scholarly journals The Impact of Practicing Obstetrics on Burnout Among Early-Career Family Physicians

2020 ◽  
Vol 52 (6) ◽  
pp. 408-413
Author(s):  
Tyler W. Barreto ◽  
Aimee Eden ◽  
Audrey Brock
Keyword(s):  
Family Medicine ◽  
Family Physicians ◽  
The United States ◽  
Early Career ◽  
Residency Programs ◽  
Complex Patients ◽  
Semistructured Interviews ◽  
Administrative Tasks ◽  
The Impact ◽  
The Relationship

Background and Objectives: According to a previous study, obstetric deliveries may be protective against burnout for family physicians. Analyses of interviews conducted during a larger qualitative study about the experiences of early-career family physicians who intended to include obstetric deliveries in their practice revealed that many interviewees discussed burnout. This study aimed to understand the relationship between practicing obstetrics and burnout based on an analysis of these emerging data on burnout. Methods: We conducted semistructured interviews with physicians who graduated from family medicine residency programs in the United States between 2013 and 2016. We applied an immersion-crystallization approach to analyze transcribed interviews. Results: Fifty-six early-career family physicians participated in interviews. Burnout was an emerging theme. Physicians described how practicing obstetrics can protect from burnout (eg, brings joy to practice, diversity in practice), how it can contribute to burnout (eg, time demands, increased stress), how it can do both simultaneously and the importance of professional agency (ie, the capacity to make own free choices), and other sources of burnout (eg, administrative tasks, complex patients). Conclusions: This study identifies a family medicine-obstetric paradox wherein obstetrics can simultaneously protect from and contribute to burnout for family physicians. Professional agency may partially explain this paradox.

scholarly journals Family Medicine Residents’ Attitudes About Training in Ethiopia and the United States

2019 ◽  
Vol 51 (5) ◽  
pp. 424-429 ◽  
Author(s):  
Weyinshet Gossa ◽  
Christine Jones ◽  
Sorana Raiculescu ◽  
Mesfin Melaku ◽  
Elnathan Kebebew ◽  
...  
Keyword(s):  
Family Medicine ◽  
Patient Care ◽  
Family Physicians ◽  
Residency Education ◽  
The United States ◽  
Personal Life ◽  
Women's Issues ◽  
The Impact ◽  
Residents Attitudes ◽  
Family Medicine Residents

Background and Objectives: In Ethiopia, family medicine began in 2013. The objective of this study was to compare family medicine residents’ attitudes about training in Ethiopia with those at a program in the United States. Methods: Family medicine residents at Addis Ababa University in Addis Ababa, Ethiopia and the University of Maryland in Baltimore, Maryland completed a 43-item Likert scale survey in 2017. The survey assessed residents’ attitudes about residency education, patient care, independence as family physicians, finances, impact of residency on personal life, and women’s issues. We calculated descriptive statistics on the demographics data and analyzed survey responses using a two-sample t-test. Results: A total of 18 (75%) Ethiopian residents and 18 (60%) US residents completed the survey (n=36). The Ethiopian residents had a wider age distribution (25-50 years) than the US residents (25-34 years). More US residents were female (72%) compared to the Ethiopian cohort (50%), while more Ethiopian residents were married (72%) compared to the US cohort (47%). There were statistically significant differences in attitudes toward patient care (P=0.005) and finances (P<0.001), differences approaching significance in attitudes toward residency education, and no significant differences in independence as family physicians, the impact of residency on personal life, and women’s issues in family medicine. Conclusions: Across two very different cultures, resident attitudes about independence as family physicians, the impact of residency on personal life and women’s issues, were largely similar, while cross-national differences in attitudes were found relative to residency education, patient care, and finances.

scholarly journals What Will It Take to Recruit and Train More Underrepresented Minority Physicians in Family Medicine? A CERA Survey Analysis

2020 ◽  
Vol 52 (9) ◽  
pp. 661-664
Author(s):  
Julia P. Roulier ◽  
Jaeyun Sung
Keyword(s):  
Family Medicine ◽  
Family Physicians ◽  
Program Directors ◽  
The United States ◽  
Recruitment Strategies ◽  
Underrepresented Minority ◽  
Survey Analysis ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Diverse Patient Population

Background and Objectives: Both the Society of Teachers of Family Medicine (STFM) and the American Academy of Family Physicians have developed strategic plans to increase the training of underrepresented minority in medicine (URMM) family physicians to meet the needs of an increasingly diverse patient population in the United States. This study examines data from the 2017 Council of Academic Family Medicine (CAFM) Educational Research Alliance (CERA) Program Directors (PD12) Survey to assess whether recruitment strategies increase the diversity of underrepresented minority physicians in family medicine. Methods: Data were collected from an online electronic survey administered by the CERA of family medicine program directors in 2018. The data included specific questions about the diversity of URMM residents in family medicine programs and about initiatives that were used in their recruitment. We analyzed the data using the Pearson χ2 criteria for cause and effect of two variables. Results: Family medicine residency programs that have initiatives dedicated to increasing resident diversity have a higher percentage of URMM residents. Specifically, residency programs that have URMM recruitment strategies are 2.5 to 4 times more likely to have a diverse residency population than those programs without strategies (P<.001-.015). Conclusions: Striving to improve diversity in family medicine residency training in accordance with the ideals of STFM will require programs to design and implement initiatives to increase recruitment of URM residents.

OHNS Residency Program and Applicant Social Media Presence During the COVID-19 Pandemic

2021 ◽  
pp. 000348942098797
Author(s):  
Shadi Ahmadmehrabi ◽  
Deborah X. Xie ◽  
Bryan K. Ward ◽  
Paul C. Bryson ◽  
Patrick Byrne
Keyword(s):  
Social Media ◽  
The United States ◽  
Cross Sectional Study ◽  
Application Process ◽  
Cross Sectional ◽  
Residency Programs ◽  
Social Media Presence ◽  
Residency Application ◽  
The Impact ◽  
Residency Match

Objectives: In addition to clinical and social disruption, the Coronavirus Disease 2019 (COVID-19) pandemic has affected many aspects of the otolaryngology residency application process. With delays in the 2021 Electronic Residency Applications Service (ERAS) timeline, students and programs have had more time to interact prior to the formal application process. This communication will report recent trends in social media presence by OHNS residency programs, and discuss mechanisms to compensate for decreased applicant-program interactions using social media ahead of the 2021 Match. Methods: In a cross-sectional study of the accredited otolaryngology residency programs in the United States, the number of social media profiles on Twitter, Instagram, and Facebook from 2009 to 2019 were recorded and compared. Results: Most programs (61%) have at least 1 social media profile. Over the past 10 years, the number of programs on social media has increased. During the COVID-19 pandemic, Twitter and Instagram showed higher rates of growth compared to Facebook. With the reduction of in-person opportunities for interactions, both applicants and programs are utilizing social media to showcase their values and their research. Twitter, in particular, also serves as a platform for professional networking. Conclusion: Both Twitter and Instagram are growing in popularity among programs and applicants to enhance networking. Social media is a powerful tool for networking and may help compensate for limitations imposed on the residency match process by the COVID-19 pandemic while maintaining professionalism considerations. The impact of social media on the 2021 otolaryngology residency match is an evolving phenomenon.

scholarly journals The health and relationship dynamics of late-life couples: a systematic review of the literature

2009 ◽  
Vol 29 (3) ◽  
pp. 455-480 ◽  
Author(s):  
RUTH B. WALKER ◽  
MARY A. LUSZCZ
Keyword(s):  
Systematic Review ◽  
Marital Quality ◽  
Late Life ◽  
The United States ◽  
Health It ◽  
Social Emotional ◽  
Marital Relations ◽  
The Impact ◽  
The Relationship ◽  
Adequate Communication

ABSTRACTLate-life husband and wife relationships are increasingly recognised as an important factor in promoting wellbeing, particularly in terms of the health, social, emotional, financial and practical needs of older people. Knowledge of marital dynamics and how they affect both members of a couple remains scarce. This systematic review aimed to identify and appraise research that has focused explicitly on the dynamics of the relationship, as evinced by data frombothspouses. Implementing rigorous identification strategies, 45 articles were identified and reviewed. These studies were grouped into three broad thematic areas: marital relations and satisfaction; concordance in emotional state or physical health; and the interplay between marital quality and wellbeing. The issues found to affect marital relations and satisfaction in late life included equality of roles, having adequate communication, and transitions to living apart. There is strong evidence for couple concordance in depression, that marital relationships affect ill-health, longevity and recovery from illness, and reciprocally that ill-health impacts on the marriage itself. The research also suggests important gender differences in the impact of marital dynamics on health. It has led to the conclusion that there is a need for more diverse studies of late-life marriages, particularly ones that examine the dynamics of non-traditional elderly couples and that extend beyond a predominant focus on the Caucasian population of the United States.

A Dynamic Theory of Populism in Power

2021 ◽  
Author(s):  
Julio F. Carrión
Keyword(s):  
Regime Change ◽  
Dynamic Theory ◽  
Empirical Relationship ◽  
The United States ◽  
Democratic Governance ◽  
Theory Of Change ◽  
Popular Participation ◽  
The Andes ◽  
The Impact ◽  
The Relationship

The relationship between populism and democracy is a hotly debated topic. Some believe that populism is inherently bad for democracy because it is anti-pluralist and confrontational. Others argue that populism can reinvigorate worn-out democracies in need of an infusion of greater popular participation. This book advances this debate by examining the empirical relationship between populism in power and democracy. Does populism in power always lead to regime change, that is, the demise of democracy? The answer is no. The impact of populism on democracy depends on the variety of populism in power: the worst outcomes in democratic governance are found under unconstrained populism. This book discusses the conditions that explain how populism becomes unconstrained, and advances a dynamic theory of change that shows how the late victories of populists build on early ones, resulting in greater power asymmetries. The book analyzes five populist presidencies in the Andes. In four of them (Bolivia, Ecuador, Peru, and Venezuela), populism became unconstrained and regime change followed. In one case, Colombia, populism in power was contained and democracy survived. The concluding chapter places the Andean cases in comparative perspective and discusses how unconstrained populism in other cases (Nicaragua and Hungary) also lead to the end of electoral democracy. Where populism in power was constrained (Honduras and the United States), regime change did not materialize. This book advances a theory of populism that help us understand how democracies transition into non-democracies. To that extent, the book illuminates the processes of democratic erosion in our time.

The Impact of Energy on the Adoption of Conservation Tillage in the United States

1998 ◽  
Vol 9 (5) ◽  
pp. 549-568
Author(s):  
Noel D. Uri
Keyword(s):  
United States ◽  
Crude Oil ◽  
Conservation Tillage ◽  
The United States ◽  
Structural Instability ◽  
Special Importance ◽  
The Real ◽  
Real Price ◽  
The Impact ◽  
The Relationship

The impact of energy on the adoption of conservation tillage is of special importance in addressing concerns about the effect of agricultural production on the environment in the United States. It is the subject of this paper. After establishing that a relationship exists between the price of energy and the adoption of conservation tillage via cointegration techniques, the relationship is quantified. It is shown that while the real price of crude oil, the proxy used for the price of energy, does not affect the rate of adoption of conservation tillage, it does impact the extent to which it is used. Finally, there is no structural instability in the relationship between the relative use of conservation tillage and the real price of crude oil over the period 1963 to 1997.

scholarly journals Maternity Care Tracks at US Family Medicine Residency Programs

2021 ◽  
Vol 53 (10) ◽  
pp. 857-863
Author(s):  
Steven E. Roskos ◽  
Tyler W. Barreto ◽  
Julie P. Phillips ◽  
Valerie J. King ◽  
W. Suzanne Eidson-Ton ◽  
...  
Keyword(s):  
Family Medicine ◽  
Maternity Care ◽  
Underserved Populations ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Survey Response Rate ◽  
Care Training ◽  
Practice Methods ◽  
Residency Program Directors ◽  
The Relationship

Background and Objectives: The number of family physicians providing maternity care continues to decline, jeopardizing access to needed care for underserved populations. Accreditation changes in 2014 provided an opportunity to create family medicine residency maternity care tracks, providing comprehensive maternity care training only for interested residents. We examined the relationship between maternity care tracks and residents’ educational experiences and postgraduate practice. Methods: We included questions on maternity care tracks in an omnibus survey of family medicine residency program directors (PDs). We divided respondent programs into three categories: “Track,” “No Track Needed,” and “No Track.” We compared these program types by their characteristics, number of resident deliveries, and number of graduates practicing maternity care. Results: The survey response rate was 40%. Of the responding PDs, 79 (32%) represented Track programs, 55 (22%) No Track Needed programs, and 94 (38%) No Track programs. Residents in a track attended more deliveries than those not in a track (at Track programs) and those at No Track Needed and No Track programs. No Track Needed programs reported the highest proportion of graduates accepting positions providing inpatient maternity care in 2019 (21%), followed by Track programs (17%) and No Track programs (5%; P<.001). Conclusions: Where universal robust maternity care education is not feasible, maternity care tracks are an excellent alternative to provide maternity care training and produce graduates who will practice maternity care. Programs that cannot offer adequate experience to achieve competence in inpatient maternity care may consider instituting a maternity care track.

scholarly journals Prediction and comparison of the impact of COVID-19 epidemic on the financial industry of major countries based on neural intelligent algorithm

2020 ◽  
Vol 39 (6) ◽  
pp. 8831-8838
Author(s):  
Bin Wang ◽  
Qingyuan Zhou
Keyword(s):  
United States ◽  
Global Economy ◽  
Mutual Influence ◽  
The United States ◽  
Household Consumption ◽  
Intermediate Input ◽  
Financial Industry ◽  
Government Consumption ◽  
The Impact ◽  
The Relationship

The global economy appears the trend of anti-globalization under the influence of COVID-19. Based on the input-output table of lead database from 2006 to 2020, this paper divides the factors that affect the development of financial industry in China, the United States and Russia into six aspects: price, intermediate input, household consumption, government consumption, export and import. ADGA-BP neural network model is proposed in this paper, which is based on six aspects of price, intermediate input, consumer, government consumption, export and import. The intermediate input is decomposed from the perspective of industrial structure to study the interrelationship between financial industry and other industries in the three countries. The results show that the intermediate input is the main factor in the development of financial industry in the three countries, but the source industries of the intermediate input are not the same; the two factors of household consumption and price are closely related to the development of financial industry in the three countries, and they all play a role in promoting China, while the relationship between household consumption and the United States and between price and Russia is reverse; Government consumption only has a significant impact on Russia; from the perspective of mutual influence, the mutual investment between the financial industry of China and the United States is relatively large, while the relationship between the Russian financial industry and the two countries is relatively weak. It shows that under the background of covid-19, the development of financial industry is affected.

scholarly journals Residency Setting Association With Resident Substance Use Disorder Training: A CERA Secondary Data Analysis

2020 ◽  
Vol 52 (3) ◽  
pp. 198-201
Author(s):  
Joshua St. Louis ◽  
Emma Worringer ◽  
Wendy B. Barr
Keyword(s):  
Substance Use ◽  
Family Medicine ◽  
Residency Program ◽  
Secondary Analysis ◽  
Secondary Data ◽  
The United States ◽  
Resident Training ◽  
Addiction Medicine ◽  
Residency Programs ◽  
Family Medicine Residency

Background and Objectives: As the opioid crisis worsens across the United States, the factors that impact physician training in management of substance use disorders become more relevant. A thorough understanding of these factors is necessary for family medicine residency programs to inform their own residency curricula. The objective of our study was to identify factors that correlate with increased residency training in addiction medicine across a broad sample of family medicine residencies. Methods: We performed secondary analysis of a national family medicine residency program director survey conducted in 2015-2016 (CERA Survey PD-8). We obtained data from the Council of Academic Family Medicine Educational Research Alliance (CERA) Data Clearinghouse. We analyzed residency clinic site designation as a patient-centered medical home (PCMH), federally-qualified health center (FQHC), or both, for their correlation with faculty member possession of DEA-X buprenorphine waiver license, as well as required residency curriculum in addiction medicine. Results: Residency programs situated in an FQHC were more likely to have faculty members who possessed DEA-X buprenorphine waiver licenses (P=.025). Residency clinics that were both a PCMH as well as an FQHC also correlated strongly (P=.001). Furthermore, residencies with faculty who possessed a DEA-X license were significantly more likely to have a required curriculum in addiction medicine (P=.002). Conclusions: Our quantitative secondary analysis of CERA survey data of family medicine residency program directors revealed that resident training in addiction medicine is strongly correlated with both residency clinic setting (FQHC or FQHC/PCMH) as well as residency faculty possession of DEA-X licenses.

Income and healthcare financing system in the United States: an asymmetric analysis

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mehdi Barati ◽  
Hadiseh Fariditavana
Keyword(s):  
The United States ◽  
Set Covering ◽  
Healthcare Financing ◽  
Financing System ◽  
Data Set ◽  
Content Type ◽  
Funding Sources ◽  
Distributed Lag ◽  
The Impact ◽  
The Relationship

PurposeThe purpose of this study is to first assess how the US healthcare financing system is influenced by income variation. Then, it examines whether or not the impact of income variation is asymmetric.Design/methodology/approachFor the analyses of this paper, the autoregressive distributed lag (ARDL) model is implemented to a data set covering the period from 1960 to 2018.FindingsThe results provide evidence that major funding sources of aggregate healthcare expenditure (HCE) respond differently to changes in income. The results also imply that the effect of income is not always symmetric.Originality/valueMany studies have attempted to identify the relationship between income and HCE. A common feature of past studies is that they have only focused on aggregate HCE, while one might be interested in knowing how major funders of aggregate HCE would be affected by changes in income. Another common feature of past studies is that they have assumed that the relationship between income and HCE is symmetric.

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