Differences in income between male and female physicians

Previous studies suggest that female physicians earn less on average from the practice of medicine than their male counterparts even after differences in personal characteristics are taken into account. In our study of sex differences in physician earnings, we estimate hourly earnings equations for 1982 using a specification that controls for differences in personal characteristics between male and female physicians more completely than the specification used in previous studies. We also employ more precise estimators for the unexplained earnings differential. Our results suggest that previous studies have overstated the unexplained differential in hourly earnings. We find that female physicians in 1982 earned 12-13 percent less than male physicians due to discrimination or unexplained factors.     

Professional satisfaction among Singapore physicians

OBJECTIVE: This paper reports on a questionnaire survey among Singapore physicians, carried out from November, 2003 to January, 2004 to gauge their professional satisfaction levels. METHODS: The survey participants (N=380) were drawn randomly from both public and private sectors and comprised both general practitioners (GPs) and specialists. Multivariate analysis identified the predictive factors leading to positive or negative responses on selected items. Findings were compared with similar studies in other countries and possible reasons for differences obtained are offered. RESULTS: Our findings indicate the majority of physicians in Singapore are quite satisfied with their autonomy to treat patients (92%) and their relationship with patients (94%), but rather dissatisfied with the amount of leisure time they have (48%) and promotion and career development prospects (38%). Compared to specialists, GPs are more likely to be satisfied with amount of time for each patient (82%), ability to initiate changes in the way work is done in medical practice (73%), and harmony of relationship among colleagues and staff associates (80%). CONCLUSIONS: To the best of the authors' knowledge, this study is the first attempt to measure physicians' view on professional satisfaction in Singapore. It could serve as a benchmark which is very useful for policy makers, hospital administrators to better manage physicians.     

Professional stress among family physicians

Professional stress syndrome was investigated among residents, academic physicians, and community physicians in family practice. A survey including measures of physician stress, depression, locus of control, family and peer support, and medical practice characteristics was completed by 294 physicians. Univariate analysis of variance procedures were used for all statistical tests. Results revealed a significant positive correlation among perceived stress in medical practice, depression, and external locus of control. Decreased levels of stress were associated with higher scores on indices of family and physician-peer support. Differences in stress patterns between residents, faculty, and community physicians emerged on several critical variables. Residents felt professional duties interfered with family life to a greater extent than did faculty or practitioner colleagues. Community physicians report higher levels of family support, less idealism, and greater sense of personal control. The stress and coping model proposed illustrates how environmental, as well as internal, factors are affected by stress and serve as moderators of the stress response.     

Dilemmas in sickness certification among Swedish physicians

Despite a growing concern for matters related to sick-leaveand its economical and human consequences, little Is still knownof the practice of sickness certification. To remedy this, astudy based on the critical incident technique was designedto explore dilemmas experienced by physicians when issuing sicknesscertificates. A questionnaire was distributed to 170 generalpractitioners (GPs), private physicians and psychiatrists inthe Swedish county of Ostergotland asking about sickness certificationdilemmas, the consequences of the dilemma and how the situationwas resolved. Through a semi-qualitative analysis, 2 main typesof dilemma were identified. Insurance-associated dilemmas werethe most frequent and concerned the grading of work incapacity,the duration of a sick-leave period and the difficulties ininterpreting the sickness insurance legislation. The focus onbiomedical diagnosis in the sickness certificate was found tocomplicate the certification routines, since working capacitymay be reduced even though a diagnosis has not been confirmed.The primary medical dilemmas consisted of difficulties relatedto encountered obstacles In the clinical management, e.g. insubjective medical history, diagnosis or patient compliance.It is concluded that the physicians' role in the insurance systemmakes it necessary to give the medical diagnosis a social interpretation.The development of standards for grading of work incapacityis needed as well as routines for closer cooperation betweenthe different actors in the sickness insurance system.     

Differences in practice income between solo and group practice physicians

An examination of the distribution of physician incomes between different types of practices could help policymakers and researchers alike to gain an understanding of the effects of different organizational characteristics of practices on the practice of medicine as a whole. This study uses a national database to explore the relationships that exist between practice incomes and practice types vis-à-vis the overall size of practices. The primary data source for this study, which includes 7757 office-based physicians, was provided by the Taiwan Department of Health (DOH), with the dependent variable of interest to this study being the annual gross income of physician practices, while the independent variables are physician practice types and the number of physicians within a clinic. Multiple regression analyses were used to model the logarithm of annual physician practice incomes as a linear function of a set of independent variables. Kruskal-Wallis test results revealed the existence of significant relationships between practice incomes and practice types (p<0.001) and the number of physicians within a clinic (p<0.001). Multiple regression analysis also showed that after adjusting for socio-demographic and professional characteristics, the annual incomes of physicians in both single-specialty or multi-specialty group practices (p<0.001) were higher than those of their solo practice counterparts. This study concludes that after adjusting for other factors, higher practice incomes are enjoyed by physicians in single-specialty or multi-specialty group practices as compared to their solo practice counterparts. The finding of higher incomes for those physicians organized into groups supports the policy call from the DOH in Taiwan for the widespread formation of group practices.     

Impact of diagnosis of overweight and obesity on weight management among hospitalized patients

BackgroundObesity is a growing epidemic associated with a 30% increase in general mortality. Despite this, diagnosis and treatment is still deficient. A large number of patients with overweight and obesity enter hospitals daily; therefore, the hospital setting could be used as a scenario for intervention in this population.ObjectivesTo determine the frequency of diagnosis and treatment of overweight/obesity in hospitalized patients and to identify the factors involved in the probability of offering a diagnosis and treatment.MethodsCross-sectional data from 316 patients aged 18 years and over admitted in the Department of Internal Medicine during 2016–2017 period. Logistic regression was used to estimate the relationship between the possible predictors and the diagnosis of overweight and/or obesity and the development of a treatment.ResultsOnly 10.8% of the population was diagnosed (overweight 2.6%, obesity 18.8%). Patients with a BMI >40 kg/m² had a greater probability of being diagnosed (OR = 1.87; 95% CI, 2.2–19.4; p = 0.001). Only 4.4% of the population received treatment (overweight 3.2%, obesity 5.6%) and the only factor that increased the probability of receiving treatment was having been diagnosed with overweight/obesity in the medical record (OR = 2.28; 95% CI, 2.31–41.94; p = 0.002).DiscussionDespite the high prevalence of overweight and obesity among hospitalized patients, there is no adequate diagnosis and treatment. Future research should be directed at strategies that increase medical recognition of overweight/obesity as well as identifying the long-term benefits of diagnosing overweight/obesity for the reduction and control of body weight.     

Knowledge and attitudes toward breast-feeding: Differences among dietitians, nurses, and physicians working with WIC clients

We assessed the knowledge of and attitude toward breast-feeding of dietitians, nurses, and physicians who work with individuals in the Alabama Special Supplemental Food Program for Women, Infants, and Children. On a scale of 0 to 100, dietitians expressed stronger interest in lactation (78.6) and exhibited greater knowledge (79.6) of the questions asked than nurses (74.5 and 73.0, respectively). Attitude and knowledge scores of physicians (70.2 and 75.5, respectively) were not statistically different from those of dietitians or nurses. Respondents disagreed greatly about the relationship of breast-feeding to weight loss and the appropriateness of oral contraceptive during breast-feeding 6 weeks postpartum. Professionals were more knowledgeable about benefits to infants than about maternal concerns. Results of this study suggest that professional breast-feeding education programs should address maternal concerns such as weight loss, contraception, and mastitis as well as benefits to the infant.     

Effective management of obesity

Successful treatment of obesity usually requires multiple interventions. The choice of therapies should be guided by the initial assessment of a patient's degree of obesity and comorbid conditions, if present. A variety of interventions can achieve short-term weight loss, but rebound weight gain is common when therapy is stopped. Thus, programs for weight maintenance are critical to ultimate success.     

Aids education practices among Massachusetts physicians

Physicians have a major role to play in the prevention of AIDS transmission. Promotion of health behaviors needs to be expanded beyond the traditional AIDS high risk populations; however, little information is available on the AIDS education practices of physicians. A survey of Massachusetts physicians in four specialty groups, Family Medicine Practitioners, Internists, Obstetricians/Gynecologists and Pediatricians, was conducted to determine the extent of their AIDS education practices. Three hundred and ninety one physicians returned the questionnaire for an overall response rate of 66%. Sixty three percent (63%) of the physicians surveyed educate patients they believe to be at least at moderate risk for AIDS transmission or exposure. However, neither physicians screening for patients' AIDS risk status nor the content of the AIDS education was uniform. Also, very few physicians have received specific training in AIDS education. A number of practice, patient, and physician characteristics were found to be related to educational practices. This study suggests that a more comprehensive screening of patients' participation in AIDS risk behaviors be conducted as part of medical history taking, and that more comprehensive education be provided to those patients determined to be at least at moderate risk for AIDS transmission or exposure.Ruth A. Carretta, M.P.H. is an Analyst with the Outside Health Resource Utilization Program, Harvard Community Health Plan, Boston, Mass. 02215; Thomas W. Mangione, Ph.D. is Associate Professor of Public Health, Boston University School of Public Health, Boston, MA 02118 and Senior Research Fellow, Center for Survey Research, University of Massachusetts — Boston, Boston, MA 02116; Presley F. Marson, M.D., M.P.H. is a student at the Boston University School of Public Health, Boston, MA 02118; S.S. Darmono, M.D., M.P.H. is a student at the Boston University School of Public Health, Boston, MA 02118. Requests for reprints should be addressed to: Thomas W. Mangione, Ph.D., Center for Survey Research, University of Massachusetts — Boston, 100 Arlington St. — Suite 210, Boston, MA 02116.This study was conducted as part of a course offered by the Boston University School of Public Health. This research was also supported in part from funds from the Boston University School of Public Health and the Center for Survey Research at the University of Massachusetts — Boston.We would like to acknowledge the contributions of Patricia M. Demers, R.N., M.S., M.P.H., Efstratios Demetriou, M.D., Elizabeth A. Harvey, Ph.D., Suzanne Moore, M.P.H., R.N.C., Ph.D. candidate, and Nancy Salitsky, R.N., M.P.H. for their assistance in the design of the questionnaire, data collection, input into the analysis, and editorial advice; Kathleen Butterfield, Jean F. Saint-Elme, M.D., M.P.H., and Anneke Suparwati, M.P.H. for their assistance in design of the questionnaire and data collection; and Carmen Arroyo for creating the data entry program and providing the data analysis runs.     

Errors of intuitive logic among physicians

The effectiveness of specific training in statistics and decision-making principles upon physicians' judgmental skills was assessed by means of problems of intuitive logical reasoning. The responses of 43 statistically sophisticated physicians (SP) were compared to those of 42 practicing physicians (PP), 43 clinical nurses (CN) and 41 hospital laborers (HL). On problems evaluating use of faulty heuristics in judgment of conditional probabilities, the SP group's responses were the most biased. The proportion of subjects displaying consistent use of a particular heuristic in solving the three problems were 0.36 (SP), 0.45 (PP), 0.35 (CN) and 0.41 (HL). On problems assessing use of prevalence rate data in estimating probabilities, SP performed substantially better than the other groups: 34% of their responses were accurate. However, 37% of their responses reflected ignorance of prevalence information concepts. We conclude that intensive statistical and decision-making training of physicians is likely to be of only limited value for improving clinicians' judgmental skills.