ABSTRACT
Analyzing health care reimbursement is a dynamic process. Infectious Diseases (ID) physicians have careers in diverse practice models. With current compensation models focusing on value and quality metrics, ID physicians are poised to be at the forefront of these delivery models. Monitoring and disseminating the current status of ID physician compensation are priorities of the Infectious Diseases Society (IDSA). In 2015, the IDSA conducted the largest ID physician compensation survey to date. The data were analyzed and disseminated, and the society subsequently responded with a plan to continue to develop and collect the most comprehensive and accurate data on ID physician compensation. Therefore, from May to June 2017, the IDSA conducted a follow-up compensation survey of its members. This survey resulted in the largest number of respondents of any ID compensation survey. It revealed that compensation across the different practice demographics had increased since the 2015 survey and is generally higher than salaries published in other comparable surveys. These data and the subsequent analyses focus on physicians who report patient care as their primary responsibility; they are presented by members of the IDSA's Clinical Affairs Committee.
ABSTRACT
Negotiating physician compensation can be complicated because many factors now influence the ways in which physicians can be compensated. Infectious diseases (ID) specialists typically provide a wide array of services, ranging from patient care to administrative leadership. Compensation surveys from national organizations have produced results based on small samples and often are not congruent with ID physicians' perceptions. In July of 2015, the Infectious Diseases Society of America (IDSA) conducted a compensation survey to assess current compensation earned by the diverse ID specialists within its membership. Members of IDSA's Clinical Affairs Committee report the results from the 2015 IDSA Physician Compensation survey, with a particular focus on the findings from respondents who indicate "patient care" as their primary responsibility and present a discussion that compares and contrasts results against other survey data.
ABSTRACT
BACKGROUND: Murine cytomegalovirus (MCMV) is an etiologic agent of acute and chronic myocarditis in BALB/c mice. Immunologic host responses appear to play a key role in pathogenesis but have been incompletely defined. METHODS: BALB/c mice were infected with a sublethal dose of MCMV. Cytokine transcription and viral load (measured by quantitative real-time polymerase chain reaction) and histopathological analyses were performed at specified time points. RESULTS: Increased tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and interferon (IFN)-gamma, as well as IL-10 mRNA transcripts, were detected in the hearts of infected mice starting at Day 1 post-infection (p.i.), with peak levels occurring at Day 8 p.i. (7-fold, 14-fold, 41-fold, and 16-fold higher than background, respectively). Peak cytokine transcription significantly correlated with a 10-fold increase in viral load (P<.001) at Day 8 p.i. Myocarditis-related pathological changes, measured by infiltration foci, were greatest at Day 8 p.i., corresponding with peak cytokine transcription and significantly correlated with IFN-gamma levels (P<.0001). Infiltration foci were predominantly composed of CD3(+) T cells. Cardiac calcification was observed in most infected mice predominantly over the right ventricle. Histological analysis of heart sections from mice infected with recombinant enhanced green fluorescence protein-MCMV revealed a localized and sporadic pattern of virus throughout all heart layers. CONCLUSIONS: MCMV-induced myocarditis in BALB/c mice is characterized by in vivo production of proinflammatory cytokines in a pattern correlating with MCMV viral load. The infection pattern and inflammatory response is highly localized, sporadic, and involves endocardium, epicardium, as well as the myocardium, with greatest amounts of virus detected in areas of pathologic calcification.
