Racial Disparities in Compensation Among US Anesthesiologists: Results of a National Survey of Anesthesiologists.

BACKGROUND: A racial compensation disparity among physicians across numerous specialties is well documented and persists after adjustment for age, sex, experience, work hours, productivity, academic rank, and practice structure. This study examined national survey data to determine whether there are racial differences in compensation among anesthesiologists in the United States. METHODS: In 2018, 28,812 active members of the American Society of Anesthesiologists were surveyed to examine compensation among members. Compensation was defined as the amount reported as direct compensation on a W-2, 1099, or K-1, plus all voluntary salary reductions (eg, 401[k], health insurance). Covariates potentially associated with compensation were identified (eg, sex and academic rank) and included in regression models. Racial differences in outcome and model variables were assessed via Wilcoxon rank sum tests and Pearson's χ 2 tests. Covariate adjusted ordinal logistic regression estimated an odds ratio (OR) for the relationship between race and ethnicity and compensation while adjusting for provider and practice characteristics. RESULTS: The final analytical sample consisted of 1952 anesthesiologists (78% non-Hispanic White). The analytic sample represented a higher percentage of White, female, and younger physicians compared to the demographic makeup of anesthesiologists in the United States. When comparing non-Hispanic White anesthesiologists with anesthesiologists from other racial and ethnic minority groups, (ie, American Indian/Alaska Native, Asian, Black, Hispanic, and Native Hawaiian/Pacific Islander), the dependent variable (compensation range) and 6 of the covariates (sex, age, spousal work status, region, practice type, and completed fellowship) had significant differences. In the adjusted model, anesthesiologists from racial and ethnic minority populations had 26% lower odds of being in a higher compensation range compared to White anesthesiologists (OR, 0.74; 95% confidence interval [CI], 0.61-0.91). CONCLUSIONS: Compensation for anesthesiologists showed a significant pay disparity associated with race and ethnicity even after adjusting for provider and practice characteristics. Our study raises concerns that processes, policies, or biases (either implicit or explicit) persist and may impact compensation for anesthesiologists from racial and ethnic minority populations. This disparity in compensation requires actionable solutions and calls for future studies that investigate contributing factors and to validate our findings given the low response rate.

The pediatric surgery workforce in low- and middle-income countries: problems and priorities.

Most of the world is in a surgical workforce crisis. While a lack of human resources is only one component of the myriad issues affecting surgical care in resource-poor regions, it is arguably the most consequential. This article examines the current state of the pediatric surgical workforce in low- and middle-income countries (LMICs) and the reasons for the current shortfalls. We also note progress that has been made in capacity building and discuss priorities going forward. The existing literature on this subject has naturally focused on regions with the greatest workforce needs, particularly sub-Saharan Africa (SSA). However, wherever possible we have included workforce data and related literature from LMICs worldwide. The pediatric surgeon is of course critically dependent on multi-disciplinary teams. Surgeons in high-income countries (HICs) often take for granted the ready availability of excellent anesthesia providers, surgically trained nurses, radiologists, pathologists, and neonatologists among many others. While the need exists to examine all of these disciplines and their contribution to the delivery of surgical services for children in LMICs, for the purposes of this review, we will focus primarily on the role of the pediatric surgeon.

[Regional differences in the number of anesthesiologists in Japan].

BACKGROUND: We have known the existence of regional differences in the number of medical doctors and the manpower shortage of anesthesiologists in Japan. METHODS: In the present investigation, we compared the number of regular members and Board Certified Anesthesiologists (BCA) of the Japan Society of Anesthesiologists (JSA) among prefectures and the Districts of JSA. RESULTS: Tokyo and Chugoku-Shikoku Districts of JSA had larger numbers of regular members of JSA per one hundred thousands population compared with Tokai, Kanto-Koshinetsu, and Tohoku Districts of JSA (the maximum difference among prefectures (MDAP) = 3.0 times and the maximum difference among the Districts (MDAD) = 2.4 times). Chugoku-Shikoku and Kyushu Districts of JSA had greater numbers of BCA per one hundred thousands population compared with Tokai, and Kanto-Koshinetsu Districts of JSA (MDAP = 3.1 times and MDAD = 2.5 times). Hokkaido District of JSA had the largest percentages of both members of JSA and BCA to all medical doctors [(MDAP = 2.3 times and MDAD = 1.7times) and (MDAP = 2.6 times and MDAD = 2.0 times), respectively)]. Tokyo District of JSA had the largest numbers of both members of JSA and BCA per one thousand hospital beds [(MDAP = 3.4 times and MDAD = 2.5 times) and (MDAP = 3.2 times and MDAD = 2.2 times), respectively)]. The regional differences in the number of regular members of JSA were bigger than those of the medical doctors (per one hundred thousands people (MDAP = 2.2 times and MDAD = 1.6 times) and per one thousand hospital beds (MDAP = 2.4 times and MDAD = 2.3 times), respectively]. CONCLUSIONS: There are remarkable regional differences in the number of regular members and BCA of JSA among prefectures and the Districts of JSA. We suspect that the regional differences in the number of anesthesiologists would affect the quality and system of corresponding clinical practice.

Anaesthesiological manpower in Europe.

Information about physician anaesthesiologist manpower in the countries of the European Union was collected from questionnaires sent to the delegates representing their respective countries on the European Board of Anaesthesiology. In the countries of the European Union and Switzerland and Norway 40,259 specialist anaesthesiologists are recorded. The number of anaesthesiologists in relation to population varies between as little as 4.4 and 4.6 (Ireland and UK) and as many as 15.6 (Italy), with a mean of 10.8/100,000 inhabitants. There are 11,610 physicians recorded in training in anaesthesiology. The ratio of trainees to specialists in the European Union countries was 28.8/100, varying from as low as 6.5 in France, to as high as 96.7 and 98/100 in Ireland and the UK respectively. These figures indicate a wide difference in the numbers of specialists and trainees between the European countries studied. However, the overall mean figure is close to that reported in the USA (9.2/100,000).