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1.
Front Public Health ; 12: 1387494, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38855454

RESUMO

Background: Burnout among healthcare providers is a significant crisis in our healthcare system, especially in the context of the COVID-19 pandemic. The aim of this study was to understand what motivates healthcare workers and students to volunteer in their community as well as examine how volunteering relates to burnout. These findings can help health organizations better meet the needs of healthcare workers, as well as provide insights for non-profits that rely on volunteer professionals. Methods: Healthcare providers (N = 8), graduate healthcare students (N = 10), and undergraduate students (N = 14) who volunteered at community health fairs completed the OLBI burnout assessment and an individual semi-structured interview to characterize their attitudes toward volunteering and its relationship with burnout. Interviews were recorded, transcribed, and analyzed using a phenomenological approach, comparing themes across levels of burnout among providers and students. Results: Participants described that feeling burnt out decreased one's likelihood to volunteer, but also that volunteering prevented burnout. The OLBI scores showed that 79.2 and 20.8% of students were low and moderately burnt out respectively, and 87.5 and 12.5% of health professionals were low and moderately burnt out, respectively. Students volunteered for professional development while healthcare professionals cited a desire for a change in their day-to-day work as a reason to volunteer. Both students and health professionals often volunteered because they wanted to make a difference, it made them feel good, and/or they felt a responsibility to volunteer. COVID-19 had a wide range of effects on burnout and motivations to volunteer. Conclusion: Volunteering may be useful for preventing burnout among healthcare workers and students, but may not be helpful for those already experiencing burnout. Interview responses and the fact that none of the volunteers had high burnout levels according to their OLBI scores suggest those who choose to volunteer may be less burnt out. Healthcare organizations and schools can encourage volunteering by emphasizing the difference healthcare students and professionals can make through volunteering in the community. Increasing convenience and emphasizing professional development can help recruit and retain healthcare student volunteers. Highlighting the chance to diversify their scope of practice may help recruit and retain healthcare professional volunteers.


Assuntos
Esgotamento Profissional , COVID-19 , Pessoal de Saúde , Voluntários , Humanos , Voluntários/psicologia , Feminino , Masculino , Esgotamento Profissional/psicologia , Adulto , COVID-19/psicologia , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Motivação , Estudantes/psicologia , Pessoa de Meia-Idade , Adulto Jovem , SARS-CoV-2 , Inquéritos e Questionários
2.
Ann Intensive Care ; 14(1): 92, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38888663

RESUMO

BACKGROUND: The COVID-19 pandemic has highlighted the importance of intensive care units (ICUs) and their organization in healthcare systems. However, ICU capacity and availability are ongoing concerns beyond the pandemic, particularly due to an aging population and increasing complexity of care. This study aimed to assess the current and future shortage of ICU physicians in France, ten years after a previous evaluation. A national e-survey was conducted among French ICUs in January 2022 to collect data on ICU characteristics, medical staffing, individual physician characteristics, and education and training capacities. RESULTS: Among 290 ICUs contacted, 242 responded (response rate: 83%), representing 4943 ICU beds. The survey revealed an overall of 300 full time equivalent (FTE) ICU physician vacancies in the country. Nearly two-thirds of the participating ICUs reported at least one physician vacancy and 35% relied on traveling physicians to cover shifts. The ICUs most affected by physician vacancies were the ICUs of non-university affiliated public hospitals. The retirements expected in the next five years represented around 10% of the workforce. The median number of physicians per ICU was 7.0, corresponding to a ratio of 0.36 physician (FTE) per ICU bed. In addition, 27% of ICUs were at risk of critical dysfunction or closure due to vacancies and impending retirements. CONCLUSION: The findings highlight the urgent need to address the shortage of ICU physicians in France. Compared to a similar study conducted in 2012, the inadequacy between ICU physician supply and demand has increased, resulting in a higher number of vacancies. Our study suggests that, among others, increasing the number of ICM residents trained each year could be a crucial step in addressing this issue. Failure to take appropriate measures may lead to further closures of ICUs and increased risks to patients in this healthcare system.

3.
Open Forum Infect Dis ; 11(5): ofae208, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38737425

RESUMO

Enduring shortages of infectious disease physicians across the United States continue despite efforts to mitigate the problem. The recent fellowship match results underscore the difficulty in rectifying that shortage. Our report sheds light on the current geographic distribution of US infectious disease physicians and highlights the challenges faced by rural communities.

4.
Ann Fam Med ; 22(3): 223-229, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38806258

RESUMO

PURPOSE: Continuity of care is broadly associated with better patient health outcomes. The relative contributions of continuity with an individual physician and with a practice, however, have not generally been distinguished. This retrospective observational study examined the impact of continuity of care for patients seen at their main clinic but by different family physicians. METHODS: We analyzed linked health administrative data from 2015-2018 from Alberta, Canada to explore the association of physician and clinic continuity with rates of emergency department (ED) visits and hospitalizations across varying levels of patient complexity. Physician continuity was calculated using the known provider of care index and clinic continuity with an analogous measure. We developed zero-inflated negative binomial models to assess the association of each with all-cause ED visits and hospitalizations. RESULTS: High physician continuity was associated with lower ED use across all levels of patient complexity and with fewer hospitalizations for highly complex patients. Broadly, no (0%) clinic continuity was associated with increased use and complete (100%) clinic continuity with decreased use, with the largest effect seen for the most complex patients. Levels of clinic continuity between 1% and 50% were generally associated with slightly higher use, and levels of 51% to 99% with slightly lower use. CONCLUSIONS: The best health care outcomes (measured by ED visits and hospitalizations) are associated with consistently seeing one's own primary family physician or seeing a clinic partner when that physician is unavailable. The effect of partial clinic continuity appears complex and requires additional research. These results provide some reassurance for part-time and shared practices, and guidance for primary care workforce policy makers.


Assuntos
Continuidade da Assistência ao Paciente , Serviço Hospitalar de Emergência , Hospitalização , Atenção Primária à Saúde , Humanos , Alberta , Estudos Retrospectivos , Continuidade da Assistência ao Paciente/estatística & dados numéricos , Feminino , Masculino , Atenção Primária à Saúde/estatística & dados numéricos , Pessoa de Meia-Idade , Serviço Hospitalar de Emergência/estatística & dados numéricos , Adulto , Hospitalização/estatística & dados numéricos , Idoso , Médicos de Família/estatística & dados numéricos , Adulto Jovem , Adolescente , Instituições de Assistência Ambulatorial/estatística & dados numéricos
5.
J Vasc Surg Venous Lymphat Disord ; 12(1): 101674, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37703942

RESUMO

Comprehensively managing vascular disease in the United States can seem overwhelming. Vascular surgery providers encounter daily stress-inducing challenges, including caring for sick patients who often, because of healthcare barriers, struggle with access to care, socioeconomic challenges, and a complex medical system. These individuals can present with advanced disease and comorbidities, and many have limited treatment options. Subsequently, it could seem as if the vascular surgeon's efforts have little opportunity to make a difference. This review describes a method to counter this sentiment through directed action, hope, and community building. Vascular surgeons are passionate about what they do and are built to fight healthcare disparities. This review also outlines the reasoning for attempting to create change and one approach to begin making a difference.


Assuntos
Cirurgiões , Doenças Vasculares , Humanos , Estados Unidos , Disparidades em Assistência à Saúde , Procedimentos Cirúrgicos Vasculares
6.
Med Teach ; : 1-4, 2023 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-37883990

RESUMO

The United States faces an impending crisis in primary care physician shortages, while Physician Associates (PAs) and Nurse Practitioners (NPs) are poised to help bridge the gap. This manuscript explores a groundbreaking solution: introducing a clinical doctorate program tailored to PAs and NPs, designed to equip them with the knowledge and skills to assume leadership roles in primary care. Unlike traditional medical education, this innovative approach allows these professionals to continue their clinical practice while advancing their education, addressing the workforce shortage and the need for advanced leadership within the primary care landscape. This comprehensive curriculum includes intensive didactic coursework, residency-like training, credentialing examinations, and research opportunities, positioning PAs and NPs as critical contributors to the future of primary care. By recognizing their untapped potential and investing in their advanced education, we can elevate the quality and accessibility of primary care, ensuring that healthcare delivery reaches new heights.

7.
Cureus ; 15(8): e43817, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37736467

RESUMO

Surgery continues to be an increasingly vital component of public health and aspect of patient care in rural communities. An anticipated shortage of surgeons within the next decade in the United States prompts a growing concern for increasing the delivery of essential surgical care to these populations. When considering the existing barriers to surgical healthcare in rural communities, there is a sense of urgency to identify innovative approaches that will promote a sustainable surgeon workforce. A narrative review was conducted to investigate the current state of access to essential surgical care in rural communities. Qualitative and quantitative data were collected to better understand the key issues in rural healthcare and to provide statistical data related to the status of the surgical workforce. With the anticipated shortage of surgeons in both rural and urban areas, this review highlights the importance of enacting immediate measures to address the concern. This review has accomplished the initial objectives of gaining a better understanding of the current state of access to surgical care in rural communities and utilizing this knowledge to provide recommendations to readily attain a sustainable number of rural surgeons. With each approach addressing ways to address the contributory issues to the surgeon shortage, this review reveals a new avenue of integrating valuable aspects from each approach, rather than relying on a single approach. In particular, enhancing the overall pipeline of medical training to attending status may prove to be more beneficial for achieving this goal. Ultimately, this may be accomplished by introducing additional rural surgical mentorship opportunities for medical students, developing a rural surgery fellowship, and incorporating a market-based response that will correspond to attractive incentives that help to retain a sustainable number of surgeons working in rural areas.

8.
GMS J Med Educ ; 40(4): Doc52, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37560039

RESUMO

Aim: Many universities offer rural medical internships for medical students. The present survey was designed to show how rural medical work is perceived by students, whether these perceptions are associated with origin and previous experience, and how well medical students know rural regions in the vicinity of their university. In addition, students were asked how to support and inspire medical students to later work in a rural region. Methods: This cross-sectional study was based on an anonymous online survey of medical students at the Universities of Halle-Wittenberg and Leipzig. The evaluations included descriptive statistics, statistical group comparisons, and qualitative content analysis of free text answers. Results: A total of 882 students took part in the survey. Students who had grown up in a rural region or had lived there for a longer time (71.7% of the respondents) rated the work-life balance better (p<0.01) and the patient variety in the countryside slightly higher (p<0.05) than their fellow students from the big city. Students who had worked in a rural practice or hospital before (62.2%) rated patient diversity (p<0.001) and work variety (p<0.001), as well as workload (p<0.01), slightly higher in rural areas than students with no prior experience. On average, the specified rural model regions were still unknown to more than 60% of the students. The suggestions for attracting medical students to later work as rural physicians included financial incentives and, above all, better information about life as a rural physician and the rural regions. Conclusion: Thus, the medical faculties of the universities as well as the counties threatened by medical undersupply should further expand the transfer of knowledge and experience regarding rural physician life for the students.


Assuntos
Serviços de Saúde Rural , Estudantes de Medicina , Humanos , Estudos Transversais , Universidades , Escolha da Profissão , Inquéritos e Questionários
9.
Isr J Health Policy Res ; 12(1): 28, 2023 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-37563656

RESUMO

In their recent IJHPR article, Wimpfheimer and colleagues outline the implications for the field of anesthesia of two major healthcare policy changes in Israel: The Yatziv Reform in licensing foreign medical graduates and the efforts to reduce residents' on-call shift duration. We argue that these reforms are necessary to strengthen the healthcare workforce and improve the quality of care in the long term, even though they may limit the availability of healthcare personnel for several years, particularly in the field of anesthesia. In this commentary, we examine the background to these policy changes, their likely impact on the medical workforce in Israel in general, and propose steps to reconcile these reforms with the global and national shortage of physicians. We urge policymakers to allocate the required resources and begin preparing for an era of continuous mismatch between physician supply and demand, which will necessitate creative solutions, increased reliance on technology, and the introduction of paramedical professionals to help offload tasks and better utilize the scarce physician workforce.


Assuntos
Mão de Obra em Saúde , Médicos , Humanos , Israel , Política de Saúde , Recursos Humanos
10.
Cureus ; 15(8): e43474, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37583547

RESUMO

OBJECTIVE: This study aimed to determine if a disproportionate number of radiologists practice in high-income versus low-income counties in New Jersey (NJ), identify which vulnerable populations are most in need of more radiologists, and discuss how these relative differences can ultimately influence health outcomes. METHODS: The NJ Health Care Profile, a database overseen and maintained by the Division of Consumer Affairs, was queried for all actively practicing radiologists within the state of NJ. These results were grouped into diagnostic and interventional radiologists followed by further stratification of physicians based on the counties where they currently practice. The median household income and population size of each county for 2021 were obtained from the US Census database. The ratio of the population size of each county over the number of radiologists in that county was used as a surrogate marker for disparities in patient care within the state and was compared between counties grouped by levels of income. RESULTS: Of the 1,186 board-certified radiologists actively practicing within the state of NJ, 86% are solely diagnostic radiologists and 14% are interventional radiologists. About 44% of radiologists practice within counties that are within the top one-third of median household income in NJ, 25% practice within counties in the middle one-third, and 31% practice within counties in the bottom one-third. CONCLUSIONS: There is a disproportionate number of radiologists practicing in high-income counties as opposed to lower-income counties. A contradiction to this trend was noted in three low-income counties: Essex, Camden, and Atlantic County, all of which exhibited low numbers of individuals per radiologist that rivaled those of higher-income counties. This finding is a concrete measure of successful radiologist recruitment efforts within these counties during the past few years to combat the increased prevalence of disease and associated complications that historically marginalized communities tend to disproportionately exhibit. Other low-income counties should look to what Essex, Camden, and Atlantic County have done to increase radiologist recruitment to levels that rival those of high-income areas.

11.
Cureus ; 15(7): e41700, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37575733

RESUMO

The state of Nevada is home to millions of people and a prominent entertainment industry. However, the state ranks among the lowest in terms of available primary care doctors and general surgeons per capita, resulting in limited access to essential healthcare services and an increased reliance on emergency departments and hospitals. Nevada also faces the challenges posed by an aging physician workforce and a significant proportion of inactive providers. The scarcity of residency positions in Nevada's medical schools drives many graduates to seek residency training opportunities elsewhere, leading to a reduced likelihood of their return to practice within the state. We propose potential solutions, including increased funding for residency positions, prioritizing the retention of medical school graduates through local residency training, and the establishment of interdisciplinary comprehensive academic health centers. These measures are essential to meet the escalating healthcare demands of Nevada's rapidly growing population and to ultimately enhance patient outcomes.

12.
BMC Health Serv Res ; 23(1): 223, 2023 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-36882756

RESUMO

BACKGROUND: The COVID-19 pandemic has highlighted human resource gaps and physician shortages in healthcare systems in New Brunswick (NB), as evidenced by multiple healthcare service interruptions. In addition, the New Brunswick Health Council gathered data from citizens on the type of primary care models (i.e. physicians in solo practice, physicians in collaborative practice, and collaborative practice with physicians and nurse practitioners) they use as their usual place of care. To add to their survey's findings, our study aims to see how these different primary care models were associated with job satisfaction as reported by primary care providers. METHODS: In total, 120 primary care providers responded to an online survey about their primary care models and job satisfaction levels. We used IBM's "SPSS Statistics" software to run Chi-square and Fisher's exact tests to compare job satisfaction levels between variable groups to determine if there were statistically significant variations. RESULTS: Overall, 77% of participants declared being satisfied at work. The reported job satisfaction levels did not appear to be influenced by the primary care model. Participants reported similar job satisfaction levels regardless of if they practiced alone or in collaboration. Although 50% of primary care providers reported having symptoms of burnout and experienced a decline in job satisfaction during the COVID-19 pandemic, the primary care model was not associated with these experiences. Therefore, participants who reported burnout or a decline in job satisfaction were similar in all primary care models. Our study's results suggest that the autonomy to choose a preferred model was important, since 45.8% of participants reported choosing their primary care models, based on preference. Proximity to family and friends and balancing work and family emerged as critical factors that influence choosing a job and staying in that job. CONCLUSION: Primary care providers' staffing recruitment and retention strategies should include the factors reported as determinants in our study. Primary care models do not appear to influence job satisfaction levels, although having the autonomy to choose a preferred model was reported as highly important. Consequently, it may be counterproductive to impose specific primary care models if one aims to prioritize primary care providers' job satisfaction and wellness.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Satisfação no Emprego , Novo Brunswick , Pandemias , Atenção Primária à Saúde
13.
Isr J Health Policy Res ; 12(1): 2, 2023 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-36793111

RESUMO

BACKGROUND: There is a decrease in the supply of physicians in Israel resulting from the declining flow of immigrant physicians from the former Soviet Union, a large proportion of whom have reached retirement age in recent years. This problem could become worse because the number of medical students in Israel cannot increase quickly, especially because the number of clinical training sites is inadequate. The quick population growth and anticipated ageing will exacerbate the shortage. The aim of our study was to accurately assess the current situation and factors that affect it, and to propose systematic steps to improve the physician shortage. MAIN BODY: The number of physicians per capita is lower in Israel than in the OECD at 3.1 vs. 3.5 per 1000 population, respectively. About 10% of licensed physicians live outside of Israel. There is a sharp increase in the number of Israelis returning from medical school abroad, but some of those schools are of low academic standard. The main step is a gradual increase in the number of medical students in Israel with a transition of clinical practice to the community, and hospital clinical hours in the evening and in the summer. Students with high psychometric scores who were not admitted to an Israeli medical school would get support to study in quality medical schools abroad. Additional steps include encouraging physicians from abroad to come to Israel, especially in specializations in distress, recruitment of retired physicians, transferring functions to other medical professions, economic incentives for departments and teachers, and incentives to prevent physicians from quitting or migrating to other countries. It is also important to close the gap between the number of physicians working in central Israel and the periphery through grants, employment opportunities for physicians' spouses, and preferential selection of students from the periphery for medical school. CONCLUSIONS: Manpower planning requires a broad, dynamic perspective and collaboration among governmental and non-governmental organizations.


Assuntos
Emigrantes e Imigrantes , Medicina , Médicos , Estudantes de Medicina , Humanos , Israel
14.
BMC Health Serv Res ; 23(1): 65, 2023 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-36681836

RESUMO

BACKGROUND: Hospital physician workforce in Japan is the lowest among developed countries. Many patients with novel coronavirus disease 2019 (COVID-19) with high risk of mortality could not be hospitalized during case surges in Japan and only about 5% of total acute care beds were used as COVID-19 beds nationwide. However, the relationship between the number of hospital physicians and patient admissions remains unclear. Thus, we aimed to evaluate this relationship in areas with the highest incidences during the surges. METHODS: Data collection was performed for teaching hospitals accredited with the specialty of internal medicine in three prefectures which experienced the highest COVID-19 incidences in Japan (Tokyo, Osaka, Okinawa). Association was examined between the number of full-time physicians (internal medicine staff physicians and residents) and admissions of internal medicine patients through ambulance transport from April 2020 to March 2021. Analysis was conducted separately for community hospitals and university hospitals because the latter have roles as research institutions in Japan. Community hospitals included private, public, and semi-public hospitals. RESULTS: Of 117 teaching hospitals in three prefectures, data from 108 teaching hospitals (83 community hospitals and 25 university hospitals) were available. A total of 102,400 internal medicine patients were admitted to these hospitals during the one-year period. Private hospitals received the greatest mean number of patient admissions (290 per 100 beds), followed by public hospitals (227) and semi-public hospitals (201), and university hospitals (94). Among community hospitals, a higher number of resident physicians per 100 beds was significantly associated with a greater number of patient admissions per 100 beds with beta coefficient of 11.6 (95% CI, 1.5 to 21.2, p = 0.025) admissions by one physician increase per 100 beds. There was no such association among university hospitals. CONCLUSIONS: Community hospitals with many resident physicians accepted more internal medicine admissions through ambulance transport during the COVID-19 pandemic. An effective policy to counter physician shortage in hospitals in Japan may be to increase internal medicine resident physicians among community hospitals to save more lives.


Assuntos
COVID-19 , Médicos , Humanos , Admissão do Paciente , Japão/epidemiologia , Pandemias , COVID-19/epidemiologia , Medicina Interna , Hospitais Universitários , Recursos Humanos
15.
Front Public Health ; 10: 1023845, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36339163

RESUMO

Russia looks for ways to overcome a shortage of physicians. Health workforce policy is focused on training an additional number of physicians. The current efforts have reduced some areas of the shortage but failed to solve the problem due to many factors that reproduce the deficit. A distorted structure of service delivery with weak primary care generates demand for outpatient specialists and hospital doctors and requires a perpetual increase in their number. The lack of long-term labor planning results in the oversupply of some specialties and the shortage of others. The regulation of post-graduate training is not enough to improve the allocation of physicians across specialties and health system sectors. We argue that an extensive increase in the number of physicians without changing their composition will hardly change the situation. A more active structural policy is required with a focus on strengthening primary care and improving planning and regulation of health workforce structure.


Assuntos
Mão de Obra em Saúde , Médicos , Humanos , Recursos Humanos , Política de Saúde , Especialização
16.
Ann Med Surg (Lond) ; 84: 104967, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36426098

RESUMO

Africa struggles with the double burden of disease, bearing the highest disease burden in the world and also having the most severe health workforce shortage. Only four countries on the continent meet the WHO-recommended density of 4.45 health workers per 1000 people. This physician shortage has been attributed to a variety of factors including shortfalls in medical education and medical schools' capacities. This commentary aims to reveal the gap and 'underrated' problem of inadequate medical schools and poor utilization of existing ones. Recommended solutions calling for the need for urgent improvement in medical education in Africa are highlighted in the paper.

17.
Ann Med Surg (Lond) ; 81: 104395, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35999832

RESUMO

The COVID-19 pandemic had a significant impact on several aspects of global healthcare systems, particularly surgical services. New guidelines, resource scarcity, and an ever-increasing demand for care have posed challenges to healthcare professionals, resulting in the cancellation of many surgeries, with short and long-term consequences for surgical care and patient outcomes. As the pandemic subsides and the healthcare system attempts to reestablish a sense of normalcy, surgical recommendations and advisories will shift. These changes, combined with a growing case backlog (postponed surgeries + regularly scheduled surgeries) and a physician shortage, can have serious consequences for physician health and, as a result, surgical care. Several initiatives are already being implemented by governments to ensure a smooth transition as surgeries resume. Newer and more efficient steps aimed at providing adequate surgical care while preventing physician burnout, on the other hand, necessitate a collaborative effort from governments, national medical boards, institutions, and healthcare professionals. This perspective aims to highlight alterations in surgical recommendations over the course of the pandemic and how these changes continue to influence surgical care and patient outcomes as the pandemic begins to soften its grip.

18.
Hawaii J Health Soc Welf ; 81(4 Suppl 2): 20-23, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35495068

RESUMO

Like many areas of the United States, Hawai'i and its rural communities are suffering from a significant physician shortage. The University of Hawai'i (UH) John A. Burns School of Medicine (JABSOM) developed the Hawai'i Rural Health Program (HRHP) in 2011 to help provide early and substantial rural training experiences for its medical students in hopes of generating more rural health care providers. Thus far, 20.6% of the students who participated in this program and have since graduated from residency are now practicing in rural communities. Final exam grades of students who participated in the program were not statistically different from those who did not participate, suggesting a similar quality of training between both the rural and traditional cohorts of students. Reflections from students who completed the program demonstrate the large and lasting impact that this immersive experience has on their medical education and desire to help rural communities.


Assuntos
Médicos , Estudantes de Medicina , Havaí , Humanos , Saúde da População Rural , População Rural
19.
Nervenarzt ; 93(7): 695-705, 2022 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-35254465

RESUMO

BACKGROUND: Over the past 20 years the importance of treatment of people with mental and neurological disorders has greatly increased. Parallel to this development it has become more difficult to attract young physicians to this field. The aim of this study was to examine the development of the number of physicians specialized in the care of patients suffering from neurological, mental and psychosomatic disorders with special consideration of the age structure. MATERIAL AND METHODS: The analyses were based on the number of professionally active physicians and specialized physicians published by the German Medical Association for the years 2000-2020. Separate age groups were looked at for psychiatry and psychotherapy (PPT), psychosomatic medicine and psychotherapy (PMPT), Nervenheilkunde (formerly psychiatry and neurology together, NHK) and neurology. RESULTS: In comparison to the year 2000 the number of specialized physicians working in PPT (4736 vs. 12,053), neurology (2226 vs. 8355) and PMPT (3543 vs. 4130) increased in 2020, while the number of specialists actively working in NHK decreased (5184 vs. 2301). Parallel to this the proportion of women increased. Dramatic changes occurred concerning the age structure. Currently, 77.7% of specialists working in NHK and 59.7% working in PMPT are over 60 years old. In 2020 there were 2988 specialists aged over 60 years in the discipline of PPT compared to only 1070 under 40 years, which is dramatically different from 20 years earlier when only 181 were over 60 years but 1491 were under 40 years old. CONCLUSION: The overaging of professional specialists and the shortage of junior physicians jeopardize modern and adequate provision of care for mentally ill patients. Possible solutions include a marked increase in medical school capacities as well as strategies to convince young physicians to work in the disciplines of PPT and PMPT.


Assuntos
Médicos , Psiquiatria , Medicina Psicossomática , Adulto , Idoso , Feminino , Humanos , Saúde Mental , Pessoa de Meia-Idade , Especialização
20.
EClinicalMedicine ; 45: 101314, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35265822

RESUMO

Background: The extent to which healthcare worker (HCWs) experiences during the COVID-19 pandemic vary by race or ethnicity after adjustment for confounding factors is not currently known. Methods: We performed an observational prospective cohort study of 24,769 healthcare workers from 50 U.S. states and the District of Columbia, enrolled between April 10, 2020 and June 30, 2021, and evaluated participant experiences during the COVID-19 pandemic, including testing, diagnosis with COVID-19, emotional experiences, burnout, and interest in vaccines and vaccine clinical trials. Findings: After adjustment for professional role, medical history, and community characteristics, Black and Asian participants were less likely to receive SARS-CoV-2 viral testing (adjusted odds ratio (aOR) 0·82 [0·70, 0·96], p=0·012 and aOR 0·77 [0·67, 0·89], p<0·001 respectively) than White participants. Hispanic participants were more likely to have evidence of COVID-19 infection (aOR 1·23 (1·00, 1·50, p=0·048). Black and Asian participants were less likely to report interest in a COVID-19 vaccine (aOR 0·11 [0·05, 0·25], p<0·001 and aOR 0·48 [0·27, 0·85] p=0·012). Black participants were less likely to report interest in participating in a COVID-19 vaccine trial (aOR = 0·39 [0·28, 0·54], p<0·001). Black participants were also less likely to report 3 or more daily emotional impacts of COVID-19 (aOR = 0·66 [0·53, 0·82], p=<0·001). Black participants were additionally less likely to report burnout (aOR = 0·66 ([0·49, 0·95], p=0·025). Interpretation: In a large, national study of healthcare workers, after adjustment for individual and community characteristics, race/ethnicity disparities in COVID-19 outcomes persist. Future work is urgently needed to understand precise mechanisms behind these disparities and to develop and implement targeted interventions to improve health equity for healthcare workers. Funding: This work was funded by the Patient-Centered Outcomes Research Institute (PCORI), Contract # COVID-19-2020-001.

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