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Poverty is linked to negative health consequences and harmful health behaviors such as smoking. Despite this established correlation, few comparative studies have investigated the relationship between local poverty rates and smoking in urban settings through a Social Ecological Model framework. The authors sought to examine the linkage between local poverty rates in Philadelphia, Pennsylvania and adult smoking rates by scrutinizing existing patterns and potential mediating factors via publicly accessible data in established planning districts. The authors determined several individual, interpersonal, organizational, community, and environmental factors, varying across these districts, that impact smoking in Philadelphia. Poverty rates influence the resources, demographic makeup, and number of tobacco retailers a district has, which have downstream effects. The authors recommend that further investment is allocated to planning districts in order to mitigate the risk of smoking. [ABSTRACT FROM AUTHOR]

Purpose: Patients and families may experience 'non-physical' harm from interactions with the healthcare system, including emotional, psychological, socio-behavioral or financial harm, some of which may be related to experiences of disrespect. We sought to use the current literature to develop a practical, improvement-oriented framework to recognize, describe and help prevent such events.Data Sources: Searches were performed in PubMed, Embase, PsychINFO, CINAHL, Health Business Elite and ProQuest Dissertations & Theses: Global: Health & Medicine, from their inception through July 2017.Study Selection: Two authors reviewed titles, abstracts, full texts, references and cited-by lists to identify articles describing approaches to understanding patient/family experiences of disrespect.Data Extraction: Findings were evaluated using integrative review methodology.Results Of Data Synthesis: Three-thousand eight hundred and eighty two abstracts were reviewed. Twenty three articles were identified. Components of experiences of disrespect included: (1) numerous care processes; (2) a wide range of healthcare professional and organizational behaviors; (3) contributing factors, including patient- and professional-related factors, the environment of work and care, leadership, policies, processes and culture; (4) important consequences of disrespect, including behavioral changes and health impacts on patients and families, negative effects on professionals' subsequent interactions, and patient attrition from organizations and (5) factors both intrinsic and extrinsic to patients that can modify the consequences of disrespect.Conclusion: A generalizable framework for understanding disrespect experienced by patients/families in healthcare may help organizations better prevent non-physical harms. Future work should prospectively test and refine the framework we described so as to facilitate its integration into organizations' existing operational systems. [ABSTRACT FROM AUTHOR]

The authors of this article advocate for making lung cancer screening a measurable and reportable process in order to enhance outreach to underserved patients and promote high-quality lung cancer screening. [ABSTRACT FROM AUTHOR]

The emerging pentecostal movement of the early twentieth century recognized the need to develop a coherent pneumato-soteriological framework from which to promote the pentecostal distinctive of Spirit baptism. In the midst of heated debate interwoven with various personality cults, a multiplicity of alternative models was advanced. George Jeffreys, the founder of the Elim Pentecostal Church, taught that Christians do not receive the Holy Spirit at conversion; they receive him only at the baptism in the Holy Spirit. Rather, Jeffreys asserted, it is the Second Person of the Holy Trinity who comes to indwell the believer at regeneration, and this Spirit of Christ is entirely distinct from and in no way synonymous with the Holy Spirit. Jeffreys' Spirit of Christ teaching was widely promoted within the Elim movement during the 1920s and 1930s and was still being discussed within British Pentecostalism as late as the 1960s, before it faded into theological obscurity. Nevertheless, the implications of this early debate on Spirit reception remain a live issue within Pentecostalism today. [ABSTRACT FROM AUTHOR]

Background: The educational milestones were designed as a criterion-based framework for assessing resident progression on the 6 Accreditation Council for Graduate Medical Education competencies. Objective: We obtained feedback on, and assessed the construct validity and perceived feasibility and utility of, draft Internal Medicine Milestones for Patient Care and Systems-Based Practice. Methods: All participants in our mixed-methods study were members of competency committees in internal medicine residency programs. An initial survey assessed participant and program demographics; focus groups obtained feedback on the draft milestones and explored their perceived utility in resident assessment, and an exit survey elicited input on the value of the draft milestones in resident assessment. Surveys were tabulated using descriptive statistics. Conventional content analysis method was used to assess the focus group data. Results: Thirty-four participants from 17 programs completed surveys and participated in 1 of 6 focus groups. Overall, the milestones were perceived as useful in formative and summative assessment of residents. Participants raised concerns about the length and complexity of some draftmilestones and suggested specific changes. The focus groups also identified a need for faculty development. In the exit survey, most participants agreed that the Patient Care and Systems-Based Practice Milestones would help competency committees assess trainee progress toward independent practice. Conclusions: Draft reporting milestones for 2 competencies demonstrated significant construct validity in both the content and response process and the perceived utility for the assessment of resident performance. To ensure success, additional feedback from the internal medicine community and faculty development will be necessary. [ABSTRACT FROM AUTHOR]

Close scrutiny of sixteenth-century Anabaptism reveals striking similarities to the early years of the modern Pentecostal movement, including considerable exercise of the gift of prophecy in its various forms. Whereas Luther and Calvin were generally wary of overt manifestations of the Holy Spirit, the so-called Radical Reformers were quick to confront the existing socio-political structures with what they saw as the unequivocal Word of God, even to the extent of their becoming a martyr movement. Various elements within early Anabaptism further embraced predictive and directive expressions of prophecy. Regretfully, the Anabaptist experience was also tainted by a measure of fanaticism, libertinism and failed predictions, which ultimately led to an abnegation of interest in extemporaneous prophecy. [ABSTRACT FROM AUTHOR]

Anointed prayer handkerchiefs were once a distinctive in Pentecostal healing praxis. Their historical origins can be traced through the Biblical use of tokens in healing, the Pauline paradigm of Acts 19:11-12, the Catholic reliquary system, and the renewal of interest in Divine healing in the nineteenth century. The use of prayer handkerchiefs was popularised through the Azusa Street revival and later through the ministry of Healing Evangelists like William Branham and T.L. Osborn. Although Colin Dye made notable use of such cloths in a healing revival in 1999, in general prayer handkerchiefs have declined in popularity. Reasons offered for this include the evangelicalization of Pentecostalism, a different perspective on healing within Charismatic churches, and growing scepticism over the perceived peddling of such cloths by certain televangelists. [ABSTRACT FROM AUTHOR]

The operational measurement of physician empathy, as well as the question of whether empathy could change at different levels of medical education, is of interest to medical educators. To address this issue, 98 internal medicine residents from all 3 years of training were studied. The Jefferson Scale of Physician Empathy was administered, and residents' empathy scores correlated with ratings on humanistic attributes made by postgraduate program directors. No statistically significant differences in scores were found among residents of different training levels. Empathy scores remained also stable during internship (test-retest reliability = 0.72). Correlation between empathy and ratings on humanism was 0.17. Thus, the findings suggest that empathy is a relatively stable trait that is not easily amenable to change in residency training programs. The issue of whether targeted educational activities for the purpose of cultivating empathy can improve empathy scores awaits empirical scrutiny. [ABSTRACT FROM AUTHOR]

This study describes the results of a retrospective review of patients' charts who had an advanced directive (AD) and who were hospitalized in a tertiary, acute care teaching hospital. The purpose of the review was to understand from clinical, sociological, ethical and legal perspectives the nature and utility of ADs. Findings and implications of the review are discussed in terms of: patient demographics; diagnoses; quality of ADs; influence of ADs on clinical decisions; and legal aspects of ADs. [ABSTRACT FROM AUTHOR]

Objective: To determine the relations among esophageal dysfunction, gastroesophageal reflux, and lung involvement in patients with systemic sclerosis.Design: Retrospective review of esophageal motility, esophageal pH, and pulmonary function data.Setting: University hospital outpatient clinic and community.Patients: 39 consecutively referred patients who were grouped according to the presence or absence of abnormal distal (pH < 4.0 for > 5% of the 24-hour monitoring period) or proximal (pH < 4.0 for > 1% of the 24-hour period) gastroesophageal acid reflux. Patients were also grouped according to the presence or absence of distal esophageal peristalsis.Measurements: Esophageal manometry, dual-probe (distal and proximal) esophageal 24-hour pH measurements, and pulmonary function studies (forced vital capacity, forced expiratory volume at 1 second, total lung capacity, and single-breath carbon monoxide diffusing capacity [DLco]).Results: The mean total lung capacity (values as percentage predicted) was 87.1% +/- 11.2% (SD) for patients with abnormal proximal reflux and 77.8% +/- 21.6% for patients with normal proximal reflux (difference, 9.3%; 95% CI, -1.4% to 20.0%). The mean forced vital capacity for these patients was 91.1% +/- 12.4% and 85.4% +/- 25.6%, respectively (difference, 5.7%; CI, -6.9% to 18.1%). The mean total lung capacity was 83.8% +/- 15.4% for patients with abnormal distal reflux and 77.9% +/- 22.7% for patients with normal distal reflux (difference, 5.9%; CI, -7.6% to 19.4%). Among potential confounders of pulmonary measures, only smoking was related to decreased pulmonary function (smoking related to decreased DLco P < 0.01). Smoking was more common in patients with abnormal distal reflux than in those with normal distal reflux (65% compared with 25%, P = 0.03). After adjusting for smoking, the difference in mean DLco between patients with abnormal compared with normal distal reflux was 7.19% (Cl, -8.5% to 22.9%).Conclusion: Important measures of lung volume indicative of interstitial lung disease (total lung capacity, forced vital capacity) do not appear to be related to abnormal gastroesophageal acid reflux in patients with systemic sclerosis. [ABSTRACT FROM AUTHOR]

• A strong multidisciplinary organizational structure is necessary to drive consensus in selection and successfully implement point of care glucose meters across a large multi-hospital system. • Beyond the standard analytical laboratory evaluation, meter performance should be evaluated at the point of use, employing consensus error grids and defined acceptability criteria. • Structured end-user evaluation is as an essential element of the meter selection process which commonly includes the evaluation of cost, connectivity, indications for use, and ease of implementation. To select and standardize point-of-care (POC) glucose meters across a multi-hospital system. We formed a multidisciplinary POC glucose standardization working group including key stakeholders from each site. A set of selection criteria: usability, clinical and laboratory performance, indications for use, interface connectivity, ease of implementation and ongoing operational costs were used to develop a scoring schema to facilitate a consensus-driven selection process. Method comparison and consensus error grid evaluation against the clinically validated reference methods demonstrated that the analytical performance for all candidate meters was comparable for both the laboratory and clinical evaluation. However, Meter 1 ranked highest in usability evaluations, implementation and streamlined interface connectivity. The meter selection process and implementation were staggered across sites due to complexity of transitioning to a new manufacturer's meter and limitations in vendor support for training and ongoing troubleshooting of interface connectivity. Standardization of POC glucose meters in a large multi-hospital system is a complex undertaking requiring robust, multidisciplinary organizational structure both system-wide and locally, development of consensus-driven selection tools, usability evaluation by end-users, laboratory and clinical evaluation of the analytical performance, and a strong vendor-laboratory partnership during the implementation process. [ABSTRACT FROM AUTHOR]

The article presents the author's comment on the significance of doctor's letter of condolence. He believes that such simple gesture provides a great consolation to the bereaved family and hence urges clinicians to adopt this practice instead of distancing from it. The author discussed several other issues concerning the promotion of this dying art.

We report on spirometric findings in a patient with severe COPD who underwent such a drainage procedure for abdominal discomfort and dyspnea associated with massive cysts. We believe subdiaphragmatic masses, through pressure on the hemidiaphragm can reduce lung volume and improve spirometry in COPD. [Extracted from the article]

Reports on the document titled The Standards of Technology Literacy: Content for the Study of Technology (STL) which defines technological literacy and identifies the content for the study of technology for students. Description of the project for development of standards of technology education which was conducted by a consortium of school districts in Connecticut; Role of STL in the work of the consortium; Plans to implement these standards.

Background: Although lung cancer screening (LCS) for high-risk individuals reduces lung cancer mortality in clinical trial settings, many questions remain about how to implement high-quality LCS in real-world programs. With the increasing use of telemedicine in healthcare, studies examining this approach in the context of LCS are urgently needed. We aimed to identify sociodemographic and other factors associated with screening completion among individuals undergoing telemedicine Shared Decision Making (SDM) for LCS. Methods: This retrospective study examined patients who completed Shared Decision Making (SDM) via telemedicine between May 4, 2020 – March 18, 2021 in a centralized LCS program. Individuals were categorized into Complete Screening vs. Incomplete Screening subgroups based on the status of subsequent LDCT completion. A multi-level, multivariate model was constructed to identify factors associated with incomplete screening. Results: Among individuals undergoing telemedicine SDM during the study period, 20.6% did not complete a LDCT scan. Bivariate analysis demonstrated that Black/African-American race, Medicaid insurance status, and new patient type were associated with greater odds of incomplete screening. On multi-level, multivariate analysis, individuals who were new patients undergoing baseline LDCT or resided in a census tract with a high level of socioeconomic deprivation had significantly higher odds of incomplete screening. Individuals with a greater level of education experienced lower odds of incomplete screening. Conclusions: Among high-risk individuals undergoing telemedicine SDM for LCS, predictors of incomplete screening included low education, high neighborhood-level deprivation, and new patient type. Future research should focus on testing implementation strategies to improve LDCT completion rates while leveraging telemedicine for high-quality LCS. [ABSTRACT FROM AUTHOR]

Individuals commonly use music as an external auditory stimulus to divert their attention away from aerobic endurance exercise tasks. Music generally results in lower ratings of perceived exertion, which may be the mechanism by which it increases aerobic exercise task duration. However, less is known regarding how music affects the performance of other forms of exercise, such as isometric exercise. Moreover, the effects of different external stimuli on isometric task duration, such as the use of virtual reality (VR), have yet to be investigated. Therefore, the purpose of this study was to investigate the effects of self-selected music (SSM) and VR on isometric exercise task duration using a forearm plank. We hypothesized that both SSM and VR would effectively increase plank duration compared with no external stimuli. Seventeen male collegiate soccer players (19 ± 1 year) completed 3 planks to failure on 3 separate days, with 48–72 hours between the trials. The ordering of each exercise condition (SSM, VR, or None) was randomized for a total of 6 potential orders. A one-way repeated-measures analysis of variance was used to evaluate differences in plank duration and average heart rate (HRavg) between each trial, and significance was set at p < 0.05. There were no differences in plank duration (SSM: 200 ± 44, VR: 173 ± 38, None: 177 ± 37 seconds) or HRavg (SSM: 96 ± 18, VR: 92 ± 21, None: 87 ± 18 beats per minute) between the conditions. We conclude that there was no effect of external stimuli (SSM or VR) on isometric exercise task duration and the use of these modalities should be based on exerciser preference. [ABSTRACT FROM AUTHOR]

Social determinants of health are nonmedical factors that can affect a person's overall health and health outcomes. Where a person is born and the social conditions they are born into can affect their risk factors for premature death and their life expectancy. In this position paper, the American College of Physicians acknowledges the role of social determinants in health, examines the complexities associated with them, and offers recommendations on better integration of social determinants into the health care system while highlighting the need to address systemic issues hindering health equity. [ABSTRACT FROM AUTHOR]

Background: The utilization of stereotactic body radiation therapy (SBRT) is increasing for primary and secondary lung neoplasms. Despite encouraging results, SBRT is associated with an increased risk of osteoradionecrosis-induced rib fracture. We aimed to (1) evaluate potential clinical, demographic, and procedure-related risk factors for rib fractures and (2) describe the radiographic features of post-SBRT rib fractures. Methods: We retrospectively identified 106 patients who received SBRT between 2015 and 2018 for a primary or metastatic lung tumor with at least 12 months of follow up. Exclusion criteria were incomplete records, previous ipsilateral thoracic radiation, or relevant prior trauma. Computed tomography (CT) images were reviewed to identify and characterize rib fractures. Multivariate logistic regression modeling was employed to determine clinical, demographic, and procedural risk factors (e.g., age, sex, race, medical comorbidities, dosage, and tumor location). Results: A total of 106 patients with 111 treated tumors met the inclusion criteria, 35 (32%) of whom developed at least one fractured rib (60 total fractured ribs). The highest number of fractured ribs per patient was five. Multivariate regression identified posterolateral tumor location as the only independent risk factor for rib fracture. On CT, fractures showed discontinuity between healing edges in 77% of affected patients. Conclusions: Nearly one third of patients receiving SBRT for lung tumors experienced rib fractures, 34% of whom experienced pain. Many patients developed multiple fractures. Post-SBRT fractures demonstrated a unique discontinuity between the healing edges of the rib, a distinct feature of post-SBRT rib fractures. The only independent predictor of rib fracture was tumor location along the posterolateral chest wall. Given its increasing frequency of use, describing the risk profile of SBRT is vital to ensure patient safety and adequately inform patient expectations. [ABSTRACT FROM AUTHOR]

A personal narrative is presented in which the author explores his experience of treating a patient suffering from chronic lung disease.

This study was designed to examine the relationships between scores of two measures of empathy. One was specifically developed for measuring empathy in patient care situations; the other was developed for the general population. It was hypothesized that the overlap between scores of the two measures would be greater for their constructs that are more relevant to patient care. Study participants were 93 first-year internal medicine residents at Thomas Jefferson University Hospital in Philadelphia. The Jefferson Scale of Physician Empathy (JSPE, specifically developed for administration to health professionals), and the Interpersonal Reactivity Index (IRI, developed for the general population) were administered. A statistically significant correlation of a moderate magnitude between the total scores of the JSPE and IRI (r&ThickSpace;=&ThickSpace;0.45, p&ThickSpace; [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: Fibrodysplasia ossificans progressiva (FOP) is a rare autosomal dominant disorder of the connective tissue. Over time, patients with FOP experience decreased range of motion in the joints and the formation of a second skeleton, limiting mobility. Patients with FOP are advised to avoid any unwarranted surgery owing to the risk of a heterotopic ossification flare-up. For patients who do require a surgical procedure, a multidisciplinary team is recommended for comprehensive management of the patient's needs. Case Report: A 27-year-old woman with FOP underwent a hysterectomy for removal of a suspected necrotic uterine fibroid. To aid in presurgical planning and management, patient-specific 3-dimensional (3D) models of the patient's tracheobronchial tree, thorax, and lumbosacral spine were printed from the patient's preoperative computed tomography (CT) imaging. The patient required awake nasal fiberoptic intubation for general anesthesia and transversus abdominus plane block for regional anesthesia. Other anesthesia modalities, including spinal epidural, were ruled out after visualizing the patient's anatomy using the 3D model. Postoperatively, the patient was started on a multi-modal analgesic regimen and a course of steroids, and early ambulation was encouraged. Conclusions: Patients with FOP are high-risk surgical patients requiring the care of multiple specialties. Advanced visualization methods, including 3D printing, can be used to better understand their anatomy and locations of heterotopic bone ossification that can affect patient positioning. Our patient successfully underwent supracervical hysterectomy and bilateral salpingectomy with no signs of fever or sepsis at follow-up. [ABSTRACT FROM AUTHOR]

This commentary compares the American College of Physicians' vision for a better U.S. health care system with the 2020 Republican and Democratic presidential candidates' views on health care, focusing on policies relevant to access, insurance coverage, and cost. [ABSTRACT FROM AUTHOR]

Background: Racial disparities are well-documented in preventive cancer care, but they have not been fully explored in the context of lung cancer screening. We sought to explore racial differences in lung cancer screening outcomes within a lung cancer screening program (LCSP) at our urban academic medical center including differences in baseline low-dose computed tomography (LDCT) results, time to follow-up, adherence, as well as return to annual screening after additional imaging, loss to follow-up, and cancer diagnoses in patients with positive baseline scans.Methods: A historical cohort study of patients referred to our LCSP was conducted to extract demographic and clinical characteristics, smoking history, and lung cancer screening outcomes.Results: After referral to the LCSP, blacks had significantly lower odds of receiving LDCT compared to whites, even while controlling for individual lung cancer risk factors and neighborhood-level factors. Blacks also demonstrated a trend toward delayed follow-up, decreased adherence, and loss to follow-up across all Lung-RADS categories.Conclusions: Overall, lung cancer screening annual adherence rates were low, regardless of race, highlighting the need for increased patient education and outreach. Furthermore, the disparities in race we identified encourage further research with the purpose of creating culturally competent and inclusive LCSPs. [ABSTRACT FROM AUTHOR]

Patient navigation has been proposed to combat cancer disparities in vulnerable populations. Vulnerable populations often have poorer cancer outcomes and lower levels of screening, adherence, and treatment. Navigation has been studied in various cancers, but few studies have assessed navigation in lung cancer. Additionally, there is a lack of consistency in metrics to assess the quality of navigation programs. The authors conducted a systematic review of published cancer screening studies to identify quality metrics used in navigation programs, as well as to recommend standardized metrics to define excellence in lung cancer navigation. The authors included 26 studies evaluating navigation metrics in breast, cervical, colorectal, prostate, and lung cancer. After reviewing the literature, the authors propose the following navigation metrics for lung cancer screening programs: (1) screening rate, (2) compliance with follow-up, (3) time to treatment initiation, (4) patient satisfaction, (5) quality of life, (6) biopsy complications, and (7) cultural competency. [ABSTRACT FROM AUTHOR]

In this position paper, the American College of Physicians (ACP) examines the challenges women face in the U.S. health care system across their lifespans, including access to care; sex- and gender-specific health issues; variation in health outcomes compared with men; underrepresentation in research studies; and public policies that affect women, their families, and society. ACP puts forward several recommendations focused on policies that will improve the health outcomes of women and ensure a health care system that supports the needs of women and their families over the course of their lifespans. [ABSTRACT FROM AUTHOR]

The purpose of the fourth year of medical school remains controversial. Competing demands during this transitional phase cause confusion for students and educators. In 2014, the Association of American Medical Colleges (AAMC) released 13 Core Entrustable Professional Activities for Entering Residency (CEPAERs). A committee comprising members of the Clerkship Directors in Internal Medicine and the Association of Program Directors in Internal Medicine applied these principles to preparing students for internal medicine residencies. The authors propose a curricular framework based on five CEPAERs that were felt to be most relevant to residency preparation, informed by prior stakeholder surveys. The critical areas outlined include entering orders, forming and answering clinical questions, conducting patient care handovers, collaborating interprofessionally, and recognizing patients requiring urgent care and initiating that care. For each CEPAER, the authors offer suggestions about instruction and assessment of competency. The fourth year of medical school can be rewarding for students, while adequately preparing them to begin residency, by addressing important elements defined in the core entrustable activities. Thus prepared, new residents can function safely and competently in supervised postgraduate settings. [ABSTRACT FROM AUTHOR]

Substance use disorders involving illicit and prescription drugs are a serious public health issue. In the United States, millions of individuals need treatment for substance use disorders but few receive it. The rising number of drug overdose deaths and the changing legal status of marijuana pose new challenges. In this position paper, the American College of Physicians maintains that substance use disorder is a treatable chronic medical condition and offers recommendations on expanding treatment options, the legal status of marijuana, addressing the opioid epidemic, insurance coverage of substance use disorders treatment, education and workforce, and public health interventions. [ABSTRACT FROM AUTHOR]

The authors discuss developments of the Accreditation Council for Graduate Medical Education's (ACGME) Milestones Project and the Next Accreditation System (NAS) in the U.S. They chronicle how the two projects were developed and their significance in providing framework to structure faculty development and feedback to trainees. However, the authors also suggest the need for education community to study the effects of the projects and align them with other phases to make them more efficient.

Several charts are presented that provide a framework for the assessment of the development of the resident physician in key dimensions of competency in internal medicine including patient management, skill in performing procedures and appropriate clinical knowledge.

Context Monitoring the teaching effectiveness of attending physicians is important to enhancing the quality of graduate medical education. Methods We used a critical incident technique with 35 residents representing a cross-section of programmes in a teaching hospital to develop a 23-item rating form. We obtained ratings of 11 attending physicians in internal medicine and general surgery from 54 residents. We performed linear and logistic regression analysis to relate the items on the form to the residents' overall ratings of the attending physicians and the programme directors' ratings of the attending physicians. Results The residents rated the attending physicians highly in most areas, but lower in provision of feedback, clarity of written communication and cost-effectiveness in making clinical decisions. When we used the residents' overall ratings as the criterion, the most important aspects of attending physicians' teaching were clarity of written communication, cost-effectiveness, commitment of time and energy and whether the resident would refer a family member or friend to the physician. When we used the programme directors' ratings as the criterion, the additional important aspects of performance were concern for the residents' professional well-being, knowledge of the literature and the delivery of clear verbal and written communication. Conclusions The critical incident technique can be used to develop an instrument that demonstrates content and construct validity. We found that residents consider commitment of time to teaching and clinical effectiveness to be the most important dimensions of faculty teaching. Other important dimensions include written and verbal communication, cost-effectiveness and concern for residents' professional development. [ABSTRACT FROM AUTHOR]

Compares nurses and physicians on an operational measure of empathy. Theme of empathy in health provider-patient relations; Benefits of patients from empathic care.

Women comprise more than one third of the active physician workforce, an estimated 46% of all physicians-in-training, and more than half of all medical students in the United States. Although progress has been made toward gender diversity in the physician workforce, disparities in compensation exist and inequities have contributed to a disproportionately low number of female physicians achieving academic advancement and serving in leadership positions. Women in medicine face other challenges, including a lack of mentors, discrimination, gender bias, cultural environment of the workplace, imposter syndrome, and the need for better work-life integration. In this position paper, the American College of Physicians summarizes the unique challenges female physicians face over the course of their careers and provides recommendations to improve gender equity and ensure that the full potential of female physicians is realized. [ABSTRACT FROM AUTHOR]

The article cites a study which investigates ways in which residents or junior doctors could evaluate their supervisors or attending physicians, conducted by the researchers from Jefferson Medical College, Philadelphia, Pennsylvania. The study shows that doctors who devote time and energy to teaching but who are also good at their job are rated highest by their juniors. Useful information on the qualities residents admire in their supervisors are also elicited in the study.