RESUMO
BACKGROUND: Much remains unknown about experiences, including working activities and pay, of women in cardiology, which is a predominantly male specialty. OBJECTIVES: The goal of this study was to describe the working activities and pay of female cardiologists compared with their male colleagues and to determine whether sex differences in compensation exist after accounting for differences in work activities and other characteristics. METHODS: The personal, job, and practice characteristics of a national sample of practicing cardiologists were described according to sex. We applied the Peters-Belson technique and multivariate regression analysis to evaluate whether gender differences in compensation existed after accounting for differences in other measured characteristics. The study used 2013 data reported by practice administrators to MedAxiom, a subscription-based service provider to cardiology practices. Data regarding cardiologists from 161 U.S. practices were included, and the study sample included 2,679 subjects (229 women and 2,450 men). RESULTS: Women were more likely to be specialized in general/noninvasive cardiology (53.1% vs. 28.2%), and a lower proportion (11.4% vs. 39.3%) reported an interventional subspecialty compared with men. Job characteristics that differed according to sex included the proportion working full-time (79.9% vs. 90.9%; p < 0.001), the mean number of half-days worked (387 vs. 406 days; p = 0.001), and mean work relative value units generated (7,404 vs. 9,497; p < 0.001) for women and men, respectively. Peters-Belson analysis revealed that based on measured job and productivity characteristics, the women in this sample would have been expected to have a mean salary that was $31,749 (95% confidence interval: $16,303 to $48,028) higher than that actually observed. Multivariate analysis confirmed the direction and magnitude of the independent association between sex and salary. CONCLUSIONS: Men and women practicing cardiology in this national sample had different job activities and salaries. Substantial sex-based salary differences existed even after adjusting for measures of personal, job, and practice characteristics.
Assuntos
Cardiologia , Gestão de Recursos Humanos , Médicas , Salários e Benefícios/estatística & dados numéricos , Adulto , Feminino , Humanos , Satisfação no Emprego , Masculino , Gestão de Recursos Humanos/economia , Gestão de Recursos Humanos/métodos , Médicas/economia , Médicas/estatística & dados numéricos , Fatores Sexuais , Estados Unidos , Tolerância ao Trabalho ProgramadoRESUMO
The mission of the American College of Cardiology is "to transform cardiovascular care and improve heart health." Cardiovascular team-based care is a paradigm for practice that can transform care, improve heart health, and help meet the demands of the future. One strategic goal of the College is to help members successfully transition their clinical practices to the future, with all its complexity, challenges, and opportunities. The ACC's strategic plan is aligned with the triple aim of improved care, improved population health, and lower costs per capita. The traditional understanding of quality, access, and cost is that you cannot improve one component without diminishing the others. With cardiovascular team-based care, it is possible to achieve the triple aim of improving quality, access, and cost simultaneously to also improve cardiovascular health. Striving to serve the best interests of patients is the true north of our guiding principles. Cardiovascular team-based care is a model that can improve care coordination and communication and allow each team member to focus more on the quality of care. In addition, the cardiovascular team-based care model increases access to cardiovascular care and allows expansion of services to populations and geographic areas that are currently underserved. This document will increase awareness of the important components of cardiovascular team-based care and create an opportunity for more discussion about the most creative and effective means of implementing it. We hope that this document will stimulate further discussions and activities within the ACC and beyond about team-based care. We have identified areas that need improvement, specifically in APP education and state regulation. The document encourages the exploration of collaborative care models that should enable team members to optimize their education, training, experience, and talent. Improved team leadership, coordination, collaboration, engagement, and efficiency will enable the delivery of higher-value care to the betterment of our patients and society.
Assuntos
Cardiologia/normas , Doenças Cardiovasculares/terapia , Pessoal de Saúde/normas , Política de Saúde , Equipe de Assistência ao Paciente/normas , Guias de Prática Clínica como Assunto , Sociedades Médicas , Comportamento Cooperativo , HumanosAssuntos
Cardiologia/normas , Competência Clínica/normas , Educação Baseada em Competências/normas , Profissionais de Enfermagem/normas , Assistentes Médicos/normas , Relatório de Pesquisa/normas , Adulto , Cardiologia/educação , Cardiologia/métodos , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/terapia , Educação Baseada em Competências/métodos , Humanos , Profissionais de Enfermagem/educação , Assistentes Médicos/educação , Estados UnidosAssuntos
Comitês Consultivos/normas , American Heart Association , Cardiologia/normas , Doenças Cardiovasculares/diagnóstico , Competência Clínica/normas , Técnicas de Diagnóstico Cardiovascular/normas , Comportamento Cooperativo , Humanos , Imageamento por Ressonância Magnética/normas , Sociedades Médicas/normas , Tomografia Computadorizada por Raios X/normas , Estados UnidosAssuntos
Angioplastia Coronária com Balão/normas , Transplante Ósseo/normas , Competência Clínica , Doença das Coronárias/terapia , Garantia da Qualidade dos Cuidados de Saúde , Angioplastia Coronária com Balão/mortalidade , Transplante Ósseo/mortalidade , Ponte de Artéria Coronária , Doença das Coronárias/diagnóstico , Doença das Coronárias/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Prognóstico , Medição de Risco , Análise de Sobrevida , Resultado do Tratamento , Estados Unidos/epidemiologiaAssuntos
Ablação por Cateter/métodos , Cardioversão Elétrica/métodos , Técnicas Eletrofisiológicas Cardíacas/métodos , Competência Profissional/normas , Ablação por Cateter/normas , Educação Médica Continuada/normas , Cardioversão Elétrica/normas , Técnicas Eletrofisiológicas Cardíacas/normas , Humanos , Internato e Residência/normasAssuntos
Procedimentos Cirúrgicos Cardíacos , Competência Clínica/normas , Fluoroscopia , Privilégios do Corpo Clínico/normas , Radiologia Intervencionista , Anormalidades Induzidas por Radiação/etiologia , Anormalidades Induzidas por Radiação/prevenção & controle , Adolescente , Adulto , Cinerradiografia/efeitos adversos , Cinerradiografia/instrumentação , Cinerradiografia/métodos , Cinerradiografia/normas , Currículo/normas , Medicina Baseada em Evidências , Prova Pericial , Feminino , Fluoroscopia/efeitos adversos , Fluoroscopia/instrumentação , Fluoroscopia/métodos , Fluoroscopia/normas , Física Médica , Humanos , Consentimento Livre e Esclarecido/normas , Masculino , Pessoa de Meia-Idade , Gravidez , Doses de Radiação , Lesões por Radiação/etiologia , Lesões por Radiação/prevenção & controle , Radiodermite/etiologia , Radiodermite/prevenção & controle , Radiologia Intervencionista/instrumentação , Radiologia Intervencionista/métodos , Radiologia Intervencionista/normas , Radiometria , Risco , Raios XAssuntos
Doenças Cardiovasculares/diagnóstico , Competência Clínica/normas , Coração/diagnóstico por imagem , Angiografia por Ressonância Magnética/normas , Imageamento por Ressonância Magnética/normas , Privilégios do Corpo Clínico/normas , Tomografia Computadorizada por Raios X/normas , American Heart Association , Cardiologia/normas , Angiografia Coronária/normas , Credenciamento/normas , Educação Médica Continuada , Humanos , Imageamento por Ressonância Magnética/métodos , Doses de Radiação , Sociedades Médicas , Tomografia Computadorizada por Raios X/métodos , Estados UnidosRESUMO
A sufficient cardiology workforce is necessary to ensure access to cardiovascular care. Specifically, access to cardiologists is important in the management and treatment of chronic cardiovascular disease. Given this, we examined the supply and distribution of the cardiologist workforce. In doing so, we mapped the ratios of cardiologists, primary care physicians, and total physicians to the population age sixty-five or older within different Hospital Referral Regions from the years 1995 and 2007. We found that within the twelve-year span of our study, the cardiology workforce grew modestly compared with the primary care physician and total physician workforces. Also, despite increases in the number of cardiologists, there was a persistent geographic maldistribution of the workforce. For example, approximately 60 percent of the elderly population had access to only 38 percent of the cardiologists. Our results suggest that large segments of the US population, specifically in rural and socioeconomically disadvantaged areas, continue to have a lower concentration of cardiologists. This maldistribution could be addressed through a variety of strategies, including the use of telemedicine and economic incentives.
Assuntos
Cardiologia , Acessibilidade aos Serviços de Saúde , Médicos/provisão & distribuição , Área de Atuação Profissional , Idoso , Humanos , Atenção Primária à Saúde , Análise de Regressão , Serviços de Saúde Rural , Estados Unidos , Recursos HumanosAssuntos
Cardiologia/educação , Competência Clínica , Ecocardiografia/normas , Adolescente , Adulto , Criança , Pré-Escolar , Doença das Coronárias/diagnóstico por imagem , Ecocardiografia/instrumentação , Ecocardiografia sob Estresse/normas , Ecocardiografia Transesofagiana/normas , Humanos , Lactente , Ultrassonografia Pré-Natal/normasAssuntos
Cardiologia , Doenças Cardiovasculares/diagnóstico por imagem , Competência Clínica , Técnicas Eletrofisiológicas Cardíacas , Fluoroscopia , Radiologia Intervencionista , Cardiologia/educação , Cardiologia/normas , Cinerradiografia , Relação Dose-Resposta a Droga , Técnicas Eletrofisiológicas Cardíacas/normas , Feminino , Fluoroscopia/normas , Cardiopatias/diagnóstico por imagem , Humanos , Processamento de Imagem Assistida por Computador , Consentimento Livre e Esclarecido , Gravidez , Complicações Cardiovasculares na Gravidez/diagnóstico , Radiologia Intervencionista/normas , RiscoRESUMO
This report presents data describing a large cohort of closed cardiovascular medical professional liability (MPL) claims. The Physician Insurers Association of America established a registry of closed MPL claims in 1985. This registry contains data describing 230,624 closed claims for 28 medical specialties through 2007. The registry is maintained to support educational programs designed to improve the quality of care and to reduce patient injury and MPL claims. In this report, descriptive techniques are used to present summary information for the medical cardiovascular claims in the registry. Of 230,624 closed claims, 4,248 (1.8%) involved cardiovascular medical physicians. Of the 4,248 closed cardiovascular medical claims, 770 (18%) resulted in indemnity payments, and the average indemnity payment was $248,291. In the entire database, 30% of closed claims were paid, and the average indemnity payment was $204,268. The most common allegation among cardiovascular closed claims was diagnostic error, and the most prevalent diagnosis was coronary atherosclerosis. Claims involving cardiac catheterization and coronary angioplasty represented 12% and 7% of the cardiovascular closed claims. Aortic aneurysms and dissections, although relatively infrequent as clinical events, represent a substantial MPL risk because of the high percentage of paid claims (30%) and the very high average indemnity payment of $417,298. In conclusion, MPL issues are common and are important to all practicing cardiologists. Detailed knowledge of risks associated with liability claims should assist practicing cardiologists in improving the quality of care, reducing patient injury, and reducing the incidence of claims.