Male Spouses of Women Physicians: Communication, Compromise, and Carving Out Time

As the numbers of female physicians continue to grow, fewer medical marriages are comprised of the traditional dyad of male physician and stay - at - home wife. The “two - career family” is an increasingly frequent state for both male and female physicians’ families, and dual - doctor marriages are on the rise. This qualitative study explored the contemporary medical marriage from the perspective of male spouses of female physicians. In 2010, we conducted semi - structured, in - depth interviews with nine spouses of internal medicine resident and faculty physicians. Interviewers queried work - home balance, career choices, and support networks. We used an interpretive, inductive, iterative approach to thematically analyze interview transcripts and develop broad, consensus - derived themes. A conceptual framework based on three major themes emerged: “A time for us? Really?”, “Supporting and protecting her, sometimes at my expense,’” and “Hers is a career, mine is a job.” This framework described the inflexibility of physicians’ time and its impact on spousal time, career development, and choices. Having a set time for synchronizing schedules, frequent verbal support, and shared decision - making were seen a s important by the husbands of female, full - time physicians. This exploratory study examined the contemporary medical marriage from the male spouse’s perspective and highlights specific strategies for success. Keywords: Academic Medicine, Gender, Career, Qualitative Research, Work - Life Balance, Medical Marriag

Difficult Dialogues: Faculty Responses to a Gender Bias Literacy Training Program

Diversity training is challenging and can evoke strong emotional responses from participants including resistance, shame, confusion, powerlessness, defensiveness, and anger. These responses create complex situations for both presenters and other learners. We observed 3 experienced presenters as they implemented 41 gender bias literacy workshops for 376 faculty from 42 STEMM (science, technology, engineering, mathematics, medicine) departments at one Midwestern university. We recorded questions and answers as well as participants’ non-verbal activity during each 2.5-hour workshop. Employing content analysis and critical incident technique, we identified content that elicited heightened activity and challenging dialogues among presenters and faculty. Results from analysis of this observational data found three important findings: (1) presenters continually reinforced the idea that implicit bias is ordinary and pervasive, thus avoiding participant alienation by allowing participants to protect their self-worth and integrity; (2) difficult dialogues were managed calmly without verbal sparring or relinquishing control; (3) the presenters created an environment where individuals were more likely to accept threatening information

Brief intervention in primary care settings. A primary treatment method for at-risk, problem, and dependent drinkers. Alcohol Res Health

Primary health care providers identify and treat many patients who are at risk for or are already experiencing alcohol-related problems. Brief interventions—counseling delivered by primary care providers in the context of several standard office visits—can be a successful treatment approach for many of these patients. Numerous trials involving a variety of patient populations have indicated that brief interventions can reduce patients ’ drinking levels, regardless of the patients ’ ages and gender. In clinical practice, brief interventions can help reduce the drinking levels of nondependent drinkers who drink more than the recommended limits, facilitate therapy and abstinence in patients receiving pharmacotherapy, and enhance the effectiveness of assessment and treatment referral in patients who do not respond to brief interventions alone. Despite the evidence for their usefulness, however, brief interventions for alcohol-related problems have not yet been widely implemented in primary care settings. KEY WORDS: primary health care; intervention; risk factors; problematic AOD (alcohol and other drug) use; AOD dependence; amount of AOD use; treatment outcome; AOD abstinence; drug therapy; psychological counseling; treatment barriers; physician; AOD education; health care delivery; health care cost; social cost of AODU (alcohol and other drug use); literature review Most Americans consume alcohol at least occasionally, and results from the Nationa

Predictors and Outcomes of Burnout in Primary Care Physicians

Objective: To assess relationships between primary care work conditions, physician burnout, quality of care, and medical errors. Methods: Cross-sectional and longitudinal analyses of data from the MEMO (Minimizing Error, Maximizing Outcome) Study. Two surveys of 422 family physicians and general internists, administered 1 year apart, queried physician job satisfaction, stress and burnout, organizational culture, and intent to leave within 2 years. A chart audit of 1795 of their adult patients with diabetes and/or hypertension assessed care quality and medical errors. Key Results: Women physicians were almost twice as likely as men to report burnout (36% vs 19%, P < .001). Burned out clinicians reported less satisfaction ( P < .001), more job stress ( P < .001), more time pressure during visits ( P < .01), more chaotic work conditions ( P < .001), and less work control ( P < .001). Their workplaces were less likely to emphasize work-life balance ( P < .001) and they noted more intent to leave the practice (56% vs 21%, P < .001). There were no consistent relationships between burnout, care quality, and medical errors. Conclusions: Burnout is highly associated with adverse work conditions and a greater intention to leave the practice, but not with adverse patient outcomes. Care quality thus appears to be preserved at great personal cost to primary care physicians. Efforts focused on workplace redesign and physician self-care are warranted to sustain the primary care workforce

Urban outpatient views on quality and safety in primary care.

OBJECTIVE: The Minimizing Errors Maximizing Outcomes Study is designed to examine the effect of workplace conditions on quality of care and medical errors. In the first phase of the study, patients were asked to tell their stories via focus groups. DESIGN: Moderators used a standard question guide. Researchers read the transcripts independently and reached consensus on major themes. Two coders independently assigned transcript statement to themes. SETTING: Three focus groups were conducted in three cities, including 21 patients from three clinics. PATIENTS: Patients with previously scheduled appointments at participating clinics were invited to join the focus groups. MEASUREMENTS AND MAIN RESULTS: Agreement between the two coders was 77.5% (kappa value 0.66). All but 2% of 187 distinct comments could be grouped into four categories: (1) Systems Issues (44% of comments). Long waits for providers and lack of access were the most common frustrations. Understaffing, underfunding and lack of health insurance were perceived as contributing to poor quality of care; (2) Interpersonal Skills (37%). Physician listening skills were valued. Participants felt patient attitudes affected care. (3) Knowledge and Technical Skills (9%). (4) Errors (7%). Medication errors, errors of inattention and technical errors were discussed. CONCLUSIONS: Patients provide important insights into complex systems issues, which can guide planners in improving quality and reducing errors. According to focus group participants, healthcare could be improved and made safer by increasing timely access to patients\u27 own physicians, decreasing the time patients spend in waiting rooms, and adding staff to double-check prescriptions