physicians Tag

17 Oct

Posted at 18:40h in Medical Billing

Editorial Notice: This article reflects the contributor's perspective on practice management. Services linked in this post are not warranted or endorsed by MedicalResearch.com or Eminent Domains Inc. Billing, coding and compliance requirements vary by payer and state; confirm current rules with each payer and qualified advisors.

A medical practice can be clinically strong and still struggle financially when billing problems go unnoticed. Delayed claims, incomplete documentation, inconsistent follow-up, and unclear patient balances can reduce cash flow long before the impact appears on a monthly profit-and-loss statement.

For physicians, the challenge is not simply submitting more claims. It is building a revenue cycle that supports timely reimbursement, protects staff capacity, and gives patients clear financial information. Addressing weaknesses early is especially important for smaller practices, where one billing employee's absence or a sudden increase in denials can disrupt the entire operation.

[caption id="attachment_76633" align="aligncenter" width="500"]Billing Challenges Physicians Should Address Photo by Negative Space[/caption]

04 Nov

Posted at 08:49h in Author Interviews, Health Care Systems
[caption id="attachment_71273" align="aligncenter" width="500"]group-practice-collaborating-doctors Freepik image[/caption]

Setting the Stage for Physician Collaboration

Physician collaboration today is far more sophisticated than a faxed referral or a hallway consult. It’s multidisciplinary teams dissecting cases in real time, virtual consults bridging continents, and shared care pathways engineered for precision. Healthcare leaders are moving past siloed decision-making toward integrated, patient-centered strategy. The trend is accelerating: according to a 2023 survey by the American Hospital Association, more than 68% of hospitals report active use of digital collaboration tools for cross-specialty case management. That’s not an incremental shift—it’s a structural rewrite of how medicine gets done.

Why Peer Collaboration Transforms Care Delivery

In one major trauma center, a cardiologist and neurosurgeon resolved a life-threatening case in under an hour by connecting through a rapid-response video link. No delays. No duplicated tests. Just decisive action. This is the power of peer collaboration: faster diagnoses, cleaner treatment plans, fewer blind spots. Open communication reduces the risk of avoidable errors—errors that cost lives and erode trust. Patients feel it too. Clarity in care translates into confidence, and confidence feeds satisfaction scores that administrators obsess over.

Key Advantages of Physician Collaboration Platforms

  1. Streamlined workflows: By centralizing case notes, lab results, and imaging into one interface, the days of hunting through multiple systems disappear. Time saved is capacity gained, freeing clinicians to focus on decision-making instead of chasing data.
  2. Knowledge sharing: Platforms connect collaborating physicians across distances, breaking the walls between institutions. A rare pathology in one region becomes a learning opportunity for hundreds of doctors elsewhere, increasing insight velocity.
  3. Cost efficiency: Misordered tests and redundant imaging don’t just burn budgets, they slow patient care. Integrated platforms cut those inefficiencies, delivering leaner operations without sacrificing depth of review.

05 Sep

Posted at 17:17h in General Medicine
[caption id="attachment_70542" align="aligncenter" width="500"]npi-lookup-physicians SPhoto by RDNE Stock project[/caption] If you spend time in medical sales, you’ve probably heard about the NPI registry. Some reps know it well, others sort of nod along and secretly Google it later. Either way, it’s one of those resources that makes your job a lot easier once you actually know how to use it. Let’s break down what it is, why it matters, and the practical steps for running an NPI lookup without getting lost in government-site purgatory.

What the NPI registry actually is

The registry is a public database that lists every provider and organization with a National Provider Identifier. Think of it as the giant phone book of healthcare professionals, except it’s federally maintained and built for compliance rather than convenience. Doctors, nurse practitioners, dentists, physical therapists—you name it—they all have an NPI number if they bill Medicare or most commercial insurance. For a sales rep, it’s less about billing and more about clarity. When you’re sorting out which “Dr. Smith” is which in your territory, the registry saves you from cold-calling the wrong office. It tells you not just the provider’s name but also practice addresses, taxonomy (specialty), and sometimes the organizations they’re tied to.

14 Feb

Posted at 17:01h in Author Interviews, Gender Differences, JAMA, University of Michigan
MedicalResearch.com Interview with: [caption id="attachment_66556" align="alignleft" width="200"]Farrah Madanay, PhDPostdoctoral Research Fellow Center for Bioethics and Social Sciences in Medicine Michigan Medicine University of Michigan Dr. Madanay[/caption] Farrah Madanay, PhD Postdoctoral Research Fellow Center for Bioethics and Social Sciences in Medicine Michigan Medicine University of Michigan MedicalResearch.com: What is the background for this study? Response: Patients are increasingly using online forums to evaluate their physicians, with not only star ratings but also written narrative reviews. These reviews tend to fall into two dimensions: interpersonal manner, which includes comments about the physician’s attitude, behavior, and communication; and technical competence, which includes comments about the physician’s knowledge, skill, and outcomes. These two dimensions are important for patient-centered care and align with research from social psychology. Whereas prior studies have revealed gender differences in workplace assessments and overall star ratings of physicians, little is known about physician gender differences in patients’ online written reviews. We were curious whether physician gender differences were prevalent in patients’ written reviews and consistent across physician specialties, from generalists, like primary care physicians, to proceduralists, like surgeons. We collected physician profile, rating, and review data from one of the largest commercial physician rating and review websites. We focused on physicians from three primary care specialties (family medicine, internal medicine, and pediatrics), and three surgical specialties (general surgery; orthopedic surgery; and cosmetic, plastic, and reconstructive surgery). Our final sample included 345,053 online reviews received by 167,150 U.S. physicians between 2015 and 2020. We used hand-coded reviews to train an advanced natural language processing algorithm to classify all reviews for the presence and valence of patients’ comments of physicians’ interpersonal manner and technical competence. We then conducted multilevel logistic regressions to analyze differences by female or male physician gender in interpersonal manner and technical competence comments and whether those comments were associated with review star ratings.

11 Aug

Posted at 19:51h in Education
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle, Navigating the broad universe of medicine resembles finding a path in a maze. Picking the right medical specialization is crucial for both professional growth and personal fulfillment. Medicine's field is varied, each having distinct challenges and benefits, thus making this decision crucial.

Self-Assessment and Introspection

Understanding oneself is vital before exploring medical fields. What are your unique interests? Which medical areas spark your enthusiasm? It's common to advise students to reflect on their likes and dislikes in various subjects. To save some time, you might hire an EssayPro to lessen your workload. This could enlighten you about your abilities and preferences. Each medical field has specific requirements. A surgeon may have unpredictable hours and stressful situations, while a dermatologist may have more set hours. Understanding the work-life balance you desire can affect your choice. Visualizing your future is essential. Where do you want to be in the next decade or two? Whether in a busy hospital emergency room, a peaceful research laboratory, or a community clinic, your long-term goals can guide your current choices.

01 May

Posted at 14:04h in Author Interviews, Health Care Systems, JAMA, Technology, UCSD
MedicalResearch.com Interview with: Zechariah Zhu, B.S. Affiliate Scientist with the Qualcomm Institute at UC San Diego and study co-author First author: John W. Ayers, PhD, MA MedicalResearch.com: What is the background for this study? Response: In today’s day and age (especially after the COVID-19 pandemic), an increasing number of people are turning to virtual options for healthcare. Most notably, there was a 1.6-fold increase in electronic patient messages, which significantly increased the burden on physicians, with a record-high proportion of physicians (62%) reporting burnout symptoms. On the other hand, we also see the rise of AI technologies like ChatGPT—an AI chatbot assistant that has taken the world by storm recently with its ability to provide lengthy response essays to many questions it is asked. Our objective for this study, then, was to evaluate the ability of ChatGPT to provide quality and empathetic responses to patient questions.

19 Dec

Posted at 18:59h in Author Interviews, Cost of Health Care, JAMA
MedicalResearch.com Interview with: [caption id="attachment_59851" align="alignleft" width="125"]MedicalResearch.com Interview with:Anna L Goldman, MD, MPH, MPA Assistant Professor of Medicine Boston Medical Center MedicalResearch.com: What is the background for this study? Response: Experts on the healthcare labor market have long debated the existence and magnitude of a physician shortage. Physician work hours are a major contributor to physician supply issues, but little research is available on recent trends in work hours by physicians. In addition, no available studies have rigorously estimated changes in the physician workforce size during the pandemic. MedicalResearch.com: What are the main findings? Were there gender differences in hours worked? Response: The average hours worked per week by physicians decreased 7.6% in the two decades between 2001 and 2021. On average, physicians worked 52.6 hours per week in 2001-2003 and 48.6 hours per week in 2019-2021. This decrease did not appear to be caused by the COVID-19 pandemic, as the trend continued on the same steady trajectory that was present prior to the pandemic. The observed decreases were driven by reduced work hours among male physicians, full-time physicians, and younger physicians. Male physicians decreased work hours twice as much as female physicians. Physician mothers were the only group to increase weekly work hours, with a 3% increase over 20 years. Physician fathers, by contract, decreased work hours by 12%. The number of part-time physicians remained flat throughout the study period. Broadly decreasing trends in work hours were similarly present among non-physician holders of doctoral degrees, suggesting a broader trend among highly-educated professionals in their approach to work hours. The physician workforce grew by 32.9% over two decades, but then fell by 6.7% during the COVID-19 pandemic, or a drop of 1 in 14 physicians. The physicians who left the workforce during the pandemic were disproportionately white and from rural areas. Work hours generated by the physician workforce, as a whole, grew 7% over the study period, which was about half the rate of population growth in the same period (16.6%). This sluggish growth in physician workforce hours was entirely offset by large increases in the work hours contributed by nurse practitioners and physician assistants. When the clinician workforce was assessed as a whole (combining hours from physicians, nurse practitioners, and physician assistants), growth in total workforce hours was 21.4%, exceeding the population growth rate. MedicalResearch.com: What should readers take away from your report? • Physician weekly work hours fell 8% from 2001-2021, with a particularly large drop for physician fathers (-12%) vs. a small increase for physician mothers (+3%). • Because of this decline in hours, total weekly hours contributed by the physician workforce lagged far behind US population growth, an increase of 7% in work hours vs. 16.6% increase in US population. This gap was entirely offset by a large increase in nurse practitioner and physician assistant hours. • From 2019 to 2021, the physician workforce fell by 7%, which represents 1 in 14 physicians leaving the workforce during the COVID-19 pandemic. MedicalResearch.com: What recommendations do you have for future research as a results of this study? Response: Research on work hours in individual physician specialties is needed to better understand the distribution of work hour changes across the spectrum of physician types. Measurement of these trends can help predict burnout in specialties where hours may be lengthening vs. shortages in fields with rapidly decreasing work hours. MedicalResearch.com: Is there anything else you would like to add? Any disclosures? Response: Our findings may shed light on the high rates of burnout that has been identified among physician-mothers in other research. While increasing work hours among mothers may indicate progress on gender parity in terms of career engagement, this change may not have been sufficiently offset by a reduction in domestic responsibility. Further research should examine the balance of household duties as physician mothers spend an increasing amount of time at work. No disclosures. Citation: Changes in Physician Work Hours and Implications for Workforce Capacity and Work-Life Balance, 2001-2021 The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website. Dr. Goldman[/caption] Anna L. Goldman, M.D., M.P.A., M.P.H Assistant Professor of Medicine General Internal Medicine Boston University Chobanian & Avedisian School of Medicine   MedicalResearch.com: What is the background for this study? Response: Experts on the healthcare labor market have long debated the existence and magnitude of a physician shortage. Physician work hours are a major contributor to physician supply issues, but little research is available on recent trends in work hours by physicians.  In addition, no available studies have rigorously estimated changes in the physician workforce size during the pandemic.

17 Jul

Posted at 22:21h in Author Interviews, Education, Gender Differences, JAMA
MedicalResearch.com Interview with: [caption id="attachment_57791" align="alignleft" width="120"] Anjali Sergeant[/caption] Anjali Sergeant McMaster Medicine Class of 2022 MedicalResearch.com: What is the background for this study? What are the main findings? Response: This collaborative study from the University of Toronto and McMaster University found that inpatients in the Greater Toronto Area (GTA) cared for by female physicians had lower mortality rates compared to those cared for by male physicians. Specifically, a 0.47% difference in patient deaths was reported, which is significant in the context of thousands of deaths in Ontario hospitals each year. This supports similar findings from an American study (Tsugawa et. al) published in 2017. Our study also examined gender-based differences in medical practice, including lab and imaging tests ordered, and medications prescribed. Female doctors ordered significantly more imaging tests for their patients but this factor did not explain their lower patient death rates. The mortality difference shrank when accounting for the number of years that doctors were in practice. This suggests that patients of female doctors may have better outcomes partially because more women make up newer medical grads in Canada, who may be more up-to-date on clinical guidelines.

20 Apr

Posted at 15:03h in Author Interviews, Duke, Electronic Records, Health Care Systems, JAMA
MedicalResearch.com Interview with: [caption id="attachment_57184" align="alignleft" width="200"]Eugenia McPeek Hinz MD MS FAMIA Associate CMIO - DHTS Duke University Health System Dr. McPeek Hinz[/caption] Eugenia McPeek Hinz MD MS FAMIA Associate CMIO - DHTS Duke University Health System MedicalResearch.com: What is the background for this study? Response: Clinician burnout rates have hovered around 50% for much of the past decade.  Burnout is a significant concern in healthcare for its effects on care givers and associated downstream adverse implications on patient care for quality and safety. The ubiquitous presence of Electronic Health Records (EHR) along with the increased clerical components and after hours use has been a significant concern for contributing to provider burnout. 

22 Jan

Posted at 22:12h in Author Interviews, Health Care Systems, JAMA
MedicalResearch.com Interview with: [caption id="attachment_56455" align="alignleft" width="200"]Dr-Sara Machado.jpeg Dr. Machado[/caption] Sara Machado PhD Fellow at the Department of Health Policy London School of Economics and Political Science MedicalResearch.com: What is the background for this study? Response: Physician distribution is a determinant of health care access, so knowing how physician density patterns evolve over time is important if we are trying to address disparities in access to care. Moreover, the last 10 years have brought about changes in health care coverage, across the US. Recent evidence points to an uneven physician distribution between urban and rural communities. We examined recent trends in physician density by physician category across rural and urban US counties.  MedicalResearch.com: What are the main findings? Response: We have two main findings.
  • First, density of primary care physicians steadily decreased in more than half of rural counties (994 out of 1,976).
  • Second, medical specialist density, which would care for cardiovascular and pulmonary disease, for example, has been largely stagnant in rural counties, at the lowest density levels (less than 10 physicians per 100,000), and increasing in metropolitan counties.

03 Nov

Posted at 17:08h in Author Interviews, Surgical Research
MedicalResearch.com Interview with: Dr. Pravesh S. Gadjradj, MD Department of Neurosurgery, Leiden University Medical Center, University Neurosurgical Center Holland Leiden, Netherlands neurosurgery brain surgery ct scan MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Many healthcare professionals throughout the world face issues surrounding medical malpractice at some point in their careers. Unfortunately, a number of these cases turn into medical malpractice lawsuits. As a specialty that treats acute pathology and refractory pain, neurosurgery is at risk for high liability. By the means of a survey among members of the Congress of Neurological Surgeons (CNS), we aimed to illustrate how malpractice lawsuits affect neurosurgeons professionally, emotionally and financially.   MedicalResearch.com: What are the main findings?  Response: Some 490 members of the CNS shared their experiences with us. Among these members, 81% faced a medical malpractice lawsuit. The main concerns expressed about being sued included losing confidence and practicing defensive medicine, personal assets being at risk, and being named in the National Practitioner Data Bank. Of the respondents, 40% stated they were frequently or always concerned about being sued, and 77 % stated their fear had led to a change in how they practice medicine. For 58 %, this change led to the practice of defensive medicine, while for others it led to more extensive documentation (14%) and/or to referring or dropping complex cases (12%). Given the medical malpractice environment, 59% of respondents considered referring complex patient cases, whereas 37% considered leaving the practice of medicine.

27 Jan

Posted at 12:10h in Author Interviews, Education, Gender Differences, Neurology, UC Davis
MedicalResearch.com Interview with: [caption id="attachment_52973" align="alignleft" width="133"]Allison Brashear, M.D., M.B.A. Dean, UC Davis School of Medicine Dr. Brashear[/caption] Allison Brashear, M.D., M.B.A. Dean, UC Davis School of Medicine MedicalResearch.com: What is the background for this study? Why is the demand for neurology services and neurologists increasing?  Response: The American Academy of Neurology estimates that by 2025 the number of neurologists in practice will increase to 18,060 but some 3,400 more will be needed to meet the demand for their services. The 58% increase in the number of residency positions in the National Resident Matching Program since 2008 also reflects the growing demand. The higher prevalence of neurologic conditions, aging U.S. population and more patients having access to the health care coverage are the major driving forces. (Note: source of NRMP neurology trend data comes from a physician/resident forum posted May 2019 https://forums.studentdoctor.net/threads/growth-trends-in-neurology-residency-positions.1375918/) MedicalResearch.com: Why is neurology included among the less desirable fields of medicine (similar to nephrology, infectious disease, endocrinology etc.) for medical students and residents to pursue?  Why is burnout and dissatisfaction so high? Response: According to the American Academy of Neurology, a minority of medical students choose to train in neurology each year, with approximately 3.1% matching into a neurology residency in 2018. The newer generations of neurologists value lifestyle and time off work more than their predecessors. According to a recent American Medical Association survey, neurology tied with critical care as the medical specialty with the highest stress levels and burnout. Too many administrative tasks, too many hours at work, increased computerization of practice and insufficient compensation were among the top causes of burnout.

30 Nov

Posted at 20:33h in Author Interviews, Depression, JAMA
MedicalResearch.com Interview with: [caption id="attachment_52326" align="alignleft" width="200"]Karina Pereira-Lima, PhD Department of Psychiatry, University of Michigan Medical School, Ann Arbor Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil Dr. Pereira-Lima[/caption] Karina Pereira-Lima, PhD Department of Psychiatry, University of Michigan Medical School, Ann Arbor Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil MedicalResearch.com: What is the background for this study? Response: Questions regarding the magnitude and direction of the associations between physician depressive symptoms and medical errors remain open in recent literature. By pooling data from 11 studies involving 21,517 physicians, we were able to verify that depressive symptoms among physicians were associated with increased risk of reporting medical errors (RR, 1.95; 95% CI, 1.63 – 2.33).

15 Nov

Posted at 22:53h in Abuse and Neglect, Electronic Records, Yale
MedicalResearch.com Interview with: [caption id="attachment_52179" align="alignleft" width="133"]Edward R. Melnick, MD, MHS Assistant Professor of Emergency Medicine Program Director, Yale-VA Clinical Informatics Fellowship Program Principal Investigator, EMBED Trial Network Yale School of Medicine New Haven, CT 06519  Dr. Melnick[/caption] Edward R. Melnick, MD, MHS Assistant Professor of Emergency Medicine Program Director, Yale-VA Clinical Informatics Fellowship Program Principal Investigator, EMBED Trial Network Yale School of Medicine New Haven, CT 06519  MedicalResearch.com: What is the background for this study? Response: We know that physicians are frustrated with their EHRs and that EHRs are a driver of burnout. This is the first study to measure these issues nationally. We included a standardized metric of technology from other industries (System Usability Scale, SUS; range 0-100) on the AMA’s 2017 physician burnout survey. This metric has been used in >1300 other studies so we can compare where the EHR’s usability is to other everyday technologies. We are also able to measure the relationship between physicians’ perception of their EHR’s usability and the likelihood they are burned out.

13 Nov

Posted at 20:59h in Author Interviews, Education, Gender Differences, JAMA
MedicalResearch.com Interview with: [caption id="attachment_52133" align="alignleft" width="200"]Shannon Ruzycki, MD, MPH, FRCPC, (she/hers) General Internist & Clinical Lecturer Department of Medicine Department of Community Health Sciences Cumming School of Medicine University of Calgary Dr. Ruzycki[/caption] Shannon Ruzycki, MD, MPH, FRCPC, (she/hers) General Internist & Clinical Lecturer Department of Medicine Department of Community Health Sciences Cumming School of Medicine University of Calgary MedicalResearch.com: What is the background for this study? Response: After hearing about the National Academies of Science, Engineering, and Medicine 2018 report to congress on sexual harassment of women in academia, our Department Head asked myself and Dr. Aleem Bharwani to study experiences of gender inequity or equity in our Department. We conducted an in-depth, 18-month mixed methods study of women and men in our Department, including semi-structured interviews and survey.

08 Oct

Posted at 17:29h in Annals Internal Medicine, Author Interviews, Outcomes & Safety, Stanford
MedicalResearch.com Interview with: [caption id="attachment_51734" align="alignleft" width="200"]Daniel Tawfik, MD, MS Pediatric Critical Care Medicine Stanford University School of Medicine Dr. Tawfik[/caption] Daniel Tawfik, MD, MS Pediatric Critical Care Medicine Stanford University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Professional burnout is very common among health care providers and is frequently associated with poor quality of care in the published literature. However, we know that reporting biases are common in many fields of literature, and these biases typically result in exaggerated effects being published relative to the true effect. Research on burnout and quality of care appears especially vulnerable, because many studies are not pre-specified or have several potential methods of analysis. If the studies or analyses with more impressive results are more likely to be published, this would result in a skewed picture of the relationship between burnout and quality of care.

06 Sep

Posted at 20:09h in Author Interviews, Cost of Health Care, Health Care Systems
MedicalResearch.com Interview with: [caption id="attachment_51181" align="alignleft" width="200"]Vivian Ho, PhD The James A. Baker III Institute Chair in Health Economics Director of the Center for Health and Biosciences Rice's Baker Institute for Public Policy Dr. Vivian Ho[/caption] Vivian Ho, PhD The James A. Baker III Institute Chair in Health Economics Director of the Center for Health and Biosciences Rice's Baker Institute for Public Policy MedicalResearch.com: What is the background for this study? Response: In 2003, approximately 29% of U.S. hospitals employed physicians, a number that rose to 42% by 2012. The share of physician practices owned by hospitals rose from 14% in 2012 to 29% in 2016. Economists refer to these relationships between hospitals and physicians as vertical integration, because they represent hospitals exerting more control over physicians as an essential part of inpatient care. As hospitals gain more control over physicians, they may incentivize delivery of more services but not necessarily higher quality care. When we launched this study, we hypothesized that tighter integration of physicians with hospitals would improve care coordination.

11 Jul

Posted at 22:39h in Author Interviews, Health Care Systems, Primary Care, University of Pennsylvania
MedicalResearch.com Interview with: [caption id="attachment_50224" align="alignleft" width="200"]Molly Candon PhD Research Assistant Professor of Psychiatry Lecturer, Department of Health Care Management The Wharton School, University of Pennsylvania Co-Instructor, Health Services and Policy Research Methods II, MS in Health Policy Research Program, Perelman School of Medicine, University of Pennsylvania  Dr. Candon[/caption] Molly Candon PhD Research Assistant Professor of Psychiatry Lecturer, Department of Health Care Management The Wharton School, University of Pennsylvania Co-Instructor, Health Services and Policy Research Methods II, MS in Health Policy Research Program, Perelman School of Medicine, University of Pennsylvania  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: A team of researchers (led by Karin Rhodes, MD and Dan Polsky, PhD) conducted a secret shopper study of thousands of primary care practices across 10 states, with trained callers simulating patients with Medicaid and requesting appointments. One of the outcome measures was whether an appointment was scheduled with a physician or Advanced Practitioner. Between 2012 and 2016, the share of appointments scheduled with Advanced Practitioners increased by five percentage points. 

02 Jul

Posted at 15:14h in Author Interviews, Electronic Records
MedicalResearch.com Interview with: [caption id="attachment_50062" align="alignleft" width="133"]Ming Tai-Seale, PhD, MPH Professor Department of Family Medicine and Public Health University of California San Diego School of Medicine  Dr. Tai-Seale[/caption] Ming Tai-Seale, PhD, MPH Professor Department of Family Medicine and Public Health University of California San Diego School of Medicine  MedicalResearch.com: What is the background for this study? Response: The electronic health record (EHR) potentially creates a 24/7 work environment for physicians. Its impact on physicians’ wellness has become a challenge for most health care delivery organizations. Understanding the relationships between physicians’ well-being and “desktop medicine”1 work in the EHR and work environment is critical if burnout is to be addressed more effectively.

06 Jun

Posted at 19:05h in Author Interviews, Dermatology, FDA
MedicalResearch.com Interview with: [caption id="attachment_49640" align="alignleft" width="148"]Stephanie L. Kuschel, B.A Indiana University School of Medicine Indianapolis, IN, 46202 Dr. Kuschel[/caption] Stephanie L. Kuschel, MD Indiana University School of Medicine Indianapolis, IN, 46202 Robert Dellavalle, MD, PhD, MSPH Professor of Dermatology and Public Health University of Colorado School of Medicine Colorado School of Public Health Chief, Dermatology Service US Department of Veterans Affairs Eastern Colorado Health Care System Denver, CO 80220  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Physicians can serve as external experts and voting members of FDA advisory committee panels, which help determine if a drug is acceptable for the US market. Considering that financial conflicts of interest (FCOI) have been shown to influence voting member habits, the FDA has regulations in place to minimize these FCOI. However, the FDA can grant waivers for some financially conflicted individuals if they meet certain requirements (like offering key insights that may out-weigh the risk of a possible FCOI). Additionally the FDA does not make stipulations regarding post-advisory role financial relationships. In fact, many former FDA committee advisors later engage in financial relationships with pharmaceutical companies. Some worry these post-hoc financial relationships could pose an ethical dilemma whereby future FDA advisory members are incentivized to alter their voting habits in expectation of future rewards. Others argue the situation may be more complex than expected. For example, the author of one study, found that while there was evidence for a pro-industry voting bias among committee members with exclusive financial relationships to the sponsoring manufacturer (of the drug under review), this was not the case for members with nonexclusive financial ties to both the sponsor and its competitors 1. Furthermore, the author found that advisors with many corporate ties were (on average) actually more likely than their peers without any financial ties to vote against the sponsor. The author argued that these advisors were more likely to be experienced researchers, and their voting habits may reflect their experience evaluating medical research. While this author and others have offered valuable insights into financial relationships of advisors during their advisory role, unfortunately little information is available regarding post-advisory role financial relationships and whether these relationship have any influence on the integrity of the voting process. The purpose of our study was to review Open Payment data on industry payments to former physician FDA dermatologic drug committee members. 

17 May

Posted at 11:13h in Author Interviews, Education, Neurology, NYU/NYMC
MedicalResearch.com Interview with: Dr. Rebecca Stainman Dr. Arielle Kurzweil MD Adult Neurology Program Director New York University School of Medicine NYU Langone Health MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Physician burnout is prevalent. Neurologists have among the highest burnout rates, ranked third among specialties in a 2011 study, and over half of US Neurologists report at least 1 symptom of burnout in a 2016 survey.  Efforts to address burnout in training programs have mostly been aimed at implementing wellness curricula and offering mental health resources. Training neurology residents to effectively identify, address, and help impaired colleagues is equally crucial in these efforts, yet there is a paucity of literature on this topic. We used simulation as a means of addressing this topic, via identifying and addressing an impaired colleague through an objective structured clinical examination (OSCE). 

14 Apr

Posted at 22:19h in Author Interviews, JAMA, University of Pennsylvania
MedicalResearch.com Interview with: [caption id="attachment_32691" align="alignleft" width="140"]Genevieve Kanter, PhD Assistant Professor Department of Health Management and Policy Drexel University Dornsife School of Public Health Philadelphia, PA Dr. Genevieve Kanter[/caption] Genevieve P. Kanter, PhD Assistant Professor (Research) of Medicine Medical Ethics and Health Policy University of Pennsylvania Perelman School of Medicine Philadelphia, PA  19104-6021 MedicalResearch.com: What is the background for this study?   Response: Physicians frequently have financial relationships with pharmaceutical and medical device firms, but only recently has information on these financial ties been made available to the public. The Open Payments program, created by the Physician Payment Sunshine Act, has made this industry payments information available through a public website since 2014. Because transparent institutions are believed to engender greater public trust, public disclosure of industry payments could increase public trust in the medical profession, which may have been weakened by physicians' relationships with industry. On the other hand, Open Payments may have decreased public trust because of the focus of media reporting on physicians receiving the largest sums of money. We sought to investigate how Open Payments and the public disclosure of industry payments affected public trust in physicians and in the medical profession. We compared changes in trust among patients who lived in states where payments information had, by state statute, previously been made available, to changes in trust among patients who lived in states where this information became newly available through Open Payments.

31 Jan

Posted at 13:16h in Author Interviews, Gender Differences, JAMA, Mental Health Research, UCSF
MedicalResearch.com Interview with: [caption id="attachment_47241" align="alignleft" width="142"]Christina Mangurian, MD MAS Professor Department of Psychiatry, Weill Institute for Neurosciences Center for Vulnerable Populations, University of California, San Francisco Dr. Mangurian[/caption] Christina Mangurian, MD MAS Professor Department of Psychiatry, Weill Institute for Neurosciences Center for Vulnerable Populations, University of California, San Francisco [caption id="attachment_47238" align="alignleft" width="150"]Veronica Yank, MD Division of General Internal Medicine Department of Medicine University of California, San Francisco Dr. Yank[/caption] Veronica Yank, MD Assistant Professor Division of General Internal Medicine Department of Medicine University of California San Francisco MedicalResearch.com: What is the background for this study? Response: This article is about the behavioral health and burnout consequences among physician mothers who are caring for seriously ill loved ones. Our work was inspired, in part, by some of the authors’ own experiences caring for loved ones with serious illnesses while also being physician mothers themselves.  We sought to determine the proportion of physician mothers with such caregiving responsibilities beyond their patients and children and the how these additional responsibilities affected the women’s health and practice.

06 Dec

Posted at 23:12h in Author Interviews, Electronic Records
MedicalResearch.com Interview with: [caption id="attachment_46446" align="alignleft" width="160"]Rebekah L Gardner MD Associate Professor of Medicine Warren Alpert Medical School Brown University Providence, Rhode Island Dr. Gardner[/caption] Rebekah L Gardner MD Associate Professor of Medicine Warren Alpert Medical School Brown University Providence, Rhode Island MedicalResearch.com: What is the background for this study? What are the main findings? Response: Burnout profoundly affects physicians, their patients, and the health care system.The role of technology in physician burnout, specifically health information technology (HIT), is not as well characterized as some of the other factors. We sought to understand how stress related to HIT use predicts burnout among physicians. Our main findings are that 70% of electronic health record (EHR) users reported HIT-related stress, with the highest prevalence in primary care-oriented specialties. We found that experiencing HIT-related stress independently predicted burnout in these physicians, even accounting for other characteristics like age, gender, and practice type. In particular, those with time pressures for documentation or those doing excessive “work after work” on their EHR at home had approximately twice the odds of burnout compared to physicians without these challenges. We found that physicians in different specialties had different rates of stress and burnout.

07 Sep

Posted at 12:23h in Author Interviews, JAMA, Outcomes & Safety
MedicalResearch.com Interview with: [caption id="attachment_44298" align="alignleft" width="128"]Dr Maria Panagioti| Senior Research Fellow Division of Population Health, Health Services Research & Primary Care University of Manchester Manchester Dr. Panagioti[/caption] Dr Maria Panagioti, Senior Research Fellow Division of Population Health Health Services Research & Primary Care University of Manchester Manchester  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several studies have shown that the demanding work environment has alarming consequences on the well-being of physicians. Over 50 percent of physicians experience significant signs of burnout across medical specialities. However, the consequences of burnout on patient care are less well-known. This is the largest meta-analysis to date which pooled data from 43,000 doctors to examine the relationship between burnout in physicians and patient safety, professionalism and patient satisfaction. We found that burnout in physicians is associated with two times increased risk for patient safety incidents, reduced professionalism and lower patient satisfaction. Particularly in residents and early career physicians, burnout was associated with almost 4 times increased risk for reduced professionalism. 

23 Aug

Posted at 20:28h in Author Interviews, Gender Differences, Heart Disease, Women's Heart Health
MedicalResearch.com Interview with: [caption id="attachment_44096" align="alignleft" width="142"]Brad N. Greenwood PhD Associate Professor Information & Decision Sciences Carlson School of Management University of Minnesota–Twin Cities, Minneapolis MN  Dr. Greenwood[/caption] Brad N. Greenwood PhD Associate Professor Information & Decision Sciences Carlson School of Management University of Minnesota–Twin Cities, Minneapolis MN MedicalResearch.com: What is the background for this study? What are the main findings? Response: There has been growing work in medicine which suggests both that a) women are more skilled physicians across a variety of ailments and b) women are particularly challenging heart attack patients (for a variety of reasons ranging from delays in seeking treatment to atypical presentation). When you coupled this with the deep literatures in economics, sociology, and political science which suggests that advocatees experience better outcomes when they share traits with their advocates, it seemed plausible that there might be differences in outcomes. The key finding is that gender concordance matters most for female patients:  female patients are about 0.7-1.2% more likely to die if treated by a male doctor, relative to a female doctor.  This number seems small.  But, if the survival rate among the female heart attack patients treated by male doctor was the same as the survival rate among female heart attack patients treated by female doctors, about 1,500-3,000 fewer of the female heart attack patients in our sample would have passed away. Our sample covers the state of Florida from 1991-2010.  Florida is about 10% of the US population.

23 Jul

Posted at 17:13h in Author Interviews, Cost of Health Care
MedicalResearch.com Interview with: Jonathan Gruber PhD Department of Economics, E52-434 MIT Cambridge, MA 02139 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: There is a large literature trying to estimate the extent of 'defensive  medicine' by looking at what happens when it gets harder to sue and/or  you can win less money. But there have been no studies of what happens if you just get rid of the right to sue.  That's what we have with active duty patients treated on a military base. The main finding is that when patients can't sue they are treated about  5% less intensively.  Much of the effect appears to arise from fewer diagnostic tests.

11 Jul

Posted at 13:51h in Author Interviews, Critical Care - Intensive Care - ICUs, JAMA, Pediatrics, Social Issues
MedicalResearch.com Interview with: [caption id="attachment_43004" align="alignleft" width="145"]Dr. Tessie W. October. MD, MPH Critical Care Specialist Children’s National Health System Dr. October[/caption] Dr. Tessie W. October. MD, MPH Critical Care Specialist Children’s National Health System  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: This is a qualitative study that examines the impact of empathetic statements made by doctors on the ensuing conversation with families of critically ill children. We know families are more satisfied when doctors show empathy, but until this study, we did not know how these empathetic statements are received by families. In this study we found that doctors frequently respond to a family’s emotions by responding with empathy, but how the doctor presented that empathetic statement mattered. When doctors made an empathetic statement, then paused to allow time for a family’s response, the family was 18 times more likely to share additional information about their fears, hopes or values. Conversely, when doctors buried the empathetic statement within medical talk or if a second doctor interrupted, the empathetic statement frequently went unheard by the family.

23 Mar

Posted at 16:53h in Author Interviews, Opiods, Pharmaceutical Companies
MedicalResearch.com Interview with: [caption id="attachment_40738" align="alignleft" width="133"]Vishal Bala Senior Quantitative Data Analyst CareDash Vishal Bala[/caption] Vishal Bala Senior Quantitative Data Analyst CareDash MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prior research into physicians and their relationships with the pharmaceutical industry has typically retained a narrow scope, focusing on how payments may be associated with prescription habits (sometimes limited to specific regions) for specific categories of drugs. For example, Modi et al. 2017 and Bandari et al. 2017 explored these connections in the context of some urologic drugs specifically. Research conducted by ProPublica in 2016 studied the connection between industry payments and physician prescriptions across some of the largest medical specialties, but was only able to look at “brand-name” vs. “generic” categories and were limited by overlapping timeframes for payments and prescriptions. CareDash took this analysis further by using Open Payments and Medicare Part D data to investigate the relationship between payments made by individual companies for specific drugs and the prescribing habits of the recipient physicians for those drugs. CareDash’s main findings are that healthcare providers who received payments for a drug from a pharmaceutical company are 5 times more likely to be high prescribers for that drug than those physicians who did not receive a payment. Physicians are 5.3 times more likely to prescribe a drug than their peers after they have received a payment for that drug from the manufacturer. When physicians already prescribe a drug significantly more often than their peers, they are 5.6 times more likely to later receive payment for that drug from the drug's manufacturer. Looking at the opioid drug class specifically, CareDash found that physicians receiving payment on behalf of an opioid were 14.5 times more likely to prescribe that opioid over alternatives.