White Male Physician Research Articles

Abdominal Transplant Surgeons: The Lack of Female Surgeons and People From Underrepresented Racial and Ethnic Minority Groups in Academic and Clinical Leadership.

The demographic disparities among surgeons in academic leadership positions is well documented. We aimed to characterize the present demographic details of abdominal transplant surgeons who have achieved academic and clinical leadership positions. We reviewed the 2022-2023 American Society of Transplant Surgeons membership registry to identify 1007 active abdominal transplant surgeons. Demographic details (academic and clinical titles) were collected and analyzed using the chi-square test, the Fisher exact test, and t tests. Multinomial logistic regressions were conducted. Female surgeons (P < .001) and surgeons from racial-ethnic minorities (P = .027) were more likely to be assistants or associates rather than full professors. White male surgeons were more likely to be full professors than were White female (P < .001), Asian female (P = .008), and Asian male surgeons (P = .005). There were no Black female surgeons who were full professors. The frequency of full professorship increased with surgeon age (P < .001). Male surgeons were more likely to hold no academic titles (P < .001). Female surgeons were less likely to be chief of transplant(P = .025), chief of livertransplant (P = .001), chief of pancreas transplant (P = .037), or chair of surgery (P = .087, significance at 10%). Chief of kidney transplant was the most common clinical position held by a surgeon from a racial or ethnic minority group. Female surgeons were more likely to hold no clinical titles (P = .001). The underrepresentation of women and people from racial and ethnic minority groups in academic and clinical leadership positions in the field of abdominal transplant surgery remains evident. White male physicians are more likely to obtain full professorship, and they comprise most of the clinical leadership positions overall. A continued push for representative leadership is needed.

Sick Time: Medicine, Management, and Slavery in Louisiana and Cuba, 1763–1868

Capitalist ideas of productivity became central to medicine under slavery. They shaped how physicians treated enslaved patients, crafted a scientific basis for medicine, and conceived of themselves as professionals. Between the late-eighteenth-century and the mid-nineteenth-century, white male physicians in Louisiana and Cuba distinguished themselves from other healers: first, by aligning with Spanish colonialism, and then, by making themselves essential to a new form of plantation management that used clock-time discipline, hierarchical divisions of labor, and complex accounting systems. These technologies helped planters track the hours and days each enslaved person spent working, eating, sleeping, birthing, suffering from sickness and injuries, and recovering. This in turn enabled precise interpretations of enslaved health in terms of productivity, which was primarily measured in work time and the number of commodities produced. Physicians, who were seeking a rigorous intellectual foundation for medical knowledge production, latched onto planter methods of calculating and controlling enslaved health. One of those methods was what planters and physicians called “sick time,” which was an allotment of time away from work intended to manage illness enough for enslaved people to return to work. However, as physicians used plantation management to cast an air of scientific accuracy over their knowledge, enslaved people reconfigured their own medical practices to make themselves less visible and countable. Fugitive practices involving trees, animals, and natural springs helped enslaved people to heal by taking their own forms of sick time.

The Impact of Patient Prejudice on Minoritized Female Physicians.

BackgroundPatient bias and prejudice directed against physicians from diverse backgrounds is a frequent occurrence in healthcare. Female physicians have long experienced discrimination in the healthcare system based on their gender alone. The dynamic known as Patient Prejudice toward Providers (PPtP) is disproportionately affecting female physicians because it is frequently compounded by sexism.AimThe goal of this study was to explore the impact of PPtP on female resident and attending physicians.MethodsUsing transcribed one-on-one interviews from a larger study of PPtP affecting resident and attending physicians, ten interviews with female physicians (resident and attending) from diverse ethnic backgrounds and countries of training at a large academic medical center were analyzed. The authors independently reviewed the interviews using an iterative process within and across interviews to inductively identify repeating words, phrases, and concepts relevant to the study aim.ResultsDemographics of the ten participants included age (mean 34.6 years), ethnicity (6 Asian, 2 Hispanic, 2 African), and country of training (10% IMG vs. 90% US trained). Four of the interviewees were residents and six were attendings. Themes that emerged from the analysis included experiencing “A Gendered Continuum of Abuse,” “Establishing a Higher Standard of Competency,” “Overcoming the Stereotype of the White Male Physician,” “The Physicality of Self Identity,” and “The Need to be Protective of Minoritized Trainees.” All participants agreed that these perceptions created an adverse environment at the workplace and impacted on patient care.ConclusionsDiscrimination of physicians based on their gender or their race/ethnicity has been reported. This study highlights the compounded effects of patient prejudice on female minoritized physicians. Organizations and individuals should identify and implement strategies to address the impact of PPtP and sexism in order to create an environment where all women can thrive professionally.

Massive adrenocortical carcinoma presenting as peripheral edema: a case report

BackgroundAdrenocortical carcinoma is a rare, but potentially lethal, malignancy that is usually detected as an incidental finding on abdominal imaging studies or owing to hormonal complications. This report recounts an unusual presentation with leg edema due to compression of the inferior vena cava. The dearth of proven effective treatment is also addressed.Case presentationA 65-year-old White male physician presented with severe, bilateral pitting edema that extended from the toes to the thighs. It progressed over several months. He also experienced paroxysmal dyspnea. Evaluation of cardiac, hepatic, and renal function failed to determine a cause. Computed tomography revealed a tumor above the right kidney, with compression of the intrahepatic inferior vena cava and upstream distension. Serum cortisol and dehydroepiandrosterone sulfate concentrations were elevated, 24-hour urinary cortisol level was elevated, and serum adrenocorticotropic hormone and testosterone concentrations were suppressed. A 27-cm tumor, the right lobe of the liver, the right kidney, and 26 lymph nodes were resected. Histological study confirmed the diagnosis of adrenocortical carcinoma. Ki67 proliferation index was 26.7% (worse prognosis associated with index > 10%). Lymph nodes were negative for malignancy, but a separate 2.7-cm tumor was found near the renal hilum. Adjuvant mitotane chemotherapy was prescribed. Serum testosterone concentration returned to normal. High-dose hydrocortisone administration was needed because of adrenal suppression and CYP 3A4 induction by mitotane.ConclusionImaging of the abdomen and pelvis should be conducted in cases of unexplained leg edema. In this case, a large adrenal cancer compressed the vena cava. Iron deficiency followed resection of the large tumor. Advanced stages of adrenocortical carcinoma are associated with poor prognosis. Mitotane chemotherapy is a standard but unproven adjuvant treatment that is associated with many complications, and its induction of hepatic CYP 3A4 enzymes necessitates adjustment of other medications.

A comparison of professional identity experiences among minoritized medical professionals

ObjectiveProfessional identity formation (PIF) is considered a fundamental process in the development of healthcare providers. In medical education, the PIF literature has historically centered on medicine's socialization practices involving white male physicians. However, recently researchers have begun to reveal how larger socio-historical contexts influence PIF in minoritized physicians. To better understand what influences Black/African American physicians’ PIF, this study compares their PIF experiences to a group of minoritized physician assistants (PAs). In comparing Black physicians’ experiences to another provider, this study explored what PIF experiences may be attributed to participants’ minoritized status and what might be attributed to the culture of medicine. MethodsIn this cross-case analysis, 45 minoritized PA students and practicing PAs were recruited from several Southeastern universities. The PA participants included 23 Black/African Americans, 12 Latinx, 4 Indigenous/Native, and 6 of mixed races/ethnicities. Interview data were then compared to previously collected data from 41 Black/African American medical trainees and physicians. Using constant comparative method, similarities and differences in PIF were explored. ResultsSimilarities between the two groups included the importance of participants’ racial/ethnic identity to patient care, experiences on-going microaggressions from patients and peers, and a desire to engage in racial uplift. However, one marked difference was found, namely that PAs felt they could bring their entire selves to the profession, whereas physicians described feeling splintered early in their training. ConclusionsSeveral possibilities that might explain why Black physicians and minoritized PAs have this one marked difference in their PIF experience, including identity threat, internalization of different discourses, and length of training for physicians. While this study was not designed to answer this question, it is clear that there is something in the culture of medicine and the training of physicians that signals to Black physicians that they cannot bring their whole selves to the profession.

Physician suicide demographics and the COVID-19 pandemic.

Objective:To identify suicide rates and how they relate to demographic factors (sex, race and ethnicity, age, location) among physicians compared to the general population when aggravated by the coronavirus disease 2019 (COVID-19) pandemic.Methods:We searched U.S. databases to report global suicide rates and proportionate mortality ratios (PMRs) among U.S. physicians (and non-physicians in health occupations) using National Occupational Mortality Surveillance (NOMS) data and using Wide-ranging Online Data for Epidemiologic Research (WONDER) in the general population. We also reviewed the effects of age, suicide methods and locations, COVID-19 considerations, and potential solutions to current challenges.Results:Between NOMS1 (1985-1998) and NOMS2 (1999-2013), the PMRs for suicide increased in White male physicians (1.77 to 2.03) and Black male physicians (2.50 to 4.24) but decreased in White female physicians (2.66 to 2.42).Conclusions:The interaction of non-modifiable risk factors, such as sex, race and ethnicity, age, education level/healthcare career, and location, require further investigation. Addressing systemic and organizational problems and personal resilience training are highly recommended, particularly during the additional strain from the COVID-19 pandemic.

Strategies to build trust with trainees who are underrepresented in medicine.

Strategies to build trust with trainees who are underrepresented in medicine.

Defeating Unconscious Bias: The Role of a Structured, Reflective, and Interactive Workshop.

Unconscious or implicit biases are universal and detrimental to health care and the learning environment but can be corrected. Historical interventions used the Implicit Association Test (IAT), which may have limitations. We determined the efficacy of an implicit bias training without using the IAT. From April 2019 to June 2020, a 90-minute educational workshop was attended by students, residents, and faculty. The curriculum included an interactive unconscious biases presentation, videoclips using vignettes to demonstrate workplace impact of unconscious biases with strategies to counter, and reflective group discussions. The evaluation included pre- and postintervention surveys. Participants were shown images of 5 individuals and recorded first impressions regarding trustworthiness and presumed profession to unmask implicit bias. Of approximately 273 participants, 181 were given the survey, of which 103 (57%) completed it with significant increases from pre- to postintervention assessments for perception scores (28.87 [SEM 0.585] vs 32.73 [0.576], P < .001) and knowledge scores (5.68 [0.191] vs 7.22 [0.157], P < .001). For a White male physician covered in tattoos, only 2% correctly identified him as a physician, and 60% felt he was untrustworthy. For a smiling Black female astronaut, only 13% correctly identified her as an astronaut. For a brooding White male serial killer, 50% found him trustworthy. An interactive unconscious bias workshop, performed without the use of an IAT, was associated with increases in perceptions and knowledge regarding implicit biases. The findings also confirmed inaccurate first impression stereotypical assumptions based on ethnicity, outward appearances, couture, and media influences.

Effect of Physician Gender and Race on Simulated Patients’ Ratings and Confidence in Their Physicians

Women and black physicians encounter workplace challenges because of their gender and race. It is unclear whether these individuals are assessed with lower patient satisfaction or confidence ratings compared with white male physicians. To examine whether physician gender and race affect participant ratings in scenarios in which physician competence is challenged. This randomized trial enrolled a geographically diverse sample of 3592 online respondents in the United States who were recruited from 2 crowdsourcing platforms: Amazon Mechanical Turk (n = 1741) and Lucid (n = 1851). A 2 × 2 factorial design for the gender and race of simulated physicians was conducted between March 9 and July 25, 2018. Participants were excluded before intervention if they were younger than 18 years, were pregnant, or had a history of cancer or abdominal surgical procedures. A clinical vignette was presented to the participant with a picture of the emergency department physician. Participants were randomly assigned to physicians with different gender and race, with 823 assigned to black women, 791 to black men, 828 to white women, and 835 to white men. A contradictory diagnosis from an online symptom checker introduced doubt about the clinical diagnosis. A composite outcome (range, 0-100, with 0 representing low patient confidence and satisfaction and 100 representing the maximum on the composite scale) measured participant (1) confidence in the physician, (2) satisfaction with care, (3) likelihood to recommend the physician, (4) trust in the physician's diagnosis, and (5) likelihood to request additional tests. Among 3277 adult participants, complete data were available for 3215 (median age, 49 years [range, 18-89 years]; 1667 [52%] female; 2433 [76%] white). No significant differences were observed in participant satisfaction and physician confidence for the white male physician control physicians (mean composite score, 66.13 [95% CI, 64.76-67.51]) compared with white female (mean composite score, 66.50 [95% CI, 65.19-67.82]), black female (mean composite score, 67.36 [95% CI, 66.03-68.69]), and black male (mean composite score, 66.96 [95% CI, 65.55-68.36]) physicians. Machine learning with bayesian additive regression trees revealed no evidence of treatment effect heterogeneity as a function of participants' race, gender, racial prejudice, or sexism. No significant differences were observed for simulated patients' evaluations of female or black physicians, suggesting that bias in favor of white male physicians is negligible in survey-based measures of patient satisfaction. ClinicalTrials.gov Identifier: NCT04190901.

Finding Common Ground: Can Provider-Patient Race Concordance and Self-disclosure Bolster Patient Trust, Perceptions, and Intentions?

Improvements in provider-patient relationships may help alleviate health disparities. Provider-patient race concordance and provider self-disclosure are variables that may help improve this relationship. This study sought to answer if provider-patient race concordance and provider self-disclosure may improve patient trust, rapport, similarity, likeability, intention to disclose, satisfaction, behavioral intention to keep a provider, and intention to recommend a provider, while using empathy as a covariate. Using 882 White or Black participants, the current research used a 2 × 2 online experimental design. Participants were asked to read a vignette in which they were told they had borderline high cholesterol and needed to eat a healthier diet, by either a Black or White male physician, who either self-disclosed or did not self-disclose regarding their own struggle to eat a healthy diet. After reading this vignette, participants were surveyed regarding the dependent variables of interest. Participants in a Black concordant dyad reported higher levels of similarity than those in any other dyad. Provider self-disclosure led to higher levels of trust, rapport, similarity, likeability, intention to disclose, satisfaction, behavioral intention to continue using the provider, and intention to recommend the provider. No interaction effects were found. While it is possible, based on past research, that race-concordant pairings may lead to trust via similarity, provider self-disclosure directly increased perceptions of trust as well as providing numerous other benefits. This study supports the importance of trainings for providers on health-related self-disclosure to benefit both parties in provider-patient dyads.

Medicalizing Blackness: Making Racial Difference in the Atlantic World 1780–1840 by Rana A. Hogarth

Reviewed by: Medicalizing Blackness: Making Racial Difference in the Atlantic World 1780–1840 by Rana A. Hogarth Tara Inniss (bio) Hogarth, Rana A. Medicalizing Blackness: Making Racial Difference in the Atlantic World 1780–1840. Chapel Hill: University of North Carolina Press, 2017, 290 pp. 6.125 x 9.25, 12 halftones, notes, bibl., index. US$90.00, hardcover. ISBN: 9781469632865. Also Paperback and eBook. The circulation of medical knowledge, particularly during the colonial period, is a vast field of potential study for the Caribbean historian of medicine. Given the number of publications in various languages across the region over the period, it is regrettable that more of the region’s scholarship has not been dedicated to knowledge formation and exchange among physicians in the region and beyond. Rana Hogarth’s comparative study of the racialization of medicine and the African body provides careful insight into the medical construction of race in Jamaica and South Carolina during the period of slavery. Organized into three parts, Hogarth demonstrates how physicians, and planters, in Jamaica and South Carolina were engaged in an iterative process to construct not only medical definitions of race, but also to racialize the African body, particularly the enslaved body, and ailments “peculiar” to black bodies in the tropics. Another useful comparison is her evolution of public institutions, such as hospitals and workhouses, for the surveillance and control of sick black bodies in both Jamaica and the Antebellum South—or what she terms as the “Greater Caribbean”. In Part I, Making Difference: Race and Yellow Fever, Hogarth traces some widely accepted views on the perceived race-based immunity of enslaved Africans to yellow fever. Even in the midst of dissenting views on the widely accepted notion that enslaved Africans were immune to the lethal effects of mosquito-borne yellow fever epidemics that swept the Greater Caribbean, leaving thousands dead, there was a consensus on the inalienable issue of racial difference between how disease afflicted the black versus the white body. Part II, In Sickness and Slavery: Black Pathologies, Hogarth examines [End Page 221] the perplexing racialized discourse around the disease Cachexia Africana (also known as dirt-eating, mal d’estomac, geophagy and pica). This was a well-known illness affecting enslaved African populations in the Caribbean, and described by enslavers/physicians. There have been many explanations for the descriptions and interventions that physicians have made about the disease. But Hogarth goes beyond these to establish that the very construction of the disease was one based on racial difference, helping to consolidate the medical authority of white men over other practitioners, including Obeah men and women, even though African practitioners were constantly contesting that authority. Part of the knowledge exchange among Jamaican and Antebellum Southern practitioners was over the diagnosis and treatment of the disease. There was a deepening sense that Africans were engaging in resistance to white authority over their own health and bodies. Therefore, there was less of an effort to “treat” the illness, and more to control and discipline the black body. One of Hogarth’s most convincing discussions of the racialization of enslaved health is in Part III, Disciplining Blackness: Hospitals. Hogarth frames the evolution of public institutions for the treatment of black bodies within a continuing discourse of surveillance and control in slavery, even as the care and treatment of enslaved workers shifted from private estate-based plantation medicine to state/public intervention. This discussion is particularly useful in providing more insight into the systemic place of race in medical institutions. Hogarth layers racialization of the black body from observation to pathologization to its ultimate surveillance and control, so at no point is the enslaved “patient” “object” “subject” ever free from the gaze of the white male physician conducting his research. Her examination of race-making in medicine in the Greater Caribbean provides fertile ground for further explorations of medical knowledge exchange both within and beyond the region. It is interesting that she pulls the Antebellum South into the ambit of influence of Caribbean-based physicians publishing on common diseases affecting enslaved populations. Contrary to our twenty-first-century notions of globalized medicine that often depict the balance of power in medical research weighed in favour...

Does the Race/Ethnicity or Gender of a Physician's Name Impact Patient Selection of the Physician?

This study's objective was to examine the extent to which individuals exhibit a preference for physicians based upon the race/ethnicity and gender of a physician's name. We conducted an online survey of 915 adults, who viewed a comparative display of four physicians' quality performance. We randomized the name of one physician, whose quality performance was equal to that of one physician and better than two other physicians, to be either typically African American male, African American female, white male, white female, or Middle Eastern (gender ambiguous). In regression models, participants more frequently selected the physician with the randomized name when displayed with a white male name, compared to when presented with an African American male, African American female, or Middle Eastern name (ORs ranging from .59 to .64). White and male study participants exhibited this pattern, while racial/ethnic minority participants did not. If the hypothetical choice bias observed here translates to people's actual selection of physicians, it could be a contributing factor for why women and racial/ethnic minority physicians have lower incomes than white male physicians.

Patient Preference in Dermatologist Attire in the Medical, Surgical, and Wound Care Settings.

Patients' perceptions of their physician can affect subjective and objective outcomes. Physician attire influences patients' perceptions of their physician and consequently may affect patient outcomes. To determine patient preferences for different types of dermatologist attire in dermatology medical, surgical, and wound care clinics. We hypothesized that patients in the dermatology medical setting would prefer professional attire, while patients in the dermatology surgical and wound care setting would prefer surgical scrubs. This study analyzed responses to a cross-sectional, anonymous survey by English-speaking dermatology patients (aged 18 years or older) at general, surgical, and wound care clinics in an academic center in Miami, Florida. Patients who could not read and understand the survey were excluded. Participants received pictures of a physician wearing business attire, professional attire, surgical attire, and casual attire, and responded by indicating which physician they preferred for each of 19 questions. Frequencies of responses were recorded, and χ2 and regression tests were performed. Response frequencies. Surveys were administered to 261 persons, and 255 participated and completed enough of the questions to be included in the outcome analyses (118 men, 121 women, 22 unknown [did not answer sex question]), mean (SD) age, 56.3 (18.6) years; about 49% of those who reported their sex were men; 56% were Hispanic; and 85% were white. Approximately 72% of respondents held a college degree or higher. About 63%, 24%, and 13% of respondents were medical, surgical, and wound care dermatology patients, respectively. Roughly 73%, 19%, 6%, and 2% of cumulative responses were for professional, surgical, business, and casual attire, respectively. Respondents who received a picture of a black male or black female physician were more likely to exclusively prefer professional attire: unadjusted odds ratios (ORs) 3.21 (95% CI, 1.39-7.42) and 2.78 (95% CI, 1.18-6.51), respectively, compared with respondents who received a picture of a white male physician. Nonwhite and unemployed respondents were less likely to prefer professional attire exclusively: ORs, 0.28 (95% CI, 0.1-0.83) and 0.28 (95% CI, 0.08-0.99), respectively. Respondents preferred professional attire in all clinic settings, though respondents in the dermatology surgery clinic were less likely to prefer professional attire compared with respondents in the medical dermatology clinic: race-adjusted OR, 0.74 (95% CI, 0.56-0.98). Wound care and medical dermatology respondents preferred professional attire comparably. In this study, most patients preferred professional attire for their dermatologists in most settings. It is possible that patients' perceptions of their physicians' knowledge and skill is influenced by the physicians' appearance, and these perceptions may affect outcomes.

Differences in incomes of physicians in the United States by race and sex: observational study

Objectives To estimate differences in annual income of physicians in the United States by race and sex adjusted for characteristics of physicians and practices.Design Cross sectional survey study.Setting Nationally representative...

Steven Palmer, Lauching Global Health: The Caribbean Odyssey of the Rockefeller Foundation, Conversations in Medicine and Society (Ann Arbor: University of Michigan Press, 2010), pp. xi + 301, $70.00, hardback, ISBN: 978-0-472-07089-3.

Steven Palmer, Lauching Global Health: The Caribbean Odyssey of the Rockefeller Foundation, Conversations in Medicine and Society (Ann Arbor: University of Michigan Press, 2010), pp. xi + 301, $70.00, hardback, ISBN: 978-0-472-07089-3. - Volume 55 Issue 3

The suicide mortality of working physicians and dentists

Some studies have shown that physicians and dentists have elevated risks of suicide, while other studies have not. Using all deaths and corresponding census data in 26 US states, we examine the suicide risk for working physicians and dentists. Death and census data for working people were obtained from 1984 through 1992. Directly age-standardized suicide rate ratios (SRRs) were calculated for white male and white female physicians and white male dentists. For white female physicians, the suicide rate was elevated compared to the working US population (SRR = 2.39, 95% CI = 1.52-3.77). For white male physicians and dentists, the overall suicide rates were reduced (SRR = 0.80, 95% CI = 0.53-1.20 and 0.68, 95% CI = 0.52-0.89, respectively). For older white male physicians and dentists, however, observed suicide rates were elevated. White female physicians have an elevated suicide rate. Only older white male physicians and dentists have elevated suicide rates, which partially explains the varied conclusions in the literature.

Analgesic nephropathy

Analgesic nephropathy

Brief report: physicians and their personal prostate cancer-screening practices with prostate-specific antigen. A national survey.

There is inconclusive evidence that prostate cancer screening with prostate-specific antigen (PSA) reduces mortality. Although PSA testing is widespread, it is unknown how many physicians have taken the PSA test themselves. To determine the prevalence of PSA testing among physicians. Cross-sectional survey. A nationwide stratified random sample of urologists (response rate 61%, n=247), Internists (response rate 51%, n=273), and family physicians (response rate 64%, n=249) were surveyed by mail in 2000. After excluding female respondents and men who either reported a positive history of prostate cancer or did not respond to that query, there were 146 urologists, 96 Internists, and 118 family physicians. Whether physicians had undergone prostate cancer screening with PSA. Eighty-seven percent (155/178) of male physicians aged, 50 and older and 21% (31/150) of white male physicians under age 50 reported having had a PSA test. More urologists than nonurologists in both age groups reported having had a screening PSA test. Most physicians aged 50 and older report undergoing PSA testing. This may reflect a belief in its efficacy and contribute to its widespread use.

A single mathematical model predicts physicians' recommendations and postmenopausal women's decisions to participate in a clinical trial to prevent breast cancer or coronary heart disease.

Few eligible postmenopausal women participate in clinical trial research to prevent breast cancer or coronary heart disease, making it impossible to adequately assess the efficacy of tested interventions for this vulnerable group. To elucidate the causal factors and decision model underlying participation behavior, 180 white, African American, and Hispanic postmenopausal women judged their likelihood of participation in a breast cancer or coronary heart disease prevention clinical trial in scenarios with varied cost/remuneration, perceived risk, doctor's recommendation, and expected toxicity. In addition, 293 white, African American, and Hispanic male and female physicians judged the strength of their participation recommendation in scenarios with varied cost/remuneration, expected toxicity, patient's age, and the source of the information about the clinical trial. An additive and constant-weight-averaging model were rejected. The same configural-weight-range model accounted for judgments in both breast cancer and coronary heart disease scenarios, with different parameter values for each group. According to this model, white and Hispanic women under 70 years of age are most likely to participate, even under somewhat adverse conditions; costs and high toxicity levels act as severe barriers to physicians' positive recommendations and women's participation. Perceived risk was the most important factor for women, yet only 8% and 15% reported ever having received risk information from their doctor for breast cancer and coronary heart disease, respectively. For these two diseases, respectively, 75% and 48% of women rated their risk of the disease as low and 76% and 88% reported they had never heard of a randomized clinical trial or of a prevention clinical trial being conducted. These results have implications for education, information dissemination, and prevention clinical-trial planners.

Mortality rates and causes among U.S. physicians

Content/ Objectives: No recent national studies have been published on age at death and causes of death for U.S. physicians, and previous studies have had sampling limitations. Physician morbidity and mortality are of interest for several reasons, including the fact that physicians’ personal health habits may affect their patient counseling practices. Methods: Data in this report are from the National Occupational Mortality Surveillance database and are derived from deaths occurring in 28 states between 1984 and 1995. Occupation is coded according to the U.S. Bureau of the Census classification system, and cause of death is coded according to the ninth revision of the International Classification of Diseases. Results: Among both U.S. white and black men, physicians were, on average, older when they died, (73.0 years for white and 68.7 for black) than were lawyers (72.3 and 62.0), all examined professionals (70.9 and 65.3), and all men (70.3 and 63.6). The top ten causes of death for white male physicians were essentially the same as those of the general population, although they were more likely to die from cerebrovascular disease, accidents, and suicide, and less likely to die from chronic obstructive pulmonary disease, pneumonia/influenza, or liver disease than were other professional white men. Conclusions: These findings should help to erase the myth of the unhealthy doctor. At least for men, mortality outcomes suggest that physicians make healthy personal choices.