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.

Primary Care Physician Salaries Up 10+% in 5 Years

New findings indicate the increase in compensation is, in part, due to the ongoing primary care physician shortage across the country.

Primary care physicians, which account for nearly a third of practicing physicians, are now seeing salaries more than 10% higher they were five years ago, outpacing the salary growth rate of specialists by nearly double.

The report, released by the Medical Management Association (MGMA), compared data collected from over 136,000 providers in more than 5,800 organizations, including physician-owned, academic and hospital practices. Findings indicate the current average total compensation for primary care physicians varies by state, with Washington, D.C. paying the least ($205,776) and Nevada paying the most ($309,431).

The report ties the increase in compensation, in part, to the ongoing primary care physician shortage.

“MGMA’s latest survey has put strong data behind a concerning trend we’ve seen in the American healthcare system for some time—we are experiencing a real shortage of primary care physicians,” Dr. Halee Fischer-Wright, MGMA’s President and CEO, is quoted as saying.

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.

The Possible Power of Physicians Speaking Positively

Freud is quoted as having said, “Words have a magical power,” and a new study may back up that theory in relation to how physicians speak to patients.

Sigmund Freud is quoted as having said, “Words have a magical power. They can either bring the greatest happiness or the deepest despair,” and a new study published in the Journal of General Internal Medicine just may back up that theory.

The study, entitled Physician Assurance Reduces Patient Symptoms in US Adults: An Experimental Study, set out to research the effects of physicians’ using reassuring words on their patients, in lieu of pharmacological treatment. Previous research on the power of positive speech from providers has varied, with some studies indicating positive assurances from the provider leads to improved patient health and outcomes, and others finding no effect on patient outcomes or other quantifiable benefits. The results of this study, however, fall into former, and indicate that the placebo effect of a doctor simply reassuring a patient can be fairly impactful. These findings are important, given that medication goes unmentioned in nearly a quarter of all doctor’s visits in the U.S. and as physicians face increasing time demands, the need to quantify the benefit of these types of visits is vital.

In the study, a healthcare provider administered a histamine skin prick to the forearm of 76 participants. The participants were asked to rate itchiness/irritation immediately before the skin prick and at 3, 9, 12, 15, and 18 minutes post histamine skin prick. After the 3-minute rating, a physician visually examined the participants’ reactions, and told some, at random, “From this point forward your allergic reaction will start to diminish, and your rash and irritation will go away,” while the physician made no remarks about the reaction for the control group of patients. After being reassured by the physician, itchiness declined significantly faster than for those who were not reassured.

Perhaps, there is some magical power in words, after all.

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.

Clinicians Who Learn Of A Patient’s Opioid Death Modestly Cut Back On Prescriptions

New research has found that physicians modestly reduced the volume of opioids they prescribed after being told one of their patients had died of an overdose.

Anna Gorman, Kaiser Health News

Physicians and other medical providers modestly reduced the volume of opioids they prescribed after being told one of their patients had died of an overdose, according to research published Thursday.

“You can hear a lot of statistics about the crisis,” said Jason Doctor, lead author of the study, published Thursday in the journal Science. “But it always feels like it is happening elsewhere if you are not aware of any deaths in your own practice.”

The research included more than 800 clinicians — doctors, nurse practitioners, physician assistants and dentists — comparing those who received a letter from the medical examiner about a patient’s death and those who didn’t. The ones who knew about the overdose death cut the overall volume of opioids they prescribed by almost 10 percent over three months, while those who didn’t know prescribed roughly the same amount as before.

The study shows that awareness and education can change prescribing behavior, said Doctor, a director at University of Southern California’s Schaeffer Center for Health Policy & Economics. The modest size of the reduction among those who were notified of a death suggests “that clinicians exercised greater caution with opioids rather than abandoning use,” according to the study.

The providers in the study who were informed about patients’ deaths were also 7 percent less likely to start new patients on opioids.

The letter did not blame providers for the deaths but showed that authorities were paying attention, according to the study.

“We were providing them with important information and also giving them a way to make things better by changing prescribing,” Doctor said. “Anyone who got the letter could continue to prescribe as much as they wanted, but we found that they didn’t. They became more judicious prescribers.”

Over 19,000 people died from prescription opioids in 2016, roughly double the number 14 years earlier, according to the National Institute on Drug Abuse. Most of that increase occurred from 2002 to 2011, and the numbers have been relatively stable since then, according to the NIDA.

Meanwhile, prescriptions of opioids are declining, and health officials are seeking ways to accelerate the trend.

The study did not measure whether the letters from the medical examiner or the changes in prescribing patterns had any effect on patient deaths.

Across the country, physicians have been accused of overprescribing opioids and have even faced charges related to patient overdose deaths. In an effort to better track prescribing patterns, states have started prescription drug monitoring databases.

The CDC recommends that providers avoid opioids if possible, but if they are necessary, they should start with the lowest effective dose.


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.

Where the Female Doctors Are

Of the 978,743 practicing physicians in the U.S., women only account for just over a third of them. We break down the states with the most and least.

When it comes to physicians, men clearly dominate the profession. According to recent data from the Kaiser Family Foundation, of the 978,743 practicing physicians in the United States, women only account for just over one-third of them (34.4%).

So, where are the female doctors? Below are the five states with the most and least female physicians in the United States, as well as how many there are and what percentage of practicing physicians they account for.

States with the Most Female Physicians

  1. California – 38,140 practicing female physicians, 35% of all physicians
  2. New York – 33,066 practicing female physicians, 38.5% of all physicians
  3. Texas – 21,072 practicing female physicians, 33.5% of all physicians
  4. Pennsylvania – 17,015 practicing female physicians, 35% of all physicians
  5. Florida – 16,221 practicing female physicians, 29.7% of all physicians

States with the Least Female Physicians

  1. Wyoming – 315 practicing female physicians, 26.9% of all physicians
  2. South Dakota – 564 practicing female physicians, 28.3% of all physicians
  3. North Dakota – 569 practicing female physicians, 29.4% of all physicians
  4. Montana – 635 practicing female physicians, 27.5% of all physicians
  5. Alaska – 677 practicing female physicians, 36.8% of all 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.