Southern Medical Journal最新文献

{"title":"Patients Use Different Words to Describe Satisfaction with Female versus Male Primary Care Physician Visits.","authors":"Sarah Jones, Carly Sokach, R Warren Sands, Scott Rothenberger, Carla Spagnoletti","doi":"10.14423/SMJ.0000000000001825","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001825","url":null,"abstract":"<p><strong>Objectives: </strong>Female physicians' reputations are more vulnerable, salaries are lower, and rates of burnout are higher compared with their male counterparts. Patient satisfaction metrics can affect reputation, reimbursement, incentives, and burnout. We hypothesized that patients may have gender-based expectations of primary care physicians (PCPs) that could differentially affect patient satisfaction for female PCPs. Because patient satisfaction surveys generate physician-specific data, we analyzed free-text patient satisfaction survey comments about outpatient visits with female and male PCPs.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional analysis of publicly available Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & Group survey responses from 2015 to 2019 attributed to 456 PCPs affiliated with one large healthcare system. Natural language processing identified frequencies of word use after stratification by \"rate provider\" scores and physician sex. We calculated overall and relative rates of word use between groups using Wald tests.</p><p><strong>Results: </strong>Free-text responses were contained in 112,076 surveys. The mean \"rate provider\" score was high (9.6/10) and did not differ by physician sex. Among the 92.8% highly rated visits, words used more often for female PCPs included <i>time</i>, <i>caring</i>, <i>feel</i>, <i>concerns</i>, and <i>like</i> and for male PCPs, the words included <i>care</i>, <i>good</i>, <i>excellent</i>, <i>staff</i>, and <i>office</i>.</p><p><strong>Conclusions: </strong>When comparing high-rated PCP visits, patients used different words to describe satisfaction with their female versus male PCP visits, which may suggest that patients hold stereotyped gender expectations for PCPs. We propose that female PCP responses to stereotyped expectations-to achieve \"top box\" patient satisfaction scores, which affect compensation, reputation, and job satisfaction-may provide a perspective on sex-based differences in physician pay and burnout.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 5","pages":"281-286"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restless Leg Syndrome and Pregnancy.","authors":"Amy M Phillips, Lindsey B Sward, Nirvana Manning, Hannah N Hass, Adam T Sandlin, Everett F Magann","doi":"10.14423/SMJ.0000000000001823","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001823","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this assessment of the literature was to evaluate the etiology, incidence, risk factors, diagnosis, management, and recurrent risk in a subsequent pregnancy of restless leg syndrome (RLS) in pregnancy.</p><p><strong>Methods: </strong>Electronic databases (PubMed, Embase, and Web of Science) were searched from January 1980-February 2024. The only limitation was that the articles had to be in English. Studies were selected that examined associations among the etiology, prevalence, risk factors, diagnosis and management of RLS during pregnancy.</p><p><strong>Results: </strong>A total of 498 articles were identified, 47 of which are the basis of this review. RLS is a common occurrence during pregnancy, occurring in up to one-fourth of all pregnancies. The pathophysiology likely involves brain iron deficiency, hormonal changes of pregnancy, mechanical strain from the growing pregnancy, and stress/insomnia. The prevalence of RLS increases in the later trimesters, with increasing parity, and may have regional variations. Risk factors include a history of RLS and underlying hypertension. Criteria for diagnosis have been established by the RLS Study Group. Management involves lifestyle modifications, behavioral strategies, iron and pharmacologic therapy.</p><p><strong>Conclusions: </strong>RLS is commonly seen in pregnancy, and the prevalence increases with increasing gestational age. Iron deficiency seems to be a common contributor to RLS. Management involves behavioral/lifestyle modifications, iron therapy, and may involve pharmacological therapy.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 5","pages":"269-274"},"PeriodicalIF":1.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Wearable Technology to Evaluate Sleep and Stress for Physicians.","authors":"Maxwell Harrell, Dev Dayal, Clay Rahaman, Joe Dekle, Robert Lister, Adam Skelton, Eugene Brabston, Thomas Evely, Aaron Casp, Amit M Momaya","doi":"10.14423/SMJ.0000000000001816","DOIUrl":"10.14423/SMJ.0000000000001816","url":null,"abstract":"<p><strong>Objectives: </strong>Physician stress and burnout are increasingly prevalent issues that often are exacerbated by chronic sleep deprivation. Poor sleep not only compromises the well-being of physicians but also can negatively affect patient care and safety. As wearable technology has become more advanced, the potential is growing to use these devices to monitor and analyze physiological metrics such as sleep and stress levels in real time. This systemic review aims to investigate the use of wearable technology to track sleep quality, stress, and burnout among physicians at various levels of training.</p><p><strong>Methods: </strong>A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using Medline, Cochrane, and Embase to identify studies that used wearable technology to monitor sleep and stress outcomes in physicians. Inclusion criteria focused on studies that specifically measured sleep quality, stress, and burnout using wearable technology. Thirteen studies were included in this review. Data extracted from the included studies detailed study design, participant characteristics, type of wearable technology used, and measured sleep outcomes and heart rate variability (HRV) data.</p><p><strong>Results: </strong>The data of 540 physicians were included in this study, with Emergency Medicine and Trauma Surgery representing the largest proportion of specialties assessed. Physicians not on call slept an average of 398.3 ± 49.0 minutes per night, whereas those on call slept an average of 226.0 ± 71.3 minutes per night. Physicians also spent 82.5 ± 13.4 minutes in rapid eye movement sleep per night and 41.3 ± 21.8 minutes awake in bed before falling asleep. HRV measures showed an average standard deviation of the R-R intervals across studies of 62.7 ± 28.8 milliseconds.</p><p><strong>Conclusions: </strong>Wearable technology data indicate that physicians sleep less than the recommended amount per night and have reduced sleep quality measures. HRV data indicate increased levels of stress and burnout. The data provided by wearable technology may improve physician well-being and ultimately patient care.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 4","pages":"213-220"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injuries Related to Nonpowder Firearms: A National Database Study.","authors":"Sean Muir, Tyler Rizzieri, Andrew Brown, Laken Fulmer, Alyssa McMandon, Kristine Graham, Holden Lewis","doi":"10.14423/SMJ.0000000000001808","DOIUrl":"10.14423/SMJ.0000000000001808","url":null,"abstract":"<p><strong>Objectives: </strong>Nonpowder firearms (NPFs) have become increasingly popular. We sought to analyze the epidemiology of NPF injuries.</p><p><strong>Methods: </strong>A search was conducted through the National Electronic Injury Surveillance System for data from 2012 to 2021 to analyze NPF-related injuries.</p><p><strong>Results: </strong>Between 2012 and 2022, the National Electronic Injury Surveillance System database recorded 3859 emergency visits related to NPFs, with the majority being males (82%) and the median age of injury being 15 years. The most common source of injuries was from gas, air, or spring-powered guns. Facial injuries were the most prevalent type of injury, accounting for 20% of the injuries.</p><p><strong>Conclusions: </strong>Despite operating at lower pressures than traditional firearms, NPFs still pose significant health risks, with technological advances increasing the potential for serious injuries, such as blindness or neurological deficits. Special attention should be given to preventing facial injuries, particularly among teenagers, by enforcing safety measures and using protective equipment.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 4","pages":"221-224"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Race, Rurality, and Age in Human Papillomavirus Vaccine Initiation among US Women.","authors":"Casey Macander, Hui Wang, Marcelo Galafassi, Graham M Jones, Antara Das, Alta Willaert, Randi Henderson-Mitchell, John C Higginbotham","doi":"10.14423/SMJ.0000000000001813","DOIUrl":"10.14423/SMJ.0000000000001813","url":null,"abstract":"<p><strong>Objectives: </strong>Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States, with a lifetime prevalence of more than 80%. HPV is associated with cervical cancer, which affects thousands of US women each year. A vaccine was introduced in 2006 to mitigate the prevalence and mortality of HPV-associated cancers. Although HPV vaccine adherence has increased over time, disparities in vaccine uptake exist among adolescents, and likely within adult communities. This study explored the impact of race/ethnicity, rural classification, and age on vaccine initiation among adult women in the United States.</p><p><strong>Methods: </strong>The final sample included N = 4666 females aged 18 to 43 years from the 2022 National Health Interview Survey. A logistic regression model explored the association of race/ethnicity, rural classification, and age with HPV vaccine initiation.</p><p><strong>Results: </strong>Only 40.1% of our sample ever received an HPV vaccine. Urban residents were significantly more likely than rural residents to have ever gotten an HPV vaccine. Hispanic, Black, and Asian participants had significantly lower HPV vaccine initiation rates compared with their White counterparts. Finally, as age increased, HPV vaccine initiation decreased.</p><p><strong>Conclusions: </strong>Efforts to increase HPV vaccine uptake for future generations of women and girls in the United States should focus on rural communities, as well as Black, Hispanic, and Asian racial minorities. Because so many women within our sample had not received any HPV vaccine, we must emphasize the importance of HPV testing and cervical cancer screening, especially among aging women.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 4","pages":"206-210"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Racial and Ethnic Disparities in Pediatric Atopic Dermatitis: Erratum.","authors":"Urdur Jonsdottir, Emily C Craver, Tanvi R Patel","doi":"10.14423/SMJ.0000000000001814","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001814","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.14423/SMJ.0000000000001743.].</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 4","pages":"246"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine: Raising the Bar or Crouching Beneath It?","authors":"Larry M Bush, Edlira Maska","doi":"10.14423/SMJ.0000000000001807","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001807","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 4","pages":"211-212"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inattentional Blindness as an Underappreciated Emphasis in Patient Safety Education: Need for Greater Recognition in Medical and Surgical Training.","authors":"Michael J Asken, Anas Atrash, Evelyn J Calderon Martinez","doi":"10.14423/SMJ.0000000000001806","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001806","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 4","pages":"229-230"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leadership in Equity, Diversity, and Inclusion: What Skills and Attributes Are Documented in the Literature?","authors":"Traci C Terrance, Hernan Barenboim, Adora Otiji, Julie Navarro, Donna Baluchi, Stacy A Ogbeide, A Enrique Varela, Kendall M Campbell, Julie E Lucero, José E Rodríguez","doi":"10.14423/SMJ.0000000000001815","DOIUrl":"10.14423/SMJ.0000000000001815","url":null,"abstract":"<p><strong>Objectives: </strong>Equity, diversity, and inclusion (EDI) leadership has recently been scrutinized, and many institutions have had to repurpose EDI leaders due to recent legislation. The skills or attributes of EDI leaders are not well understood. The authors sought to identify skills or attributes associated with EDI leaders.</p><p><strong>Methods: </strong>The authors searched the PubMed database using the search terms \"Diversity,\" \"Equity,\" \"Inclusion,\" \"Leadership,\" \"Chief diversity officer,\" \"Diversity leadership skills,\" and \"Diversity officer.\" The authors then reviewed titles, abstracts, and papers to identify the skills or attributes of EDI leaders.</p><p><strong>Results: </strong>The search yielded 580 items. The authors analyzed the 10 remaining papers after the abstract, title, and paper review. All of the authors reviewed the articles and constructed the following list of skills: motivating others, fostering potential, inspiring trust, thinking strategically, setting goals and expectations, giving feedback, and being authentic.</p><p><strong>Discussion: </strong>EDI leaders are well equipped for leadership in other spaces because the skills and attributes identified in this review are transferrable to assistant and associate dean positions, chair positions, and other leadership positions in academic medicine. Individual EDI leaders can use these documented skills and attributes to reposition their leadership in this ever-changing political environment. Institutional leaders also can use this information to retain talented EDI leaders in influential leadership positions.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 4","pages":"231-234"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation-Based Knee Joint Arthrocentesis Workshop for Internal Medicine Residents.","authors":"Ujjwal Madan, Suman Manek, Muhammad Shah Miran, Kavita Jadhav, Sarah Ifteqar","doi":"10.14423/SMJ.0000000000001809","DOIUrl":"10.14423/SMJ.0000000000001809","url":null,"abstract":"<p><strong>Objectives: </strong>Knee arthrocentesis is a safe and valuable diagnostic and therapeutic primary care procedure. Enhancing Internal Medicine (IM) residents' competency in this skill is crucial for effective patient care. We implemented a simulation-based knee arthrocentesis workshop (SBKAW) to improve residents' comfort in offering knee joint arthrocentesis in primary care settings.</p><p><strong>Methods: </strong>IM residents from five clinic cohorts participated in an SBKAW that included a presentation of instructional material and hands-on training on simulation knee models, led by a rheumatologist and clinic faculty. Pre- and postintervention online surveys were administered to assess participants' comfort levels in performing knee joint arthrocentesis, before and after the workshop.</p><p><strong>Results: </strong>Sixty-four IM residents participated in the SBKAW, 62 (96.9%) of whom had no prior training on knee joint arthrocentesis. The self-reported comfort level in performing knee arthrocentesis pre- and post-SBKAW was 4.7% (very comfortable 3.1%, comfortable 1.6%) and 84.2% (very comfortable 22.8%, comfortable 61.4%), respectively. Before the SBKAW, 50 (78.1%) and 36 (56.3%) residents reported familiarity with indications and contraindications, respectively, and this improved to 56 (98.2%) residents post-SBKAW. Fifty-four (94.7%) residents reported arthrocentesis as a \"very important\" or \"important\" skill for an internist. Forty-eight (84.2%) residents expressed interest in future SB training.</p><p><strong>Conclusions: </strong>Our simulation training highlights the importance of incorporating SBKA into IM residency training curricula, which can enhance patient outcomes and satisfaction, and IM resident training by improving their self-confidence and skills for performing knee arthrocentesis.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"118 4","pages":"235-239"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}