Project description:ImportancePhysician work hours are an underexplored facet of the physician workforce that can inform policy for the rapidly changing health care labor market.ObjectiveTo examine trends in individual physician work hours and their contribution to clinical workforce changes over a 20-year period.Design, setting, and participantsThis cross-sectional study focused on active US physicians between January 2001 and December 2021 who were included in the Current Population Survey. Outcomes for physicians, advanced practice professionals (APPs), and nonphysician holders of doctoral degrees were compared, and generalized linear models were used to estimate differences in time trends for weekly work hours across subgroups.Main outcomes and measuresPhysician and APP workforce size, defined as the number of active clinicians, 3-year moving averages of weekly work hours by individual physicians, and weekly hours contributed by the physician and APP workforce per 100 000 US residents.ResultsA total of 87 297 monthly surveys of physicians from 17 599 unique households were included in the analysis. The number of active physicians grew 32.9% from 2001 to 2021, peaking in 2019 at 989 684, then falling 6.7% to 923 419 by 2021, with disproportionate loss of physicians in rural areas. Average weekly work hours for individual physicians declined by 7.6% (95% CI, -9.1% to -6.1%), from 52.6 to 48.6 hours per week from 2001 to 2021. The downward trend was driven by decreasing hours among male physicians, particularly fathers (11.9% decline in work hours), rural physicians (-9.7%), and physicians aged 45 to 54 years (-9.8%). Physician mothers were the only examined subgroup to experience a statistically significant increase in work hours (3.0%). Total weekly hours contributed by the physician workforce per 10 000 US residents increased by 7.0%, from 13 006 hours in 2001 to 2003 to 13 920 hours in 2019 to 2021, compared with 16.6% growth in the US population over that time period. Weekly hours contributed by the APP workforce per 100 000 US residents grew 71.2% from 2010 through 2012 to 2019 through 2021.Conclusions and relevanceThis cross-sectional study showed that physician work hours consistently declined in the past 20 years, such that physician workforce hours per capita lagged behind US population growth. This trend was offset by rapid growth in hours contributed by the APP workforce. The gap in physician work hours between men and women narrowed considerably, with diverging potential implications for gender equity. Increasing physician retirement combined with a drop in active physicians during the COVID-19 pandemic may further slow growth in physician workforce hours per capita in the US.
Project description:The spreading of COVID-19 has led to panic buying all over the world. In this study, we applied an animal model framework to elucidate changes in human purchasing behavior under COVID-19 pandemic conditions. Purchasing behavior and potential predictors were assessed in an online questionnaire format (N = 813). Multiple regression analyses were used to evaluate the role of individually Perceived Threat of COVID-19, anxiety related personality traits (trait-anxiety, intolerance of uncertainty) and the role of media exposure in predicting quantity and frequency of purchasing behavior. High levels of Perceived Threat of COVID-19 were associated significantly with a reported reduction in purchasing frequency (b = -.24, p < .001) and an increase in the quantity of products bought per purchase (b = .22, p < .001). These results are comparable to observed changes in foraging behavior in rodents under threat conditions. Higher levels of intolerance of uncertainty (b = .19, p < .001) and high extend of media exposure (b = .27, p < .001) were positively associated with Perceived Threat of COVID-19 and an increase in purchasing quantity. This study contributes to our understanding of aberrated human purchasing behavior and aims to link findings from animal research to human behavior beyond experimental investigations.
Project description:Physician wellness was greatly impacted during the COVID-19 pandemic. Busy clinical services, personal safety concerns, changing guidelines, and compassion fatigue weighed on physicians. Although studies have examined physician wellness, few have studied how it changed over time. A survey about wellness was distributed to 299 physicians at Ascension St. Vincent Hospital-Indianapolis March 2020, July 2020, November 2020, and March 2021. Physicians also free-texted about their well-being during the pandemic. Participation rates over the four time periods averaged 22.23%. Responses were compared among the time periods using Pearson Chi-Square and Fisher's Exact Tests. Six wellness factors (anxiety, worry about becoming ill, worry about infecting family, worry about caring for children, concern about personal finances) were reported as worse after the pandemic began, but statistically significantly improved over the course of the study. In contrast, seven wellness measures (increased issues with depression, frustration, hopelessness, fatigue, dread going to work, worry about missing work, worry about caring for family), that also worsened after the pandemic began, did not statistically improve over time. Physician wellness was impacted by the pandemic; however, not all measures followed the same course over time. Longitudinal assessments of wellness can help inform programs to best support physicians.
Project description:ImportanceThe COVID-19 pandemic has placed increased strain on health care workers and disrupted childcare and schooling arrangements in unprecedented ways. As substantial gender inequalities existed in medicine before the pandemic, physician mothers may be at particular risk for adverse professional and psychological consequences.ObjectiveTo assess gender differences in work-family factors and mental health among physician parents during the COVID-19 pandemic.Design, setting, and participantsThis prospective cohort study included 276 US physicians enrolled in the Intern Health Study since their first year of residency training. Physicians who had participated in the primary study as interns during the 2007 to 2008 and 2008 to 2009 academic years and opted into a secondary longitudinal follow-up study were invited to complete an online survey in August 2018 and August 2020.ExposuresWork-family experience included 3 single-item questions and the Work and Family Conflict Scale, and mental health symptoms included the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 scale.Main outcomes and measuresThe primary outcomes were work-to-family and family-to-work conflict and depressive symptoms and anxiety symptoms during August 2020. Depressive symptoms between 2018 (before the COVID-19 pandemic) and 2020 (during the COVID-19 pandemic) were compared by gender.ResultsAmong 215 physician parents who completed the August 2020 survey, 114 (53.0%) were female and the weighted mean (SD) age was 40.1 (3.57) years. Among physician parents, women were more likely to be responsible for childcare or schooling (24.6% [95% CI, 19.0%-30.2%] vs 0.8% [95% CI, 0.01%-2.1%]; P < .001) and household tasks (31.4% [95% CI, 25.4%-37.4%] vs 7.2% [95% CI, 3.5%-10.9%]; P < .001) during the pandemic compared with men. Women were also more likely than men to work primarily from home (40.9% [95% CI, 35.1%-46.8%] vs 22.0% [95% CI, 17.2%-26.8%]; P < .001) and reduce their work hours (19.4% [95% CI, 14.7%-24.1%] vs 9.4% [95% CI, 6.0%-12.8%]; P = .007). Women experienced greater work-to-family conflict (β = 2.79; 95% CI, 1.00 to 4.59; P = .03), family-to-work conflict (β = 3.09; 95% CI, 1.18-4.99; P = .02), and depressive (β = 1.76; 95% CI, 0.56-2.95; P = .046) and anxiety (β = 2.87; 95% CI, 1.49-4.26; P < .001) symptoms compared with men. We observed a difference between women and men in depressive symptoms during the COVID-19 pandemic (mean [SD] PHQ-9 score: 5.05 [6.64] vs 3.52 [5.75]; P = .009) that was not present before the pandemic (mean [SD] PHQ-9 score: 3.69 [5.26] vs 3.60 [6.30]; P = .86).Conclusions and relevanceThis study found significant gender disparities in work and family experiences and mental health symptoms among physician parents during the COVID-19 pandemic, which may translate to increased risk for suicide, medical errors, and lower quality of patient care for physician mothers. Institutional and public policy solutions are needed to mitigate the potential adverse consequences for women's careers and well-being.
Project description:To understand and analyse the global impact of COVID-19 on outpatient services, inpatient care, elective surgery, and perioperative colorectal cancer care, a DElayed COloRectal cancer surgery (DECOR-19) survey was conducted in collaboration with numerous international colorectal societies with the objective of obtaining several learning points from the impact of the COVID-19 outbreak on our colorectal cancer patients which will assist us in the ongoing management of our colorectal cancer patients and to provide us safe oncological pathways for future outbreaks.
Project description:School and day care closures due to the COVID-19 pandemic have increased caregiving responsibilities for working parents. As a result, many have changed their work hours to meet these growing demands. In this study, we use panel data from the US Current Population Survey to examine changes in mothers' and fathers' work hours from February through April 2020, the period of time prior to the widespread COVID-19 outbreak in the United States and through its first peak. Using person-level fixed effects models, we find that mothers with young children have reduced their work hours four to five times more than fathers. Consequently, the gender gap in work hours has grown by 20-50 per cent. These findings indicate yet another negative consequence of the COVID-19 pandemic, highlighting the challenges it poses to women's work hours and employment.
Project description:Going beyond a focus on individual-level employment outcomes, we investigate couples' changing work patterns in the United Kingdom (UK) and the United States (US) during the COVID-19 pandemic. Analyzing longitudinal panels of 2186 couples from the Understanding Society COVID-19 Survey (UK) and 2718 couples from the Current Population Survey (US), we assess whether the pandemic has elevated the importance of human capital vis-à-vis traditional gender specialization in shaping couples' work patterns. The UK witnessed a notable increase in sole-worker families with the better-educated partner working, irrespective of gender. The impact of the pandemic was similar but weaker in the US. In both countries, couples at the bottom 25% of the prepandemic family income distribution experienced the greatest increase in neither partner working but the least growth in sole-worker arrangements. Through a couple-level analysis of changing employment patterns, this study highlights the importance of human capital in shaping couples' paid-work organization during the pandemic, and it reveals the socioeconomic gradient in such organization.