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BackgroundPrimary care physicians generally earn less than specialists. Studies of other occupations have identified perception of pay fairness as a predictor of work- and life-related outcomes. We evaluated whether physicians' pay fairness perceptions were associated with their work satisfaction, turnover intention, and personal health.MethodsThree thousand five hundred eighty-nine physicians were surveyed. Agreement with "my total compensation is fair" was used to assess pay fairness perceptions. Total compensation was self-reported, and we used validated measures of work satisfaction, likelihood of leaving current practice, and health status. Hierarchical logistic regressions were used to assess the associations between pay fairness perceptions and work/life-related outcomes.ResultsA total of 2263 physicians completed surveys. Fifty-seven percent believed their compensation was fair; there was no difference between physicians in internal medicine and non-primary care specialties (P = 0.58). Eighty-three percent were satisfied at work, 70% reported low likelihood of leaving their practice, and 77% rated their health as very good or excellent. Higher compensation levels were associated with greater work satisfaction and lower turnover intention, but most associations became statistically non-significant after adjusting for pay fairness perceptions. Perceived pay fairness was associated with greater work satisfaction (OR, 4.90; 95% CI, 3.94-6.08; P

An introduction is presented in which the editor discusses articles within the issue on topics including continuing education on ethical relevance and its importance in health and health care, ethics required in human-centered research using nonhuman animals, and ethics in caring for patients.

The popularity of portraits of clinicians during the COVID-19 pandemic suggested the importance of visual representation of what mass illness demands of us all--and particularly those on the front lines of health care. In addition to surges in variants of the SARS-CoV-2 virus, persons of Asian descent have endured waves of bigotry and violence. With the myriad of natural and man-made threats confronting the world today, an ancient Confucian proverb on the common good prompts us to recognize humanity's shared future. Although text-based, calligraphy is visually engaging and reminds us of the importance and poignancy of words that are well chosen and beautifully rendered. This article displays and describes Chinese calligraphies by Terry Zhizhong Yuan, commissioned by the AMA Journal of Ethics, to commemorate the American Medical Association's 175th anniversary and the extraordinary times in which we live. [ABSTRACT FROM AUTHOR]

One of the most recognized paintings of Western medicine, Luke Fildes' The Doctor aimed to represent a caring physician in a humble setting during an era when people living with poverty rarely had access to health care and nearly all physicians were White men. The Doctor challenges us to think about what good doctoring is. [ABSTRACT FROM AUTHOR]

Numerous studies have documented deteriorating occupational health among practicing physicians. This trend poses a serious risk not only for physicians but also for the many patients under their care. Past research finds that one protective factor involves the quality of physicians' motivation. When physicians are more autonomously motivated, they tend to experience better occupational health. However, few studies have identified antecedent factors that support physicians' autonomous work motivation. To identify and model potential root causes of physicians' autonomous work motivation and occupational health, the current study assessed physicians' intrinsic aspirations and need satisfaction at work. Hypotheses were tested in a sample of 2,116 U.S. practicing physicians. Structural equation modeling showed that physicians who endorsed intrinsic aspirations more strongly reported better occupational health, and that this association was mediated by physicians' need satisfaction and autonomous work motivation. Implications for designing more effective individual- and system-level interventions to improve physician occupational health are discussed. [ABSTRACT FROM AUTHOR]

There are three core elements to professionalism that doctors can adopt in a managed care environment: devotion to medical service, a profession of values, and negotiation of priorities. Doctors operating within this model of professionalism, doctors can participate in various degrees of activism. The most basic form of activism is acting as the patient's advocate. Doctors may have to speak out against managed care policies that are not in the patient's best interest. The opposite end of the activism spectrum is deliberately disobeying a law.

The article focuses on anti-Asian racism and xenophobia during the COVID-19 is not surprising on October 24, 1871, the U.S. history the Chinese Massacre in Los Angeles including the sheriff spokesperson described the possibly reducible to a single errant guy who claimed to have a sex addiction.

The article discusses that knowledge is power, scholarly journals as information gatekeepers play a potent role in promulgating it. Topics discussed include borne witness to deadly harms inflicted on communities of color, and these harms, journals continue disseminating content, including a recent JAMA podcast, that fails to recognize racism as a trans generational source of health inequity; and the existence of racism in health care is "not opinion or conjecture.

An introduction is presented in which the editor discusses several articles published within issue on topics related to racial justice and health equity.

A personal narrative is presented in which the author talk about the U.S government's dispossession of First Americans' land and property and the means by which they nourished their bodies and spirits.

The article focuses on America's documentary crucible the Declaration of Independence espouses ideals of equality, humanity, and democracy inlcuding the frontline health care workers have shown up to work even at personal risk to themselves.

The author conveys her thoughts about the 2019 novel coronavirus outbreak and the South Korean film "Parasite," which won the Academy Award for best picture.

The article examines the need of motivating health equity in pharmacy industry. Topics include physicians expecting to embody medicine's ethical oaths and codes, to apply clinical knowledge and skills without prejudice; and the AMA Journal of Ethics has committed to catalysing greater appreciation for and understanding of health equity and to motivating "assurance of the conditions for optimal health for all people."

Background: Primary care physicians generally earn less than specialists. Studies of other occupations have identified perception of pay fairness as a predictor of work- and life-related outcomes. We evaluated whether physicians' pay fairness perceptions were associated with their work satisfaction, turnover intention, and personal health.Methods: Three thousand five hundred eighty-nine physicians were surveyed. Agreement with "my total compensation is fair" was used to assess pay fairness perceptions. Total compensation was self-reported, and we used validated measures of work satisfaction, likelihood of leaving current practice, and health status. Hierarchical logistic regressions were used to assess the associations between pay fairness perceptions and work/life-related outcomes.Results: A total of 2263 physicians completed surveys. Fifty-seven percent believed their compensation was fair; there was no difference between physicians in internal medicine and non-primary care specialties (P = 0.58). Eighty-three percent were satisfied at work, 70% reported low likelihood of leaving their practice, and 77% rated their health as very good or excellent. Higher compensation levels were associated with greater work satisfaction and lower turnover intention, but most associations became statistically non-significant after adjusting for pay fairness perceptions. Perceived pay fairness was associated with greater work satisfaction (OR, 4.90; 95% CI, 3.94-6.08; P < 0.001), lower turnover intention (OR, 2.46; 95% CI, 2.01-3.01; P < 0.001), and better health (OR, 1.33; 95% CI, 1.08-1.65; P < 0.01).Discussion: Physicians who thought their pay was fair reported greater work satisfaction, lower likelihood of leaving their practice, and better overall health. Addressing pay fairness perceptions may be important for sustaining a satisfied and healthy physician workforce, which is necessary to deliver high-quality care. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including allocate medication via a subscription payment model; evaluate state Medicaid programs’ reliance on drug rebates from pharmaceutical companies; and the ethics of prescription medication.

The article offers information on the redesign of the periodical from this issue, including the increase in the use of visual assets in redesign; the content of the journal, such as a continuing medical education and ethics case library; and the peer-review of the manuscripts submitted.

The article focuses on several ideology expressed in personal actions and public policies that continue to prevent everyone from realizing their full potential. Topics include reports that individuals are struggling to deal with the physical suffering and economic distress that have been wrought by the COVID-19 pandemic.

The article offers the author's insights on the editorial mission of the periodical American Medical Association Journal of Ethics (JOE) to help in the ethical decisions of medical students and physicians.