346 results on '"Physician Executives standards"'
Search Results
2. Patient Satisfaction in Academic Pain Management Centers: How Do We Compare?
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Gonnella JC, Abd-Elsayed A, and Kohan L
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- Academic Medical Centers standards, Analgesics, Opioid administration & dosage, Humans, Pain Management standards, Practice Patterns, Physicians' standards, Academic Medical Centers methods, Pain Management methods, Patient Satisfaction, Physician Executives standards, Physician's Role, Surveys and Questionnaires
- Abstract
Purpose of Review: The aim of the study was to investigate patient satisfaction amongst academic pain management centers and associated factors., Recent Findings: Approximately 25% of pain management centers perform better than other practices on Press Ganey surveys. The majority of respondents (96%) indicated that pain management practices were uniquely positioned to receive poorer scores on patient satisfaction surveys. The majority of respondents (20/26), who reported a reason, indicated that limiting opioid prescribing led to poor patient satisfaction scores. Eighty-three percent of respondents indicated that they received pressure from administrators to improve patient satisfaction scores. The opioid epidemic in the USA must be addressed in order to diminish the senseless loss of life that is occurring in staggering numbers. The quality of care physicians provide has increasingly been assessed via patient satisfaction surveys. The results of these surveys often are utilized to provide financial incentives to physicians to obtain higher satisfaction scores. In the field of pain management, physicians may experience pressure to prescribe opioids in order to obtain higher patient satisfaction scores.
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- 2020
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3. Contributors to Independent Research Funding Success from the Perspective of K12 BIRCWH Program Directors.
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Choo E, Mathis S, Harrod T, Hartmann KE, Freund KM, Krousel-Wood M, Curry TE Jr, and Guise JM
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- Biomedical Research standards, Biomedical Research trends, Female, Humans, Interdisciplinary Research standards, National Institutes of Health (U.S.) standards, Physician Executives standards, Research Personnel standards, United States epidemiology, Women's Health standards, Career Mobility, Interdisciplinary Research trends, National Institutes of Health (U.S.) trends, Physician Executives trends, Research Personnel trends, Women's Health trends
- Abstract
Introduction: Faculty training awards are an important means of advancing early career faculty in research. The National Institutes of Health (NIH) Building Interdisciplinary Research Careers in Women's Health (BIRCWH) is a long-running K12 career development program and has been integral in promoting the research success of faculty nationally. We surveyed BIRCWH program directors to understand factors likely to influence long-term research careers and funding success., Materials and Methods: We developed an online survey containing open-ended questions about individual and programmatic attributes and activities that promote success in achieving independent research funding. Domains of interest included: 1) strategies for funding success; 2) traits for predicting success; 3) groups considered vulnerable to attrition; and 4) existing resources and means of support., Results: Fifteen institutions (75%) were included in the final analysis. Passion for research, persistence, resilience, and strong mentorship relationships were identified by all directors as factors important to scholar success. Responses also revealed an important pattern: program directors attributed attrition either to individual or organizational characteristics. This distinction has meaningful consequences for framing efforts to diminish attrition. Faculty who were clinicians, women, parents and underrepresented minorities were identified as vulnerable to attrition from the research careers. Common perceived challenges in these groups included isolation/feeling alienated, juggling numerous priorities, inadequate research time, lack of role models, and work-life balance issues., Conclusion: K12 BIRCWH directors identified persistence and resilience and developing community, networks, and other support opportunities as elements of scholar success. Programs and mentors can help early career faculty by teaching skills and providing tools they can use to maximize the value of these opportunities and expand their mentees' research relationships. Our study also highlights the importance of social factors, particularly isolation, on clinicians, women, and minoritized scholars on career success., (Copyright © 2020. Published by Elsevier Inc.)
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- 2020
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4. Characterizing the Effect of Pass/Fail U.S. Medical Licensing Examination Step 1 Scoring in Neurosurgery: Program Directors' Perspectives.
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Ganesh Kumar N, Makhoul AT, Pontell ME, and Drolet BC
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- Adult, Educational Measurement methods, Female, Humans, Male, Middle Aged, Physician Executives psychology, Surveys and Questionnaires, United States, Educational Measurement standards, Internship and Residency standards, Licensure, Medical standards, Neurosurgery education, Neurosurgery standards, Physician Executives standards
- Abstract
Background: The neurosurgery match is among the most competitive across all specialties. As a result, numerical Step U.S. Medical Licensing Examination Step 1 scores have historically played a major role in selecting applicants for interviews. With the anticipated change in Step 1 scoring to pass/fail will come significant ramifications for how program directors (PDs) screen and select applicants. The present study characterized the responses of PDs to the change in U.S. Medical Licensing Examination Step 1 scoring and its consequences on medical students applying to neurosurgery., Methods: After receipt of an institutional review board exemption, a validated 19-item survey was electronically distributed to 99 PDs of neurosurgery training programs as a part of a national study across 30 residency specialties. Descriptive statistical analyses were performed, and statistical significance was determined by nonoverlapping 95% confidence intervals., Results: A total of 48 responses were obtained (48.5%). Most PDs were men, with a mean age of 52 years, and, on average, had served 7.4 years as a PD. Most PDs (79%) disagreed with binary Step 1 scoring. Most (85%) believed the change will make objective comparison of applicants more difficult, and 83% reported they will begin to require Step 2 clinical knowledge scores with application submission. More than one half (71%) believed medical school reputation will become more important in resident selection. Only 15% believed that pass/fail Step 1 scoring will improve medical student well-being., Conclusion: Binary Step 1 scoring represents a significant change in medical student evaluations, with consequences for the neurosurgery residency application process. The results from the present study might help guide PD practices and prepare medical students for the anticipated changes to the application process., (Published by Elsevier Inc.)
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- 2020
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5. International Medical Graduates Applying to Neurosurgical Residency in the United States Through the Lenses of an Applicant Versus a Program Director.
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Lu VM and Chambless LB
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- Foreign Medical Graduates trends, Humans, Internship and Residency trends, Physician Executives trends, United States, Clinical Competence standards, Foreign Medical Graduates standards, Internship and Residency methods, Internship and Residency standards, Job Application, Physician Executives standards
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- 2020
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6. The President, Past President, Executive Director, and the Board of the Child Neurology Society Denounce Racism and Inequality.
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Pearl PL, Mink JW, Cohen BH, Bamford N, Bass N, Jordan L, Wainwright MS, and Larson RB
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- Child, Governing Board standards, Humans, Healthcare Disparities standards, Neurology standards, Pediatrics standards, Physician Executives standards, Racism prevention & control, Societies, Medical standards
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- 2020
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7. Leading from the Middle: Benefits of a Physician Leadership Program.
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DeRusso PA, Greeley WJ, and St Geme JW 3rd
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- Education, Medical, Continuing organization & administration, Female, Humans, Male, Physician Executives standards, Program Evaluation, Leadership, Physician Executives education, Staff Development organization & administration
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- 2020
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8. How Well Do Core Faculty Understand The Emergency Medicine Milestones?
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Sorge R, Li-Sauerwine S, Fernandez J, and Hern G
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- Comprehension, Humans, Professional Competence standards, Surveys and Questionnaires, United States, Emergency Medicine education, Faculty standards, Internship and Residency, Physician Executives standards
- Abstract
Introduction: It is unclear how emergency medicine (EM) programs educate core faculty about the use of milestones in competency-based evaluations. We conducted a national survey to profile how programs educate core faculty regarding their use and to assess core faculty's understanding of the milestones., Methods: Our survey tool was distributed over six months in 2017 via the Council of Emergency Medicine Residency Directors (CORD) listserv. Responses, which were de-identified, were solicited from program directors (PDs), assistant/associate program directors (APDs), and core faculty. A single response from a program was considered sufficient., Results: Our survey had a 69.7% response rate (n=140/201). 62.9% of programs reported educating core faculty about the EM Milestones via the distribution of physical or electronic media. Although 82.6% of respondents indicated that it was important for core faculty to understand how the EM Milestones are used in competency-based evaluations, respondents estimated that 48.6% of core faculty possess "fair or poor" understanding of the milestones. Furthermore, only 50.7% of respondents felt that the EM Milestones were a valuable tool., Conclusion: These data suggest there is sub-optimal understanding of the EM Milestones among core faculty and disagreement as to whether the milestones are a valuable tool.
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- 2019
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9. Teaching Safe Opioid Prescribing During the Opioid Epidemic: Results of the 2018 Clerkship Directors in Internal Medicine Survey.
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Ari M, Kisielewski M, Osman NY, Szauter K, Packer CD, and Pincavage AT
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- Analgesics, Opioid adverse effects, Clinical Clerkship methods, Female, Humans, Internal Medicine education, Internal Medicine methods, Male, Physician Executives education, Surveys and Questionnaires, United States epidemiology, Analgesics, Opioid administration & dosage, Clinical Clerkship standards, Drug Prescriptions standards, Internal Medicine standards, Opioid Epidemic prevention & control, Physician Executives standards
- Abstract
Background: Educating medical trainees across the continuum is essential to a multifaceted strategy for addressing the opioid epidemic., Objective: To assess the current state of internal medicine clerkship content on safe opioid prescribing and opioid use disorder, and barriers to curriculum implementation., Design: National Annual (2018) Clerkship Directors in Internal Medicine (CDIM) cross-sectional survey., Participants: One hundred thirty-four clerkship directors at all Liaison Committee of Medical Education accredited US medical schools with CDIM membership as of October 1, 2018., Main Measures: The survey section on safe opioid prescribing and opioid use disorder education in the internal medicine clerkship addressed assessment of current curricula, perceived importance of curricula, barriers to implementation, and plans to start or expand curricula. Descriptive statistics were used to summarize responses, and Pearson's chi-square and Fisher's exact tests for statistical comparisons., Key Results: The survey response rate was 82% (110/134). Overall 54.1% of responding institutions reported covering one or more topics related to safe opioid prescribing or opioid use disorder in the internal medicine clerkship. A preponderance of clerkship directors (range 51-86%) reported that various opioid-related topics were important to cover in the internal medicine clerkship. Safe opioid prescribing topics were covered more frequently than topics related specifically to opioid use disorder. The main barriers identified included time (80.9%) and lack of faculty expertise (65.5%)., Conclusions: Clerkship directors agreed that incorporating safe opioid prescribing and opioid use disorder topics in the internal medicine clerkship is important, despite wide variation in current curricula. Addressing curricular time constraints and lack of faculty expertise in internal medicine clerkships will be key to successfully integrating content to address the opioid epidemic.
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- 2019
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10. Exploring Institutional Practices to Develop Faculty Evaluators: Results from the 2016 Clerkship Directors in Internal Medicine National Survey.
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O'Brien KE, Ledford R, DeWaay D, Klocksieben F, Kisielewski M, Burger A, and LaRochelle J
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- Clinical Clerkship methods, Female, Humans, Internal Medicine methods, Male, Program Evaluation methods, Clinical Clerkship standards, Faculty, Medical standards, Internal Medicine standards, Physician Executives standards, Program Evaluation standards, Surveys and Questionnaires
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- 2019
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11. Medical Oversight and Scope of Practice of Medical Spas (Med-Spas).
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Gibson JF, Srivastava D, and Nijhawan RI
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- Certification legislation & jurisprudence, Certification standards, Cosmetic Techniques statistics & numerical data, Dermatology statistics & numerical data, Government Regulation, Health Facilities statistics & numerical data, Humans, Patient Safety legislation & jurisprudence, Patient Safety standards, United States epidemiology, Cosmetic Techniques standards, Dermatology standards, Health Facilities legislation & jurisprudence, Health Facilities standards, Physician Executives legislation & jurisprudence, Physician Executives standards
- Abstract
Background: The regulation of medical spas (med-spas) in the United States varies considerably from state to state with important ramifications for patient safety., Objective: To describe the current state of med-spas in the United States and degree of medical oversight in these facilities., Materials and Methods: Descriptive study based on web search and standardized phone interviews of med-spas in the most heavily populated cities in each state of the United States. Information obtained included the following: whether medical directors were listed; if so, whether they were advertised as being on site; medical directors' training and board certification; and services offered., Results: Of 247 medical spas reviewed, 72% advertised a medical director on their website, and 6.5% claimed that the director was on site. Of listed medical directors, 41% were trained in dermatology and/or plastic surgery. In phone interviews, 79% of med-spas endorsed the medical director to be board certified, and 52% stated that the medical director was on site less than 50% of the time., Conclusion: There is significant variation in medical directorship and oversight among medical spas in the United States. Appropriate regulation of medical directors' training and the degree of oversight provided are warranted to optimize patient safety.
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- 2019
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12. American Academy of Physical Medicine and Rehabilitation Position Statement on Definitions for Rehabilitation Physician and Director of Rehabilitation in Inpatient Rehabilitation Settings.
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Laker SR, Adair WA 3rd, Annaswamy TM, Frank LW, Hatzakis M Jr, Hubbell SL, Ifejika NL, Ivanhoe CB, Jones VA, Lupinacci MF, Purcell AD, Standaert CJ, and Dolak MA
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- Humans, Physiatrists education, Physical and Rehabilitation Medicine education, Physician Executives education, Societies, Medical standards, United States, Physical and Rehabilitation Medicine standards, Physician Executives standards, Practice Guidelines as Topic standards, Quality Improvement, Rehabilitation Centers standards
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- 2019
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13. Did we learn the lesson after 60 years of Management by Objectives? A survey among former physician executives in German hospitals.
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Schnoor J, Braehler E, and Heyde CE
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- Germany, Hospital Administration methods, Hospital Administration trends, Hospitals standards, Hospitals trends, Humans, Physician Executives standards, Surveys and Questionnaires, Hospital Administration standards, Leadership, Physician Executives psychology
- Abstract
Background: Management by Objectives (MbO) has been shown to establish efficient team work in both industry and medicine. Its most important prerequisite for success is target agreements between managers and medical professionals on equal footing. In medicine, lump-sum financing urges the delivery of a health care service with minimal effort. Consequently, daily clinical life changed, with economic goals seeming to become priority over medical principles., Objective: To determine how well MbO can still be practiced in hospitals with lumped treatment prices., Methods: We used an anonymized questionnaire for already retired physician executives who completed their active leadership positions between 2010 and 2015 in Saxony (Germany). We asked various type of target agreements that had been used in order to achieve medical or economic targets., Results and Conclusions: Out of 111 former executives, the questionnaires of 25 respondents could be analysed. Eight respondents confirmed target agreements that were mostly set by managing directors. If used, most targets had not been adapted to the infrastructure and personnel strength, nor were they coordinated with neighbouring departments. Four respondents received financial incentives. Most medical executives were unsatisfied and preferred to abandon further goal setting. Due to the low number of cases, the representativeness of the study is limited. Nevertheless, it might be questioned if a flat-rate remuneration system facilitates the change into an authoritarian leadership concept.
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- 2019
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14. The prevalence and implications of copy and paste: internal medicine program director perspectives.
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Roddy JT, Arora VM, Chaudhry SI, Rein LM, Banerjee A, Swenson SL, and Fletcher KE
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- Cross-Sectional Studies, Humans, Internal Medicine methods, Internship and Residency methods, Prevalence, Electronic Health Records standards, Internal Medicine standards, Internship and Residency standards, Physician Executives standards
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- 2018
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15. Variability in Care Management Programs in Medicare ACOs: A Survey of Medical Directors.
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Donelan K, Barreto EA, Michael CU, Nordby P, Smith M, and Metlay JP
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- Health Personnel psychology, Humans, Physician Executives psychology, United States epidemiology, Accountable Care Organizations standards, Health Personnel standards, Managed Care Programs standards, Medicare standards, Physician Executives standards, Surveys and Questionnaires
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- 2018
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16. RESPONSE: Fostering Competent Physician Leaders for the Future.
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O'Gara PT
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- Forecasting, Humans, Physician Executives trends, Physicians trends, Clinical Competence standards, Leadership, Physician Executives standards, Physicians standards
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- 2018
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17. Recent trends in publications of US vascular surgery program directors.
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Aurshina A, Hingorani A, Hingorani A, Zainab A, Marks N, Blumberg S, and Ascher E
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- Bibliometrics, Biomedical Research standards, Cross-Sectional Studies, Efficiency, Humans, Periodicals as Topic standards, Physician Executives standards, Program Evaluation, Time Factors, United States, Vascular Surgical Procedures standards, Authorship, Biomedical Research trends, Periodicals as Topic trends, Physician Executives trends, Vascular Surgical Procedures trends
- Abstract
Objective In order to examine the academic productivity of US vascular surgery program directors, the number of vascular publications listed in PubMed from 2001 to 2015 for US vascular surgery program directors was reviewed. We suggest that this can be used as a benchmark for academic productivity. Methods The names of the program directors were taken from the Accreditation Council for Graduate Medical Education (ACGME) website at two time points: December 2009 (Independent Programs) and December 2015 (Independent + Integrated). This was used to query PubMed, which listed 5196 publications: 3284 from 2001 to 2009 and 1912 from 2010 to 2015. Results There were 104 program directors (2001-2009) and 114 program directors (2010-2015) with average number of publications in PubMed per program director as 3.68/year (SD ± 2.31) and 2.80/year (SD ± 2.73), respectively ( P = .01). From 2001 to 2009, 1215 (37%) and in 2010 to 2015, 860 (45%) of the publications were from Journal of vascular surgery. The top third produced 67% and 69% of publications in the two time-points. No statistical difference was ascertained regionally: northeast, southeast, midwest and west ( P = .46). The numbers of publications/year decreased by 17% compared to first 10 years. From 2001 to 2009, there were no programs with no publications which increased to five and three with no Journal of Vascular Surgery publications which increased to 21 in 2010-2015. The independent and integrated program directors published average of 2.85 (SD ± 2.69) and 3.47 (SD ± 3.1) total publications; 1.25 (SD ± 1.4) and 3.47 (SD ± 1.7) Journal of Vascular Surgery papers/year, respectively ( P = .28, P = .23). Changes in the study subject were noted by percentage of total publications: endovascular lower extremity arterial (4.7% to 8.9%), Thoracic Endovascular Aortic Repair (TEVAR) (4.5% to 9.9%), Arterio-Venous (AV) access (0.0% to 3.0%), basic science (14.7% to 6.8%), open thoracic (3.0% to 0.6%). Conclusion There seems to be a significant decline in the number of publications over the last 15 years. Yet, the subject of the publications has progressed from Open to TEVAR with an increase in endovascular publications. However, basic science publications reduced by half.
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- 2018
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18. Competitive Advantage of MBA for Physician Executives: A Systematic Literature Review.
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Turner AD, Stawicki SP, and Guo WA
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- Commerce economics, Commerce education, Commerce organization & administration, Competitive Behavior, Curriculum, Education, Graduate organization & administration, Humans, Leadership, Physician Executives economics, Physician Executives organization & administration, Practice Management economics, Practice Management standards, Commerce standards, Physician Executives education, Physician Executives standards, Practice Management organization & administration
- Abstract
In response to systemic challenges facing the US healthcare system, many medical students, residents and practicing physicians are pursuing a Master in Business Administration (MBA) degree. The value of such proposition remains poorly defined. The aim of this review is to analyze current literature pertaining to the added value of MBA training for physician executives (PEs). We hypothesized that physicians who supplement their clinical expertise with business education gain a significant competitive advantage. A detailed literature search of four electronic databases (PubMed, SCOPUS, Embase and ERIC) was performed. Included were studies published between Jan 2000 and June 2017, focusing specifically on PEs. Among 1580 non-duplicative titles, we identified 23 relevant articles. Attributes which were found to add value to one's competitiveness as PE were recorded. A quality index score was assigned to each article in order to minimize bias. Results were tabulated by attributes and by publication. We found that competitive domains deemed to be most important for PEs in the context of MBA training were leadership (n = 17), career advancement opportunities (n = 12), understanding of financial aspects of medicine (n = 9) and team-building skills (n = 10). Among other prominent factors associated with the desire to engage in an MBA were higher compensation, awareness of public health issues/strategy, increased negotiation skills and enhanced work-life balance. Of interest, the learning of strategies for reducing malpractice litigation was less important than the other drivers. This comprehensive systemic review supports our hypothesis that a business degree confers a competitive advantage for PEs. Physician executives equipped with an MBA degree appear to be better equipped to face the challenge of the dynamically evolving healthcare landscape. This information may be beneficial to medical schools designing or implementing combined dual-degree curricula.
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- 2018
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19. Is It Time for Entrustable Professional Activities for Residency Program Directors?
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Bing-You RG, Holmboe E, Varaklis K, and Linder J
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- Adult, Female, Humans, Male, Middle Aged, United States, Young Adult, Education, Medical, Graduate standards, Educational Measurement methods, Faculty, Medical standards, Internship and Residency standards, Physician Executives standards, Professional Competence standards, Professional Role
- Abstract
Residency program directors (PDs) play an important role in establishing and leading high-quality graduate medical education programs. However, medical educators have failed to codify the position on a national level, and PDs are often not recognized for the significant role they play. The authors of this Commentary argue that the core entrustable professional activities (EPAs) framework may be a mechanism to further this work and define the roles and responsibilities of the PD position. Based on personal observations as PDs and communications with others in the academic medicine community, the authors used work in competency-based medical education to define a list of potential EPAs for PDs. The benefits of developing these EPAs include being able to define competencies for PDs using a deconstructive process, highlighting the increasingly important role PDs play in leading high-quality graduate medical education programs, using EPAs as a framework to assess PD performance and provide feedback, allowing PDs to focus their professional development efforts on the most important areas for their work, and helping guide the PD recruitment and selection processes.
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- 2017
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20. Residency Program Directors' View on the Value of Teaching.
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Korte C, Smith A, and Pace H
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- Education, Pharmacy methods, Education, Pharmacy standards, Education, Pharmacy, Graduate methods, Humans, Pharmacy Residencies methods, Pilot Projects, Program Development methods, Surveys and Questionnaires standards, Education, Pharmacy, Graduate standards, Pharmacy Residencies standards, Physician Executives standards, Program Development standards, Teaching standards
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Purpose: There is no standardization for teaching activities or a requirement for residency programs to offer specific teaching programs to pharmacy residents. This study will determine the perceived value of providing teaching opportunities to postgraduate year 1 (PGY-1) pharmacy residents in the perspective of the residency program director. The study will also identify the features, depth, and breadth of the teaching experiences afforded to PGY-1 pharmacy residents., Methods: A 20-question survey was distributed electronically to 868 American Society of Health-System Pharmacists-accredited PGY-1 residency program directors., Results: The survey was completed by 322 program directors. Developing pharmacy educators was found to be highly valued by 57% of the program directors. Advertisement of teaching opportunities was found to be statistically significant when comparing program directors with a high perceived value for providing teaching opportunities to program demographics. Statistically significant differences were identified associating development of a teaching portfolio, evaluation of Advanced Pharmacy Practice Experiences students, and delivery of didactic lectures with program directors who highly value developing pharmacy educators., Conclusions: Future residency candidates interested in teaching or a career in academia may utilize these findings to identify programs that are more likely to value developing pharmacy educators. The implementation of a standardized teaching experience among all programs may be difficult., (© The Author(s) 2015.)
- Published
- 2016
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21. Transition of Editorship and Medical Care.
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Hageman JR
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- Humans, Delivery of Health Care organization & administration, Editorial Policies, Education, Medical, Continuing, Physician Executives standards
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- 2016
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22. Structural heart interventions training in Europe.
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Marmagkiolis K, Arzamendi D, Goktekin O, and Cilingiroglu M
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- Cardiac Surgical Procedures standards, Cardiology standards, Clinical Competence standards, Europe epidemiology, Heart Defects, Congenital epidemiology, Humans, Cardiac Surgical Procedures education, Cardiology education, Heart Defects, Congenital surgery, Internship and Residency standards, Physician Executives standards, Surveys and Questionnaires
- Abstract
Background: Structural heart interventions have made major strides over the last years with the introduction of TAVR, percutaneous mitral valve repair and adult congenital heart disease procedures., Methods: As part of the SCAI SHD Early Career Task Force committee, we complied a survey of 17 questions using a Survey Monkey website. We sent invitations twice by email to 183 European program directors of interventional cardiology fellowship programs in Europe., Results: The most commonly performed procedures performed by the fellows were transseptal punctures, TAVR, BAV, PFO and BMV. For the rest of the structural procedures, each fellow performed <10 procedures during their training., Conclusion: Structural heart interventions training will keep expanding over the next years with the introduction of newer devices and techniques and accumulation of experience. Given the small number of the more rare structural procedures, it becomes apparent that we need to design national or international training networks to provide adequate training experience to all trainees., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
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- 2016
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23. Focused Transthoracic Cardiac Ultrasound: A Survey of Training Practices.
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Conlin F, Roy Connelly N, Raghunathan K, Friderici J, and Schwabauer A
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- Anesthesiology standards, Clinical Competence standards, Echocardiography standards, Female, Humans, Internship and Residency standards, Male, Physician Executives standards, United States, Anesthesiology education, Anesthesiology methods, Echocardiography methods, Internship and Residency methods, Physician Executives education, Surveys and Questionnaires
- Abstract
Objective: The role of focused assessment by transthoracic echocardiography or focused cardiac ultrasound (FoCUS) in the perioperative setting is uncertain and evolving. To the authors' knowledge, there are no studies that evaluate the current teaching practices regarding FoCUS in US anesthesiology residencies. The authors surveyed residents and residency program directors to examine the frequency, type, and variability of instruction regarding training of FoCUS., Design: A survey study., Setting: Anesthesiology residency programs in the United States., Participants: All 133 Accreditation Council for Graduate Medical Education anesthesiology program directors and their residents were invited to participate in an anonymous electronic survey., Measurements and Main Results: In all, 292 respondents replied to the survey, and 245 were included in the analysis. Overall response rate was 30% for program directors. The majority of the respondents were trainees (83.7%). FoCUS training was reported to be present by 36% of respondents. Respondents from institutions in which>10% of attending physicians used FoCUS were nearly 3 times as likely as those in which fewer attending physicians used FoCUS to report presence of FoCUS training program. The most common training mode is lectures with simulation (34%), followed by bedside training (31%). The most frequently reported responsible training parties were anesthesiologists (75%), followed by cardiologists (14%). Although FoCUS training is relatively rare, most respondents (187 of 205 residents and 26 of 40 program directors) said that FoCUS should be the standard in training for anesthesia residents., Conclusions: Despite the increasing availability and use of ultrasound in clinical practice, FoCUS-related use and training remain uncommon in anesthesiology. Trainees in anesthesiology are not receiving adequate instruction in FoCUS despite their desire to acquire this skill., (Copyright © 2016 Elsevier Inc. All rights reserved.)
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- 2016
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24. Managing Disruptive Behavior by Patients and Physicians: A Responsibility of the Dialysis Facility Medical Director.
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Jones ER and Goldman RS
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- Ambulatory Care Facilities standards, Delivery of Health Care, Humans, Kidney Failure, Chronic diagnosis, Kidney Failure, Chronic psychology, Patient Discharge, Patient Transfer, Quality Indicators, Health Care, Renal Dialysis standards, Ambulatory Care Facilities organization & administration, Attitude of Health Personnel, Health Knowledge, Attitudes, Practice, Job Description, Kidney Failure, Chronic therapy, Patients psychology, Physician Executives standards, Physicians psychology, Problem Behavior, Renal Dialysis psychology
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The Centers for Medicare & Medicaid Services' Conditions for Coverage make the medical director of an ESRD facility responsible for all aspects of care, including high-quality health care delivery (e.g., safe, effective, timely, efficient, and patient centered). Because of the high-pressure environment of the dialysis facility, conflicts are common. Conflict frequently occurs when aberrant behaviors disrupt the dialysis facility. Patients, family members, friends, and, less commonly appreciated, nephrology clinicians (i.e., nephrologists and advanced care practitioners) may manifest disruptive behavior. Disruptive behavior in the dialysis facility impairs the ability to deliver high-quality care. Furthermore, disruptive behavior is the leading cause for involuntary discharge (IVD) or involuntary transfer (IVT) of a patient from a facility. IVD usually results in loss of continuity of care, increased emergency department visits, and increased unscheduled, acute dialysis treatments. A sufficient number of IVDs and IVTs also trigger an extensive review of the facility by the regional ESRD Networks, exposing the facility to possible Medicare-imposed sanctions. Medical directors must be equipped to recognize and correct disruptive behavior. Nephrology-based literature and tools exist to help dialysis facility medical directors successfully address and resolve disruptive behavior before medical directors must involuntarily discharge a patient or terminate an attending clinician., (Copyright © 2015 by the American Society of Nephrology.)
- Published
- 2015
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25. The medical director in integrated clinical care models.
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Parker TF 3rd and Aronoff GR
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- Accountable Care Organizations standards, Delivery of Health Care, Integrated standards, Humans, Kidney Failure, Chronic diagnosis, Kidney Failure, Chronic physiopathology, Models, Organizational, Patient Care Team standards, Physician Executives standards, Process Assessment, Health Care, Quality Improvement, Quality Indicators, Health Care, Treatment Outcome, Accountable Care Organizations organization & administration, Delivery of Health Care, Integrated organization & administration, Job Description, Kidney Failure, Chronic therapy, Patient Care Team organization & administration, Physician Executives organization & administration, Professional Role, Renal Dialysis standards
- Abstract
Integrated clinical care models, like Accountable Care Organizations and ESRD Seamless Care Organizations, present new opportunities for dialysis facility medical directors to affect changes in care that result in improved patient outcomes. Currently, there is little scholarly information on what role the medical director should play. In this opinion-based review, it is predicted that dialysis providers, the hospitals in which the medical director and staff physicians practice, and the payers with which they contract are going to insist that, as care becomes more integrated, dialysis facility medical directors participate in new ways to improve quality and decrease the costs of care. Six broad areas are proposed where dialysis unit medical directors can have the greatest effect on shifting the quality-care paradigm where integrated care models are used. The medical director will need to develop an awareness of the regional medical care delivery system, collect and analyze actionable data, determine patient outcomes to be targeted that are mutually agreed on by participating physicians and institutions, develop processes of care that result in improved patient outcomes, and lead and inform the medical staff. Three practical examples of patient-centered, quality-focused programs developed and implemented by dialysis unit medical directors and their practice partners that targeted dialysis access, modality choice, and fluid volume management are presented. Medical directors are encouraged to move beyond traditional roles and embrace responsibilities associated with integrated care., (Copyright © 2015 by the American Society of Nephrology.)
- Published
- 2015
- Full Text
- View/download PDF
26. What Medical Directors Need to Know about Dialysis Facility Water Management.
- Author
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Kasparek T and Rodriguez OE
- Subjects
- Equipment Design, Humans, Job Description, Leadership, Quality Control, Quality Indicators, Health Care, Water Microbiology, Water Quality, Ambulatory Care Facilities organization & administration, Ambulatory Care Facilities standards, Delivery of Health Care organization & administration, Delivery of Health Care standards, Physician Executives organization & administration, Physician Executives standards, Professional Role, Renal Dialysis standards, Water Purification instrumentation, Water Purification standards, Water Supply standards
- Abstract
The medical directors of dialysis facilities have many operational clinic responsibilities, which on first glance, may seem outside the realm of excellence in patient care. However, a smoothly running clinic is integral to positive patient outcomes. Of the conditions for coverage outlined by the Centers for Medicare and Medicaid Services, one most critical to quality dialysis treatment is the provision of safe purified dialysis water, because there are many published instances where clinic failure in this regard has resulted in patient harm. As the clinical leader of the facility, the medical director is obliged to have knowledge of his/her facility's water treatment system to reliably ensure that the purified water used in dialysis will meet the standards for quality set by the Association for the Advancement of Medical Instrumentation and used by the Centers for Medicare and Medicaid Services for conditions for coverage. The methods used to both achieve and maintain these quality standards should be a part of quality assessment and performance improvement program meetings. The steps for water treatment, which include pretreatment, purification, and distribution, are largely the same, regardless of the system used. Each water treatment system component has a specific role in the process and requires individualized maintenance and monitoring. The medical director should provide leadership by being engaged with the process, knowing the facility's source water, and understanding water treatment system operation as well as the clinical significance of system failure. Successful provision of quality water will be achieved by those medical directors who learn, know, and embrace the requirements of dialysis water purification and system maintenance., (Copyright © 2015 by the American Society of Nephrology.)
- Published
- 2015
- Full Text
- View/download PDF
27. The evolving role of the medical director of a dialysis facility.
- Author
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Maddux FW and Nissenson AR
- Subjects
- Clinical Competence, Delivery of Health Care, Integrated history, Delivery of Health Care, Integrated standards, History, 20th Century, History, 21st Century, Humans, Kidney Failure, Chronic diagnosis, Kidney Failure, Chronic history, Leadership, Medicare, Nephrology history, Nephrology standards, Physician Executives history, Physician Executives standards, Quality of Health Care history, Quality of Health Care standards, United States, Workforce, Delivery of Health Care, Integrated trends, Kidney Failure, Chronic therapy, Nephrology trends, Physician Executives trends, Physician's Role history, Quality of Health Care trends
- Abstract
The medical director has been a part of the fabric of Medicare's ESRD program since entitlement was extended under Section 299I of Public Law 92-603, passed on October 30, 1972, and implemented with the Conditions for Coverage that set out rules for administration and oversight of the care provided in the dialysis facility. The role of the medical director has progressively increased over time to effectively extend to the physicians serving in this role both the responsibility and accountability for the performance and reliability related to the care provided in the dialysis facility. This commentary provides context to the nature and expected competencies and behaviors of these medical director roles that remain central to the delivery of high-quality, safe, and efficient delivery of RRT, which has become much more intensive as the dialysis industry has matured., (Copyright © 2015 by the American Society of Nephrology.)
- Published
- 2015
- Full Text
- View/download PDF
28. Introduction: Role of the medical director series.
- Author
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Provenzano R and Hymes JL
- Subjects
- Humans, Models, Organizational, Quality of Health Care, Workforce, Delivery of Health Care, Integrated organization & administration, Delivery of Health Care, Integrated standards, Nephrology organization & administration, Nephrology standards, Physician Executives organization & administration, Physician Executives standards, Physician's Role
- Published
- 2015
- Full Text
- View/download PDF
29. Limits to scholarship: how can we enhance the program director's role?
- Author
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De Golia SG and Katznelson L
- Subjects
- Humans, Academic Medical Centers standards, Biomedical Research organization & administration, Internship and Residency organization & administration, Physician Executives standards, Psychiatry education
- Published
- 2015
- Full Text
- View/download PDF
30. Quantifying publication scholarly activity of psychiatry residency training directors.
- Author
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Johnston NS, Martinez AV, Schillerstrom JE, Luber MP, and Hamaoka DA
- Subjects
- Adult, Bibliographies as Topic, Humans, Academic Medical Centers standards, Biomedical Research organization & administration, Internship and Residency organization & administration, Physician Executives standards, Psychiatry education
- Abstract
Objective: The authors quantify the number of PubMed-indexed publications by psychiatry program directors during a 5-year observation period., Methods: The authors obtained the names of general adult, child and adolescent, and geriatric psychiatry program directors from the ACGME website and entered them into a PubMed.gov database search. Then, they counted the number of indexed publications from July 2008 to June 2013 and categorized them by academic year., Results: The median number of publications was one for adult psychiatry program directors (n=184), one for child and adolescent directors (n=121), and three for geriatric psychiatry directors (n=58)., Conclusions: The number of PubMed-indexed publications for program directors of general adult, child and adolescent, and geriatric psychiatry residencies is relatively low. Further research is needed to identify and examine the challenges facing program directors that may limit their ability to participate in this form of scholarly activity.
- Published
- 2015
- Full Text
- View/download PDF
31. The program director scholar: aspiration and perspiration.
- Author
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Summers RF and Young JQ
- Subjects
- Humans, Academic Medical Centers standards, Biomedical Research organization & administration, Internship and Residency organization & administration, Physician Executives standards, Psychiatry education
- Published
- 2015
- Full Text
- View/download PDF
32. Impact of the information age on residency training: communication, access to public information, and clinical care.
- Author
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Hilty DM, Belitsky R, Cohen MB, Cabaniss DL, Dickstein LJ, Bernstein CA, Kaplan AS, Scheiber SC, Crisp-Han HD, Wrzosek MI, and Silberman EK
- Subjects
- Adult, Electronic Mail standards, Female, Health Insurance Portability and Accountability Act, Humans, Social Media standards, United States, Internship and Residency standards, Physician Executives standards, Physician-Patient Relations, Psychiatry education
- Abstract
Access to technology in practice helps physicians manage information, communicate, and research topics; however, those in training receive almost no formal preparation for integrating web-based technologies into practice. One reason for this is that many faculty-aside from junior faculty or those in recent generations-did not grow up using Internet communication, may use it minimally, if at all, in their own practices, and may know little about its forms and varieties. This report presents a case to illustrate how these disparities may play out in the supervisory situation and makes suggestions about helping supervisors integrate technology-awareness into their teaching.
- Published
- 2015
- Full Text
- View/download PDF
33. Readiness for practice: a survey of neurosurgery graduates and program directors.
- Author
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Haji FA and Steven DA
- Subjects
- Adult, Cohort Studies, Female, Humans, Male, Clinical Competence standards, Internship and Residency standards, Neurosurgery education, Neurosurgery standards, Physician Executives standards, Surveys and Questionnaires
- Abstract
Background: Postgraduate neurosurgical education is undergoing significant reform, including transition to a competency-based training model. To support these efforts, the purpose of this study was to determine neurosurgical graduates' and program directors' (PDs) opinions about graduates' level of competence in reference to the 2010 Royal College Objectives of Training in Neurosurgery., Methods: An electronic survey was distributed to Canadian neurosurgery PDs and graduates from 2011. The questionnaire addressed graduates' abilities in nonprocedural knowledge and skills, CanMEDS roles, proficiency with core neurosurgical procedures and knowledge of complex neurosurgical techniques., Results: Thirteen of 22 (59%) graduate and 17/25 (65%) PD surveys were completed. There were no significant differences between PD and graduate responses. Most respondents agreed that these graduates possess the knowledge and skills expected of an independently practicing neurosurgeon across current objectives of training. A small proportion felt some graduates did not achieve this level of proficiency on specific vascular, functional, peripheral nerve and endoscopic procedures. This was partially attributed to limited exposure to these procedures during training and perceptions that some techniques required fellowship-level training., Conclusions: Graduating neurosurgical residents are perceived to possess a high level of proficiency in the majority of neurosurgical practice domains. Inadequate exposure during training or a perception that subspecialists should perform some procedures may contribute to cases where proficiency is not as high. The trends identified in this study could be monitored on an ongoing basis to provide supplemental data to guide curricular decisions in Canadian neurosurgical training.
- Published
- 2014
- Full Text
- View/download PDF
34. Capsule commentary on Garg et al., resident duty hours: a survey of internal medicine program directors.
- Author
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Stimpfel AW
- Subjects
- Female, Humans, Male, Data Collection, Internal Medicine standards, Internship and Residency standards, Personnel Staffing and Scheduling standards, Physician Executives standards, Work Schedule Tolerance
- Published
- 2014
- Full Text
- View/download PDF
35. Resident duty hours: a survey of internal medicine program directors.
- Author
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Garg M, Drolet BC, Tammaro D, and Fischer SA
- Subjects
- Adult, Cross-Sectional Studies, Female, Humans, Internal Medicine trends, Internship and Residency trends, Male, Middle Aged, Personnel Staffing and Scheduling trends, Physician Executives trends, Data Collection methods, Internal Medicine standards, Internship and Residency standards, Personnel Staffing and Scheduling standards, Physician Executives standards, Work Schedule Tolerance psychology
- Abstract
Introduction: In 2011, the Accreditation Council for Graduate Medical Education (ACGME) implemented new Common Program Requirements to regulate duty hours of resident physicians, with three goals: improved patient safety, quality of resident education and quality of life for trainees. We sought to assess Internal Medicine program director (IMPD) perceptions of the 2011 Common Program Requirements in July 2012, one year following implementation of the new standards., Methods: A cross-sectional study of all IMPDs at ACGME-accredited programs in the United States (N = 381) was performed using a 32-question, self-administered survey. Contact information was identified for 323 IMPDs. Three individualized emails were sent to each director over a 6-week period, requesting participation in the survey. Outcomes measured included approval of duty hours regulations, as well as perceptions of changes in graduate medical education and patient care resulting from the revised ACGME standards., Results: A total of 237 surveys were returned (73% response rate). More than half of the IMPDs (52%) reported "overall" approval of the 2011 duty hour regulations, with greater than 70% approval of all individual regulations except senior resident daily duty periods (49% approval) and 16-hour intern shifts (17% approval). Although a majority feel resident quality of life has improved (55%), most IMPDs believe that resident education (60%) is worse. A minority report that quality (8%) or safety (11%) of patient care has improved., Conclusion: One year after implementation of new ACGME duty hour requirements, IMPDs report overall approval of the standards, but strong disapproval of 16-hour shift limits for interns. Few program directors perceive that the duty hour restrictions have resulted in better care for patients or education of residents. Although resident quality of life seems improved, most IMPDs report that their own workload has increased. Based on these results, the intended benefits of duty hour regulations may not yet have been realized.
- Published
- 2014
- Full Text
- View/download PDF
36. Examining clinical performance feedback in Patient-Aligned Care Teams.
- Author
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Hysong SJ, Knox MK, and Haidet P
- Subjects
- Humans, Nurses standards, Physician Executives standards, Physicians, Primary Care standards, Primary Health Care methods, Clinical Competence standards, Hospitals, Veterans standards, Leadership, Patient Care Team standards, Primary Health Care standards
- Abstract
Background: The move to team-based models of health care represents a fundamental shift in healthcare delivery, including major changes in the roles and relationships among clinical personnel. Audit and feedback of clinical performance has traditionally focused on the provider; however, a team-based model of care may require different approaches., Objective: Identify changes in audit and feedback of clinical performance to primary care clinical personnel resulting from implementing team-based care in their clinics., Design: Semi-structured interviews with primary care clinicians, their department heads, and facility leadership at 16 geographically diverse VA Medical Centers, selected purposively by their clinical performance profile., Participants: An average of three interviewees per VA medical center, selected from physicians, nurses, and primary care and facility directors who participated in 1-hour interviews., Approach: Interviews focused on how clinical performance information is fed back to clinicians, with particular emphasis on external peer-review program measures and changes in feedback associated with team-based care implementation. Interview transcripts were analyzed, using techniques adapted from grounded theory and content analysis., Key Results: Ownership of clinical performance still rests largely with the provider, despite transitioning to team-based care. A panel-management information tool emerged as the most prominent change to clinical performance feedback dissemination, and existing feedback tools were seen as most effective when monitored by the nurse members of the team. Facilities reported few, if any, appreciable changes to the assessment of clinical performance since transitioning to team-based care., Conclusions: Although new tools have been created to support higher-quality clinical performance feedback to primary care teams, such tools have not necessarily delivered feedback consistent with a team-based approach to health care. Audit and feedback of clinical performance has remained largely unchanged, despite material differences in roles and responsibilities of team members. Future research should seek to unpack the nuances of team-based audit and feedback, to better align feedback with strategic clinical goals.
- Published
- 2014
- Full Text
- View/download PDF
37. Open dialogue needed to make physician acquisitions work.
- Author
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Angood P and McKinney M
- Subjects
- Chief Executive Officers, Hospital trends, Humans, Personnel Selection methods, Physician Executives trends, Chief Executive Officers, Hospital standards, Clinical Competence standards, Personnel Selection standards, Physician Executives standards
- Published
- 2014
38. Doctors are competitive: use that to improve care delivery.
- Author
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Dhaliwal G
- Subjects
- Competitive Behavior, Humans, Interprofessional Relations, Leadership, Physician Executives standards, Physicians standards, Quality Assurance, Health Care methods, Attitude of Health Personnel, Physician Executives psychology, Physicians psychology, Quality Assurance, Health Care organization & administration
- Published
- 2014
39. Effective management is key to successful meetings.
- Author
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Pickett RB
- Subjects
- Communication, Humans, Physician Executives standards, Decision Making, Organizational, Group Processes, Leadership, Physician Executives organization & administration
- Published
- 2014
40. Thought leadership--new directions.
- Author
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Angood PB
- Subjects
- Humans, Leadership, Physician Executives standards
- Published
- 2014
41. Too important to leave to doctors?
- Author
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Kaplan AS and Terrell GE
- Subjects
- Delivery of Health Care standards, Delivery of Health Care trends, Humans, Leadership, Physician Executives trends, United States, Clinical Competence standards, Delivery of Health Care organization & administration, Physician Executives standards
- Published
- 2014
42. The value of physician leadership.
- Author
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Angood P and Birk S
- Subjects
- Accountable Care Organizations standards, Chief Executive Officers, Hospital standards, Chief Executive Officers, Hospital statistics & numerical data, Humans, Interprofessional Relations, Interviews as Topic, Quality Assurance, Health Care methods, Quality Assurance, Health Care standards, Value-Based Purchasing, Workforce, Accountable Care Organizations organization & administration, Attitude of Health Personnel, Hospital Administration standards, Leadership, Physician Executives standards, Quality Assurance, Health Care organization & administration
- Published
- 2014
43. The physician leader's 10 Commandment.
- Author
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Paskert JP
- Subjects
- Communication, Humans, Clinical Competence, Interprofessional Relations, Leadership, Physician Executives standards, Physician-Patient Relations
- Published
- 2014
44. The evolution of leadership: a perspective from Mayo Clinic.
- Author
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Peters DE, Casale SA, Halyard MY, Frey KA, Bunkers BE, and Caubet SL
- Subjects
- Ambulatory Care Facilities history, Cooperative Behavior, Delivery of Health Care economics, Delivery of Health Care history, Drug Costs trends, Health Care Costs trends, History, 19th Century, History, 20th Century, History, 21st Century, Humans, Interinstitutional Relations, Interprofessional Relations, Leadership, Patient Care Team history, Patient Care Team standards, Physician Executives history, Workforce, Ambulatory Care Facilities organization & administration, Delivery of Health Care organization & administration, Patient Care Team organization & administration, Physician Executives standards
- Published
- 2014
45. Calling all American physician leaders.
- Author
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Lundberg GD
- Subjects
- Health Care Costs standards, Humans, Physicians standards, United States, Leadership, Physician Executives standards
- Published
- 2014
- Full Text
- View/download PDF
46. Strengthening leadership in the NHS.
- Author
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Ham C
- Subjects
- Humans, State Medicine, United Kingdom, Hospitals, Public organization & administration, Leadership, Physician Executives standards
- Published
- 2014
- Full Text
- View/download PDF
47. Talent management and physician leadership training is essential for preparing tomorrow's physician leaders.
- Author
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Satiani B, Sena J, Ruberg R, and Ellison EC
- Subjects
- Certification, Curriculum, Humans, Physician Executives organization & administration, Physician Executives standards, Physician Executives supply & distribution, Program Development, Staff Development, Education, Medical standards, Leadership, Physician Executives education, Physician's Role, Practice Management, Medical organization & administration, Practice Management, Medical standards
- Abstract
Talent management and leadership development is becoming a necessity for health care organizations. These leaders will be needed to manage the change in the delivery of health care and payment systems. Appointment of clinically skilled physicians as leaders without specific training in the areas described in our program could lead to failure. A comprehensive program such as the one described is also needed for succession planning and retaining high-potential individuals in an era of shortage of surgeons., (Copyright © 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
48. Anesthesia scholarship, research, and publication.
- Author
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Hindman BJ and Dexter F
- Subjects
- Female, Humans, Male, Accreditation standards, Anesthesiology standards, Anesthesiology trends, Education, Medical, Graduate standards, Faculty, Medical, Internship and Residency standards, Manuscripts, Medical as Topic, Physician Executives standards, Schools, Medical trends, Specialties, Surgical standards
- Published
- 2014
- Full Text
- View/download PDF
49. Academic productivity of directors of ACGME-accredited residency programs in surgery and anesthesiology.
- Author
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Culley DJ, Fahy BG, Xie Z, Lekowski R, Buetler S, Liu X, Cohen NH, and Crosby G
- Subjects
- Academic Medical Centers standards, Academic Medical Centers trends, Accreditation trends, Anesthesiology trends, Education, Medical, Graduate trends, Efficiency, Female, Humans, Internship and Residency trends, Male, Physician Executives trends, Specialties, Surgical trends, Accreditation standards, Anesthesiology standards, Education, Medical, Graduate standards, Internship and Residency standards, Physician Executives standards, Specialties, Surgical standards
- Abstract
Background: Scholarly activity is expected of program directors of Accreditation Council for Graduate Medical Education (ACGME)-accredited residency training programs. Anesthesiology residency programs are cited more often than surgical programs for deficiencies in academic productivity. We hypothesized that this may in part reflect differences in scholarly activity between program directors of anesthesiology and surgical trainings programs. To test the hypothesis, we examined the career track record of current program directors of ACGME-accredited anesthesiology and surgical residency programs at the same institutions using PubMed citations and funding from the National Institutes of Health (NIH) as metrics of scholarly activity., Methods: Between November 1, 2011 and December 31, 2011, we obtained data from publicly available Web sites on program directors at 127 institutions that had ACGME-accredited programs in both anesthesiology and surgery. Information gathered on each individual included year of board certification, year first appointed program director, academic rank, history of NIH grant funding, and number of PubMed citations. We also calculated the h-index for a randomly selected subset of 25 institution-matched program directors., Results: There were no differences between the groups in number of years since board certification (P = 0.42), academic rank (P = 0.38), or years as a program director (P = 0.22). However, program directors in anesthesiology had less prior or current NIH funding (P = 0.002), fewer total and education-related PubMed citations (both P < 0.001), and a lower h-index (P = 0.001) than surgery program directors. Multivariate analysis revealed that the publication rate for anesthesiology program directors was 43% (95% confidence interval, 0.31-0.58) that of the corresponding program directors of surgical residency programs, holding other variables constant., Conclusions: Program directors of anesthesiology residency programs have considerably less scholarly activity in terms of peer-reviewed publications and federal research funding than directors of surgical residency programs. As such, this study provides further evidence for a systemic weakness in the scholarly fabric of academic anesthesiology., Competing Interests: Name: Deborah J. Culley, MD Contribution: This author helped design the study, conduct the study, analyze the data, and write the manuscript Attestation: Deborah J. Culley has seen the original study data, reviewed the analysis of the data, approved the final manuscript, and is the author responsible for archiving the study files Conflicts of Interest: Deborah J. Culley received honoraria from American Board of Anesthesiology Dr. Culley is a Director of the American Board of Anesthesiology and a member of the ACGME Anesthesiology RRC Name: Brenda G. Fahy, MD Contribution: This author helped design the study, conduct the study, and write the manuscript Attestation: Brenda G. Fahy has seen the original study data and approved the final manuscript Conflicts of Interest: Brenda G. Fahy received honoraria from American Board of Anesthesiology Dr. Fahy is a Director of the American Board of Anesthesiology and a member of the ACGME Anesthesiology RRC. Name: Zhongcong Xie, MD, PhD Contribution: This author helped write the manuscript Attestation: Zhongcong Xie has seen the original study data and approved the final manuscript Conflicts of Interest: The author has no conflicts of interest to declare. Name: Robert Lekowski, MD Contribution: This author helped conduct the study and write the manuscript Attestation: Robert Lekowski has seen the original study data and approved the final manuscript Conflicts of Interest: The author has no conflicts of interest to declare. Name: Sascha Buetler, MD, PhD Contribution: This author helped conduct the study and write the manuscript Attestation: Sascha Buetler has seen the original study data and approved the final manuscript Conflicts of Interest: The author has no conflicts of interest to declare. Name: Xiaoxia Liu, MS Contribution: This author helped with statistical support and rewriting of the manuscript Attestation: Xiaoxia Liu has seen the original study data and approved the final manuscript Conflicts of Interest: The author has no conflicts of interest to declare. Name: Neal H. Cohen, MD Contribution: This author helped design the study and write the manuscript Attestation: Neal H. Cohen has seen the original study data and approved the final manuscript Conflicts of Interest: Neal H. Cohen Former Chairman of the ACGME Anesthesiology RRC. Name: Gregory Crosby, MD Contribution: This author helped design the study, analyze the data, and write the manuscript Attestation: Gregory Crosby has seen the original study data, reviewed the analysis of the data, and approved the final manuscript Conflicts of Interest: The author has no conflicts of interest to declare.
- Published
- 2014
- Full Text
- View/download PDF
50. Approval and perceived impact of duty hour regulations: survey of pediatric program directors.
- Author
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Drolet BC, Whittle SB, Khokhar MT, Fischer SA, and Pallant A
- Subjects
- Adult, Education, Medical, Graduate standards, Female, Humans, Internship and Residency standards, Male, Middle Aged, Workload standards, Data Collection methods, Pediatrics standards, Perception, Personnel Staffing and Scheduling standards, Physician Executives standards, Work Schedule Tolerance
- Abstract
Objectives: To determine pediatric program director (PD) approval and perception of changes to resident training and patient care resulting from 2011 Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements., Methods: All US pediatric PDs (n = 181) were identified from the ACGME. Functional e-mail addresses were identified for 164 (90.6%). Three individualized e-mail requests were sent to each PD to complete an anonymous 32-question Web-based survey., Results: A total of 151 responses were obtained (83.4%). Pediatrics PDs reported approval for nearly all of the 2011 ACGME duty hour regulations except for 16-hour intern shift limits (72.2% disapprove). Regarding the perceived impact of the new standards, many areas were reportedly unchanged, but most PDs reported negative effects on resident education (74.7%), preparation for senior roles (79.9%), resident ownership of patients (76.8%), and continuity of care (78.8%). There was a reported increase in PD workload (67.6%) and use of physician extenders (62.7%). Finally, only 48.3% of PDs reported that their residents are "always" compliant with 2011 requirements., Conclusions: Pediatric PDs think there have been numerous negative consequences of the 2011 Common Program Requirements. These include declines in resident education and preparation to take on more senior roles, as well as diminished resident accountability and continuity of care. Although they support individual aspects of duty hour regulation, almost three-quarters of pediatric PDs say there should be fewer regulations. The opinions expressed by PDs in this study should prompt research using quantitative metrics to assess the true impact of duty hour regulations.
- Published
- 2013
- Full Text
- View/download PDF
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