A Volunteer Passion: A Qualitative Look at How We Measure and Reward the Work of Medical Educators.

Background  Medical educators face many challenges, including the absence of defined roles, lack of standard career paths, and limited support in systems that generally prioritize research and clinical productivity over educational activities. Providers also teach to widely varying degrees. This study was designed to specifically examine the professional rewards and obstacles experienced by physicians who have dedicated significant energy and career focus to medical education. Methodology A phenomenological approach was used in this qualitative study. Purposeful sampling was utilized to identify medical educators from different institutions and geographical areas. Participants were categorized by gender and career stage. Semi-structured interviews were conducted, and reflexive thematic analysis was used to develop themes across items and participants. Results Twenty-two medical educators were interviewed (11 males, 11 females), with an average age of 51 (range: 38-72) years. The average time from completion of training was 18 years (range: <1 to 41 years). Two main themes were constructed, which related to medical educators' career motivations and challenges: (1) Joy and purpose (subthemes: Interaction with learners, Impact, and Innovation) and (2) Everyone teaches (subthemes: Lack of recognition, Lack of reward, Malalignment of metrics) Conclusions The greatest source of motivation and satisfaction for medical educators is linked to the work itself; in addition to interactions with learners, educators derive pleasure from the innovation, collaboration, and systems thinking involved in their work. Importantly, participants also experience dissatisfaction, primarily due to a lack of recognition and reward, and metrics that do not consistently demonstrate their achievements. Participants provided examples of metrics that more accurately reflected the work of education; they identified clear benefits of academic promotion; and they highlighted significant challenges in the promotional system. The implementation of appropriate systems of measurement and reward is needed to better support the work of medical educators. Our aim should be not only to increase opportunities for satisfaction but also to reduce factors that cause frustration and limit advancement.

A survey-based study: assessing inpatient attending perspectives on teaching learners, feeling valued, and symptoms of burnout.

BACKGROUND: Physician burnout is rising, especially among academic physicians facing pressures to increase their clinical workload, lead administrative tasks and committees, and be active in research. There is a concern this could have downstream effects on learners' experiences and academic physician's ability to teach learners on the team. METHODS: A 29-question RedCap survey was electronically distributed to 54 attending physicians within an academic learning health system who oversaw the General Medicine inpatient teaching services during the 2022-2023 academic year. The aims were to assess this cohort of attending physicians' experiences, attitudes, and perceptions on their ability to effectively teach learners on the team, feeling valued, contributors to work-life balance and symptoms of burnout, Fisher's Exact Tests were used for data analysis. RESULTS: Response rate was 56%. Attendings splitting time 50% inpatient / 50% outpatient felt that team size and type of admissions model affected their ability to effectively teach learners (p = 0.022 and p = 0.049). Attendings with protected administrative time felt that non-patient care obligations affected their ability to effectively teach the learners (p = 0.019). Male attendings and attendings with ≤ 5 years of General Medicine inpatient teaching experience felt less valued by residency leadership (p = 0.019 and p = 0.026). 80% of attendings experienced emotional exhaustion, and those with > 10 weeks on a General Medicine inpatient teaching service were more likely to experience emotional exhaustion (p = 0.041). Attendings with > 10 weeks on a General Medicine inpatient teaching service and those who were a primary caregiver were more likely to experience depersonalization (p = 0.012 and p = 0.031). 57% of attendings had reduced personal achievement. CONCLUSIONS: Institutions should seek an individual and organizational approach to professional fulfillment. Special attention to these certain groups is warranted to understand how they can be better supported. Further research, such as with focus groups, is needed to address these challenges.

The relationship between telemedicine tools and physician satisfaction, quality of care, and patient visits during the COVID-19 pandemic.

OBJECTIVE: The objective of our study is to investigate the impacts of telemedicine technology and its specific tools on physicians' overall satisfaction, quality of care, and percentage of patient visits in ambulatory care settings after the COVID-19 lockdowns. MATERIALS AND METHODS: Data for our analysis was sourced from the 2021 annual National Electronic Health Records Survey (NEHRS), which included 1,875 complete questionnaire responses from physicians in the 2021 NEHRS. We used regression models to test the effects of telemedicine on physicians' overall satisfaction, quality of care, and percentage of patients' visits. RESULTS: We report that telemedicine technology has significant positive effects on physicians' satisfaction with telemedicine and quality of care evaluation, both at an aggregate level and at the disaggregate levels of individual telemedicine features, and partially significant effects on patients' telemedicine visits. DISCUSSION: Telemedicine features that contributed significantly to physician satisfaction and quality of care evaluation were telephone, videoconferencing, standalone telemedicine platform, and telemedicine platform integrated with EHR, while only telephone and integrated telemedicine platform contributed significantly to patients' telemedicine visits. CONCLUSION: For telemedicine research and practice, this study confirms that telemedicine improves physician satisfaction and quality of care perceptions and will therefore be preferred by physicians. However, telemedicine has a mixed impact on percentage of patient visits, which suggests that providers may have to work harder to regularize telemedicine acceptance among patients in the post-COVID era.

The Shoeshine Stand and the Renaissance of Primary Care.

Over the past century, family physicians have moved from small independently owned practices, many of them solo, to being employed by large hospital systems, corporate entities, or health systems. Today, almost three-quarters of all physicians are employed and the highest percentage of employed physicians are family physicians.This essay contrasts the elements of independent practice with employed practice as part of what has been lost in the past half century, but what might be regained if physicians demanded more autonomy and control over their practices.

Building physician wellness into the culture: evaluating a family physician well-being programme using the physician wellness inventory.

PURPOSE: Family physicians have a higher incidence of burnout, dissatisfaction, and disengagement compared to other medical specialties. Addressing burnout on the individual and systemic level is important to promoting wellness and preventing deleterious effects on physicians and patients. We used the Physician Wellness Inventory (PWI) to assess the effects of a wellness programme designed to equip family physicians with skills to address burnout. METHODS: The PWI is a fourteen-item 5-point Likert scale broken down into 3 scores; (i) career purpose, (ii) cognitive flexibility, and (iii) distress. The PWI was distributed to a cohort of n = 111 family physician scholars at 3 time points: January 2021, May-June 2021, and October 2021. The response rate was 96.4% at baseline, and 72.1% overall. Demographic information was collected to assess differences. The survey was distributed online through Qualtrics (Provo, UT). RESULTS: Cognitive Flexibility scores at the endpoint were higher for POC scholars than white scholars (P = 0.024). Distress scores for all groups decreased over time. Female scholars were more nervous, and anxious at the start than male scholars (P = 0.012), which decreased over time (P = 0.022). New career scholars were more likely than later career scholars to be distressed (P = 0.007), but both groups' distress decreased over time (P = 0.003). Later career scholars' feelings of being bothered by little interest or pleasure in doing things decreased more than new career scholars (endpoint: P = 0.022; overall: P = 0.023). CONCLUSIONS: The wellness programme shows improvement in PWI scores, indicating the programme content should be evaluated further for system level improvements.

A prospective randomized controlled trial measuring satisfaction and parents stress after Gomco and Plastibell infant circumcision.

PURPOSE: To compare the physician and parental satisfactions between the two types of circumcision maneuvers used in our units, Gomco and Plastibell circumcision. METHODOLOGY: This study was performed from 2019 to 2021. A total of 190 children were circumcised either by Gomco or Plastibell procedure. Each child was evaluated during the procedure, immediately after the operation, and 1, 2, and 3 weeks after the procedure. Data were collected, statistically analyzed using SPSS version 25. RESULTS: A total of 190 children underwent circumcision from 2019 to 2021. Of the total 190, 98 children (51.6%) underwent circumcision by Gomco, while 92 (48.4%) underwent circumcision by Plastibell. Bleeding was significantly higher in Plastibell method, while excess skin was significantly higher in Gomco method (p value 0.048). Physician evaluation results show no significant difference between both methods in late physician evaluation. 23/92 (28%) of parents were not satisfied after Plastibell circumcision, compared to 8/98 (8.2%) of parents who were not satisfied with the results of Gomco circumcision (p value 0.002). CONCLUSION: Gomco needs a longer operative time, and Plastibell circumcision is less preferable by parents. There is no significant difference in physician satisfaction between the two procedures, but parents are less satisfied with Plastibell circumcision.

Practice Efficiency in Dermatology: Enhancing Quality of Care and Physician Well-Being.

A focus on improved efficiency can impact both patient care and physician well-being. Efficiency is one of the six domains of healthcare quality. It is also recognized as one of the three main pillars of professional fulfillment. Quality improvement measures in the area of efficiency are focused on reducing waste, specifically related to physicians' time, energy, and cognitive demands. Interventions and practices reported in the literature or communicated by dermatologists have documented efforts centered on patient care workflows, documentation, communication, and other areas. Team-based care models maximize the skill sets of other trained providers, while workflow changes encompassing process standardization, communication, and task automatization have improved patient safety and efficiency. Strategies to promote documentation efficiency have centered on eliminating extraneous documentation alongside the use of templates, text expander functionality, and dictation tools. The use of in-office or virtual scribes, when provided with adequate training and consistent feedback, has improved charting time, accuracy, and physician satisfaction. Although upfront investments in time and financial resources may be required, quality improvement in efficiency can benefit healthcare quality, patient safety, and physician satisfaction.

Physician-Reported Experience and Usability of the MyPal Platform: A Palliative Care Digital Health Intervention.

There is a lack of research focusing on the physician-end, their experiences, and their perception of usability with an eHealth intervention. The aim of this study was to evaluate physician satisfaction, and perception of usability following the use of the MyPal platform, a digital health intervention to foster palliative care for hematological cancer patients. Participants were healthcare professionals active in the project's multinational randomized clinical trial evaluating the impact of the MyPal platform. A post-study electronic questionnaire was administered comprised of; 2 standardized questionnaires (PSSUQ, UEQ) and a feature satisfaction questionnaire, and an open ended question. All questionnaire scores were relatively high and the platform was more than marginally accepted by all participants.

Designing clinical guidelines that improve access and satisfaction in the emergency department.

Clinical guidelines are evidence-based clinician decision-support tools that improve health outcomes, reduce patient harm, and decrease healthcare costs, but are often underused in emergency departments (EDs). This article describes a replicable, evidence-based design-thinking approach to developing best practices for guideline design that improves clinical satisfaction and usage. We used a 5-step process to enhance guideline usability in our ED. First, we conducted end-user interviews to identify barriers to guideline usage. Second, we reviewed the literature to identify key principles in guideline design. Third, we applied our findings to create a standardized guideline format, incorporating rapid cycle learning and iterative improvements. Fourth, we ensured the clinical validity of our updated guidelines by using a rigorous process for peer review. Lastly, we evaluated the impact of our guideline conversion process by tracking clinical guidelines access per day from October 2020 to January 2022. Our end-user interviews and review of the design literature revealed several barriers to guideline use, including lack of readability, design inconsistencies, and guideline complexity. Although our previous clinical guideline system averaged 0.13 users per day, >43 users per day accessed the clinical guidelines on our new digital platform in January 2022, representing an increase in access and use exceeding 33,000%. Our replicable process using open-access resources increased clinician access to and satisfaction with clinical guidelines in our ED. Design-thinking and use of low-cost technology can significantly improve clinical guideline visibility and has the potential to increase guideline use.

Teleneurology via tablet technology: an effective low-cost method to increase healthcare accessibility.

INTRODUCTION: Telemedicine is a valuable tool to increase access to health care, especially for patients in rural areas who need to visit a specialist. In place of telemedicine robots, which are costly and complicated, hospitals have implemented successful telemedicine programs using lower-cost tablet technology; opting for tablet technology increases the organizational feasibility of a large-scale telemedicine program. METHODS: Vanderbilt University Medical Center (VUMC), in Nashville, Tennessee, USA, launched its teleneurology network program in 2014 to serve patients in surrounding community hospitals who needed a neurology consult. Consults are conducted using an iPad, including examinations and the secure sharing of images and patient information. This article reports on teleneurology consult data and the results of patient and physician satisfaction surveys. RESULTS: Between February 2014 and November 2021, the VUMC teleneurology network program provided consultations for 14 241 patients with a wide variety of neurological diagnoses presenting to 12 community-based hospitals. Patient and community physician satisfaction surveys showed that 96% of physicians were satisfied with the overall care provided, and 89% of patients reported that the telehealth visits met their medical needs. CONCLUSION: One of the goals of telemedicine programs is to increase access to care. Therefore, it is important that the technology used to implement the program also be accessible in terms of cost and complexity. Tablets are low-cost technology, and their use in telemedicine has been shown to satisfy both physicians and patients with a wide variety of diagnoses.

An Audit of Inpatient Consultation-Liaison Psychiatry Services at an Inner New York City Safety Net Hospital.

Background Our study's primary objective is to audit the resource utilization of a consultation-liaison (CL) psychiatry service in an inner New York City safety net hospital. This cross-sectional, observational study was conducted as a subset of a quality improvement project at the hospital to investigate the characteristics of the emergent nature of consults, types, and the specialty from which the referral was placed to the CL services. This study aims to improve the efficacy of our consult process by improving the appropriateness and precision of consult requests. Methodology This cross-sectional, observational study was reviewed and approved by the Institutional Review Board under a quality improvement exemption. The study investigated the EPIC electronic medical record data for characteristics of consult referrals in the third quarter of 2019 from July 1, 2019, to September 30, 2019. A total of 629 consults were recorded during this period. We excluded follow-up calls, duplicate data rows, and patients with missing data points; the final consults were 421. Patients who required more than one new consult (follow-up excluded) within 90 days were considered; thus, the total number of patients who were included in the study was 327. Results Of the 421 consults identified in the dataset for review, only 45.8% were valid consults, 32.8% were not valid, and 21.4% were uncertain. Further, the most common department from which consults were placed was Medicine (73.2%), followed by Surgery (12.8%), Obstetrics/Gynecology (9%), Critical Care (3.6%), and, finally, Pediatrics (1.4%). Conclusions The study overviews the quality of general consults for the CL psychiatry service and how the CL staff manages it. It also provides an idea about the number of consults that can be comprehensively addressed.

The Effects of COVID-19 on Physicians' Perceived Ability to Provide Care for Patients With Type II Diabetes Mellitus.

Background and objective The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents multiple, diverse challenges to providing appropriate medical care, especially in terms of medication and treatment adherence for chronic diseases such as type 2 diabetes mellitus (T2DM). The COVID-19 pandemic has exacerbated these barriers by potentially forcing physicians to modify their treatment plans due to limitations on in-person visits and changes to patients' financial and social support systems. It remains uncertain whether physicians believe they can provide the same standard of care using telehealth technology or other means to their patients during the pandemic. The goal of this study was to explore physician perceptions about their ability to provide care to patients with T2DM during the COVID-19 pandemic. Methodology This cross-sectional study collected data between January 25, 2021, and February 2, 2021, using an anonymous, self-administered online survey involving DO and MD physicians including residents treating patients with T2DM. The survey was administered via REDCap and collected data on participant demographics, attitudes, perceptions, knowledge, and prior and current (COVID-19-era) experience with care for T2DM patients. Physicians registered with the Florida Department of Health with publicly available emails were invited to participate. Results The survey showed that during the COVID-19 pandemic, 57.9% of physicians (n=48) believed that their patients have a weaker social support system; 68.7% (n=57) modified their patient care plans due to patients' financial difficulties; 78.4% (n=65) believed a regular physical exam is necessary to properly treat patients; 48.2% (n=40) did not believe they had a more complete picture of the case with remote consultations; 47.0% (n=39) were not as satisfied with remote consultations as with face-to-face patient visits; 68.7% (n=57) believed telehealth is necessary to adequately treat patients; 38.5% (n=32) have been less likely to refer their patients to other providers or specialists; 45.8% (n=38) reported concerns over admitting their patients to the hospital for acute medical care; 61.5% (n=51) reported having more patients delay scheduling their routine follow-up care; 61.5% (n=51) believed their patients have been less compliant with the healthcare plans recommended to them. Conclusions The study showed that COVID-19 has significantly impacted physicians' perceptions and abilities to provide care for patients with T2DM. COVID-19 has negatively impacted several crucial aspects of diabetes management, including consistent in-person examinations, social support, and referral to other required services, which could result in long-term consequences for these patients. Furthermore, our study suggests that physicians may not be as satisfied with the care they are able to provide via remote consultations as they are with in-person visits, which has significant implications as we move toward a more telehealth-driven healthcare delivery system.

Physician satisfaction with telemedicine and in-person visits in otolaryngology.

OBJECTIVES: To investigate the differential factors associated with physician satisfaction between telemedicine and in-person visits in otolaryngology. METHODS: Study data included 646 telemedicine and 365 in-person encounters delivered from May-June 2020 at a tertiary center outpatient setting. Encounter-specific physician satisfaction was rated by 15 otolaryngologists using Provider Satisfaction Questionnaire (range 0-100) consisted of 5 items (patient needs addressed, patient involvement, adequacy of information given, quality of emotion support provided, and general interaction satisfaction). A multivariable linear mixed-effects model was used to explore patient demographic and clinical factors associated with physician satisfaction. RESULTS: Physician satisfaction scores for telemedicine and in-person visits were 83.0 [95 % CI: 77.0-88.9] and 88.1 [95 % CI: 82.5-93.6], respectively. Among telemedicine visits, physician satisfaction scores were significantly higher for follow-up (vs. new), videoconference (vs. telephone) encounters, and English-speaking patients in a multivariable model. New encounters had significantly lower satisfaction subdomain scores for adequacy of information given to the patient (ß = -4.7 [95 % CI: -7.3 to -2.0], p = 0.001) and addressing the needs of the patient among telemedicine visits (ß = -4.1, [95 % CI: -7.1 to -1.1], p = 0.007) while there were no differences in satisfaction scores between new vs follow-up visits among in-person visits. For non-English speaking patients, the physician satisfaction scores were significantly lower for subdomain scores assessing active patient participation (ß = -13.1, [95 % CI: -13.1 to -17.4], p < 0.001) and emotional support given to the patient (ß = -7.8, [95 % CI: -11.0 to -4.5], p < 0.001) for telemedicine visits. CONCLUSIONS: Telemedicine has been broadly adopted as an alternative option to deliver care in otolaryngology since COVID-19 pandemic. Appropriate triaging based on patient and encounter characteristics may enhance physician satisfaction and overall experiences with telemedicine. Further efforts are needed to provide adequate interpretation and videoconference services during telemedicine visits.

Different Measures and Ways to Categorize Pediatrician Burnout and the Association with Satisfaction.

OBJECTIVE: Compare pediatrician burnout when measured and categorized in different ways to better understand burnout and the association with satisfaction. STUDY DESIGN: We analyzed national survey data from a cohort study of early to midcareer pediatricians. In 2017, participants randomly received 1 of 3 question sets measuring burnout components (emotional exhaustion, depersonalization, and personal accomplishment): group A received the Maslach Burnout Inventory, group B received a previously used measure, and group C received a new severe measure. Repeated measures ANOVA tested differences across burnout categorizations: high emotional exhaustion and high depersonalization and low personal accomplishment; high emotional exhaustion and high depersonalization; and high emotional exhaustion or high depersonalization. Logistic regression tested relationships between burnout profiles (engaged, intermediate, and burnout) and satisfaction. Seventy-one percent of participants completed the survey (1279/1800). RESULTS: Burnout varied depending on measurement (groups A, B, and C) and categorization. For example, for group A, when categorized as high emotional exhaustion, high depersonalization, and low personal accomplishment, burnout was lower (4.8%) than categorized as high emotional exhaustion and depersonalization (15.2%) (P < .001) or categorized as high emotional exhaustion or depersonalization (44.6%) (P < .001). Most participants were satisfied with their career (83.6%). Using burnout profiles, 38.4%-85.1% fell in the engaged profile. For each group, burnout profiles were associated with satisfaction. For example, group A participants in the burnout or intermediate profile were less likely than those engaged to be satisfied with their careers (aOR, 0.08 [95% CI, 0.03-0.24]; and aOR, 0.23 [95% CI, 0.10-0.56], respectively). CONCLUSIONS: The way burnout is measured and categorized affects burnout prevalence and its association with satisfaction. Transparency in methodology used is critical to interpreting results.

Patient- and physician-reported satisfaction with gastroesophageal reflux disease (GERD) treatment in Chinese clinical practice.

OBJECTIVE: The aim of this study was to assess the level of satisfaction with currently prescribed medications for gastroesophageal reflux disease (GERD) in patients and physicians in China. METHODS: Physicians across China were invited to complete physician surveys concerning factors affecting the prescription of medication for GERD and their satisfaction through an online questionnaire. The enrolled physicians invited the first five GERD patients who visited them on the same day to complete online patient surveys concerning the satisfaction with medications for GERD and its influencing factors. RESULTS: In total, 334 physician surveys (response rate 36.82%) and 1409 patient surveys (86.07%) were analyzed. Over half (62.57%) the physicians recommended taking a proton pump inhibitor (PPI) twice daily and the majority (88.02%) recommended taking a PPI for 1 week to 3 months. Factors affecting the prescription were how much it could improve quality of life (84.73%), followed by safety, medication compliance, and efficacy. Approximately 30% of patients reported taking a PPI twice daily and 47.20% reported taking a PPI for 1 week to 3 months. Factor affecting patients' adherence to medications was safety (64.30%), followed by medical insurance, efficacy and convenience. Approximately one-third of physicians and patients did not report "satisfied" or "very satisfied" with medications for GERD, including 10.51% of patients and 12.87% of physicians reporting "dissatisfied" or "very dissatisfied." CONCLUSION: One-third of GERD patients and physicians were not satisfied or very satisfied with medications for GERD. Novel medications may help optimize the management of GERD.

Early-Career Physician Burnout.

Early-career physicians face a broad range of challenges unique to their phase of life and career. Beginning in residency, anesthesiologists encounter stressors unique to their work environment, which, when coupled with their personal life demands, places significant burden and creates potential for burnout. In this article, the authors review the literature to explore the contributors of burnout in early-career anesthesiologists, evaluate the relationship between compassionate care and empathic distress, and propose strategies to prevent and treat burnout in this specific subset of anesthesiologists.

Physician Satisfaction With Virtual Ophthalmology Clinics During the COVID-19 Pandemic: A Tertiary Eye Care Center Experience.

Background In this study, we aimed to assess ophthalmologists' experience with teleophthalmology during the coronavirus disease 2019 (COVID-19) pandemic in the central region of Saudi Arabia. In addition, we evaluated their satisfaction level and explored their satisfaction determinants. Methodology We conducted an online survey for ophthalmologists who participated in the virtual ophthalmology clinic during COVID-19 between November 2020 and September 2021. The survey was used to evaluate ophthalmologists' experience with teleophthalmology during the pandemic. Ophthalmologists were asked to measure their satisfaction with equipment and technical issues, communication, and clinical assessment, and to provide an overall program evaluation. Data were analyzed via frequency measures (e.g., numbers, percentages, mean, and standard deviation). Results Out of the 113 ophthalmologists who were invited to participate in our study, 71 completed the survey. In total, 23 (32.4%) participants were general ophthalmologists, 15 (21.1%) were subspecialists in the cornea, 16 (22.5%) were subspecialists in glaucoma, one (1.4%) was a subspecialist in neuro-ophthalmology, seven (9.9%) were subspecialists in pediatric ophthalmology, eight (11.3%) were subspecialists in the retina, and one (1.4%) participant was a subspecialist in oculoplastic. Overall, 56.3% of the respondents were satisfied with teleophthalmology. Ophthalmologists who subspecialized in the retina demonstrated higher levels of satisfaction than other subspecialties. The most common challenge reported by ophthalmologists in the virtual consultation was the lack of adequate equipment to evaluate the patients (53.5%), followed by technical issues (43.7%) and the patients' lack of experience in using virtual consultation services (38%). Overall satisfaction score was the highest among ophthalmologists who reported providing at least five video consultations before the survey. Conclusions The findings from our study suggest that the subspeciality of ophthalmologists and the number of video consultations conducted by ophthalmologists are important determinants in their level of satisfaction with teleophthalmology. The majority of the respondents were satisfied with the virtual clinic during the COVID-19 pandemic. The current pandemic could pave the way for the future use of telemedicine in ophthalmology if virtual eye examinations become standardized.

Telemedicine in Otolaryngology During COVID-19: Patient and Physician Satisfaction.

OBJECTIVE: To examine patient and physician satisfaction with telemedicine in otolaryngology during COVID-19 and identify associated factors. STUDY DESIGN: Prospective cohort study. SETTING: Tertiary care center. METHODS: Patient satisfaction was rated by patients (age ≥18 years) who had encounters from May to July 2020 (n = 407). Physician satisfaction was rated by 15 otolaryngologists for specific encounters delivered from May to June 2020 (n = 1011). Patient satisfaction was measured with a Press Ganey questionnaire and a Telemedicine Satisfaction Questionnaire. Mean Press Ganey satisfaction scores of telemedicine encounters during COVID-19 were compared with the pre-COVID-19 Press Ganey scores from in-person encounters (n = 3059) to test a noninferiority hypothesis. Physician satisfaction was measured with a Provider Satisfaction Questionnaire. RESULTS: The mean Press Ganey patient satisfaction score for telemedicine encounters was 94.5 (SD, 8.8), no worse than that for in-person encounters prior to COVID-19 at 93.7 (SD, 15.5; Δ = 0.8 [95% CI, -0.5 to 2.1, excluding the noninferiority margin of -1]). Encounters with videoconference (vs telephone) and patients reporting higher income were associated with higher Telemedicine Satisfaction Questionnaire scores. Physician satisfaction scores during COVID-19 with telemedicine encounters were overall high at 83.3 (95% CI, 77.5-89.1), slightly lower when compared with the scores with in-person encounters at 88.4 (95% CI, 82.5-94.3; Δ = -5.2 [95% CI, -6.6 to -3.8]). Encounters with videoconference (vs telephone) and patients with English as a preferred language and follow-up visits were associated with higher Provider Satisfaction Questionnaire scores. CONCLUSIONS: Telemedicine is a feasible alternative format in otolaryngology during COVID-19 with overall high patient and physician satisfaction. Patient satisfaction with telemedicine encounters during COVID-19 was no worse than in-person encounters prior to the pandemic. Physician satisfaction with telemedicine was relatively lower in comparison with in-person encounters.

For Residents, by Residents: Developing a Physician Handoff Tool at a University Affiliated Community Hospital.

The 80-hour per week work limit resulted in an increased number of patient handoffs. A satisfactory handoff system should optimize the exchange of vital patient information while concisely minimizing error. This project describes our experience and lessons learned in successfully developing and implementing an Electronic Health Record (EHR)-integrated handoff system based on the I-PASS model. The handoff system, termed Physician Handoff, was refined through end-user feedback. End-users were evaluated on the quality of handoff in the following categories: Illness Severity, Patient Summary, Action List, and Situational Awareness. Resulting survey showed high adoption and satisfaction rate with Physician Handoff. Success can be attributed to interdepartmental collaboration, credentialing the users, and recognizing the importance of end-user feedback.