Pain is a leading public health problem in the United States, with an annual economic burden of more than $630 billion, and is one of the most common reasons that individuals seek emergency department (ED) care. There is a paucity of data regarding sex differences in the assessment and treatment of acute and chronic pain conditions in the ED. The Academic Emergency Medicine consensus conference convened in Dallas, Texas in May of 2014 to develop a research agenda to address this issue among others related to sex differences in the ED. Prior to the conference, experts and stakeholders from emergency medicine and the pain research field reviewed the current literature and identified eight candidate priority areas. At the conference, these eight areas were reviewed and all eight were ratified using a nominal group technique to build consensus. These priority areas were: 1) gender differences in the pharmacologic and non-pharmacologic interventions for pain, including differences in opioid tolerance, side effects, or misuse; 2) gender differences in pain severity perceptions, clinically meaningful differences in acute pain, and pain treatment preferences; 3) gender differences in pain outcomes of ED patients across the lifespan; 4) gender differences in the relationship between acute pain and acute psychological responses; 5) the influence of physician-patient gender differences and characteristics on the assessment and treatment of pain; 6) gender differences in the influence of acute stress and chronic stress on acute pain responses; 7) gender differences in biologic mechanisms and molecular pathways mediating acute pain in ED populations; and 8) gender differences in biologic mechanisms and molecular pathways mediating chronic pain development after trauma, stress, or acute illness exposure. These areas represent priority areas for future scientific inquiry, and gaining understanding in these will be essential to improving our understanding of sex and gender differences in the assessment and treatment of pain conditions in emergency care settings.

Key Points Question What are the projected size and demographic characteristics of the urology workforce per capita in the US through 2060? Findings In this cross-sectional study, 2 stock and flow models of continued (13.8%) and stagnant (0%) growth of the urology workforce based on the American Urological Association Annual Census data in 2019 and the US Census Bureau’s projections showed that within the context of the impending urology workforce shortage, there will be an exaggerated shortage of total urologists per capita for populations aged 65 years and older. Meaning These findings highlight the need for structural changes and advocacy to increase the available urology workforce.

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Key Points Question Do practice patterns, reimbursements, and geographic distribution of urologists who treat Medicare beneficiaries differ by urologist sex? Findings In this population-based cohort study of 8665 US urologists who received Medicare payments in 2016, statistically significant differences in practice patterns and payments were found for female urologists, including considerable geographic gaps in access to these physicians (ie, one-third of hospital markets had 0 female urologists for Medicare beneficiaries). Meaning Female urologists appeared to provide unique care for more female Medicare beneficiaries and to perform more female-specific care, but a wide variation in geographic concentration of urologists based on urologist sex was found.