Physician Profiling Research Articles

Gender and personalized profile information influence online ratings of Canadian academic ophthalmologists

ObjectiveTo determine the characteristics associated with higher online ratings of academic ophthalmologists in Canada. DesignRetrospective cross-sectional study. MethodsAll ophthalmologists affiliated with Canadian ophthalmology departments were queried in March 2023 using WebMDs. Online ratings and physician profile details were extracted and descriptively analyzed using nonparametric tests with significance at p < 0.05. Subgroup analysis was conducted using ≥ 4-star rated profiles. ResultsEight hundred and ninety-nine department faculty from 15 institutions were considered, and 660 ophthalmologists with active, rated profiles were included. A total of 27,823 online ratings with a median of 4.14 stars (out of 5) were observed. Most profiles were of men (74.1%). Women received lower overall ratings compared to men (median = 4.08 vs. 4.20; p = 0.021), and lower number of reviews (median = 23 vs. 34; p < 0.001). Most profiles included office addresses (87.9%), private practice affiliation (79.8%), and contact information (51.1%). There was a positive correlations between higher ratings and profiles that included biographies (rho = 0.13; p = 0.001), languages spoken (rho = 0.15; p < 0.001), educational background (rho = 0.13; p < 0.001), areas of expertise (rho = 0.10; p = 0.010), awards (rho = 0.12; p = 0.002), and among physicians indicating they accept new patients (rho = 0.15; p < 0.001) and accommodate virtual visits (rho = 0.09; p = 0.020). ConclusionsCanadian ophthalmologists having certain personal information on their online profiles tended to have higher ratings, despite weak associations, possibly due to wider public outreach. Women had fewer and lower overall ratings compared to men. Further research about online ratings’ influence on physician selection and physician career satisfaction is needed.

Attitudes among physicians towards transgender and gender diverse people in Turkey: Relationship with religiousness, political view and conservatism.

According to several recent studies, physicians in various medical branches have some differences in attitudes towards transgender and gender-diverse (TGD) persons based on religious or political beliefs. Our study aims to uncover the attitudes of the general physician community in Turkey, which has a youthful profile, regarding TGD individuals. The attitudes towards transgender individuals scale (ATTI) and the general conservatism scale, along with a form that asks about socio-demographic factors, political beliefs, and level of religion, were administered online to physicians. The ATTI score of physicians (mean=77.8) is favourable and did not vary among branches. Being female, being close to TGD, having left-wing views, low conservatism and low religious belief scores were associated with positive attitudes towards TGD individuals. The physician profile's moderate religious belief and left-wing views can be interpreted as a country-specific dynamic and did not prevent the approach from being positive. Despite physicians' positive attitude towards TGD individuals on a professional level, there is resistance to contacting them in their daily lives. The possibility of the partial contribution of socially desirable response behaviour to positive scores should not be ignored.

Identity and access: Gender-based preferences and physician availability in primary care

Patient preferences for physicians may be influenced by shared characteristics such as gender. We analyzed experimental data from a survey of US adults in which respondents were asked to choose between physician profiles that on average varied only by gender. We find that female patients prefer female physicians to male physicians by 51.8 percentage points (95 % CI: 0.470 to 0.566, p < 0.01), and that result holds across Black, White, and Hispanic sub-groups. With no countervailing preference among male patients, this result holds in the overall sample at 26.8 percentage points (95 % CI: 0.228 to 0.307, p < 0.01). We also analyzed data from a simulated patient field experiment concerning access to primary care appointments and find that female physicians, on average, offer appointments 7.1 days later than male physicians (95 % CI: 5.1 to 9.1, p < 0.01), consistent with the finding that female physicians are preferred. Female physicians’ offices appear to favor female patients, offering appointments to them 2.6 days earlier compared to male patients (95 % CI: -5.3 to 0.195, p = 0.07). However, Hispanic female patients were offered 4.2-percentage-points fewer appointments compared to Hispanic males (95 % CI: -0.069 to -0.014, p < 0.01) by female physicians’ offices. Similarly, Black female patients were told that the physician is “not taking new patients” 3.5 percentage points more often (95 % CI: -0.004 to 0.073, p = 0.08) and were offered appointments that were 2.6 minutes shorter compared to Black males (95 % CI: -4.8 to -0.44, p = 0.02). Overall, our analysis suggests that female primary care physicians are in high demand relative to their supply, and that access to scarce female physicians is mediated by race and ethnicity.

Industry payments and implicit bias in cardiothoracic surgery: Difference in industry payments to cardiothoracic surgeons by gender

ObjectiveIndustry payments, as sources of revenue and prestige, may contribute to gender implicit bias. We examined industry payments to cardiothoracic surgeons to determine differences with respect to gender while accounting for practice focus and experience. MethodsPayments to cardiothoracic surgeons from 2014, 2016, 2018, 2020, and 2022 were abstracted from the Centers for Medicare and Medicaid Services Open Payment database. Data were restricted to individual payments >$1000 and the following payment criteria: consulting fees, compensation for services other than consulting, honoraria, education, compensation for serving as faculty or as a speaker for a nonaccredited and noncertified continuing education program, and grant. Physician profiles were queried for gender, practice type, and year of last fellowship completion. Descriptive statistics were reported based on these factors. ResultsIn 2014, 509 cardiothoracic surgeons (497 men and 12 women) received meaningful industry payments. Male surgeons received $10,471,192 (99.3%) with median payment of $6500 and mean of $21,069, whereas women received $70,310 (0.7%) with median of $3500 and mean of $5859. In 2022, 674 cardiothoracic surgeons (613 men and 61 women) received industry payments, with men receiving $10,967,855 (92.4%) with a median payment of $6611 and mean of $17,892 and women receiving $905,431 (7.6%) with a median payment of $6000 and mean of $14,843. ConclusionsIndustry payments to women increased from 2014 to 2022 as the proportion of women in practice rose. Industry support of women, with increases in compensation and roles as speakers, consultants, and educators, offers a potential strategy to combat implicit bias within cardiothoracic surgery.

The Impact of American Board of Urology Certification on Postoperative Outcomes for Patients in New York State.

Our goal was to determine if board certification status was associated with improved postoperative outcomes for certain urologic oncology operations. We performed a retrospective cohort study of patients aged 65 and over having radical prostatectomy (RP), radical cystectomy (RC), and radical or partial nephrectomy (RPN) by surgeons with New York State licenses from 2015 to 2021 using the Medicare limited dataset. Our primary exposure was surgeon American Board of Urology certification determined by the New York State Physician Profile. All surgeons were in practice for at least 5 years. Our primary outcomes were 90-day mortality, 30-day unplanned readmission, and hospital length of stay (LOS). We used multivariable linear and logistic regression adjusted for surgeon, hospital, and patient characteristics. We performed the analysis in R, and 2-sided P values < .05 were considered statistically significant. We identified 12,601 patients who had a procedure performed. At the time of the procedure, a minority of procedures (1.3%) were performed by nonboard-certified (NBC) urologists. Among the patient cohort, there were 262 and 1419 mortality and readmission events, respectively; median LOS was 2 days (interquartile range 1155). Patients operated on by NBC urologists tended to have lower-volume surgeons who were less likely to be fellowship trained and to have surgery at smaller hospitals. Patients treated by NBC urologists were more likely to have RP, and less likely to have RC and RPN. On multivariate analysis, board certification was protective against readmission for RP (P < .001) and RC (P = .02), longer LOS for RC (P = .001), and mortality for RPN (P = .008). Urology board certification was associated with fewer readmissions after RP and RC, a shorter LOS after RC, and a lower risk of mortality after RPN. Given low event numbers, these findings require validation with a larger dataset.

Quality of bladder cancer treatment information on YouTube: May the user's profile affect the quality of results?

Social media are widely used information tools, including the medical/health field. Unfortunately, the levels of misinformation on these platforms seem to be high, with a medium-low quality of the proposed content, as evidenced by previous studies. You Tube is one of the most important platforms for audio/video content. It shows content to users through a recommendation algorithm system. We have classified in two cohorts the first results obtained by researching "bladder tumor treatment" on You Tube through two different user profiles: "Cohort A" with a not logged-in session in incognito mode (46 videos enrolled) and "Cohort B" with a logged-in session with a physician profile (50 videos enrolled). The videos were evaluated using validated instruments such as DISCERN and PEMAT-AV Furthermore, we used a Likert's scale for the evaluation of levels of misinformation. Overall quality of information was moderate to poor (DISCERN 3) in 54% of cohort A and 24% of cohort B. Moreover, a high degree of misinformation (Likert score 3) was found in 52% of cohort A cases and 32% of cohort B. Levels of misinformation in both cohorts are positively correlated to the number of views per month. Globally, the levels of information quality, understandability and actionability are lower for the results obtained from searches performed with anonymous user profile (Cohort A).

Representation of the hierarchical and functional structure of an ambulatory network of medical consultations through Social Network Analysis, with an emphasis on the role of medical specialties.

Ambulatory Health Care Networks (Amb-HCN) are circuits of patient referral and counter-referral that emerge, explicitly or spontaneously, between doctors who provide care in their offices. Finding a meaningful analytical representation for the organic and hierarchical functioning of an Amb-HCN may have managerial and health policymaking implications. We aimed to characterize the structural and functional topology of an Amb-HCN of a private health insurance provider (PHIP) using objective metrics from graph theory. This is a cross-sectional quantitative study with a secondary data analysis study design. A Social Network Analysis (SNA) was conducted using office visits performed between April 1, 2021 and May 15, 2022, retrieved from secondary administrative claim databases from a PHIP in Belo Horizonte, Southeastern Brazil. Included were beneficiaries of a healthcare plan not restricting the location or physician caring for the patient. A directional and weighted network was constructed, where doctors were the vertices and patient referrals between doctors, within 7-45 days, were the network edges. Vertex-level SNA measures were calculated and grouped into three theoretical constructs: patient follow-up (aimed at assessing the doctor's pattern of patient follow-up); relationship with authorities (which assessed whether the doctor is an authority or contributes to his or her colleague's authority status); and centrality (aimed at positioning the doctor relative to the network graph). To characterize physician profiles within each dimension based on SNA metrics results, a K-means cluster analysis was conducted. The resulting physician clusters were assigned labels that sought to be representative of the observed values of the vertex metrics within the clusters. Overall, 666,263 individuals performed 3,863,222 office visits with 4,554 physicians. A total of 577 physicians (12.7%) had very low consultation productivity and contributed very little to the network (i.e., about 1.1% of all referrals made or received), being excluded from subsequent doctor profiles analysis. Cluster analysis found 951 (23.9%) doctors to be central in the graph and 1,258 (31.6%) to be peripheral; 883 (22.2%) to be authorities and 266 (6.7%) as seeking authorities; 3,684 (92.6%) mostly shared patients with colleagues, with patient follow-up intensities ranging from weak to strong. Wide profile dispersion was observed among specialties and, more interestingly, within specialties. Non-primary-care medical specialties (e.g., cardiology, endocrinology etc.) were associated with central profile in the graph, while surgical specialties predominated in the periphery, along with pediatrics. Only pediatrics was associated with strong and prevalent (i.e., low patient sharing pattern) follow-up. Many doctors from internal medicine and family medicine had unexpectedly weak and shared patient follow-up profiles. Doctor profiles exhibited pairwise relationships with each other and with the number of chronic comorbidities of the patients they treated. For example, physicians identified as authorities were frequently central and treated patients with more comorbidities. Ten medical communities were identified with clear territorial and specialty segregation. Viewing the Amb-HCN as a social network provided a topological and functional representation with potentially meaningful and actionable emerging insights into the most influential actors and specialties, functional hierarchies, factors that lead to self-constituted medical communities, and dispersion from expected patterns within medical specialties.

Family physicians and menstrual care: An analysis of CERA 2023.

Menstrual health is an important indicator of overall health and has large impacts on quality of life. Despite number and impact, discussion of menstruation remains largely taboo within health care. Patients and physicians are not engaging in regular, meaningful discussions on menstruation. Family physicians, as primary care providers, can facilitate these important conversations. We sought to understand the profile of menstrual care providing family physicians and assessed physician comfort, knowledge, training, and perceived importance regarding menstrual care. This is a cross-sectional analysis of the 2022 Council of Academic Family Medicine Educational Research Alliance survey. The survey included actively practicing US physicians who are members of the Council of Academic Family Medicine organizations. Descriptive demographic statistics were calculated; chi-square tests were generated for menstrual care-specific items; logistic regression models were fit to determine the association between receiving formal menstrual care training, importance of physician training in menstrual care, and demographic factors. Eighty-five percent of respondents report frequently providing menstrual care. Participants of younger age, or who had earned their degree more recently, were significantly more likely to provide frequent menstrual care. Respondents who earned their medical degree at an earlier year were significantly more likely to believe that physician training in menstrual care was of limited importance (OR = 1.02, 95% CI = 1.00, 1.03). Our findings show that family physicians are providing menstrual care, despite non-uniform training, and recognize its importance to patients. By understanding physician profile and the care they provide, we can work toward comprehensive physician education in menstrual care and providing appropriate menstrual care to patients.

Physician weight influences responses to a public health message about the genetics of obesity

ObjectiveMany patients prefer lean physicians to physicians with obesity and place higher credence in their weight management advice. Because genetic information about weight can be viewed as self-serving for individuals with overweight or obesity, physicians with obesity may be discounted when sharing such information. As provision of genetic information regarding weight becomes increasingly common in public health messaging, could a physician’s own weight influence how these messages are received by the public? MethodsIn an online survey, 967 participants were randomly assigned a physician profile (lean v. has obesity) with a media interview transcript discussing genetic factors of a common health condition (obesity v. osteoporosis). ResultsParticipants perceived the physician with obesity who discussed genetic factors in obesity as less trustworthy and less credible. Participants were also less likely to anticipate following her advice on weight-related issues. Participants with higher BMI had less negative perceptions of this physician. ConclusionPhysicians with obesity, when providing public health messaging regarding genetic information about obesity, may be met with distrust and negative attitudes toward the physician. Practical implicationsFuture research should investigate health communication strategies that address this form of weight stigma while accurately conveying genetic factors that contribute to weight.

European practice patterns for antiplatelet management in NSTE-ACS patients: Results from the REal-world ADoption survey focus on Acute antiPlatelet Treatment (READAPT) survey

BackgroundThe 2020 European Society of Cardiology (ESC) guidelines for the diagnosis and management of patients with non-ST elevation-acute coronary syndrome (NSTE-ACS) recommend early invasive coronary angiography in high-risk patients and no routine pre-treatment with oral P2Y12 receptor inhibitor in NSTE-ACS patients prior to defining coronary anatomy. ObjectiveTo assess the implementation of this recommendation in the real-life setting. MethodsA web-survey in 17 European countries collected physician profiles and their perceptions of the diagnosis, medical and invasive management of NSTE-ACS patients at their hospital. A sample size of at least 1100 responders permitted the estimation of proportions with a precision of at least ±3.0%. ResultsAmong the 3024 targeted participants, 1154 provided valid feedback defined as a 50% response rate of answers to the survey questions. Overall, >60% of the participants declared full implementation of the guidelines at their institution. The time delay from admission to coronary angiography and PCI was reported to be <24 h in over 75% of the hospitals while pre-treatment was intended in >50% of NSTE-ACS patients. Ad-hoc percutaneous coronary intervention (PCI) was performed in >70% of the cases while intravenous platelet inhibition was rarely used (<10%). Between countries differences in practice patterns for antiplatelet management for NSTE-ACS were observed, suggesting heterogeneous implementation of the guidelines. ConclusionsThis survey indicates that the implementation of 2020 NSTE-ACS guidelines on early invasive management and pre-treatment is heterogeneous, potentially due by local logistical constraints.

Physician profiles according to determinants of scope of practice in Brazil

Physician profiles according to determinants of scope of practice in Brazil

The Influence of Paid Memberships on Physician Rating Websites With the Example of the German Portal Jameda: Descriptive Cross-sectional Study.

The majority of Germans see a deficit in information availability for choosing a physician. An increasing number of people use physician rating websites and decide upon the information provided. In Germany, the most popular physician rating website is Jameda.de, which offers monthly paid membership plans. The platform operator states that paid memberships have no influence on the rating indicators or list placement. The goal of this study was to investigate whether a physician's membership status might be related to his or her quantitative evaluation factors and to possibly quantify these effects. Physician profiles were retrieved through the search mask on Jameda.de website. Physicians from 8 disciplines in Germany's 12 most populous cities were specified as search criteria. Data Analysis and visualization were done with Matlab. Significance testing was conducted using a single factor ANOVA test followed by a multiple comparison test (Tukey Test). For analysis, the profiles were grouped according to member status (nonpaying, Gold, and Platinum) and analyzed according to the target variables-physician rating score, individual patient's ratings, number of evaluations, recommendation quota, number of colleague recommendations, and profile views. A total of 21,837 nonpaying profiles, 2904 Gold, and 808 Platinum member profiles were acquired. Statistically significant differences were found between paying (Gold and Platinum) and nonpaying profiles in all parameters we examined. The distribution of patient reviews differed also by membership status. Paying profiles had more ratings, a better overall physician rating, a higher recommendation quota, and more colleague recommendations, and they were visited more frequently than nonpaying physicians' profiles. Statistically significant differences were found in most evaluation parameters within the paid membership packages in the sample analyzed. Paid physician profiles could be interpreted to be optimized for decision-making criteria of potential patients. With our data, it is not possible to draw any conclusions of mechanisms that alter physicians' ratings. Further research is needed to investigate the causes for the observed effects.

Differences in Financial Conflicts of Interest Among Participants in a National Spine Conference.

Retrospective Study. At the North American Spine Society (NASS) conference, participants may influence spine surgery practices and patient care through their contributions. Therefore, their financial conflicts of interest are of notable interest. This study aims to compare the demographics and payments made to participating surgeons. A list of 151 spine surgeons was created based on those who participated in the 2022 NASS conference. Demographic information was obtained from public physician profiles. General payments, research payments, associated research funding, and ownership interest were collected for each physician. Descriptive statistics and two-tailed t-tests were used. In 2021, 151 spine surgeon participants received industry payments, totaling USD 48 294 115. The top 10% of orthopedic surgeons receiving payments accounted for 58.7% of total orthopedic general value, while the top 10% of neurosurgeons accounted for 70.1%. There was no significant difference between these groups' general payment amounts. Surgeons with 21-30years of experience received the most general funding. There was no difference in funding between surgeons in academic or private settings. For all surgeons, royalties accounted for the largest percentage of the general value exchanged, while food/beverage accounted for the largest percentage of transactions. Our study found that only years of experience had a positive association with general payments, and most monetary value belonged to a small handful of surgeons. These participants receiving significant money may promote techniques requiring products of companies providing their compensation. Future conferences may require disclosure policy changes so attendees understand the degree of funding participants receive.

Self-presentation in medicine: How language patterns reflect physician impression management goals and affect perceptions

This paper evaluated how physicians' communication patterns reflect their self-presentation goals and link to patient perceptions. Specifically, in a large field study (N = 54,420 profiles from HealthGrades.com), physician self-descriptions were analyzed linguistically through automated means, with evidence suggesting those who were more self-focused and confident tended to have higher patient ratings online than those who were less self-focused and confident. Physicians who discussed their expertise and compassion for patients were also rated more favorably. A within-subjects experiment in Study 2 (N = 500) also demonstrated that linguistic self-presentation patterns can affect patient perceptions. Participants who read physician profiles with high rates of self-references and verbal confidence rated doctors as warmer and more competent than those who read physician profiles with low rates of self-references and certainty. Together, words are indicators of physicians’ self-presentation strategies and can change patient evaluations. Theoretical contributions for self-presentation and psychology of language research are discussed.

Current Trends in Subspecialty Fellowship Training for 1691 Academic Neurological Surgeons

Neurosurgical subspecialty fellowship training has become increasingly popular in recent decades. However, few studies have evaluated recent trends in postgraduate subspecialty education. This study aims to provide a detailed cross-sectional analysis of subspecialty fellowship training completion trends and demographics among U.S. academic neurosurgeons. Academic clinical faculty (M.D. or D.O.) teaching at accredited neurosurgery programs were included. Demographic, career, and fellowship data were collected from departmental physician profiles and the American Association of Neurological Surgeons (AANS) membership database. Relative citation ratio scores were retrieved using the National Institutes of Health iCite tool. This study included 1691 surgeons (1756 fellowships) from 125 institutions. The majority (79.13%) reported fellowship training. Fellowship completion was more common among recent graduates (residency year >2000), as was training in multiple subspecialties (P < 0.0001). Spine was the most popular subspecialty (16.04%), followed by pediatrics (11.18%), and cerebrovascular (9.46%). The least common were trauma/critical care (2.52%) and peripheral nerve (1.26%). Spine, neuroradiology, and endovascular subspecialties grew in popularity over time. Pediatrics and spine were the most popular for females and males, respectively. Epilepsy and cerebrovascular had the most full professors, while endovascular and spine had the most assistant professors. Stereotactic/functional and epilepsy had the most Ph.Ds. Fellowship training correlated with higher weighted, but not mean, relative citation ratio scores among associate (P= 0.002) and full professors (P= 0.005). There is an emerging proclivity for additional fellowship training among young neurosurgeons, often in multiple subspecialties. These findings are intended to help guide professional decision-making and optimize the delivery of postgraduate education.

No Sunshine for Women: Industry Payment Disparities in Vascular Surgery

Industry relationships provide opportunities for professional growth and technical innovation. This study characterized the gender disparities in financial relationships between industry and vascular surgeons. A retrospective study was performed using the Centers for Medicare and Medicaid open payments database. Data were extracted for all payments made to vascular surgeons from 2014 to 2020, with gender determined for all vascular surgeons receiving payments. The physician profile or publicly available website was used to determine gender. The payment form and amount were collected. The average payment per category, by gender, was calculated. A total of 438,367 payments were made to 5380 vascular surgeons (87% men and 13% women) from 2014 to 2020. The average payment for a male surgeon was significantly greater than that for a female surgeon ($247 ± $3693 vs $150 ± $817; P < .001). When examining the payment categories, the female surgeons received 13% of industry payments in education and 26% of industry grant payments. However, they received 0% of licensing or royalty payments, 0% of ownership, and only 3% of honoraria payments. Among the largest 15 companies, which represented >70% of payments to surgeons, men earned, on average, 2.5 times more per payment than women, with a range of 30% to 1000% more per person (Fig 1). During the study period, the average male vascular surgeon received approximately nearly three times more in industry payments than did the average female surgeon ($21,720 vs $8276). The average annual amount paid to surgeons by industry per year had decreased by 30%, from $4703 to $3279. Despite this overall decline, the relationship between payments to male and female surgeons remained constant at 2.6 to 2.8 times throughout the study period (Fig 2). Analysis of the open payments database revealed that female vascular surgeons earned less than one half as much as men from industry, with little improvement in the payment disparities over time.Fig 2View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Extracting Additional Influences From Physician Profiles With Topic Modeling: Impact on Ratings and Page Views in Online Healthcare Communities.

How physicians can get better ratings and more page views in online healthcare communities is an important issue. Based on 38,457 physicians' profiles from a popular online healthcare community in China, we used Latent Dirichlet Allocation model, which is a common topic model, to analyze the non-English text to obtain more doctor's latent characteristics. We found five of the most frequently mentioned topics. In addition to the first topic (doctor's academic rank and practice name), “research ability,” “foreign experience,” “committee position,” and “clinical experience” were included as unstructured descriptions in the doctor's profile. Inferences about physician ratings and page views could be improved if these themes were set as characteristics of physicians. Specifically, in our findings, Physicians' mentions of their “research ability” and “foreign experience” had a significant positive impact on physician ratings. Surprisingly, physicians mentioning more “clinical experience” had a significant negative impact on physician ratings. Moreover, while descriptions about “foreign experience” and “committee position” had a significant positive impact on page views, physician mentions of “research ability” had a significant negative impact on page views. These results provide new insights into the ways in which online healthcare community managers or physicians create their personal online profiles.

Industry Payments to Plastic Surgeons, 2013 to 2018: Who's Getting Paid?

The Physician Payments Sunshine Act of 2010 mandated that all industry payments to physicians be publicly disclosed. To date, industry support of plastic surgeons has not been longitudinally characterized. The authors seek to evaluate payment trends from 2013 to 2018 and characteristics across plastic surgeon recipients of industry payments. The authors cross-referenced those in the 2019 American Society of Plastic Surgeons member database with Centers for Medicare & Medicaid Services Open Payments database physician profile identification number indicating industry funds received within the study period. We categorized surgeons by years since American Board of Plastic Surgery certification, practice region, and academic affiliation. A sum of $89,436,100 (247,614 payments) was received by 3855 plastic surgeons. The top 1 percent of earners (n = 39) by dollar amount received 52 percent of industry dollars to plastic surgeons; of these, nine (23 percent) were academic. Overall, 428 surgeons (11 percent) were academic and received comparable dollar amounts from industry as their nonacademic counterparts. Neither geographic location nor years of experience were independent predictors of payments received. The majority of individual transactions were for food and beverage, whereas the majority of industry dollars were typically for royalties or license. Over half of all industry dollars transferred went to just 1 percent of American Society of Plastic Surgeons members receiving payments between 2013 and 2018. Considerable heterogeneity exists when accounting for payment subcategories.

Mapping and quantification of the twitter footprint of cardiologists.

The increasing importance placed by medical journals for dissemination of published articles on social media, such as posting Altmetric scores, has further expedited the need for differentiating bona fide science from pseudo-science. The 'Kardashian index' (a.k.a., K-index) was suggested, which correlates the citations of a scientist with his/her Twitter followers. From a list of top 100 cardiology hospitals in accordance with the most recent US News and World Report rankings, 1500 cardiologists were selected based on institutional physician profile pages complete with cardiologists' headshots. The K-index of cardiologists, and variables like all-time posts, and posts for the past 12 months (1 June 2019 to 31 May 2020) from cardiologists were documented and analysed. The K-index of cardiologists in our study was stratified into the following categories (upper boundary inclusive); K-index 0-1 (n = 104); K-index 1-2 (n = 30); K-index 2-3 (n = 24); K-index 3-4 (n = 14); K-index 4-5 (n = 5); and K-index >5 (n = 22). There was no statistically significant difference (P = 0.94) in the citation number across the K-index categories (no consistent pattern observed, median citations ranging from 237 to 610). However, cardiologists with higher K-index categories had a higher number of 12-month posts (median 14 vs. 392 for K-index categories 0-1 and >5, respectively; P-value <0.001). Considering no evidence of a difference in the number of citations across K-index categories, the stigma associated with higher K-index needs to be reconsidered.

Patient violence, physicians treatment decisions, and patient welfare: Evidence from China.

Although violence in healthcare settings has become a common occurrence worldwide, there is limited evidence on the spillover effects of patient violence on physicians' medical decisions. Utilizing microdata on inpatients from a major public hospital, we investigated how extreme patient violence-the murder of a physician in China-affected physicians' treatment decisions and patient welfare in a hospital geographically distant from the murder site. By matching this patient dataset to physician profiles, we performed a difference-in-differences analysis in which the treatment group comprised patients admitted shortly before and after the murder shock, and the control group consisted of patients admitted during the same months in the previous year. Immediately after the shock, the provision of medical treatment was notably higher, with a 16.9% increase in the number of surgeries and a 9.5% increase in the treatment expenditures. However, patient health outcomes were worse, with an increased mortality rate of 0.9% points. Findings suggest that patient violence dramatically changed physician behavior, causing negative consequences on patients even when the healthcare workers were not direct victims of patient violence.