 2011 and March 2016. All cardiologists submitting outpatient claims during the study period were included, with cardiologists practicing interventional cardiology or electrophysiology being excluded. Outpatients of study cardiologists were identified and followed as a patient cohort. Our primary outcome was overall annual physician billings. We assessed practice patterns by identifying days worked and volumes billed for outpatient visits, inpatient visits, and diagnostic test interpretation. Patient outcomes included healthcare utilization, all-cause mortality, all-cause hospital admission, and emergency department visit or hospitalization for cardiovascular cause. We developed multivariable regression models to estimate the effect of gender on billings and each patient outcome. We identified 394 cardiologists, of whom 20% were women. The patient cohort included 818,122 patients. Unadjusted annual billings were significantly higher among male cardiologists than female ($769,371 vs. $515,997 p < 0.0001). Men billed more annual outpatient visits (1,808 vs. 1,169, p < 0.0001) and outpatient visits per day (11 patients per day vs. 9, p = 0.0004) than women. Male cardiologists billed more days for diagnostic test interpretation than women (for echocardiograms, 172 vs. 146, p = 0.016) though the numbers of echocardiograms billed per day were similar. Billings were significantly associated with outpatient practice size and echocardiogram reading, but not cardiologist gender after adjustment for patient and provider factors. There were no differences by cardiologist gender for patient outcomes after adjustment for cardiologist and patient factors. <h3>CONCLUSION</h3> Our results demonstrate substantial gender-based billings disparity, which may be driven by practice styles in terms of days worked and patients seen per day in outpatient cardiology and diagnostic test interpretation. Our findings contribute to the growing body of evidence on the gender pay gap in medicine, as well as discussion of the equity of FFS remuneration. Further research is needed to understand what drives these differences in practice choices.

Narrowing the mindware gap in medicine.

Medical error is now recognized as one of the leading causes of death in the United States. Of the medical errors, diagnostic failure appears to be the dominant contributor, failing in a significant number of cases, and associated with a high degree of morbidity and mortality. One of the significant contributors to diagnostic failure is the cognitive performance of the provider, how they think and decide about the process of diagnosis. This thinking deficit in clinical reasoning, referred to as a mindware gap, deserves the attention of medical educators. A variety ofspecific approaches are outlined here that have the potential to close the gap.

The gender pay gap in medicine: A systematic review.

Women are becoming doctors in greater numbers. Despite this, there is evidence of female doctors' continued differential treatment compared to their male counterparts. The aim of this study was to review systematically the extant literature on the gender-based pay gap in medicine across time, different medical specialties, and different countries of clinical practice. Systematic search of three databases using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies needed to be empirical and contain either an unadjusted or adjusted gender-based finding related to pay. A total of 46 articles published since 2000 contained a gender-based finding related to physician pay. Thirty-two of these 46 articles presented either adjusted or unadjusted means comparisons (or both) comparing pay between male and female physicians. Eighteen of the 46 articles controlled for one or more variables in examining pay between the two groups. Across almost all studies, female doctors earn significantly less than men, often tens of thousands of dollars less annually, despite similar demographic and work-related profiles. This earnings gap is persistent across time, medical specialty, and country of practice. The gender-based pay gap is an ongoing crisis within medicine that must be addressed. From a practice perspective, women physicians may benefit from greater organizational awareness of potential workplace bias and the implementation of more supportive policies aimed at better equalizing compensation through greater support and transparency related to salary negotiations, promotional opportunities, and pay scales across various job titles.

Gender Disparity in 2013-2018 Industry Payments to Plastic Surgeons.

The gender pay gap in medicine has been under intense scrutiny in recent years; female plastic surgeons reportedly earn 11% less than their male peers. "Hidden" pay in the form of industry-based transfers exposes compensation disparity not captured by traditional wage-gap estimations. The aim of this study was to reveal the sex distribution of industry payments to board-certified plastic surgeons across all years covered by the Center for Medicare and Medicaid Services Open Payment Database (CMS OPD). We obtained the National Provider Identifier (NPI) for each surgeon in the American Society of Plastic Surgeons (ASPS) member directory to record gender. Next, "General Payments" data points from annual files for all years present in the CMS OPD, 2013 to 2018, were aggregated and joined to provider details by Physician Profile ID before quantitative analysis was performed. Of 4840 ASPS surgeons, 3864 (79.8%) reporting ≥1 industry payment were included with 3220 male (83.3%) and 644 female (16.7%). Over 2013 to 2018, females received mean [standard deviation] 56.01 [2.51] payments totaling $11,530.67 [$1461.45] each vs 65.70 [1.80] payments totaling $25,469.05 [$5412.60] for males. The yearly ratio of male-to-female payments in dollars was 2.36 in 2013, 2.69 in 2014, 2.53 in 2015, 2.31 in 2016, 1.72 in 2017, and most recently 1.96 in 2018. Individual male plastic surgeons received over twice the payment dollars given to their female counterparts, accepting both more frequent and higher-value transfers from industry partners. Payment inequity slightly declined in recent years, which may indicate shifting industry engagement gender preferences.

Pay gaps in medicine and the impact of COVID-19 on doctors' careers

Gender equality and the gender pay gap in medicine have been long-standing problems globally.1 Concerns about a large gender pay gap in medicine prompted the Department of Health and Social Care in England to commission an independent review, Mend the Gap: the Independent Review into Gender Pay Gaps in Medicine in England,2 that has now been published and which we led. This review shows that the total medical gender pay gap in England is 24·4% for hospital doctors, 33·5% for general practitioners, and 21·4% for clinical academics.

Trends in Race/Ethnicity Among Applicants and Matriculants to US Surgical Specialties, 2010-2018

Surgical programs across the US continue to promote and invest in initiatives aimed at improving racial/ethnic diversity, but whether this translates to changes in the percentage of applicants or matriculants from racial/ethnic minority groups remains unclear. To examine trends in the percentage of applicants and matriculants to US surgical specialties who identified as part of a racial/ethnic group underrepresented in medicine from the 2010-2011 to 2018-2019 academic years. This cross-sectional study examined trends in self-reported racial/ethnic identity among applicants and matriculants to US residency programs to evaluate demographic changes among surgical programs from 2010 to 2018. Data were obtained from the Association of American Medical Colleges. The study population consisted of a total of 737 034 applicants and 265 365 matriculants to US residency programs, including 134 158 applicants and 41 347 matriculants to surgical programs. A total of 21 369 applicants (15.9%) and 5704 matriculants (13.8%) to surgical specialties identified as underrepresented in medicine. There was no statistically significant difference in the percentage of applicants underrepresented in medicine based on race/ethnicity for all surgical specialties combined in 2010 vs 2018 (15.3% [95% CI, 14.7%-15.9%] vs 17.5% [95% CI, 16.9%-18.1%]; P = .63). Thoracic surgery was the only surgical specialty in which there was a statistically significant change in the percentage of applicants (8.1% [95% CI, 4.9%-13.2%] vs 14.6% [95% CI, 10.2%-20.4%]; P = .02) or matriculants (0% [95% CI, 0%-19.4%] vs 10.0% [95% CI, 4.0%-23.1%]; P = .01) underrepresented in medicine based on race/ethnicity. Obstetrics and gynecology had the highest mean percentage of applicants (20.2%; 95% CI, 19.4%-20.8%) and matriculants (19.0%; 95% CI, 18.2%-19.8%) underrepresented in medicine among surgical specialties. Thoracic surgery had the lowest mean percentage of applicants (12.5%; 95% CI, 9.46%-15.4%) and otolaryngology the lowest mean percentage of matriculants (8.5%; 95% CI, 7.2%-9.9%) underrepresented in medicine. In this cross-sectional study, overall US surgical programs had no change in the percentage of applicants or matriculants who self-identified as underrepresented in medicine based on race/ethnicity, but the proportion remained higher than in nonsurgical specialties. Reevaluation of current strategies aimed at increasing racial/ethnic representation appear to be necessary to help close the existing gap in medicine and recruit a more racially/ethnically diverse surgical workforce.

Gender Differences in Cardiothoracic Surgery Interest Among General Surgery Applicants

Although the overall gender gap in medicine is narrowing, significant gender disparities remain in the cardiothoracic surgery (CTS) field; women represent only 7% of practicing surgeons and 20% of residents. The purpose of this study was to identify gender differences in CTS exposure and interest among fourth year medical students applying to general surgery residency. An anonymous survey was emailed to general surgery residency applicants at a major academic program for the 2019 and 2020 application cycles. Data were stratified by gender and analyzed using the χ2 and t tests. Of the 303 responders to the survey, 44% were women. A total of 58% of women were unlikely to be interested in or were definitely not interested in pursuing a career in CTS compared with 35% of men (P < .05). Men were 2.5 times more likely than women to be interested in CTS (odds ratio, 2.5; 95% confidence interval, 1.5 to 4.1). More men had rotated through CTS (55% vs 44%; P= .04) and shadowed a cardiothoracic surgeon (41% vs 29%; P= .03). More than 30% of women interested in CTS reported mentorship as the most important factor in their decision. Mentorship and CTS rotations were both independently associated with CTS interest after adjusting for gender. Interest in CTS is disappointingly low among women and represents a troublesome disparity that must be addressed. Early exposure to CTS and more mentorship from cardiothoracic surgeons are critical to reverse the current trend. Further studies are necessary to determine factors limiting female exposure to CTS rotations and dissuading female applicants from pursuing careers in CTS.

The Gender Pay Gap in Medicine: A Systematic Review

Women are becoming doctors in greater numbers. Despite this, there is evidence of women doctors’ continued differential treatment compared to their male counterparts. This study’s aim was to review systematically the extant literature on the gender-based pay gap in medicine across time, different medical specialties, and different countries of clinical practice. A systematic search was performed of three databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of 46 articles published since 2000 contained a gender-based finding related to physician pay. Thirty-two of these 46 articles presented either adjusted or unadjusted means comparisons (or both) comparing pay between male and female physicians. Eighteen of the 46 articles controlled for one or more variables in examining pay between the two groups. Across almost all studies women doctors earn significantly less than men, often tens of thousands of dollars less annually, despite similar demographic and work-related profiles. This earnings gap is persistent across time, medical specialty, and country of practice. The gender-based pay gap is an ongoing crisis within medicine that must be addressed. Future research should focus on understanding better the specific factors that drive this gap, and include more international and longitudinal studies.

Abstract D065: Investigating the Interplay of monocytes in the tumor microenvironment of glioblastomas

Abstract We are members of INDUCER- Increasing Diversity in Undergraduate Cancer Biology Education &amp; Research. Our program strives to give opportunities to experience cancer research to underrepresented students interested in the biomedical sciences. We want to help bridge the gap in medicine between Caucasians and People of Color and combat racial disparity. We utilize the GL261 cell line in the murine model to study and understand glioblastomas and their tumor microenvironment, which includes microglia and macrophages. Microglia function as macrophages of the central nervous system, play a critical role in the innate and adaptive responses to pathogens and can take on a pro-inflammatory/anti-tumorigenic (M1) or anti-inflammatory/pro-tumorigenic (M2) phenotype. Our research introduces Colony Stimulating Factor 1 Receptor (CSF1R), which is expressed by both microglia and macrophages, whose signaling is critical for their proliferation and survival. Pexidartinib is a CSF1R inhibitor drug developed by Plexxikon Inc (PLX), a pharmaceutical company. They have generated PLX3397 and PLX5622. Each drug inhibits specific kinases, for example, PLX3397 inhibits c-KIT, CSF1R, and FLT3, which are key players in tumor proliferation, while PLX5622 is a specific inhibitor that only targets CSF1R signaling. Both PLX3397 and PLX5622, provided to mice in their chow, ablate microglia in the CNS of wild type mice, without affecting peripheral macrophages. Upon discontinuation of the diet, microglia repopulate the CNS. PLX73086 is a second generation CSF1R inhibitor, and little is known about its effects on microglia and macrophages. What is known is that it should only ablate macrophages in the periphery, not affecting the CNS because it is not expected to cross the Blood Brain Barrier. Upon the discontinuation of the diet, repopulation is similarly expected. In our research, we studied the effects of PLX73086 on macrophages and microglia of the murine glioma model, after being fed the diet for 7 days and 7 days off the diet. We compared the extent of ablation and repopulation of the tissue. Citation Format: Maryam Tayyab, Maame Gyamfi, Michael Caponegro, Dr. Styliani-Anna (Stella) Tsirka. Investigating the Interplay of monocytes in the tumor microenvironment of glioblastomas [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D065.

Bridging the Gap Between Ethical Theory and Practice in Medicine: A Constructivist Grounded Theory Study.

Physicians try hard to alleviate mental and physical ailments of their patients. Thus, they are heavily burdened by observing ethics and staying well-informed while improving health of their patients. A major ethical concern or dilemma in medication is that some physicians know their behavior is unethical, yet act against their moral compass. This study develops models of theory-practice gap, offering optimal solutions for the gap. These solutions would enhance self-motivation or remove external obstacles to stimulate ethical practices in medicine. The Constructivist Grounded Theory Methodology is applied here where the participants and the main researcher mutually interacted with each other. Data collection was performed through qualitative methods including observation and semi-structured interviews with 21 physicians and medical students. Initial and focused coding was done, from which principal concepts were later extracted. MAXQDA software was used for analyzing data. Analysis of twelve major concepts in the study resulted in two factors and solution groups, from which four general notions influencing the ethical theory and practice gap in medicine were extracted: (1) providing effective education to change attitude and behavior; (2) considering motivational and emotional factors; (3) reconstructing regulations and processes to facilitate ethical practice; (4) conducting comprehensive and systematic studies. The existing medical educational system needs to be reconsidered to add to individual internal motivation, including optimizing persuasion strategies, maximizing participation of students, adhering to virtuous ethical theories, and fostering emotions. Additionally, regulations and processes can be reconstructed to remove practical obstacles and promote ethical practice with insignificant damages to individual self-motivation.

Trends in gender composition on editorial boards in leading medicine, nursing, and pharmacy journals

ObjectiveTo investigate the proportions and trends in gender ratios of journal editorial boards in medicine, nursing, and pharmacy from 1995 to 2016. DesignThis was a pooled cross-sectional evaluation of 21 high-impact medical, nursing, and pharmacy journals. Setting and participantsThe gender composition of editorial boards for each discipline was obtained. Gender expression was based on the person’s name or other information available on the Internet. Outcome measuresThe proportion of all editorial board member positions, including editorial leadership positions, occupied by the underrepresented gender, and trends over time were measured. ResultsA total of 5309 editorial board members and 312 editorial leadership positions were identified. From 1995 to 2016, women remained underrepresented across medicine and pharmacy journal editorial boards, whereas men remained underrepresented across nursing journal editorial boards. However, there were statistically significant increases in the representation of the underrepresented gender on editorial boards across all disciplines. Medicine was the only discipline to experience a statistically significant increase in the underrepresented gender of the editorial board being appointed to a leadership position; the proportion of women increased from 3% in 1995 to 35% in 2016. ConclusionThe gender gap in medicine and pharmacy journals appears to be narrowing. Although men continue to lag behind women in nursing journals, they are and have been overrepresented when considering the proportion of men practicing in the field. Overall, continued efforts are needed to resolve gender inequities in academic health sciences.

Striving for balance: A review of female dermatologists’ perspective on managing a dual-career household,

As the gender gap in medicine continues to close, female dermatologists are striving to balance the competing demands of career ambitions and family responsibilities. Despite gaining a new sense of autonomy and personal fulfillment, working women report feelings of guilt, frustration, and exhaustion as they struggle to be a good doctor, partner, mother, family member, and friend. The presence of children in the household and the asymmetrical division of labor have been reported as main stressors for women in dual-career families. Finding time for self-care and maintaining a robust support system are effective strategies to mitigate these challenges.In this study, we performed a literature review to evaluate the internal and external pressures among working women in dual-career families. In addition, we provide the personal commentary of Sara Samimi and Karolyn A. Wanat, two female dermatologists living in dual-career families, to gain further insight into the difficulties of balancing personal and professional responsibilities.

From #MeToo to #TimesUp in health care: can a culture of accountability end inequity and harassment?

From #MeToo to #TimesUp in health care: can a culture of accountability end inequity and harassment?

Government to launch review of gender pay gap in medicine

The government will commission an independent review on how the gender pay gap can be eliminated in medicine, the secretary of state for health has said. Speaking in the House of …

Patient-Centered Outcomes Research: Early Evidence From A Burgeoning Field.

Patient-Centered Outcomes Research: Early Evidence From A Burgeoning Field.

Gender gap in medicine: only one woman councilor in the Japan Surgical Society.

Japan ranks low in the global gender gap index. Academic promotion is difficult for women doctors, and the leaky pipeline of women doctors is evident in academic medicine. The Japan Surgical Society (JSS) has 2,874 (7.2% of total membership) female members as of April 2014. The total number of councilors in JSS has increased, but there is still only one female member on the Council. The fact that there are so few women in decision-making positions makes it challenging to fight for equality. The Japanese Association of Medical Science (JAMS) is an association with exclusive institutional membership comprising the major medical societies in Japan, and currently has a membership of 122 specialist medical societies. It is essential to have at least one female committee member in each committee of the JAMS, which would provide opportunities to establish career paths for women doctors, to make rules that suit the lifestyle of women doctors, and to improve work-life balance.

The Privilege Gap in Medicine

The Privilege Gap in Medicine