Exploration of Leisure Time Valuation to Explain Sex-Based Wage Gaps among Salaried Primary Care Physicians in the US

In the US, female physicians have lower hourly incomes than their male counterparts, across specialties and after adjusting for physician and practice characteristics; however, female physicians work fewer hours than their male counterparts. We wanted to determine whether a simple method of valuing leisure time - overtime pay - might help explain sex-based wage gaps among US primary care physicians. Therefore, we used Community Tracking Study Physician Survey data from 1996-2005 to model the impact of overtime pay on sex-based wage gaps. As overtime premiums increased in our models, sex-based wage disparities decreased: they become statistically insignificant when overtime wages reached 0%, 32%, and 61% premiums using the ordinary least squared model and with 0%, 62%, and 55% premiums using the propensity score weighted model, for internal medicine, family practice, and pediatric physicians, respectively. We conclude that modest overtime premiums reduced sex-based hourly wage gaps for the salaried primary care physicians we examined. Future analyses of sex-based wage gaps should account for leisure time and its trade for work hours when it becomes scarce

The United States Chiropractic Workforce: An alternative or complement to primary care?

UnlabelledBackgroundIn the United States (US) a shortage of primary care physicians has become evident. Other health care providers such as chiropractors might help address some of the nation's primary care needs simply by being located in areas of lesser primary care resources. Therefore, the purpose of this study was to examine the distribution of the chiropractic workforce across the country and compare it to that of primary care physicians.MethodsWe used nationally representative data to estimate the per 100,000 capita supply of chiropractors and primary care physicians according to the 306 predefined Hospital Referral Regions. Multiple variable Poisson regression was used to examine the influence of population characteristics on the supply of both practitioner-types.ResultsAccording to these data, there are 74,623 US chiropractors and the per capita supply of chiropractors varies more than 10-fold across the nation. Chiropractors practice in areas with greater supply of primary care physicians (Pearson's correlation 0.17, p-value < 0.001) and appear to be more responsive to market conditions (i.e. more heavily influenced by population characteristics) in regards to practice location than primary care physicians.ConclusionThese findings suggest that chiropractors practice in areas of greater primary care physician supply. Therefore chiropractors may be functioning in more complementary roles to primary care as opposed to an alternative point of access

Statutory Reform to Protect Migrations as Phenomena of Abundance

Animal migrations capture the human mind and heart like few other natural phenomena. Migrations provide ecological, psychological (e.g., aesthetic), cultural, and economic benefits. Increasingly, though, migrations are being recognized as threatened phenomena-that is, spectacular aspects of the life history of animal species often involving large numbers of individuals, but which are threatened with impoverishment or demise, even though the species per se may not be in peril. Migration phenomena are themselves worthy of protection, as a category of biodiversity Yet, conserving migratory populations and their migrations is particularly problematic. Migratory animals are especially vulnerable to a variety of threats because they come into contact with multiple ecosystems and jurisdictions, tend to congregate in large numbers in discrete and often vulnerable areas, and require considerable fuel for their long-distance journeys. In addition, migration is essentially a phenomenon of abundance-the benefits and values of migrations depend on an abundance of animals taking part and conserving species\u27 populations before they become rare has always been an uphill battle. This Article presents an idea for a new federal law that reflects the perspective that conserving migratory behaviors and processes as phenomena of value in and of themselves, and not only of value for species persistence, can provide unique and important benefits. Current conservation laws generally serve the species-based conservation perspective and, with a few exceptions, are not designed or implemented to protect benefits of abundant animal migrations. The existing fragmented framework of laws and authorities also is insufficient to protect most migratory populations against a diversity of threats across multiple jurisdictions and broad geographic scales. Our proposed federal law would offer a unified framework, require abundance targets, and authorize a comprehensive set of legal tools, including both carrots and sticks, for conserving a limited set of nationally or regionally significant migrations. Such a law would likely improve the current situation for the nation\u27s most notable migratory populations and generally promote the conservation of all migrations as phenomena of abundance

Statutory Reform to Protect Migrations as Phenomena of Abundance

Animal migrations capture the human mind and heart like few other natural phenomena. Migrations provide ecological, psychological (e.g., aesthetic), cultural, and economic benefits. Increasingly, though, migrations are being recognized as threatened phenomena-that is, spectacular aspects of the life history of animal species often involving large numbers of individuals, but which are threatened with impoverishment or demise, even though the species per se may not be in peril. Migration phenomena are themselves worthy of protection, as a category of biodiversity Yet, conserving migratory populations and their migrations is particularly problematic. Migratory animals are especially vulnerable to a variety of threats because they come into contact with multiple ecosystems and jurisdictions, tend to congregate in large numbers in discrete and often vulnerable areas, and require considerable fuel for their long-distance journeys. In addition, migration is essentially a phenomenon of abundance-the benefits and values of migrations depend on an abundance of animals taking part and conserving species\u27 populations before they become rare has always been an uphill battle. This Article presents an idea for a new federal law that reflects the perspective that conserving migratory behaviors and processes as phenomena of value in and of themselves, and not only of value for species persistence, can provide unique and important benefits. Current conservation laws generally serve the species-based conservation perspective and, with a few exceptions, are not designed or implemented to protect benefits of abundant animal migrations. The existing fragmented framework of laws and authorities also is insufficient to protect most migratory populations against a diversity of threats across multiple jurisdictions and broad geographic scales. Our proposed federal law would offer a unified framework, require abundance targets, and authorize a comprehensive set of legal tools, including both carrots and sticks, for conserving a limited set of nationally or regionally significant migrations. Such a law would likely improve the current situation for the nation\u27s most notable migratory populations and generally promote the conservation of all migrations as phenomena of abundance

Characteristics of US Adults Who Have Positive and Negative Perceptions of Doctors of Chiropractic and Chiropractic Care

AbstractObjectiveThe purpose of this study was to compare characteristics, likelihood to use, and actual use of chiropractic care for US survey respondents with positive and negative perceptions of doctors of chiropractic (DCs) and chiropractic care.MethodsFrom a 2015 nationally representative survey of 5422 adults (response rate, 29%), we used respondents' answers to identify those with positive and negative perceptions of DCs or chiropractic care. We used the χ2 test to compare other survey responses for these groups.ResultsPositive perceptions of DCs were more common than those for chiropractic care, whereas negative perceptions of chiropractic care were more common than those for DCs. Respondents with negative perceptions of DCs or chiropractic care were less likely to know whether chiropractic care was covered by their insurance, more likely to want to see a medical doctor first if they were experiencing neck or back pain, less likely to indicate that they would see a DC for neck or back pain, and less likely to have ever seen a DC as a patient, particularly in the recent past. Positive perceptions of chiropractic care and negative perceptions of DCs appear to have greater influence on DC utilization rates than their converses.ConclusionWe found that US adults generally perceive DCs in a positive manner but that a relatively high proportion has negative perceptions of chiropractic care, particularly the costs and number of visits required by such care. Characteristics of respondents with positive and negative perceptions were similar, but those with positive perceptions were more likely to plan to use—and to have already received—chiropractic care

Space Station Freedom automation and robotics: An assessment of the potential for increased productivity

This report presents the results of a study performed in support of the Space Station Freedom Advanced Development Program, under the sponsorship of the Space Station Engineering (Code MT), Office of Space Flight. The study consisted of the collection, compilation, and analysis of lessons learned, crew time requirements, and other factors influencing the application of advanced automation and robotics, with emphasis on potential improvements in productivity. The lessons learned data collected were based primarily on Skylab, Spacelab, and other Space Shuttle experiences, consisting principally of interviews with current and former crew members and other NASA personnel with relevant experience. The objectives of this report are to present a summary of this data and its analysis, and to present conclusions regarding promising areas for the application of advanced automation and robotics technology to the Space Station Freedom and the potential benefits in terms of increased productivity. In this study, primary emphasis was placed on advanced automation technology because of its fairly extensive utilization within private industry including the aerospace sector. In contrast, other than the Remote Manipulator System (RMS), there has been relatively limited experience with advanced robotics technology applicable to the Space Station. This report should be used as a guide and is not intended to be used as a substitute for official Astronaut Office crew positions on specific issues

The United States Chiropractic Workforce: An alternative or complement to primary care?

UnlabelledBackgroundIn the United States (US) a shortage of primary care physicians has become evident. Other health care providers such as chiropractors might help address some of the nation's primary care needs simply by being located in areas of lesser primary care resources. Therefore, the purpose of this study was to examine the distribution of the chiropractic workforce across the country and compare it to that of primary care physicians.MethodsWe used nationally representative data to estimate the per 100,000 capita supply of chiropractors and primary care physicians according to the 306 predefined Hospital Referral Regions. Multiple variable Poisson regression was used to examine the influence of population characteristics on the supply of both practitioner-types.ResultsAccording to these data, there are 74,623 US chiropractors and the per capita supply of chiropractors varies more than 10-fold across the nation. Chiropractors practice in areas with greater supply of primary care physicians (Pearson's correlation 0.17, p-value < 0.001) and appear to be more responsive to market conditions (i.e. more heavily influenced by population characteristics) in regards to practice location than primary care physicians.ConclusionThese findings suggest that chiropractors practice in areas of greater primary care physician supply. Therefore chiropractors may be functioning in more complementary roles to primary care as opposed to an alternative point of access

Inequity in access to personalized medicine in France: Evidences from analysis of geo variations in the access to molecular profiling among advanced non-small-cell lung cancer patients: Results from the IFCT Biomarkers France Study

In this article, we studied geographic variation in the use of personalized genetic testing for advanced non-small cell lung cancer (NSCLC) and we evaluated the relationship between genetic testing rates and local socioeconomic and ecological variables. We used data on all advanced NSCLC patients who had a genetic test between April 2012 and April 2013 in France in the frame of the IFCT Biomarqueurs-France study (n = 15814). We computed four established measures of geographic variation of the sex-adjusted rates of genetic testing utilization at the “départment” (the French territory is divided into 94 administrative units called ‘départements’) level. We also performed a spatial regression model to determine the relationship between département-level sex-adjusted rates of genetic testing utilization and economic and ecological variables. Our results are the following: (i) Overall, 46.87% lung cancer admission patients obtained genetic testing for NSCLC; département-level utilization rates varied over 3.2-fold. Measures of geographic variation indicated a relatively high degree of geographic variation. (ii) there was a statistically significant relationship between genetic testing rates and per capita supply of general practitioners, radiotherapists and surgeons (negative correlation for the latter); lower genetic testing rates were also associated with higher local poverty rates. French policymakers should pursue effort toward deprived areas to obtain equal access to personalized medicine for advanced NSCLC patients