An Assessment of Gender Differences in Plastic Surgery Patient Education and Information in the United States: Are We Neglecting Our Male Patients?

Purpose: The purpose of this survey was to identify factors that may be influencing the appreciation of exercise physiology as a discipline as demonstrated by hiring practices in regional clinical settings. Methods: A telephone survey was administered to 33 cardiac rehabilitation programs in 5 states in the Mid-Atlantic region of the United States (Kentucky, North Carolina, Tennessee, Virginia, and West Virginia). Results: The distribution of nurses and exercise physiologists (EPs) employed by the 33 facilities varied by state, but overall there were 86 nurses and 55 EPs working among the surveyed facilities. Of the 33 surveyed facilities, 12 (36%) reported a preference for hiring nurses over EPs; only 4 (12%) reported a preference for hiring EPs over nurses. The remaining facilities (n = 17; 52%) reported no preference (n = 12; 36%) or that the decision depends on a variety of factors (n = 5; 15%). Several common themes were identified from respondents. These included that, compared to nurses, EPs have greater expertise in exercise prescription and better understanding of safe exercise progression for patients. However, nurses were believed to possess greater assessment and clinical skill with an emphasis on emergency response preparedness and greater general patient education skills. Conclusion: Academic programs that prepare students for careers as EPs employed in clinical settings may benefit from additional coursework and internship site selection that focus on clinical assessment skills, emergency preparedness, and patient education to reinforce their work in an exercise science curriculum.

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Lawsuits against plastic surgeons: Does locale affect incidence of claims?

Canadian Journal of Plastic Surgery ◽

10.1177/229255030701500309 ◽

2007 ◽

Vol 15 (3) ◽

pp. 155-157 ◽

Cited By ~ 3

Author(s):

Jonathan L Kaplan ◽

Warren C Hammert ◽

James E Zin

Keyword(s):

United States ◽

Emergency Room ◽

Plastic Surgery ◽

Medical Malpractice ◽

The United States ◽

Absolute Number ◽

Malpractice Claims ◽

High Incidence ◽

Medical Malpractice Claims ◽

Geographical Locations

Background Physicians continue to practice in a very litigious environment. Some physicians try to mitigate their exposure to lawsuits by avoiding geographical locations known for their high incidence of medical malpractice claims. Not only are certain areas of the United States known to have a higher incidence of litigation, but it is also assumed that certain areas of the hospital incur a greater liability. There seems to be a medicolegal dogma suggesting a higher percentage of malpractice claims coming from patients seen in the emergency room (ER), as well as higher settlements for ER claims. Objective To determine if there is any validity to the dogma that a higher percentage of malpractice claims arise from the ER. Methods An analysis of common plastic surgery consults that result in malpractice claims was performed. The location where the basis for the lawsuit arose – the ER, office (clinic) or the operating room (OR) – was evaluated. The value of the indemnity paid and whether its value increased or decreased based on the location of the misadventure was evaluated. Results According to the data, which represented 60% of American physicians, there was a larger absolute number of malpractice claims arising from the OR, not the ER. However, the highest average indemnity was paid for cases involving amputations when the misadventure originated in the ER. Conclusions The dogma that a greater percentage of lawsuits come from incidents arising in the ER is not supported. However, depending on the patient's injury and diagnosis, a lawsuit from the ER can be more costly than one from the OR.

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Racial and Sex Disparities in Trauma Outcomes Based on Geographical Region

The American Surgeon ◽

10.1177/0003134820960063 ◽

2020 ◽

pp. 000313482096006

Author(s):

William Q. Duong ◽

Areg Grigorian ◽

Cyrus Farzaneh ◽

Jeffry Nahmias ◽

Theresa Chin ◽

...

Keyword(s):

United States ◽

The United States ◽

Trauma Patients ◽

Improvement Program ◽

Trauma Outcomes ◽

Risk Of Death ◽

Hospital Access ◽

Risk Of Mortality ◽

Sex Disparities ◽

Male Patients

Objectives Disparities in outcomes among trauma patients have been shown to be associated with race and sex. The purpose of this study was to analyze racial and sex mortality disparities in different regions of the United States, hypothesizing that the risk of mortality among black and Asian trauma patients, compared to white trauma patients, will be similar within all regions in the United States. Methods The Trauma Quality Improvement Program (2010-2016) was queried for adult trauma patients, separating by U.S. Census regions. Multivariable logistic regression analyses were performed for each region, controlling for known predictors of morbidity and mortality in trauma. Results Most trauma patients were treated in the South (n = 522 388, 40.7%). After risk adjustment, black trauma patients had a higher associated risk of death in all regions, except the Northeast, compared to white trauma patients. The highest associated risk of death for blacks (vs. whites) was in the Midwest (odds ratio [OR] 1.30, P < .001). Asian trauma patients only had a higher associated risk of death in the West (OR 1.39, P < .001). Male trauma patients, compared to women, had an increased associated risk of mortality in all four regions. Discussion This study found major differences in outcomes among different races within different regions of the United States. There was also both an increased rate and associated risk of mortality for male patients in all regions. Future prospective studies are needed to identify what regional differences in trauma systems including population density, transport times, hospital access, and other trauma resources explain these findings.

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