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Finding the Perfect Doctor: Identifying Lesbian, Gay, Bisexual, and Transgender–Competent Physicians
Objectives. We assessed the existence of procedures and policies for identifying lesbian, gay, bisexual, and transgender (LGBT)–competent physicians at US academic faculty practices, and sought to identify physician training programs that enhance LGBT competency. Methods. We invited all 138 Liaison Committee on Medical Education–accredited US academic faculty practices to participate in a survey in 2012. We systematically assessed their procedures and policies to identify LGBT-competent physicians and their LGBT-competency training. We also assessed geographic region, funding source, and an LGBT health center in the same state. We performed univariate, bivariate, and multivariate logistic regression analyses. Results. The response rate was 50%. Few participants had existing procedures (9%) or policies (4%) to identify LGBT-competent physicians. Procedures included online directories with self-identified LGBT-competent physicians available to the public. Sixteen percent of participants reported having comprehensive LGBT-competency training, and 52% reported having no training. Of note, 80% of participants indicated interest to do more to address these issues. Conclusions. There exist both need and interest for US academic faculty practices to develop procedures, policies, and programs that improve access to LGBT-competent physicians and to train physicians to become LGBT-competent.
Journal Article
Physician activism in American politics: The opposition to the Price nomination
Although a substantial literature considers physician advocacy fundamental to medical professionalism, only a minority of physicians actually pursue it. We analyze the characteristics of 6,402 physicians who engaged in political advocacy by signing the Clinician Action Network's 2016 petition objecting to the American Medical Association's endorsement of the nomination of Tom Price as Secretary of Health and Human Services. These physicians were matched to the NPI (all physicians) and PECOS (largely Medicare payment recipients) directories. Physicians in the directories were matched to publicly disclosed campaign contributions. Contributions are used to measure political preferences expressed on a liberal-conservative scale. We document a pronounced generational realignment in the politics of the medical profession, with recent graduates trending sharply Democratic. Petition signing vs. non-signing is responsive to gender, specialty, geographic location, personal liberal-conservative preferences and year of graduation from medical school. Petition signers were more likely to be women (62% of signers versus 34% of non-signers), recent medical school graduates (58% of signers versus 42% of non-signers), and in lower-paying specialties (27% of signers versus 12% of non-signers). The changing face of physician advocacy has important implications for understanding how the medical profession is likely to influence health care policy in coming decades.
Journal Article
How Long Do Adolescents Wait for Psychiatry Appointments?
Appointment wait times are a neglected dimension of children’s access to psychiatry. We systematically examined how long an adolescent waits for a new patient appointment with a psychiatrist for routine medication management. From state directories, we identified 578 providers of adolescent psychiatric care in Ohio. Researchers posing as parents telephoned randomly selected offices, seeking care for a hypothetical 14-year-old patient under different scenarios. Overall, we measured 498 wait times at 140 unique offices. The median wait time was 50 days (interquartile range = 29–81 days). In adjusted models, adolescents with Medicaid waited longer than those with private insurance, especially during the spring (geometric mean = 50.9 vs. 41.9 days;
p
= 0.02). Wait times also varied markedly by region, with geometric means ranging from 22.4 to 75.1 days (
p
< 0.01). This study demonstrates that adolescents often experience lengthy wait times for routine care. This methodology represents a useful approach to real-time monitoring of psychiatric services.
Journal Article
Articulation of Undergraduate and Graduate Education in Public Health
The rapid growth of individual undergraduate courses, minors, and baccalaureate degrees in public health presents a new issue for graduate public health education: how does a graduate or professional program address previously completed undergraduate public health coursework? A review of college directories found listings for 154 North American baccalaureate degrees in public health, public health education, and public health nursing. This article addresses the purposes of public health undergraduate education as (1) general liberal arts education, (2) education complementary to other non-public health graduate degrees, (3) preprofessional education, and (4) professional education preparing undergraduates for entry-level careers. Following a discussion of reasons to consider articulation of undergraduate and graduate degrees, as well as barriers to articulation, the article presents potential strategies for articulation and future issues to consider in addressing admission of undergraduate public health students to master of public health programs.
Journal Article
A 10-Year Follow-Up Survey of Programs and Services for Students with Learning Disabilities in Graduate and Professional Schools
This 10-year follow-up study compares programs and services for students with learning disabilities (LD) in graduate and professional schools between 1985 and 1995. In 1995, surveys were sent to the same institutions (n = 682) as in the earlier survey, with a response rate of 30.6%. Significant changes over the 10 years include a higher level of awareness about LD and evidence of greater compliance with Section 504, a greater specificity of assessments required for the identification of students who receive services, improvements in the types and extent of services available, and increased program visibility. Despite these positive changes, 24% of the respondents indicated that they did not have a coordinator for LD at their institution, and 33% did not have a written plan for services. Eighteen institutions with programs or services for students with LD gave permission to publish their names. Implications and recommendations are discussed.
Journal Article
Shortage of Black doctors is rooted in racist history − a $600M gift will help historically Black medical schools address the gap
Fueled by the Supreme Court’s June 2023 ruling that bans affirmative action in higher education, conservative lawmakers across the country have advanced their own state bans on diversity initiatives, especially those that might make students feel shame or guilt for past harms against people of color. Black Americans were more vulnerable during the pandemic “because of several manifestations of structural racism, including lack of access to testing, a higher chronic disease burden and racial bias within health care institutions.” Benjamin Chrisinger received funding from the John Fell Fund of Oxford University Press and Department of Social Policy and Intervention at the University of Oxford.
Newspaper Article