Ample evidence suggests continued racial disparities once listed for liver transplantation, though few studies examine disparities in the selection process for listing. The objective of this study, via retrospective chart review, was to determine whether listing for liver transplantation was influenced by socioeconomic status and race/ ethnicity. We identified 1968 patients with end-stage liver disease who underwent evaluation at a large, Midwestern center from January 1, 2004 through December 31, 2012 (72.9% white, 19.6% black, and 7.5% other). Over half (54.6%) of evaluated patients were listed; the three most common reasons for not listing were medical contraindications (11.9%), patient expired during evaluation (7.0%), and psychosocial contraindications (5.9%). In multivariable logistic regressions (listed vs not listed), across the three racial categories, the odds of being listed were lower for alcohol-induced hepatitis (±hepatitis C), unmarried, more than one insurance, inadequate insurance, and lower annual household income quartile. Similar factors predicted time to transplant listing, including being identified as black race. Black race, even when adjusting for the above mentioned medical and socioeconomic factors, was associated with 26% lower odds of being listed and a longer time to listing decision compared to all other patients.

Background: Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job, defined by 3 dimensions: exhaustion, depersonalization, and reduced personal accomplishment. While there is a growing body of research on burnout in physicians, there is a dearth of literature on burnout in pain medicine physicians. Objective: This study aimed to determine the incidence of burnout amongst pain medicine physicians and whether there are sociodemographic or psychological demand characteristics of the job setting that predict burnout in pain medicine physicians. Study Design and Setting: Cross-section survey of pain medicine physicians across the United States. Methods: Pain medicine physicians were asked questions on sociodemographics and professional characteristics and measures of decisional authority, psychological job demands, job insecurity, perceived coworker support, and job dissatisfaction. Results: Two hundred seven pain medicine physicians’ responses were analyzed, 60.4% reported high emotional exhaustion, 35.7% reported high depersonalization, and 19.3% reported low personal accomplishment. Greater psychological job demands and greater job dissatisfaction predicted greater emotional exhaustion. Younger age and greater job dissatisfaction predicted higher depersonalization. Lastly, lower coworker support and greater job dissatisfaction predicted lower personal accomplishment. There were no statistical violations of assumptions or collinearity. Limitations: Low response rate and potential for response bias limit generalizability of the study. Conclusion(s): Pain medicine physicians in the United States reported high levels of emotional exhaustion, often considered the most taxing aspect of burnout. Job dissatisfaction appeared to be the leading agent in the development of all 3 components of burnout in pain medicine physicians in the United States. Key words: Burnout, pain medicine physicians, job dissatisfaction, decisional authority, psychological job demands

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