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Concept: Specialty

487

Objective To estimate financial payments from industry to US journal editors.Design Retrospective observational study.Setting 52 influential (high impact factor for their specialty) US medical journals from 26 specialties and US Open Payments database, 2014.Participants 713 editors at the associate level and above identified from each journal’s online masthead.Main outcome measures All general payments (eg, personal income) and research related payments from pharmaceutical and medical device manufacturers to eligible physicians in 2014. Percentages of editors receiving payments and the magnitude of such payments were compared across journals and by specialty. Journal websites were also reviewed to determine if conflict of interest policies for editors were readily accessible.Results Of 713 eligible editors, 361 (50.6%) received some (>$0) general payments in 2014, and 139 (19.5%) received research payments. The median general payment was $11 (£8; €9) (interquartile range $0-2923) and the median research payment was $0 ($0-0). The mean general payment was $28 136 (SD $415 045), and the mean research payment was $37 963 (SD $175 239). The highest median general payments were received by journal editors from endocrinology ($7207, $0-85 816), cardiology ($2664, $0-12 912), gastroenterology ($696, $0-20 002), rheumatology ($515, $0-14 280), and urology ($480, $90-669). For high impact general medicine journals, median payments were $0 ($0-14). A review of the 52 journal websites revealed that editor conflict of interest policies were readily accessible (ie, within five minutes) for 17/52 (32.7%) of journals.Conclusions Industry payments to journal editors are common and often large, particularly for certain subspecialties. Journals should consider the potential impact of such payments on public trust in published research.

Concepts: Medicine, Specialty, The New England Journal of Medicine

204

Introduction: Over the last decade, the use of medical marijuana has expanded dramatically; it is now permitted in 16 states and the District of Columbia. Our study of family physicians in Colorado is the first to gather information about physician attitudes toward this evolving practice.

Concepts: Medicine, United States, Physician, Anatomy, Pediatrics, Medical school, Specialty, Doctor of Medicine

168

To evaluate perceptions of being mistreated during internship among first year Oman Medical Specialty Board residents.

Concepts: Medicine, Oncology, Physician, Pediatrics, Psychiatry, Specialty

168

While skin disorders are commonly seen in paediatric emergency departments (PED), the exact frequency of the various dermatological conditions is unknown. Our aim was to evaluate the occurrence and spectrum of skin disorders in an urban PED and the need for a dermatological opinion.

Concepts: Medicine, Myocardial infarction, Hospital, Specialty, Acute assessment unit

98

With its Choosing Wisely campaign, the American Board of Internal Medicine (ABIM) Foundation boldly invited professional societies to own their role as “stewards of finite health care resources.”(1) Beginning in 2009, the National Physicians Alliance, funded by the ABIM Foundation, guided volunteers from three primary care specialties through the development of “Top Five” lists - specialty-specific enumerations of five achievable practice changes to improve patient health through better treatment choices, reduced risks and, where possible, reduced costs.(2) In April 2012, the effort was expanded and launched as the Choosing Wisely campaign, with lists from nine specialty societies and a patient-education . . .

Concepts: Health care, Medicine, Health, Physician, Illness, Political philosophy, Specialty, American Board of Internal Medicine

91

In July 2015, a 26-year-old pediatrician described to our team of Physicians for Human Rights (PHR) investigators his experiences in Aleppo, Syria’s most populous city. When he was a medical student in 2012, government forces detained and severely beat him. He now works as an emergency medicine physician and surgery resident in a hospital that has twice been bombed by the Syrian government. He lives in fear of being killed by bombs on his way to work or while there. His family wants him to leave Syria as they did, but he explained, “It’s our country, and if we leave, it . . .

Concepts: Health care, Medicine, Surgery, Physician, Pediatrics, Medical school, Specialty, Syria

70

In March 2012, the Society of General Internal Medicine convened the National Commission on Physician Payment Reform to recommend forms of payment that would maximize good clinical outcomes, enhance patient and physician satisfaction and autonomy, and provide cost-effective care. The formation of the commission was spurred by the recognition that the level of spending on health care in the United States is unsustainable, that the return on investment is poor, and that the way physicians are paid drives high medical expenditures. The commission began by examining factors driving the high level of expenditures in the U.S. health care system. It . . .

Concepts: Health care, Health economics, Medicine, United States, Physician, Medical school, Internal medicine, Specialty

66

Membership in medical societies is associated with a number of benefits to members that may include professional education, opportunities to present research, scientific and/or leadership training, networking and others. In this perspective article, the authors address the value that medical specialty society membership and inclusion have in the development of an academic physician’s career and how underrepresentation of women may pose barriers to their career advancement. Because society membership itself is not likely sufficient to support the advancement of academic physicians, this report focuses on one key component of advancement that can also be used as a measure of inclusion in society activities-the representation of women physicians among recipients of recognition awards. Previous reports demonstrated underrepresentation of women physicians among recognition award recipients from two physical medicine and rehabilitation (PM&R) specialty organizations; including examples of zero or near-zero results. This report investigated whether zero or near-zero representation of women physicians among recognition award recipients from medical specialty societies extended beyond the field of PM&R. Examples of the underrepresentation of women physicians, as compared to their presence in the respective field, was found across a range of additional specialties, including dermatology, neurology, anesthesiology, orthopedic surgery, head and neck surgery, and plastic surgery. The authors propose a call for action across the entire spectrum of medical specialty societies to: 1) examine gender diversity and inclusion data through the lens of the organization’s mission, values and culture; 2) transparently report the results to members and other stakeholders including medical schools and academic medical centers; 3) investigate potential causes of less than proportionate representation of women; 4) implement strategies designed to improve inclusion; 5) track outcomes as a means to measure progress and inform future strategies; and 6) publish the results in order to engage community members in conversation about the equitable representation of women.

Concepts: Medicine, Surgery, Physician, Pediatrics, Medical school, Psychiatry, Internal medicine, Specialty

54

In June 2015, the American Society of Clinical Oncology (ASCO) published a proposed framework for assessing the value of various cancer treatments.(1) The goal was to evaluate selected treatment regimens on the basis of their clinical benefit, toxicity, and cost. ASCO’s ideas about cost had been incubating for a long time: the organization had created a Task Force on the Cost of Cancer Care in 2007, although, like most medical specialty organizations, it had generally remained silent on the issue of cost. But the cost of cancer care has been growing rapidly: though it accounts for a relatively small portion . . .

Concepts: Medicine, Cancer, Oncology, Specialty

51

Twenty years ago, we described the emergence of a new type of specialist that we called a “hospitalist.”(1) Since then, the number of hospitalists has grown from a few hundred to more than 50,000 (see graph) - making this new field substantially larger than any subspecialty of internal medicine (the largest of which is cardiology, with 22,000 physicians), about the same size as pediatrics (55,000), and in fact larger than any specialty except general internal medicine (109,000) and family medicine (107,000). Approximately 75% of U.S. hospitals, including all highly ranked academic health centers, now have hospitalists. The field’s rapid growth . . .

Concepts: Medicine, Cardiology, Physician, Pediatrics, Medical school, Internal medicine, Specialty, Medical specialties