Project description:The American Academy of Dermatology is modernizing its clinical practice guidelines to be more timely and easily interpretable, while decreasing the influence of conflicts of interest in guideline generation. The main changes include the transition from SORT to GRADE methodology and the requirement that nonconflicted members of the guideline work groups remain nonconflicted throughout the entire guidelines process.
Project description:ObjectiveSex disparity is a major societal issue. The aim of this paper was to describe changes in the representation of women among speakers of the American Psychiatric Association (APA) annual meeting over 10 years, between 2009 and 2019 and to compare them to changes in the proportion of women among American psychiatrists.MethodsData were collected from the programs of the APA annual meetings of 2009 and 2019, and from the Association of American Medical Colleges. Descriptive and comparative statistical analyses were performed.ResultsThere were 1,138 distinct speakers at the 2009 conference and 1,784 at the 2019 conference. The number of distinct female speakers increased from 413 (36.3%) to 813 (45.6%). The proportion of female speakers at the meetings was almost equivalent to the proportion of women in the American psychiatrists' workforce. The number of female chairs increased from 158 (39.6%) to 322 (46.4%). There were 38 female speakers in child and adolescent psychiatry in 2009 (51.4% of 74 speakers) and 74 in 2019 (51.0% of 155 speakers).ConclusionsThe representation of women at the APA annual meetings increased between 2009 and 2019. At the same time, the growth in the percentage of women in the American psychiatrists' workforce was slower. The APA appears to promote female representation during its annual meetings.
Project description:BackgroundDermatology lags behind other medical specialties in workforce diversity, particularly regarding gender, race, and ethnicity. This study aims to analyze the current demographics of dermatology physicians in the United States, comparing them with other medical specialties, the overall population of practicing U.S. physicians, and the U.S. population as a whole.Design and methodData from the Association of American Medical Colleges and the U.S. Census Bureau (2007-2022) were used to evaluate gender, racial, and ethnic diversity within dermatology. Demographic factors analyzed included gender, race, and ethnicity, with racial categories grouped as White, Asian, and underrepresented minorities in medicine (URiM). Chi-square tests assessed the fit of gender and age distributions with population proportions, while linear regression models examined trends over time.ResultsFrom 2007 to 2021, the number of dermatologists grew by 22.9%, with a corresponding decrease in population per dermatologist, indicating growth relative to the general population. The proportion of female dermatologists rose by 68.1% during this period, while the male proportion declined by 5.1%. From 2019 to 2022, a significant linear increase (p < 0.001) in URiM representation among dermatology residents was observed, with a model-predicted annual increase of 1.6%.ConclusionsThe increasing diversity in dermatology may be attributed to initiatives such as scholarships and mentorship programs implemented by dermatology organizations and residency programs. By fostering a more diverse workforce, dermatology can better address the healthcare needs of a diverse population and promote health equity across all demographics.
Project description:BackgroundThe incidence of melanoma is rising faster than that of any other preventable cancer in the United States. The American Academy of Dermatology has sponsored free skin cancer education and screenings conducted by volunteer dermatologists in the United States since 1985.ObjectiveWe aimed to assess the American Academy of Dermatology's national skin cancer screening program from 1986 to 2014 by analyzing the risk factor profile, access to dermatologic services, and examination results.MethodsWe conducted several detailed statistical analyses of the screening population.ResultsFrom 1986 to 2014, records were available for 2,046,531 screenings, 1,963,141 (96%) of which were subjected to detailed analysis. Men comprised 38% of all participants. The number of annual screenings reached approximately 100,000 in 1990 and remained relatively stable thereafter. From 1991 to 2014 (data for 1995, 1996 and 2000 were unavailable), clinical diagnoses were rendered for 20,628 melanomas, 156,087 dysplastic nevi, 32,893 squamous cell carcinomas, and 129,848 basal cell carcinomas. Only 21% of screenees had a regular dermatologist. Those with a clinical diagnosis of skin cancer were more likely than the general screening population to be uninsured.LimitationsInability to verify clinical diagnoses histopathologically.ConclusionOur findings suggest that the SPOTme program has detected thousands of skin cancers that may have gone undetected or experienced a delay in detection.
Project description:A large body of research has revealed the challenges that disproportionately affect women as they climb the academic ladder. One area that has received relatively little attention is women's experiences at academic conferences, which are often integral to academics' professional development. As conferences are attended by professional colleagues and influential players in specific fields, the professional consequences of any gender bias in criticism are likely to be amplified at such venues. Here, we explore the degree to which the likelihood of audience members asking a question and offering criticism is associated with the gender of a presenter. Audience questions were tabulated during the authors' visits to the three American Anthropological Association Annual Meetings. The results suggested that men were indeed marginally more likely to ask a question, both when considering all types of questions and when considering only critical questions. However, there was no evidence that they differentially targeted women for these questions. Future research might explore what motivates assertive and critical speech in men and women and how their experiences in receiving it might differ, particularly in academic settings in which critical speech might be considered more acceptable.
Project description:ImportanceThe number of advanced practice clinicians (APCs, including nurse practitioners and physician assistants) in the US is increasing. The effect this has on dermatology is unclear.ObjectiveTo develop a method to identify APCs practicing dermatology in claims data and to evaluate the contribution of dermatology APCs to the dermatology workforce and how this has changed over time.Design, setting, and participantsThis retrospective cohort study used the Medicare Provider Utilization and Payment Data Public Use files (2013 to 2020). As APCs are not listed by specialty, a method to identify APCs practicing dermatology was developed and validated using common dermatology procedural codes. The data were analyzed from November 2022 to April 2023.Main outcomes and measuresThe proportion of clinicians and office visits by dermatology APCs and physician dermatologists were evaluated using Mann-Kendall tests. Joinpoint analysis was also used to compare the average annual percentage change of dermatology procedures and clinicians in rural-urban areas between dermatology APCs and physician dermatologists.ResultsThe method to identify APCs practicing dermatology had 96% positive predictive value, 100% negative predictive value, 100% sensitivity, and 100% specificity. Between 2013 and 2020, 8444 dermatology APCs and 14 402 physician dermatologists were identified. They provided 109 366 704 office visits in Medicare. The percentage of dermatology clinicians who were APCs increased over time, from 27.7% in 2013 to 37.0% in 2020 (P = .002). The proportion of dermatologic office visits provided by APCs also increased over time, from 15.5% in 2013 to 27.4% in 2020 (P = .002). For all procedure categories, the average annual percentage change was positive for dermatology APCs (range, 10.05%-12.65%) and was higher than that of physician dermatologists. For all rural-urban designations, the average annual percentage change was positive for dermatology APCs (range, 2.03%-8.69%) and was higher than metropolitan, micropolitan, and small-town areas from that of physician dermatologists.Conclusions and relevanceIn this retrospective cohort study, there was a temporal increase in the amount of dermatologic care provided by APCs in Medicare. These findings demonstrate changes in the dermatology workforce and may have implications for dermatology as a specialty.