Tag: physicians

Dementia And Guns: When Should Doctors Broach The Topic?

As the number of Americans with dementia rises, health professionals are grappling with when and how to pose the question: “Do you have guns at home?”

Melissa Bailey, Kaiser Health News

Some patients refuse to answer. Many doctors don’t ask. As the number of Americans with dementia rises, health professionals are grappling with when and how to pose the question: “Do you have guns at home?”

While gun violence data is scarce, a Kaiser Health News investigation with PBS NewsHour published in June uncovered over 100 cases across the U.S. since 2012  in which people with dementia used guns to kill themselves or others.  The shooters often acted during bouts of confusion, paranoia, delusion or aggression — common symptoms of dementia.  Tragically they shot spouses, children and caregivers.

Yet health care providers across the country say they have not received enough guidance on whether, when and how to counsel families on gun safety.

Dr. Altaf Saadi, a neurologist at UCLA who has been practicing medicine for five years, said the KHN article revealed a “blind spot” in her clinical practice. After reading it, she looked up the American Academy of Neurology’s advice on treating dementia patients. Its guidelines suggest doctors consider asking about “access to firearms or other weapons” during a safety screen — but they don’t say what to do if a patient does have guns.

Amid a dearth of national gun safety data, there are no scientific standards for when a health care provider should discuss gun access for people with cognitive impairment or at what point in dementia’s progression a person becomes unfit to handle a gun.

Most doctors don’t ask about firearms, research has found. In a 2014 study, 58 percent of internists surveyed reported never asking whether patients have guns at home.

“One of the biggest mistakes that doctors make is not thinking about gun access,” said Dr. Colleen Christmas, a geriatric primary care doctor at Johns Hopkins School of Medicine and member of the American Neurological Association. Firearms are the most common method of suicide among seniors, she noted. Christmas said she asks every incoming patient about access to firearms, in the same nonjudgmental tone that she asks about seat belts, and “I find the conversation goes quite smoothly.”

Recently, momentum has been building among health professionals to take a greater role in preventing gun violence. In the wake of the Las Vegas shooting that left 58 concertgoers dead last October, over 1,300 health care providers publicly pledged to ask patients about gun ownership and gun safety when risk factors are present.

The pledges came in response to an article by Dr. Garen Wintemute, director of the Violence Prevention Research Program at the University of California-Davis. In response to feedback from that article, his center has now developed a toolkit called What You Can Do, offering health professionals guidance on how to reduce the risk of gun violence.

In a nation bitterly divided over gun ownership issues, in which many staunchly defend the right to bear arms under the Second Amendment, these efforts have met dissent. Dr. Arthur Przebinda, director of Doctors for Responsible Gun Ownership, framed Wintemute’s efforts as part of a broader anti-gun bias on the part of institutional medicine. Przebinda said asking physicians to sign such a pledge encourages them “to propagandize Americans against their constitutionally protected rights to gun ownership and privacy.”

Przebinda said he gets several requests a day from patients looking for gun-friendly physicians. Some, he said, are tired of their doctors sending them anti-gun YouTube videos and other materials. His group, which he said has over 1,400 members, has set up a referral service connecting patients to gun-friendly doctors.

For doctors and other health professionals, navigating this politically fraught issue can be difficult. Here are the leading issues:

Is it legal to talk to patients about guns?

Yes. No state or federal law bars health professionals from raising the issue.

Why don’t doctors do it?

The top three reasons are lack of time, being unsure what to tell patients and believing patients won’t heed their advice about gun ownership or gun safety, one survey of family physicians found.

“There’s no medical or health professional school in the country that does an adequate job at training about firearms,” Wintemute argued. He said he is now working with the American Medical Association to design a continuing medical education course on the topic.

Other doctors don’t believe they should ask. Przebinda argues that doctors should almost never ask their patients about guns, except in “very rare, very exceptional circumstances” — for example, if a patient is despondent or homicidal. He said placing patients’ gun ownership information into an electronic medical record puts their privacy at risk.

When should they broach the subject?

The Veterans Health Administration recommends asking about firearms as part of a safety screening when “investigating or establishing the suspected diagnosis of dementia.” The Alzheimer’s Association also recommends asking, “Are firearms present in the home?” as part of a safety screening. That screening is part of a care planning session that Medicare covers after initial dementia diagnosis and annually as the disease progresses.

The American College of Physicians recommends physicians “counsel patients on the risk of having firearms in the home, particularly when children, adolescents, people with dementia, people with mental illnesses, people with substance use disorders, or others who are at increased risk of harming themselves or others are present.”

Wintemute said he does not suggest all doctors routinely ask every patient about firearms. His group recommends doing so when risk factors are present, including risk of violence to self or others, history of violent behavior or substance misuse, “serious, poorly controlled mental illness” or being part of “a demographic group at increased risk of firearm injury.”

What should health care providers recommend patients do with their guns?

The National Rifle Association and What You Can Do both offer tips on how to store guns safely, including using trigger locks and gun safes.

The Alzheimer’s Association advises that locking up guns may not be enough, because people with dementia may “misperceive danger” and break into a gun cabinet to protect themselves. To fully protect a family, the organization recommends removing the guns from the home.

But health professionals may be reluctant to recommend that due to legal concerns, said Jon Vernick, co-director of the Johns Hopkins Center for Gun Policy and Research. Most states allow the temporary transfer of firearms to a family member without a background check. But seven states don’t: Connecticut, Hawaii (for handguns), Massachusetts, Michigan, New Jersey, North Carolina and Rhode Island, according to Vernick. He recommends health professionals look up their state gun laws on sites such as the NRA Institute for Legislative Action or the Giffords Law Center to Prevent Gun Violence.

In addition, 13 states have passed “red flag” laws allowing law enforcement, and sometimes family members, to petition a judge to temporarily seize firearms from a gun owner who exhibits dangerous behavior.

What happens when clinicians ask about guns?

Natasha Bahr, an instructor and social worker who works with geriatric patients at a clinic focusing on memory disorders at the University of North Texas Health Science Center, said as part of a standard assessment, she asks every patient, “Do you have firearms in the home?”

“I get so much pushback,” she said. About 60 percent of her patients refuse to answer, she said.

Patients tell her, “It’s none of your business,” “I have the freedom to not answer that question” or “It’s my Second Amendment right,” she said. “They make it sound like I’m judging, and I’m really not.”

Dr. John Morris, director of the Knight Alzheimer’s Disease Research Center at Washington University in St. Louis, said he asks his patients about firearms in the context of other safety concerns. When safety is at risk, he typically advises families to lock up firearms and store ammunition separately.

“People with dementia typically lack insight into their problems. So they will protest,” he said. Dementia is characterized by “the gradual deterioration not just of memory but of judgment and problem-solving and good decision-making,” Morris noted.

In one case, Morris said, he had to persuade the daughter of a dementia patient to secure her father’s hunting rifles. Uncomfortable with the role reversal, she was reluctant to do so.

“It’s very difficult to tell your father he can no longer have his firearms,” Morris said. The father responded: “I have never misused my firearms. … It’s not going to be a problem,” Morris recalled. “But, he’s remembering his past history — he can’t predict the future.”

Eventually, the daughter decided to remove the rifles from the home. After a few weeks, her father forgot all about them, Morris said.

Morris said the story highlights how difficult it is for families to care for people with dementia. “They’re forced to make decisions, often against the persons’ will,” he said, “but they have to do it for the person’s safety and well-being.”

KHN’s coverage of these topics is supported by Gordon and Betty Moore Foundation, John A. Hartford Foundation and The SCAN Foundation

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Physicians Are Plagued by EHR, but Few Are Asking Them How to Improve It

Despite documentation burden being a leading factor of physician burnout, organizations and EHR vendors are barely asking physicians how to improve.

EHRs are a common pain point for physicians, with multiple studies singling out documentation burden as a leading factor of physician burnout. However, a new survey of U.S. physicians by Deloitte found that only about a third of organizations and EHR vendors sought physician feedback on how to improve EHR processes.

Approximately 624 U.S. primary care and specialty physicians participated in the Deloitte 2018 Survey of U.S. Physicians, and of those respondents, only 34% of surveyed physicians indicated their organization or EHR vendor sought their feedback, though 58% of responding physicians said there is a big opportunity for improvement in clinical documentation, and it was the number one area physicians indicated could be done more efficiently in their day.

51% of physicians who were not asked for feedback said they were unaware of EHR optimization efforts either by their organization or through their EHR vendor.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Physicians Say Mandatory Nurse Staffing Ratios Will Hinder ED Care

In an op-ed published last week, three emergency medicine physicians strongly opposed a proposed ballot initiative to mandate nurse-to-patient ratios.

There is a battle brewing in Massachusetts over nurse-to-patient staffing ratios, which will be decided at the ballot box this November. Question 1, also known as the Nurse-Patient Assignment Limits Initiative, was proposed by the Massachusetts Nurses Association, and is part of a larger fight nurses nationwide have been waging for years in an effort to secure safer staffing ratios. However, an op-ed written by three emergency medicine physicians and published last week in SouthCoast Today, says the mandated nurse staffing ratios could hinder quality of care and patient safety efforts.

The physicians—Jennifer Pope, MD, Chair of the Emergency Department at St. Luke’s Hospital, Brian Tsang, MD, Chair of the Emergency Departments at Charlton Memorial Hospital and Tobey Hospital, and Matt Bivens, MD, EMS Medical Director of Southcoast Health hospitals—called the state’s ballot initiative for mandated nurse staffing ratios “a disaster-in-waiting for Massachusetts, especially for emergency departments,” in their op-ed.

“Question One on the November ballot to mandate a government-set nursing-patient ratio invites us to discard what already works, and instead adopt the California model — in fact, a far more extreme version of that model, because of the aggressive proposed timeline. What would happen in the emergency departments?” the op-ed asks.

The physicians postulate what would come next—hospitals will let go of support staff, patients will be rushed in and out of the hospital more aggressively, emergency department waiting room times will soar.

The physicians said, in conclusion, “We worry this will cost jobs of ancillary staff, burden nurses with more low-skilled work, block patients in waiting rooms, rush patients out of the hospitals early, and break systems across the state that are already known for high-quality patient safety and care. We will vote no on Question One.”

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

The Doctor Is in, but Millennials Seem to Be Out

More millennials are shunning the traditional primary care model, in favor of retail clinics, free-standing urgent care centers, and telemedicine.

For years, office-based primary care visits have been a staple of American healthcare. However, millennials—the roughly 83 million Americans born between 1981 and 1996—seem to prefer the convenience, speed, connectivity, and price transparency of retail clinics, free-standing urgent care centers, and online telemedicine sites over traditional doctor’s appointments, reports The Washington Post.

In a national poll conducted in July by the Kaiser Family Foundation that surveyed 1,2000 randomly selected adults, it was found that 26% said they did not have a primary care provider. When that percentage was broken down by age groups, there was a staggering difference. 45% of 18- to 29-year-olds had no primary-care provider, compared with 28% of respondents aged 30 to 49, 18% of those 50 to 64, and 12% aged 65+.

A 2017 survey by the Employee Benefit Research Institute and Greenwald and Associates showed similar numbers: 33% of millennials reported not having a regular doctor, compared with 15% of those aged 50 to 64.

“There is a generational shift. These trends are more evident among millennials, but not unique to them. I think people’s expectations have changed. Convenience [is prized] in almost every aspect of our lives, from shopping to online banking,” Ateev Mehrotra, MD, an associate professor at Boston’s Harvard Medical School, is quoted as saying in the article.

This shift is upending the office-based primary care model, with more primary care practices hiring on additional physicians or nurse practitioners in an effort to reduce wait times, as well as embracing digital tools, such as patient portals, in an attempt to woo millennials back to primary care, not only for the practice’s bottom line, but for patient safety.

Some experts warn that straying from the traditional primary care model may be driving up health costs and worsening the problem of unnecessary care, including the dangerous misuse of antibiotics.

“We all need care that is coordinated and longitudinal. Regardless of how healthy you are, you need someone who knows you,” said Michael Munger, MD, President of the American Academy of Family Physicians.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

White Coats As Superhero Capes: Med Students Swoop In To Save Health Care

While doctors have traditionally been branded a mostly conservative group, there is growing evidence that young doctors-to-be are leaning leftward and interested in activism.

Rachel Bluth, Kaiser Health News

Each wall of the library reading room at the New York Academy of Medicine is lined with tall wooden bookshelves holding leather-bound medical tomes. Atop the shelves perch busts — seemingly all white, all male — lit by two large brass chandeliers. Floor-to-ceiling windows overlook New York City’s Central Park and Fifth Avenue.

This setting, which speaks to medicine’s staid past, recently became the backdrop for plotting medicine’s future.

On a gray Sunday in September, 150 medical and nursing students dragged themselves in before 9 a.m. to learn how to meld their chosen professional careers with societal and political activism.

“As doctors, we will have this tremendous opportunity to talk to people every day,” said Miriam Callahan, a second-year student at Columbia University medical school. “We’ll have the ability to organize with them, to bring people together.”

While doctors have traditionally been branded a mostly conservative group, there is growing evidence that young doctors-to-be are leaning leftward. This year, the American Medical Association student caucus persuaded the organization to drop its decades-long opposition to single-payer health care and instead study the concept, for example.

The conference at the academy, which was organized by medical students and sponsored by the New York City Department of Health’s Center for Health Equity along with four New York medical schools, sought to help students navigate that path. It featured a panel discussion and speeches by public health workers and doctors, including Dr. Abdul El-Sayed, a physician who mounted an unsuccessful progressive campaign this year for governor of Michigan.

Dressed in blazers and dress shirts reflecting their professional identity, some also donned Planned Parenthood Buttons or Democratic Socialists of America pins. The agenda had a clear progressive bent, with workshops on LGBTQ+ health, gun violence, abortion access and criminal justice reform.

Attendees gave each other advice about how to advocate for single-payer, for example. Don’t talk about socialism, focus on the inefficiency and inequality you see, some said. Forget the “decrepit old physicians only worried about money,” their minds will never change, advised others.

Some participants were motivated by a humanitarian streak. Others were galvanized by the conditions they saw at free clinics, where they work as part of their medical education, or by a goal to increase national student engagement on issues like gun violence.

All were struggling with what they perceived as the responsibility that comes with a white coat and grappling with their place in a health care system they saw as broken.

Keven Cabrera, a fourth-year medical student at the Zucker School of Medicine at Hofstra University/Northwell, said this notion became real to him when he and some of his classmates participated this year in the March for Our Lives, a rally against gun violence.

Accustomed to the student position at the bottom of the medical hierarchy, he was taken aback by how much the white coat, even a short one that marks a student instead of a full-fledged attending doctor, afforded him respect in the community.

“We were all surprised by how much our voices counted,” Cabrera said.

Everyone came to the table with the general agreement that health care for all was a moral necessity and abortion access was a fundamental right.

So they discussed how best to move these ideas forward. How do you get better reproductive education into a conservative medical school syllabus? How can you organize other students to protest, call legislators and show up for marches?

In one noisy room after lunch, students crowded around tables where doctors with experience lobbying on behalf of Physicians for a National Health Program led role-playing conversations to demonstrate how best to communicate with congressional staff or state assembly members. They also learned how to use the stories of patients they saw on a daily basis to work within the system to advocate for single-payer health care.

The students fretted — at least a bit — about how activism could help or hinder their professional success. A group sat in a semicircle listening to a doctor tell his story of being arrested at a protest.

Students asked about how civil disobedience could affect their residency placements, or get them marked as agitators within their departments. Then another chimed in: “Would you even want to be in a residency program where they would disqualify you for a protest arrest?”

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Definitions May Vary, but Burnout Is a Problem All the Same

Does defining burnout as a diagnosable condition, such as depression, even matter in regards to treating the problem, or should the focus fall elsewhere?

This month, The Journal of the American Medical Association published two major studies and one searing editorial on physician burnout.

The first study, entitled Prevalence of Burnout Among Physicians, A Systematic Review, is a summary of research to date on the prevalence of physician burnout. In conclusion, the review found, “there was substantial variability in prevalence estimates of burnout among practicing physicians and marked variation in burnout definitions, assessment methods, and study quality.”

The second study, Association of Clinical Specialty with Symptoms of Burnout and Career Choice Regret Among US Resident Physicians, followed doctors-in-training over the course of six years, and kept track of how they felt about their work. In conclusion, the study found that “reported symptoms of burnout occurred in 45.2% of participants and career choice regret in 14.1%.”

The accompanying editorial, Physician Burnout—A Serious Symptom, But of What?, written by Thomas L. Schwenk, MD and Katherine J. Gold, MD, MSW, MS, takes aim at these studies and the problem of burnout as a whole.

“The term burnout has taken on meaning far beyond what is understood about it as an actual diagnosis or even a syndrome. The medical profession has taken a self-reported complaint of unhappiness and dissatisfaction and turned it into a call for action on what is claimed to be a national epidemic that purportedly affects half to two-thirds of practicing physicians,” the editorial reads, in part.

It goes on to say, “There is clearly something important and worrisome happening to physician well-being.”

From where you stand, as a physician, does defining burnout as a diagnosable condition, such as depression, even matter in regards to treating the problem? Or do you believe the focus should fall elsewhere?

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Could Medical Scribes Be A Cure to Physician Burnout?

While there is no easy cure-all for burnout, the results of a new study indicate that utilizing medical scribes to assist with EHR documentation could help.

Time-consuming EHR documentation is a burden that is consistently found to be linked to increased physician documentation workload, and, in turn, physician burnout. Could the use of medical scribes alleviate that burden for physicians, improve productivity and patient communication, and enhance job satisfaction among physicians. A study published this month in JAMA Internal Medicine aimed to find out the answer to that question, and their conclusion is a resounding yes.

The 12-month crossover study randomly assigned eighteen primary care physicians to start the first three-month period of the study with or without scribes, and then had alternated exposure to scribes every three months over the course of the year. At the end of each study period, physicians completed a survey. Meanwhile, the researchers also surveyed patients of participating primary care physicians after scribed clinic visits.

Findings indicated that compared with periods that were not scribed, scribed periods were linked to less self-reported after-hours EHR documentation by physicians (<1 hour per day). Scribed physicians also self-reported that they spent more than 75% of the visit interacting with the patient and less than 25% of the visit on a computer. Patients also reported encouragingly in regards to the presence of medical scribes, with 61% of surveyed patients saying that scribes had a positive bearing on their visits and only 2.4% of them indicating a negative bearing.

While there is no easy cure-all for burnout, the results of this study certainly indicate that there are ways to help lessen the burdens thrust upon physicians by EHRs, and one of those is the utilization of medical scribes.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Majority of Physicians Pessimistic about the Future of Medicine, New Report Finds

The results of the sixth biennial Survey of America’s Physicians have been released, and the findings can only be described as startling.

The Physicians Foundation has released the results of their sixth biennial Survey of America’s Physicians, and the findings are startling.

The survey “took the pulse” of nearly 9,000 U.S. physicians across the country, and examined, at its heart, what they think about the current state of the medical profession.

Over all, the findings indicate being a physician is an evolving medical profession, which continues to struggle with issues of burnout and low morale, despite more physicians now working fewer hours and seeing fewer patients.

Below are some key findings from the report:

  • 62% of physicians are pessimistic about the future of medicine.
  • 55% of physicians describe their morale as somewhat or very negative, which is consistent with findings in previous years.
  • 78% of physicians sometimes, often or always experience feelings of burnout.
  • 80% of physicians are at full capacity or are overextended.
  • 49% of physicians would not recommend medicine as a career to their children.
  • 46% plan to change career paths.
  • 46% of physicians indicate relations between physicians and hospitals are somewhat or mostly negative.
  • Physicians indicated patient relationships are their greatest source of professional satisfaction, while EHRs are their greatest source of professional dissatisfaction.

The survey also includes a portion where physicians are welcome to write in their own comments. Some of those highlighted in the report include:

  • “I could not in good conscience recommend medicine to a young person. It isn’t a profession anymore, it’s a business enterprise. If I had wanted to be a businessman, I’d have taken a less demanding path.”
  • “I am no longer a professional, I am an employee and treated with less respect and consideration than previously.”
  • “As a physician in her late 40’s, I have unfortunately seen the practice of medicine evolve from caring for the patient to caring for the administrator. The focus is on ticking off boxes rather than improving the health of the individual or community.”

Do you think the numbers and comments highlighted here accurately portray the overall sentiment of physicians today?

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

First National Physician Suicide Awareness Day

The day places a priority on mental health awareness in an effort to allow physicians to better care for themselves and their patients

Today is the first ever National Physician Suicide Awareness Day. Founded by the American Foundation for Suicide Prevention, the nation’s leading organization dedicated to suicide prevention, the day places a priority on mental health awareness in an effort to allow healthcare professionals to better care for themselves and their patients.

It has been found that, on average, one doctor per day will take their own life in the United States, making it the highest suicide rate of any profession and more than twice that of the general population. According to resources provided by the AFSP, suicide generally is caused by the convergence of multiple risk factors — the most common being untreated or inadequately managed mental health conditions.

Suicide is preventable. Help is possible. We encourage any physician that may be struggling with their mental health to seek help.

If you are in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting TALK to 741741.

To learn more about National Physician Suicide Awareness Day, including facts, figures, and scores of resources for physicians, please visit afsp.org/physician.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

“Female Physicians Do Not Work as Hard,” Claimed Physician Now Facing Backlash

The statement, which was made in the Women in Medicine issue of the Dallas Medical Journal, has prompted viral levels of backlash across the internet.

Last week, Dr. Gary Tigges, an Internal Medicine physician in Plano, Texas, came under fire for a statement he made about the gender pay gap among physicians in the September edition of the Dallas Medical Journal.

Dr. Tigges’ statement was included as part of a two-page Big and Bright Ideas feature in the journal’s Women in Medicine issue, which asked physicians if they believe a pay gap exists between male and female physicians, and if so, what the cause may be, as well as what steps physicians can take to address this.

Dr. Tigges’ response read, “Yes, there is a pay gap. Female physicians do not work as hard and do not see as many patients as male physicians. This is because they choose to, or they simply don’t want to be rushed, or they don’t want to work the long hours. Most of the time, their priority is something else… family, social, whatever. Nothing needs to be “done” about this unless female physicians actually want to work harder and put in the hours. If not, they should be paid less. That is fair.”

Photos of his response quickly went viral and prompted backlash on sites such as Facebook, Twitter, and Yelp.

“Thank you for publicly displaying your disgusting thoughts on the value of women physicians in the workplace. Is this how you feel about your female patients too? That they don’t do enough? Or don’t try or work as hard because of social or personal commitments?” Dr. Hala Sabry-Elnaggar wrote in response to Tigges’ statement in a Facebook post displaying a photo of the letter. Her post went on to say, “Women physicians have been proven to put their skills into their work with better mortality outcomes and they continue to do this despite the discrimination more than 80% of them face at work. So please educate yourself beyond your medical degree about what your colleagues are doing… and how their presence is important to the healthcare team and to their patients,” and it was signed, “Sincerely, A woman physician who prioritizes her patients.”

Dr. Sabry-Elnaggar wasn’t the only one to speak out against Tigges’ statement; her post alone generated more than 1,200 comments and was shared more than 5,600 times.

Another Facebook post made by Dr. Jean Robey, which features the same image of Tigges’ statement as Dr. Sabry-Elnaggar’s, said, in part, “I trained and practice in an environment that treated my sex like a handicap I needed to own and account for. I was asked what disadvantage my sex was the first day and I was shocked to know I had one and only responded with my perceived disadvantage is my advantage because society and people like you discounted me and my contribution from day one. You would be pressed to find my compassion and intuition and empath and intellect in a male or in another to lay claim that I automatically underachieve or unaccomplished or undercontribute. I will never tolerate being paid less because I’m a woman or to accept the idea that women even with their other demands and roles shouldn’t be supported in medicine or any field to participate in the solution. I will never be unfair but it is bold to say sir that you can simply quantify the disparity in pay because of the disparity in contributions. You will grow to see that more times than not you needed a woman leading and helping. You wait till your loved ones fall ill or you are older and vulnerable. You will be quite remorseful to ever state such sentiments.”

Since its publication, Dr. Tigges has walked back his statement and claims it has been taken out of context, that he did not mean to imply women should earn less for equal work. “My response sounds terrible and horrible and doesn’t reflect what I was really trying to say,” Tigges said. “I’m not saying female physicians should be paid less, but they earn less because of other factors.”

Tigges also stated that he heard from “several trusted female physician colleagues who disagree with and are deeply hurt and offended” by his comments.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.