Medical professional liability risk and mitigation: an overview for early-career gastroenterologists.
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ABSTRACT:
SUBMITTER: Azizian J
PROVIDER: S-EPMC8438786 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveTo report doctors' early career preferences for emergency medicine, their eventual career destinations and factors influencing their career pathways.DesignSelf-administered questionnaire surveys.SettingUnited Kingdom.ParticipantsAll graduates from all UK medical schools in selected graduation years between 1993 and 2015.Main outcome measuresChoices for preferred eventual specialty; eventual career destinations; certainty about choice of specialty; correspondence between early specialty choice for emergency medicine and eventually working in emergency medicine.ResultsEmergency medicine was chosen by 5.6% of graduates of 2015 when surveyed in 2016, and 7.1% of graduates of 2012 surveyed in 2015. These figures represent a modest increase compared with other recent cohorts, but there is no evidence of a sustained long-term trend of an increase. More men than women specified emergency medicine - in 2016 6.6% vs. 5.0%, and in 2015 7.9% vs. 6.5%. Doctors choosing emergency medicine were less certain about their choice than doctors choosing other specialties. Of graduates of 2005 who chose emergency medicine in year 1, only 18% were working in emergency medicine in year 10. Looking backwards, from destinations to early choices, 46% of 2005 graduates working in emergency medicine in 2015 had specified emergency medicine as their choice of eventual specialty in year 1.ConclusionsThere was no substantial increase across the cohorts in choices for emergency medicine. Policy should address how to encourage more doctors to choose the specialty, and to create a future UK health service environment in which those who choose emergency medicine early on do not later change their minds in large numbers.
| S-EPMC7586038 | biostudies-literature
Project description:Increasing numbers of young video gamers view esports (i.e., competitive video gaming) as a career opportunity, rather than just a recreational activity. Previous studies have explored the motivational differences between esport and recreational gamers and the motivational changes through career journey to become a professional esport player. The present study explored the predictors of career plans to become a professional esport player, with a specific focus on gaming motivations. Gaming time, gaming motivations, and esport-related playing experience were also examined among Hungarian gamers with competitive gaming experience (N = 190), such as years spent in esports, medium and frequency of participating in esport tournaments, the effort put into training before the tournaments, and the plans to become a professional esport player. Binary logistic regressions were carried out and results showed that the gaming motivations of competition, skill development, and social motivations predicted career planning as a professional esport player. Additionally, results showed that younger players were more likely to seek career opportunity as professional esport players than older players. Future studies should focus on novice esport players' psychological exposure to the hypercompetitive scene of esports, such as high expectations or the risk of becoming problematic videogame users due to their motivational changes.
| S-EPMC7438909 | biostudies-literature
Project description:BackgroundGrowing demand for medical assistants (MAs) in team-based primary care has led health systems to explore career ladders based on expanded MA responsibilities as a solution to improve MA recruitment and retention. However, the practical implementation of career ladders remains a challenge for many health systems. In this study, we aim to understand MA career aspirations and their alignment with available advancement opportunities.MethodsSemi-structured focus groups were conducted August to December 2019 in primary care clinics based in three health systems in California and Utah. MA perspectives of career aspirations and their alignment with existing career ladders were discussed, recorded, and qualitatively analyzed.ResultsTen focus groups conducted with 59 participants revealed three major themes: mixed perceptions of expanded MA roles with concern over increased responsibility without commensurate increase in pay; divergent career aspirations among MAs not addressed by existing career ladders; and career ladder implementation challenges including opaque advancement requirements and lack of consistency across practice settings.ConclusionMAs held positive perceptions of career ladders in theory, yet recommended a number of improvements to their practical implementation across three institutions including improving clarity and consistency around requirements for advancement and matching compensation to job responsibilities. The emergence of two distinct clusters of MA professional needs and desires suggests an opportunity to further optimize career ladders to provide tailored support to MAs in order to strengthen the healthcare workforce and talent pipeline.
| S-EPMC9109348 | biostudies-literature
Project description:The goal of STEM professional development for teaching is that participants continue to practice what they learn in the long term. However, we do not know if the outcomes are achieved and ultimately persist. We tracked postdoctoral participants from the Faculty Institutes for Reforming Science Teaching (FIRST) IV program into their current positions as early-career biology faculty. We assessed their teaching approaches, practices, and student perceptions of the learning environment over 6 to 9 years after finishing the program. Simultaneously, we evaluated paired faculty in the same departments. We found that professional development outcomes persisted over time and across a career transition. FIRST IV faculty maintained their learner-centered practices and were more learner-centered than their peers. Last, we found that teaching approaches were correlated with teaching practices in all faculty participants. These results provide evidence for the success of the FIRST IV program and the long-term persistence of professional development outcomes.
| S-EPMC7304974 | biostudies-literature
Project description:BackgroundThe rapidly rising rates of brain diseases due to the growing ageing population and the explosion in treatment options for many neurological conditions increase the demand for neurologists. We report trends in doctors' career choices for neurology; investigate factors driving their choices; and compare doctors' original choices with their specialty destinations.MethodsA multi-cohort, multi-purpose nation-wide study using both online and postal questionnaires collected data on career choice, influencing factors, and career destinations. UK-trained doctors completed questionnaires at one, three, five, and ten years after qualification. They were classified into three groups: graduates of 1974-1983, graduates of 1993-2002, and graduates of 2005-2015.ResultsNeurology was more popular among graduates of 2005-2015 than earlier graduates; however, its attraction for graduates of 2005-2015 doctors reduced over time from graduation. A higher percentage of men than women doctors chose neurology as their first career choice. For instance, among graduates of 2005-2015, 2.2% of men and 1.1% of women preferred neurology as first choice in year 1. The most influential factor on career choice was "enthusiasm for and commitment to the specialty" in all cohorts and all years after graduation. Only 39% who chose neurology in year 1 progressed to become neurologists later. Conversely, only 28% of practicing neurologists in our study had decided to become neurologists in their first year after qualification. By year 3 this figure had risen to 65%, and by year 5 to 76%.ConclusionsCareer decision-making among UK medical graduates is complicated. Early choices for neurology were not highly predictive of career destinations. Some influential factors in this process were identified. Improving mentoring programmes to support medical graduates, provide career counselling, develop professionalism, and increase their interest in neurology were suggested.
| S-EPMC6621943 | biostudies-literature
Project description:Setbacks are an integral part of a scientific career, yet little is known about their long-term effects. Here we examine junior scientists applying for National Institutes of Health R01 grants. By focusing on proposals fell just below and just above the funding threshold, we compare near-miss with narrow-win applicants, and find that an early-career setback has powerful, opposing effects. On the one hand, it significantly increases attrition, predicting more than a 10% chance of disappearing permanently from the NIH system. Yet, despite an early setback, individuals with near misses systematically outperform those with narrow wins in the longer run. Moreover, this performance advantage seems to go beyond a screening mechanism, suggesting early-career setback appears to cause a performance improvement among those who persevere. Overall, these findings are consistent with the concept that "what doesn't kill me makes me stronger," which may have broad implications for identifying, training and nurturing junior scientists.
| S-EPMC6773762 | biostudies-literature
Project description:We use variation in the generosity of local juries to identify the causal impact of medical malpractice liability on social welfare. Growth in malpractice payments contributed at most 5 percentage points to the 33% total real growth in medical expenditures from 1990-2003. On the other hand, malpractice leads to modest mortality reductions; the value of these more than likely exceeds the costs of malpractice liability. Therefore, reducing malpractice liability is unlikely to have a major impact on health care spending, and unlikely to be cost-effective over conventionally accepted values of a statistical life.
| S-EPMC3601788 | biostudies-literature
Project description:ImportanceDespite increasing evidence and recognition of persistent gender disparities in academic medicine, qualitative data detailing the association of gender-based experiences with career progression remain sparse, particularly at the mid- to senior-career stage.ObjectiveTo investigate the role gender has played in everyday professional experiences of mid- to senior-career women clinician-scientists and their perceptions of gender-related barriers experienced across their careers.Design, setting, and participantsIn this qualitative study, a total of 60 of 159 invited clinician-scientists who received National Institutes of Health K08 or K23 awards between 2006 and 2009 and responded to a survey in 2021 agreed to participate. Invitees were selected using random, purposive sampling to support sample heterogeneity. Semistructured in-depth interviews were conducted January to May 2022. For this study, interviews from 31 women were analyzed using the framework approach to thematic analysis. Data analyses were performed between August and October 2023.Main outcomes and measuresDescriptive themes of participant experiences of gender and gender-based barriers in academic medicine.ResultsA total of 31 women clinician-scientists (8 identifying as Asian [25.8%], 14 identifying as White [45.2%], and 9 identifying as members of a minority group underrepresented in medicine [29.0%]; 14 aged 40-49 years [45.2%] and 14 aged 50-59 years [45.2%]) were included. Among them, 17 participants (54.8%) had children who required adult supervision or care, 7 participants (22.6%) had children who did not require supervision or care, and 6 participants (19.4%) did not have children. There were 4 dominant themes identified within participant experiences in academic medicine: the mental burden of gendered expectations at work and home, inequitable treatment of women in bureaucratic processes, subtle and less subtle professional exclusion of women, and value of communities built on shared identities, experiences, and solidarity.Conclusions and relevanceThis study found that women perceived the institution of academic medicine as a male-centric system misaligned with the needs of women, with associated feelings of exclusion, disillusionment, and loss of trust in their institutions. Findings suggest that the confluence of domestic obligations and unaccommodating institutional environments may make it difficult for women clinician-scientists to achieve established timelines of career progression and productivity; these findings may have long-term implications for the well-being and retention of women in academic medicine.
| S-EPMC11253288 | biostudies-literature
Project description:Experiential learning can facilitate the development of transferrable skills necessary for success in attaining tenure and promotion in academia. In this article, we discuss the benefits of designing and implementing an individualized professional development experience or practicum. By doing this, we describe the experiential learning component of the Accomplishing Career Transitions (ACT) Program of the American Society for Cell Biology. The ACT program aims to assist postdoctoral trainees and junior faculty from backgrounds underrepresented in STEM as they strive to transition into tenure-track positions and ultimately attain tenure at research-intensive or teaching-intensive academic institutions.
| S-EPMC8217969 | biostudies-literature
Project description:ObjectiveTo identify lessons learned from the experience of the Agency for Healthcare Research and Quality (AHRQ) Patient Safety and Medical Liability (PSML) Demonstration Program.Data sources/study settingOn September 9, 2009, President Obama directed the Secretary of Health and Human Services to authorize demonstration projects that put "patient safety first" with the intent of reducing preventable adverse outcomes and stemming liability costs. Seven demonstration projects received 3 years of funding from AHRQ in the summer of 2010, and the program formally came to a close in June 2015.Study designThe seven grantees implemented complex, broad-ranging innovations addressing both patient safety and medical liability in "real-world" contexts. Some projects featured novel approaches, while others implemented adaptations of existing models. Each project was funded by AHRQ to collect data on the impact of its interventions. In addition, AHRQ funded a cross-cutting qualitative evaluation focused on lessons learned in implementing PSML interventions.Data collection/extraction methodsSite visits and follow-up interviews supplemented with material abstracted from formal project reports to AHRQ.Principal findingsThe PSML demonstration projects focused on three broad approaches: (1) improving communication around adverse events through disclosure and resolution programs; (2) preventing harm through implementation of clinical "best practices"; and (3) exploring alternative methods of settling claims. Although the demonstration contributed to accumulating evidence that these kinds of interventions can positively affect outcomes, there is also evidence to suggest that these interventions can be difficult to scale.ConclusionsIn addition to producing at least preliminary positive outcomes, the demonstration also lends credence to the idea that targeted interventions that improve some aspect of patient safety or malpractice performance may also contribute more broadly to institutional culture and the alignment of all parties around reducing risk and preventing harm. However, more empirical work needs to be carried out to quantify the effect of such interventions.
| S-EPMC5134358 | biostudies-literature