Factors Contributing to Non-Attendance of GI Endoscopic Procedures in a Tertiary Care Center in the Middle East.

INTRODUCTION: The cancer burden in the Middle East is high and growing. Colorectal cancer (CRC) is the second most common cancer for both men and women in the UAE. Although early diagnosis of malignancy reduces morbidity and increases the survival rates, non-attendance of gastroenterology (GI) endoscopic procedures is a significant global problem, which can lead to delay in cancer diagnosis and treatment. Several factors have been found to contribute to non-attendance behavior, including socioeconomic, cultural, and organizational related barriers. The purpose of this study was to identify factors contributing to non-attendance behavior among outpatients scheduled for GI endoscopic procedures in a tertiary hospital in the United Arab Emirates. We conclude with recommendations that can help in reducing the rate of patient no-shows for GI endoscopic procedures in the region. METHODS: In a tertiary medical center in the Middle East, we surveyed patients who did not attend their scheduled GI endoscopic procedures over a period of one year. The questionnaire sought to identify possible reasons for patient's non-attendance. Descriptive measures including means, standard deviation, frequencies, and percentages were used to analyze the demographic characteristics of the study participants. The chi-square test was performed to analyze gender differences. RESULTS: Of 314 outpatients who met study inclusion criteria, 168 agreed to participate (53.5% response rate). The majority of participants were women (n=96, 60.4 %), aged 18 to 73, with a mean of 42 years. The largest age group was between 35 and 44 (n=46, 28.9 %). Approximately equal numbers of non-attendance appointments were scheduled for combined colonoscopy and upper endoscopy (36.3 %), colonoscopy alone (31.3 %), or upper endoscopy alone (31.3 %). The most common causes for cancellation or non-attendance included concerns about the appointment (35.5%), inconvenient timing of the appointment (27.9%) and changes in medical status (26.4%). Gender differences were noted for non-attendance behaviors, with women significantly more likely than men to report feelings of embarrassment (Chi-square 6.261, df=1, p=.012). CONCLUSION: Our study has identified several barriers to patient attendance of endoscopic procedures, as well as opportunities to reduce the rate of patient no-shows, including patient education, scheduling options, and protocols to minimize discomfort and misconceptions around GI endoscopic procedures, particularly accommodating for same gender endoscopists, with the ultimate goal of increasing early cancer screening and prevention.

Impact of the COVID-19 Pandemic on a Physician Group's WhatsApp Chat: Qualitative Content Analysis.

BACKGROUND: Social media has emerged as an effective means of information sharing and community building among health professionals. The utility of these platforms is likely heightened during times of health system crises and global uncertainty. Studies have demonstrated that physicians' social media platforms serve to bridge the gap of information between on-the-ground experiences of health care workers and emerging knowledge. OBJECTIVE: The primary aim of this study was to characterize the use of a physician WhatsApp (WhatsApp LLC) group chat during the early months of the COVID-19 pandemic. METHODS: Through the lens of the social network theory, we performed a qualitative content analysis of the posts of a women physician WhatsApp group located in the United Arab Emirates between February 1, 2020, and May 31, 2020, that is, during the initial surge of COVID-19 cases. RESULTS: There were 6101 posts during the study period, which reflected a 2.6-fold increase in platform use when compared with platform use in the year prior. A total of 8 themes and 9 subthemes were described. The top 3 uses of the platform were requests for information (posts: 2818/6101, 46.2%), member support and promotion (posts: 988/6101, 16.2%), and information sharing (posts: 896/6101, 14.7%). A substantial proportion of posts were related to COVID-19 (2653/6101, 43.5%), with the most popular theme being requests for logistical (nonmedical) information. Among posts containing COVID-19-related medical information, it was notable that two-thirds (571/868, 65.8%) of these posts were from public mass media or unverified sources. CONCLUSIONS: Health crises can potentiate the use of social media platforms among physicians. This reflects physicians' tendency to turn to these platforms for information sharing and community building purposes. However, important questions remain regarding the accuracy and credibility of the information shared. Our findings suggest that the training of physicians in social media practices and information dissemination may be needed.

Does provider gender matter in endoscopy? An international perspective.

There is a growing body of literature on the importance of provider gender on patient-related metrics, including satisfaction, compliance, follow-up, and health-related outcomes. Studies have shown that female patients are more likely to factor gender when choosing their physicians than male patients and are much more likely to choose female physicians when provided the option of selecting providers. Early studies in this field have consistently demonstrated a significant gender preference for female endoscopists by female patients. In this perspective, we review findings from United States and international literature on patient-provider gender concordance for endoscopic procedures. We present the current state, describe our experience in an international setting in the Middle East, and offer strategies to promote the advancement of women in gastroenterology, many of which have been successfully implemented to address the health preferences and needs of our female patients.

The Use of Social Media by Female Physicians in an International Setting: A Mixed Methods Study of a Group WhatsApp Chat.

Background: The past decade has witnessed an increase in informal and bottom up driven "she-for-she" efforts, often using social media, to promote the advancement of women in medicine. Yet, this area of research is nascent with limited information on the use of social media platforms by female physicians, especially in the international medical arena. The purpose of this study was to investigate the use of a social media platform by a diverse group of female physicians in an international setting. Materials and Methods: The study used a mixed methods approach, including quantitative descriptive statistics and qualitative thematic analysis of the content of posts of a women physicians WhatsApp group during a 1-year time period (June 1, 2018-May 31, 2019). Results: The group consisted of 122 members with 4897 posts during the 1-year time period. Nine themes were identified including requests for medical information, logistics, personal recommendations, promotion, celebration, community engagement, education, women's empowerment, and employment inquiries. Engagement was high with 72% of members posting during the last 30 days of analysis and 92% of questions posted receiving a response, often within minutes. There were no instances of unprofessional social media behavior. Conclusions: The social media platform was effective in enabling female physicians to expand networks, exchange ideas, share scientific information, celebrate accomplishments, and provide support to colleagues. Creating a social media forum for women physicians may be an effective tool to foster a network of support and community.

Twelve tips for developing and running a successful women's group in international academic medicine.

Gender inequity in academic medicine remains an important issue worldwide. While institutional programs and policies can help promote equity in recruitment, retention, scholarship, promotion, and leadership, they often do not address the physical and social isolation that many women in international academic medicine face. Creating networking opportunities through building women's groups can provide a personal and professional support structure that decreases isolation and promotes the advancement of women. Based on a multidisciplinary literature review on change processes, group formation, and women's empowerment, as well as lessons learned from personal experience, we offer 12 tips to successfully create, maintain, and support physician women's groups, employing Kotter's change-management framework. We believe that these groups can provide a structured platform for networking opportunities to advance women physicians in academic medicine worldwide.