Professional Diversity and Personal Commitments of Pediatric Otolaryngologists

Albright, James T.; Kearns, David R.; Gray, Steven D.

doi:10.1001/archotol.129.10.1073

Cited by 3 publications

(4 citation statements)

References 5 publications

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“…46 Even for those positions that are filled, pediatric subspecialists in fields such as child and adolescent psychiatry, pediatric otolaryngology, and pediatric surgery have identified that they are too busy to satisfy patient demand for services. [47][48][49] In pediatric emergency medicine and pediatric critical care medicine, for example, the heavy workload and long hours have led to high stress and burnout. For these reasons, a significant number of physicians reported leaving both of these subspecialties, which, over time, could adversely impact workforce supply and constrain access to pediatric subspecialty services.…”

Section: Supply Of the Pediatric Subspecialist Workforcementioning

confidence: 99%

“…These activities, although critical to increasing medical knowledge and improving the health of patients, limits the ability of these physicians to provide clinical care to pediatric patients. 20,48,53 Other indicators of undersupply are provided by evidence of barriers to accessing pediatric subspecialty care. Of course, the geographic maldistribution of physicians remains a significant barrier.…”

Section: Supply Of the Pediatric Subspecialist Workforcementioning

confidence: 99%

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The Pediatric Subspecialty Workforce: Public Policy and Forces for Change

2005

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Policy has not adequately addressed the unique circumstances of pediatric subspecialties, many of which are facing workforce shortages. Pediatric subspecialties, which we define to include all medical and surgical subspecialties, are discrete disciplines that differ significantly from each other and from adult medicine subspecialties. Concerns about a current shortage of pediatric subspecialists overall are driven by indicators ranging from recruitment difficulties to long wait times for appointments. The future supply of pediatric subspecialists and patient access to pediatric subspecialty care will be affected by a number of key factors or forces for change. We discuss 5 of these factors: changing physician and patient demographics; debt load and lifestyle considerations; competition among providers of subspecialty care; equitable reimbursement for subspecialty services; and policy to regulate physician supply. We also identify issues and strategies that medical and specialty societies, pediatric subspecialists, researchers, child advocates, policy makers, and others should consider in the development of subspecialty-specific workforce-policy agendas.

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Section: Supply Of the Pediatric Subspecialist Workforcementioning

confidence: 99%

Section: Supply Of the Pediatric Subspecialist Workforcementioning

confidence: 99%

The Pediatric Subspecialty Workforce: Public Policy and Forces for Change

2005

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“…Because otolaryngology communities are small, comparative effectiveness research often requires multi‐institutional collaboration to attain analytic sample sizes. Such collaboratives are increasingly common, thereby conferring significant opportunity to disseminate best practices, encourage multidisciplinary collaboration, and improve care 12‐19 . Formation of research consortia suggests a cultural trend toward collaborative dissemination of new information.…”

mentioning

confidence: 99%

“…Such collaboratives are increasingly common, thereby conferring significant opportunity to disseminate best practices, encourage multidisciplinary collaboration, and improve care. [12][13][14][15][16][17][18][19] Formation of research consortia suggests a cultural trend toward collaborative dissemination of new information. However, little research describes how subspecialty surgeons adopt new procedures and whether they decide to sustain those changes.…”

mentioning

confidence: 99%

How Do Academic Otolaryngologists Decide to Implement New Procedures Into Practice?

Powers

Smith

Arroyo

et al. 2021

Otolaryngol.--head neck surg.

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Objective To identify barriers and facilitators to adoption of a new surgical procedure via an implementation science framework to characterize associated socioemotional, clinical, and decision-making processes. Study Design Qualitative study with a semistructured interview approach. Setting Large tertiary care referral center. Methods Academic otolaryngologists with at least 2 years of practice were identified and interviewed. Transcripts were thematically coded and separated into steps in the clinical pathway. Synthesis of major themes characterized facilitators and barriers to uptake of a new surgical technique. Results Of 22 otolaryngologists, 19 were interviewed (85% male). They had a median 18 years of practice (interquartile range, 7.8-26.3), and 65% were subspecialty trained. In the decision to implement a new procedure, improving patient outcomes and addressing unmet clinical needs facilitated adoption, whereas costs and adopting profit-driven technologies without improved outcomes were barriers. In patient consults, establishing trust facilitated implementation of new techniques; barriers included participants’ hesitation to communicate about the unknowns of a new procedure. Intraoperatively, little change to existing workflow or improved efficiency facilitated adoption, while a substantial learning curve for the new procedure was a barrier. Achieving favorable outcomes and patient satisfaction sustained implementation of new procedures. Too few referrals or indications for the new procedure hindered implementation. Conclusion Our study demonstrates that innovation in otolaryngology is often an individual iterative process that providers pursue to improve patients’ outcomes. Although models for the oversight of surgical innovation emphasize the need for evidence, obtaining sufficient numbers of providers and patients to generate evidence remains a challenge in specialty surgical practice.

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Alternative Approaches to Expanding Pediatric Urology Services and Productivity

et al. 2012

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The use of advance practice nurse practitioners, part-time contract adult and pediatric urologists, and pediatric physician specialists can effectively increase the number of patients treated without adding full-time pediatric urology staff. The assignment of patient and disease populations to each team member has been an ongoing process of critically defining and updating responsibilities in an attempt to expand care, increase productivity and maximize the quality of delivery of these services.

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Professional Diversity and Personal Commitments of Pediatric Otolaryngologists

Cited by 3 publications

References 5 publications

The Pediatric Subspecialty Workforce: Public Policy and Forces for Change

The Pediatric Subspecialty Workforce: Public Policy and Forces for Change

How Do Academic Otolaryngologists Decide to Implement New Procedures Into Practice?

Alternative Approaches to Expanding Pediatric Urology Services and Productivity

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