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Dodelzon K, Milch HS, Mullen LA, Dialani V, Jacobs S, Parikh JR, Grimm LJ. Factors Contributing to Disproportionate Burnout in Women Breast Imaging Radiologists: A Review. JOURNAL OF BREAST IMAGING 2024; 6:124-132. [PMID: 38330442 DOI: 10.1093/jbi/wbad104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Indexed: 02/10/2024]
Abstract
Physician burnout continues to increase in prevalence and disproportionately affects women physicians. Breast imaging is a woman-dominated subspeciality, and therefore, worsening burnout among women physicians may have significant repercussions on the future of the breast imaging profession. Systemic and organizational factors have been shown to be the greatest contributors to burnout beyond individual factors. Based on the Mayo Model, we review the evidence regarding the 7 major organizational contributors to physician burnout and their potential disproportionate impacts on women breast radiologists. The major organizational factors discussed are work-life integration, control and flexibility, workload and job demands, efficiency and resources, finding meaning in work, social support and community at work, and organizational culture and values. We also propose potential strategies for institutions and practices to mitigate burnout in women breast imaging radiologists. Many of these strategies could also benefit men breast imaging radiologists, who are at risk for burnout as well.
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Affiliation(s)
- Katerina Dodelzon
- Department of Radiology, Weill Cornell Medicine at NewYork-Presbyterian, New York, NY, USA
| | - Hannah S Milch
- Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Lisa A Mullen
- Division of Breast Imaging, The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Vandana Dialani
- Division of Breast Imaging, Department of Radiology, Beth Israel Lahey Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sarah Jacobs
- New Ulm Medical Center Radiology, Allina Health, New Ulm, MN, USA
| | - Jay R Parikh
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lars J Grimm
- Department of Radiology, Duke University Medical Center, Durham, NC, USA
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Sebro R. Individual Radiologist Productivity Metrics: Counterpoint-No Individual Metrics Should Be Shared. AJR Am J Roentgenol 2024; 222:e2330145. [PMID: 37703194 DOI: 10.2214/ajr.23.30145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Affiliation(s)
- Ronnie Sebro
- Department of Radiology, Biostatistics, and Orthopedic Surgery, Center for Augmented Intelligence, Mayo Clinic, 4500 San Pablo S, Jacksonville, FL 32224
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Wahezi SE, Caparo M, Naeimi T, Kohan L. The importance of interventional pain research in academic settings: a call for change to fortify our future. A message from the Association of Pain Program Directors (APPD). PAIN MEDICINE (MALDEN, MASS.) 2023; 24:1293-1295. [PMID: 37467075 DOI: 10.1093/pm/pnad099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/03/2023] [Accepted: 07/13/2023] [Indexed: 07/21/2023]
Affiliation(s)
- Sayed E Wahezi
- Department of Rehabilitation Medicine, Pain Medicine Program, Montefiore Medical Center, Bronx, NY, United States
| | - Moorice Caparo
- Department of Rehabilitation Medicine, Pain Medicine Program, Montefiore Medical Center, Bronx, NY, United States
| | - Tahereh Naeimi
- Department of Rehabilitation Medicine, Pain Medicine Program, Montefiore Medical Center, Bronx, NY, United States
| | - Lynn Kohan
- Department of Anesthesiology, University of Virginia, Charlottesville, VA 22903, United States
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Orji P, Kattan M, Klein E, Wood HM. Development of a Clinical-scholar Index Score for Measuring Academic Contributions in Urology. Urology 2023:S0090-4295(23)00146-2. [PMID: 36804550 DOI: 10.1016/j.urology.2022.12.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/18/2022] [Accepted: 12/14/2022] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To develop an academic index that would permit annual measurement of faculty non-clinical activities. METHODS Academic activities were extracted from curriculum vitae (CV) and sorted into pre-determined categories. Categories were weighted based on discussion with department leadership. Weights were scaled 0-1 with 0 being defined as an activity that was non-essential to the mission, brought little to no external recognition or was beneath the appropriate milestone for the individual (middle author publications for a senior career staff member). 1 was defined as an activity that was essential to the department's mission, a significant time commitment for the individual, and provided external recognition. Annual scholarly index scores were determined for all participants based on their weighted contributions for the year. RESULTS Early career staff primarily make contributions through peer-reviewed publications and presentation. Velocity of scholarly contributions was greatest during the Mid-career (MC) stage. Senior career (SC) urologists had the most diverse array of contributions of any group. Like many of the MC faculty, SC faculty demonstrated a decrease in nonclinical productivity beginning in 2018 following a shift in organizational priorities to increased clinical productivity. CONCLUSIONS Nonclinical contributions of academic urologists can be quantified and tracked annually using this academic index. By doing so, leadership can more easily identify ways to support career development, which is especially important in mid-career, where individuals likely have the greatest opportunity for growth or stagnation. Finally, shifts in organization-wide priorities affect academic contributions and can be quantified by the model.
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Affiliation(s)
- Peace Orji
- Case Western Reserve University School of Medicine, Cleveland, OH.
| | - Michael Kattan
- Cleveland Clinic Glickman Urological and Kidney Institute Cleveland Clinic, Cleveland, OH
| | - Eric Klein
- Cleveland Clinic Glickman Urological and Kidney Institute Cleveland Clinic, Cleveland, OH
| | - Hadley M Wood
- Cleveland Clinic Glickman Urological and Kidney Institute Cleveland Clinic, Cleveland, OH
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Altolaguirre CV, Reddy R, Gamaldo CE, Salas RME. Developing a standardized EMR workflow for medical students and preceptors. HEALTH POLICY AND TECHNOLOGY 2022. [DOI: 10.1016/j.hlpt.2022.100696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Finding the Right Academic Position. Acad Radiol 2022; 29:1578-1582. [PMID: 35039219 DOI: 10.1016/j.acra.2021.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 12/12/2021] [Accepted: 12/18/2021] [Indexed: 12/14/2022]
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Equal pay for equal work in radiology: Expired excuses and solutions for change. Clin Imaging 2022; 83:93-98. [PMID: 35030407 DOI: 10.1016/j.clinimag.2021.12.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 12/22/2021] [Indexed: 11/24/2022]
Abstract
The gender pay gap is not a problem of the past. Women continue to receive less pay for equal work and radiology is one of four medical specialties with the largest gender pay gap. Numerous social factors contribute to the gender pay gap; however, radiology can close the gender pay gap through intentional strategies, including acknowledging the gender pay gap, eliminating bias and minority taxes through progressive compensation and parental leave models, devaluing overwork, developing longitudinal mentorship and sponsorship, and demanding transparent institutional policies. Patient care and overall organizational success will improve when the barriers resulting in the gender pay gap are eliminated.
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Brigstock NM, Besner GE. Development of an academic RVU (aRVU) system to promote pediatric surgical academic productivity. J Pediatr Surg 2022; 57:93-99. [PMID: 34657736 DOI: 10.1016/j.jpedsurg.2021.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND/PURPOSE Improvements in patient care are directly affected by scientific discovery, and surgeons have historically played a vital role in this process. However, increasing clinical demands and incentivization for pure clinical productivity present challenges for promoting academic productivity. The objective of this work was to analyze the effects of adding an academic relative value unit (aRVU) scoring system to an existing work RVU (wRVU)-based incentivization plan on academic productivity in a Department of Pediatric Surgery. METHODS Prior to 2012, incentive bonuses in our Department were mainly based on clinical wRVU activities. A weighted scoring system for 30 specific aRVUs was established in 2012. Incentivization for wRVUs vs. aRVUs was based on the clinical full-time equivalent (cFTE) of each faculty member. Academic activities incentivized included grant submissions/funding, peer reviewed publications, national presentations, Study Section participation, education and mentoring activities, receipt of research or teaching awards, initiation of Institutional Review Board (IRB) protocols, new academic society committee memberships/chairpersons, and patents. Academic progress was analyzed from 2012 to 2020. RESULTS During the study period, annual external federal funding increased from $750,168 to $5,768,243 (7.7-fold increase); annual peer-reviewed publications increased from 24 to 140 (5.8-fold increase); annual national presentations accepted for oral/poster presentations nearly doubled; and faculty members and their trainees received 41 competitive research awards including 8 American Pediatric Surgical Association Awards, 9 American Academy of Pediatrics Section on Surgery Awards, and 3 American College of Surgeons Awards. During the same study period, wRVUs increased by 8%. CONCLUSIONS Incentivization based on the addition of an aRVU system to a pre-existing wRVU system was associated with a significant increase in academic productivity, while still maintaining clinical productivity. Implementing an aRVU program is an important means of increasing academic productivity in Pediatric and other Surgery Departments.
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Affiliation(s)
- Nicole M Brigstock
- Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA
| | - Gail E Besner
- Department of Pediatric Surgery, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
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Porter KK, Arleo EK, Spalluto LB, McGinty G, Hess CP. A lactation credit model to support breastfeeding in radiology: The new gold standard to support "liquid gold". Clin Imaging 2021; 80:16-18. [PMID: 34218079 DOI: 10.1016/j.clinimag.2021.06.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/11/2021] [Accepted: 06/24/2021] [Indexed: 11/25/2022]
Abstract
Breastfeeding has medical and economic benefits and providing an environment supportive of breastfeeding should be a priority in radiology to promote diversity, equity and inclusion. Most breastfeeding radiologists do not meet their breastfeeding goals and inadequate time for pumping is the most commonly cited barrier. The UCSF lactation credit model sets the standard for breastfeeding support in medicine by providing protected time without productivity penalties and it should be adapted and implemented across radiology practices to more fully support breastfeeding radiologists and radiation oncologists.
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Affiliation(s)
- Kristin K Porter
- University of Alabama at Birmingham, Department of Radiology, 619 19th Street South, Birmingham, AL 35249, United States of America.
| | - Elizabeth Kagan Arleo
- University of Alabama at Birmingham, Department of Radiology, 619 19th Street South, Birmingham, AL 35249, United States of America
| | - Lucy B Spalluto
- University of Alabama at Birmingham, Department of Radiology, 619 19th Street South, Birmingham, AL 35249, United States of America
| | - Geraldine McGinty
- University of Alabama at Birmingham, Department of Radiology, 619 19th Street South, Birmingham, AL 35249, United States of America
| | - Christopher P Hess
- University of Alabama at Birmingham, Department of Radiology, 619 19th Street South, Birmingham, AL 35249, United States of America
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Clinician-Scientists: Can They Survive in the Modern Era? J Am Coll Radiol 2021; 18:192-197. [PMID: 33413899 DOI: 10.1016/j.jacr.2020.09.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/25/2020] [Accepted: 09/02/2020] [Indexed: 11/22/2022]
Abstract
Clinician-scientists are commonly characterized as health care professionals who are proficient in both research and clinical practice. Their dual expertise positions them to play a vital role in translating research outcomes to clinical practice. However, economic changes in the past few decades are threatening their very survival. The purposes of this article are to review some of the economic forces that pose the greatest risks to clinician-scientists in the modern era and to glean lessons from the business world in overcoming these challenges. Health care consolidation and decreasing reimbursements are putting increasing financial pressure on academic institutions, leaving them more inclined to cut back on departmental research support. Innovative companies commit a certain percentage of their revenue to research and discovery. Academic institutions should similarly view their research budget as research and discovery that will sustain the future growth of radiology. They should quantify and define expectations for academic productivity, focus on return on investment, and bolster the infrastructure to foster commercial partnerships that can provide additional revenue to support the research mission. Success in academics does not occur by accident. It requires more than individual talent and hard work. It also requires institutional leaders who are committed to developing future academic leaders and supporting innovation.
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Tierney WM, Auzenne D, Cook L, Jones BL, Mackert M, Paydarfar D, Ding X, Woods JM, Kahlon M. Importance of Community Impact as the Fourth Academic Mission: A Qualitative Study. Popul Health Manag 2021; 24:610-615. [PMID: 33709790 DOI: 10.1089/pop.2021.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Most US medical schools have 3 primary missions: education, research, and clinical service. Recently there have been calls for a fourth primary mission focused on improving health in their surrounding communities. To date, few medical schools have done so. To identify factors supporting and challenges to establishing a sustainable community impact mission, the authors conducted semi-structured key informant interviews with the dean, associate deans, departments chairs, and institute and center directors at a new US medical school that established a fourth "community impact" mission at its conception. Interviewees believed that it was appropriate for a community-focused tax-supported medical school to embrace community impact as a fourth mission to enhance community health outside of its hospitals and clinics. Many also felt that community impact should be an overriding framework for activities in the 3 primary missions. Achieving community impact would require creating a "learning health community" via partnerships with community organizations and linking faculty effort and funding to specific and valid measures of community health improvement. Sustainable funding would require core school funds and a broad portfolio of extramural funding. Faculty promotions with community impact as a focus would need explicit, achievable, and unique milestones. Interviewees made specific suggestions on the support and structure needed to launch and sustain this fourth mission. Establishing a fourth mission of community impact can extend medical schools' influence beyond typical health care venues to enhance the health of their communities and their residents. Doing so requires rethinking organizational structures, support, and measures of success.
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Affiliation(s)
- William M Tierney
- Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, Texas, USA.,Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA
| | - David Auzenne
- Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Lori Cook
- Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Barbara L Jones
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA.,Department of Health Social Work, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Michael Mackert
- Dell Medical School, University of Texas at Austin, Austin, Texas, USA.,Stan Richards School of Advertising & Public Relations, Moody College of Communication, University of Texas at Austin, Austin, Texas, USA
| | - David Paydarfar
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Xiao Ding
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas, USA
| | - Joy Melody Woods
- Stan Richards School of Advertising & Public Relations, Moody College of Communication, University of Texas at Austin, Austin, Texas, USA
| | - Maninder Kahlon
- Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
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Carlson ER. Academic Relative Value Units: A Proposal for Faculty Development in Oral and Maxillofacial Surgery. J Oral Maxillofac Surg 2020; 79:36.e1-36.e13. [PMID: 33144097 DOI: 10.1016/j.joms.2020.09.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE The Resource-based Relative Value Scale (RBRVS) designates quantitative values to clinical health care services to identify the relative work and cost of these services. Each clinical service translates to relative value units (RVUs). Clinical RVUs describe clinician work effort to guide employed clinician salaries in academic medical centers. The development of an academic RVU (aRVU) system also seems reasonable to establish and assess the quantity and quality of academic effort of members of our specialty that supports resident and student achievement. MATERIALS AND METHODS The 1998 Association of American Medical Colleges (AAMC) Mission-based Management (MBM) Program was assessed and adapted in creating an aRVU system. This aRVU system is hypothesized to guide oral and maxillofacial surgery faculty in advancing their missions of didactic and interactive teaching, production and dissemination of scholarly activity, performance of basic science and translational research, and participation in administrative service to academic medical centers. RESULTS A logic model was constructed to create and support the aRVU equation as a proposal for faculty development in oral and maxillofacial surgery. Numerous potential barriers exist to the implementation of this proposal, including those related to legacy and generational issues in academic medical centers. CONCLUSION The proposed aRVU system provides quantitative metrics for recognition of faculty development in oral and maxillofacial surgery. This system is based on strategic planning and allocation of effort sessions, and therefore, reflects mutually agreed upon faculty/department chair interests and goals. Annual performance evaluations of oral and maxillofacial surgery faculty can be based on aRVU accumulation.
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Affiliation(s)
- Eric R Carlson
- Professor and Kelly L Krahwinkel Chairman, Director, Oral/Head and Neck Oncologic Surgery Fellowship Program, Department of Oral and Maxillofacial Surgery, University of Tennessee Medical Center, Knoxville, TN.
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