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2014 Physician Compensation Report Highlights

2014 Physician Compensation Report Highlights

A newcomer snatched a spot in the top 3 highest earning specialties – check out which one in our summary of Medscape’s 2014 annual compensation report! In this year’s Medscape Physician Compensation Report, a great turnout of over 24,000 physicians across 25 specialties shared their salaries, hours worked, and details of how healthcare reform impacted their healthcare environment. Salary increases were seen in all but six specialties, compared with last year’s 2013 Physician Compensation Report. ♦ The top three earning specialties this year are Orthopedics ($413k), Cardiology ($351k), and both Urology and Gastroenterology at $348k. ♦ The lowest earners remain roughly the same as last year, with Infectious Diseases specialists ($174k), Family Medicine ($176k), and Endocrinologists ($181k).     Source: Medscape. Other highlights from the report include: ♦ Rheumatology hands down had the highest increase at 15% this year. ♦ Nephrology had the lowest increase (8%). ♦ Specialties whose compensation declined this year included Pathology (3%), Radiology (2%), Pulmonary Medicine (2%), and Cardiology (2%). ♦ On average, men made 31% more than women in 2013, down from 39% in 2010. ♦ The highest earners live in the North Central ($257k) and Great Lakes ($258k) regions. ♦ The lowest earners live in the Mid-Atlantic ($240k) and Northeast ($239k) regions. ♦ Almost a quarter of physicians (24%) participated in an Accountable Care Organization, compared with 16% in 2012 and only 3% in 2011. ♦ About 25% of responders said they would drop insurers that pay poorly, while 39% said they would not. Interestingly, in the satisfaction portion of the survey, top earners (plastic surgeons, surgeons, orthopedists, radiologists, and anesthesiologists) were the least likely to...
OSA & Subclinical Myocardial Injury

OSA & Subclinical Myocardial Injury

About 2% to 6% of Americans have obstructive sleep apnea (OSA), a condition that is largely underdiagnosed but has been associated with multiple cardiovascular diseases (CVDs), including coronary heart disease (CHD) and heart failure (HF). “Although the relationship between OSA and CVD has been well defined,” says Amil M. Shah, MD, MPH, “it has been challenging for clinicians to establish a causal relationship because of the association of OSA with other risk factors.” In clinical research, elevated levels of high sensitivity troponin T (hs-TnT), a marker of myocardial injury, have been predictive of both CHD and HF in the general population. Previous studies have been conflicting as to whether there is a link between OSA severity and troponin levels, particularly after accounting for comorbidities. “The relationship between OSA severity and hs-TnT levels has not been well described in the literature,” says Dr. Shah. “More severe OSA may be associated with subclinical myocardial injury.” Understanding the relationship between OSA and CVD pathway biomarkers may help explain the association between the diseases.   New Data Dr. Shah and colleagues had a study published in the American Journal of Respiratory and Critical Care Medicine to determine if more severe OSA, measured by the respiratory disturbance index, is associated with subclinical myocardial injury and increased myocardial wall stress. Subclinical myocardial injury was indicated by increased hs-TnT levels, while increased myocardial wall stress was indicated by elevated N-terminal pro B-type natriuretic peptide (NT-proBNP) levels. The analysis included 1,645 community-based, middle-aged and older patients who were part of the Atherosclerosis Risk in Communities and the Sleep Health studies. Participants were free of CHD and HF...
Communication Etiquette in Medical Training

Communication Etiquette in Medical Training

Patient-centered communication can impact several aspects of the patient-doctor relationship, including disclosure of illness-related information and compliance with medical recommendations. Etiquette-based medicine involves simple patient-centered communication strategies that convey professionalism and respect to patients. “Research has shown that patients prefer physicians who practice etiquette-based medicine behaviors, most notably those who sit down and introduce themselves,” says Leonard S. Feldman, MD. Little is known, however, about  whether physicians in training are actually performing these easy-to-practice behaviors. An In-Depth Look In a study published in the Journal of Hospital Medicine, Dr. Feldman and colleagues sought to understand whether etiquette-based communication behaviors were practiced by trainees on inpatient medicine rotations. Trained observers followed 29 internal medicine interns in their first year out of medical school at Johns Hopkins Hospital and the University of Maryland Medical Center for 3 weeks. They witnessed 732 inpatient encounters and used an iPod Touch application to record whether the interns employed five key strategies in etiquette-based communication: 1) introducing oneself, 2) explaining one’s role in the patient’s care, 3) touching the patient, 4) asking open-ended questions, and 5) sitting down with the patient.   According to the findings, interns touched their patients—defined as either a physical exam or simply a handshake or a gentle, caring touch—during 65% of visits and asked open-ended questions 75% of the time. However, they introduced themselves only 40% of the time, explained their role in just 37% of cases, and sat down during only 9% of visits (Table). The study subjects performed all five of the recom-mended etiquette-based communication behaviors during just 4% of all patient encounters. Interns were only slightly more...
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