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A Gender Divide on Microaggressions in Medicine

Many microaggressions are gaffes where the perpetrator is making a misguided attempt at humor. I vividly recall the time I was in training many years ago, and I told my supervising physician about my pregnancy. He responded good-naturedly: “Pregnant? How did you even find the time? We must not be working you hard enough!” I remember mustering a feeble smile, not quite knowing how to respond to his misplaced humor. More

Rebuilding the social safety net is in everyone’s interest

When healthcare systems and not-for-profit social service providers step up to provide food, housing and transportation assistance to needy patients, they often discover government cutbacks undermine their efforts. The U.S. spends less than other advanced industrial nations on social services—about 4% of gross domestic product. The average among other rich countries is around 10%.

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Underrepresentation of Women Among Authors of Invited Commentaries in Medical Journals—Where Are the Female Editorialists?

To the growing list of gender-based disparities faced by women in academic medicine, we can add 1 more: on average, across thousands of medical journals, women with comparable credentials and experience are less likely than men to author invited commentary articles (ie, editorials). Smaller studies, limited to specific disciplines, suggested this was the case but did not account for factors that are likely to be associated with invitations to write editorials, such as publication history. Thomas and colleagues reported on their examination of 72 038 medical journal commentary articles published from 2013 to 2017. The researchers used validated methods to infer author gender and matched commentary authors to controls on characteristics likely to be associated with invitations, including field of expertise, seniority, number of publications, and citation record. Adjustment for these confounders attenuated but did not eliminate the substantial differences in favor of men. Surprisingly, the magnitude of the disadvantage was larger for senior women. Overall, the odds of authoring an editorial were 21% lower for women compared with men. However, for the most senior women, the odds of authoring an editorial were 31% lower than for men with comparable credentials. More

Black Scientists Held Back by Perceptions of Their Priorities

Eight years ago, a study published in Science found that black researchers were 10 percentage points less likely than white ones to receive funding from the National Institutes of Health, even after controlling for factors like educational background, previous research awards and publication record. Its authors theorized that the difference might reflect an accumulation of slight advantages over the course of white scientists’ careers. That study, which the N.I.H. itself commissioned, prompted the agency to put $500 million toward a 10-year initiative to improve the situation, for example by increased mentoring of minority researchers and efforts to address possible bias in peer review. But new research suggests racial disparity in grant funding persists, and offers a fresh theory about a source of some of it: research topic choice.

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Dealing with the shortage of rural physicians

Natalie King, MD, a family medicine practitioner, trained in Toledo, Ohio, an inner-city environment less than two hours away from the family farm where she grew up. That residency training prepared her to work in under-resourced urban areas. But when she was offered a job at a community health clinic in Jellico, Tennessee—population 2,217—she didn’t hesitate. Shannon Brownlee, MSc, senior vice president of the Lown Institute, a non-profit organization working to create a more equitable healthcare system, says that in an age of mergers and acquisitions, she would like to see more health systems making greater investments in their rural facilities. More

Health care needs to be “disrupted,” but not in the way startups think

To Silicon Valley entrepreneurs, health care is a sector ripe for disruption. They’re not wrong, given skyrocketing health care spending that’s yielding diminishing returns on health. From high-tech fitness trackers to genome sequencing and pill delivery services, the number of health care startups has exploded. In 2018, investors poured more than $8 billion into digital health startups, up from $5.7 billion invested the year before on the promise of shaking up health care, and innovating our way to better health. More

Health Equity

Everyone deserves the opportunity to live a healthy life, regardless of where they live, how much they make, or who they are. More

How More State Health Care Spending Can Lead to Worse Health

Squeezed by rising health care costs, states have shifted money away from “social spending” on programs like public education, public health services, housing assistance, food assistance and income support. That shift “is having dire and long-lasting consequences for the nation’s health and community well-being,” warns a new report from the Lown Institute, a nonpartisan nonprofit that advocates for affordable health care. More