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Reisdorff EJ, Masselink LE, Gallahue FE, Suter RE, Chappell BP, Evans DD, Salsberg E, Marco CA. Factors associated with emergency physician income. J Am Coll Emerg Physicians Open 2023; 4:e12949. [PMID: 37064163 PMCID: PMC10090942 DOI: 10.1002/emp2.12949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 04/18/2023] Open
Abstract
Objective Income fairness is important, but there are limited data that describe income equity among emergency physicians. Understanding the magnitude of and factors associated with income differences may be helpful in eliminating disparities. This study analyzed the associations of demographic factors, training, practice setting, and board certification with emergency physician income. Methods We distributed a survey to professional members of the American College of Emergency Physicians. The survey included questions on annual income, educational background, practice characteristics, gender, age, race, ethnicity, international medical graduate status, type of medical degree (MD vs DO), completion of a subspecialty fellowship, job characteristics, and board certification. Respondents also reported annual income. We used linear regression to determine the respondent characteristics associated with reported annual income. Results From 45,961 members we received 3407 responses (7.4%); 2350 contained complete data for regression analysis. The mean reported annual income was $315,306 (95% confidence interval [CI], $310,649 to $319,964). The mean age of the respondents was 47.4 years, 37.4% were women, 3.2% were races underrepresented in medicine (Black, American Indian, or Alaskan Native), and 4.8% were Hispanic or Latino. On linear regression, female gender was associated with lower reported annual income; difference -$43,565, 95% CI, -$52,217 to -$34,913. Physician age, degree (MD vs DO), underrepresented racial minority status, and underrepresented ethnic minority status were not associated with annual income. Fellowship training was associated with lower income; Accreditation Council for Graduate Medical Education (ACGME) program difference -$30,048; 95% CI, -$48,183 to -$11,912, non-ACGME-program difference -$27,640, 95% CI, -$40,970 to -$14,257. Working at a for-profit institution was associated with higher income; difference $12,290, 95% CI, $3693 to $20,888. Board certification was associated with higher income; difference, $43,267, 95% CI, $30,767 to $55,767. Conclusions This study identified income disparities associated with gender, practice setting, fellowship completion, and American Board of Emergency Medicine or American Osteopathic Board of Emergency Medicine certification.
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Affiliation(s)
| | - Leah E. Masselink
- George Washington University Fitzhugh Mullan Institute for Health Workforce EquityWashingtonDCUSA
| | - Fiona E. Gallahue
- Department of Emergency MedicineThe University of WashingtonSeattleWashingtonUSA
| | - Robert E. Suter
- Department of Emergency MedicineUniversity of Texas SouthwesternDallasTexasUSA
- Department of Military MedicineUniformed Services University of the Health SciencesBethesdaMarylandUSA
| | - Brad P. Chappell
- Department of Emergency MedicineUniversity of California, Harbor‐UCLA Medical CenterLos AngelesCaliforniaUSA
| | - Dian D. Evans
- Emory University Nell Hodgson Woodruff School of NursingAtlantaGeorgiaUSA
| | - Ed Salsberg
- George Washington University Fitzhugh Mullan Institute for Health Workforce EquityWashingtonDCUSA
| | - Catherine A. Marco
- Department of Emergency MedicinePenn State Health, Hershey Medical CenterHersheyPennsylvaniaUSA
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D'Assunção FLC, Kalenderian E, Carneiro DC, Verçosa MVF, Dos Santos JP, Yansane AI, D'Assunção VCDSC, Felinto AR. Presence of management, entrepreneurship, leadership and marketing topics in the dental school curriculum in Brazil. Eur J Dent Educ 2022; 26:384-392. [PMID: 34490698 DOI: 10.1111/eje.12714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/01/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION To analyse the presence and characteristics of curricular components related to management, entrepreneurship, leadership and marketing as part of the structure and teaching methods of undergraduate courses in dentistry in Brazil. MATERIALS AND METHODS This is an observational study that used the Ministry of Education's Undergraduate Course Accreditation Platform, which included 424 undergraduate courses in Dentistry on the last date of collection (August 31 2019). The following items were analysed as follows: the existence of curricular components in relation to the proposed themes, the most recurring denominations of curricular components, minimum and maximum workload, mandatory/optional classification, theoretical/practical teaching condition and in which year the curricular components were inserted. RESULTS 367/424 (86.6%) of dentistry courses in Brazil included at least one of the topics: management, entrepreneurship, leadership and marketing curricular components in their curriculum, whilst 57/424 (13.4%) did not have these curricular components in their curricular structure. The most frequent names were "Management" 99 (45.21%) and "Entrepreneurship" 80 (36.5%). There was a predominance of the "theoretical method" and the number of hours varied considerably, with the most common course hours between 40 and 60 h. The majority of curricular components were inserted in the third to fifth year and offered on a compulsory basis. CONCLUSION Most curricular matrices of dentistry courses in Brazil had components related to the topics studied. However, due to the variety of curricular components' names, hours, periods of courses and different teaching methodologies, there is a need to redesign the teaching and learning process, defining educational and evaluation models with common curricular components.
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Affiliation(s)
| | - Elsbeth Kalenderian
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, School of Dentistry, San Francisco, California, USA
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Department of Dental Management Sciences, University of Pretoria, School of Dentistry, Pretoria, South Africa
| | | | | | | | - Alfa-Ibrahim Yansane
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, School of Dentistry, San Francisco, California, USA
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Cagetti MG, Balian A, Camoni N, Campus G. Influence of the COVID-19 Pandemic on Dental Emergency Admissions in an Urgent Dental Care Service in North Italy. Int J Environ Res Public Health 2021; 18:1812. [PMID: 33673335 PMCID: PMC7918203 DOI: 10.3390/ijerph18041812] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 01/08/2023]
Abstract
A retrospective study was performed to verify if the number of admissions for urgent dental care in the Urgent Dental Care Service of San Paolo Hospital in Milan (Italy) was directly related to the different phases of the COVID-19 pandemic. Different periods were analyzed: 25 March-5 April 2019 (pre-COVID); 23 March-3 April 2020 (lockdown); 8 June-19 June 2020 (reopening); and November 9-November 20 (second wave). Raw data regarding admissions, diagnoses, and treatments were extracted. Descriptive and bivariate analyses were performed. The survey included 901 admissions, 285 in pre-COVID, 93 during lockdown, 353 in reopening, and 170 in the second wave. In each time period, statistically significant differences were found in the prevalence of each kind of diagnoses (χ2(3) = 20.33 p = 0.01 for endodontic emergencies, χ2(3) = 29.05 p < 0.01 for cellulitis/phlegmon, χ2(3) = 28.55 p < 0.01 for periodontal emergencies, Fisher's Exact Test p < 0.01 for trauma, and χ2(3) = 59.94 p < 0.01 for all other kinds of diagnosis). A remarkable increase in consultations (+186.36%) and other treatments (+90.63%) occurred during reopening. Tooth extraction was the most frequently delivered treatment, but suffered the largest reduction during lockdown (-79.82%). The COVID-19 pandemic has highly affected dental activity in north Italy, underling the weaknesses of a private dental system in a pandemic scenario.
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Affiliation(s)
- Maria Grazia Cagetti
- Department of Biomedical, Surgical and Dental Science, University of Milan, 20142 Milan, Italy; (M.G.C.); (N.C.)
| | - Araxi Balian
- Department of Biomedical, Surgical and Dental Science, University of Milan, 20142 Milan, Italy; (M.G.C.); (N.C.)
| | - Nicole Camoni
- Department of Biomedical, Surgical and Dental Science, University of Milan, 20142 Milan, Italy; (M.G.C.); (N.C.)
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3012 Bern, Switzerland;
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Viale San Pietro 3/c, 07100 Sassari, Italy
- School of Dentistry, Sechenov University, 119991 Moscow, Russia
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Wolf TG, Wagner RF, Zeyer O, Ilhan D, Crnić T, Otterbach EJ, Campus G. Expectations Regarding Dental Practice: A Cross-Sectional Survey of European Dental Students. Int J Environ Res Public Health 2020; 17:ijerph17197296. [PMID: 33036227 PMCID: PMC7579228 DOI: 10.3390/ijerph17197296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/30/2020] [Accepted: 10/03/2020] [Indexed: 11/23/2022]
Abstract
Obtaining information on expectations among dental students regarding their career planning was the main purpose of this observational online survey. The questionnaire was designed with 18 items in five different languages: English, French, German, Italian and Spanish. Data were collected on nationality, age, sex, country of residence, university attended, semester, expected year of graduation and expectations about future career. More than 3000 participants (n = 3851, 2863 females 74.34% and 988 males 25.66% with a sex ratio of 0.35) participated in the survey. Almost one-third (31.29%) of the participants plan to start their own practice at least three years after vocational training, a quarter (25.76%) after three, and only 12.59% after one year. A positive influence of the family in the decision to start a practice was observed in 50.07% of the sample with a statistically significant difference regarding sex (p < 0.01). Almost one-third of the participants did not wish to work in an institution run by private equity or insurance companies, while 21.79% would work in that environment (p < 0.01). European dental students desire mainly to become self-employed and start their own practice. New professional practices also offer them options for their future career that they have not yet decided on or thought about.
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Affiliation(s)
- Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (R.F.W.); (G.C.)
- Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- FVDZ Free Association of German Dentists, 53177 Bonn, Germany;
- Correspondence: ; Tel.: +41-31-632-35-80
| | - Ralf Friedrich Wagner
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (R.F.W.); (G.C.)
- Association of Statutory Health Insurance Dentists North Rhine (KZV Nordrhein), 40237 Düsseldorf, Germany
| | - Oliver Zeyer
- SSO Swiss Dental Association, 3000 Bern, Switzerland;
| | - Duygu Ilhan
- Private Practice, Valikonağı Street, 34635 Istanbul, Turkey;
- Turkish Dental Association (Türk Dişhekimleri Birliği), 06530 Çukurambar, Cankaya/Ankara, Turkey
| | - Tin Crnić
- EDSA European Dental Students’ Association, D02 PN40 Dublin, Ireland;
| | | | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland; (R.F.W.); (G.C.)
- Department of Medicine, Surgery and Experimental Sciences, School of Dentistry, University of Sassari, I-07100 Sassari, Italy
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Nasseh K, Bowblis JR, Vujicic M. Pricing in commercial dental insurance and provider markets. Health Serv Res 2020; 56:25-35. [PMID: 32844447 PMCID: PMC7839642 DOI: 10.1111/1475-6773.13544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 06/26/2020] [Accepted: 06/30/2020] [Indexed: 11/28/2022] Open
Abstract
Objective To examine the impact of commercial dental insurer and provider concentration on dentist reimbursement. Data Sources We utilized provider data from the American Dental Association, reimbursement data from IBM Watson MarketScan® Commercial Research Databases, submitted billed charges from FAIR Health®, dental insurance market concentration data from FAIR Health®, and county‐level demographic and economic data from the Area Health Resources File and the Council for Community and Economic Research. Study Design We used the Herfindahl‐Hirschman Index to separately measure commercial dental insurance concentration and dentist concentration. We studied the effect of provider and insurance concentration on dentist reimbursement. Using two‐stage least squares, we accounted for potential endogeneity in dental insurer and provider concentration. Principal Findings Across the dental procedures we examined, a 10 percent increase in dental insurance concentration is associated with a 1.95 percent (P‐value = .033) reduction in gross payments to dentists. Conversely, a 10 percent increase in dentist concentration is associated with a more modest 0.71 percent (P‐value = .024) increase in gross payments. A 10 percent increase in dental insurance concentration is associated with a 1.16 percentage point (P‐value = .016) decline in the allowed‐to‐list price ratio, while a 10 percent increase in dentist concentration is associated with a 0.56 percentage point (P‐value = .001) increase in the allowed‐to‐list price ratio. Similar patterns were found across dental procedure subcategories. Conclusions Dental provider markets are substantially less concentrated than insurance markets, which may limit the ability of dentists to garner higher reimbursement.
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Affiliation(s)
- Kamyar Nasseh
- American Dental Association, Health Policy Institute, Chicago, Illinois, USA
| | - John R Bowblis
- Department of Economics, Farmer School of Business, Miami University, Oxford, Ohio, USA
| | - Marko Vujicic
- American Dental Association, Health Policy Institute, Chicago, Illinois, USA
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Nasseh K, Bowblis JR, Vujicic M, Huang SS. Consolidation in the dental industry: a closer look at dental payers and providers. Int J Health Econ Manag 2020; 20:145-162. [PMID: 31583512 PMCID: PMC7326818 DOI: 10.1007/s10754-019-09274-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 09/25/2019] [Indexed: 06/10/2023]
Abstract
We examine the effect of commercial dental insurance concentration on the size of dental practices, the decision of dentists to own a practice, and the choice of dentists to work at a dental management service organization-a type of corporate group practice that has become more prevalent in the United States in recent years. Using 2013-2015 dentist-level data from the American Dental Association, county-level data on firms and employment from the United States Census, and commercial dental insurance market concentration data from FAIR Health®, we find a modest effect of dental insurance market concentration on the size of dental practices. We also find that a higher level of commercial dental insurance market concentration is associated with a dentist's decision not to own a practice. There is inconclusive evidence that higher levels of dental insurance market concentration impact a dentist's decision to affiliate with a dental management service organization. Overall, our findings imply that dentists consolidate in response to increases in concentration among commercial dental insurers.
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Affiliation(s)
- Kamyar Nasseh
- Health Policy Institute, American Dental Association, 211 E. Chicago Ave., Chicago, IL, 60611-2637, USA.
| | - John R Bowblis
- Department of Economics, Miami University, Oxford, OH, 45056, USA
| | - Marko Vujicic
- Health Policy Institute, American Dental Association, 211 E. Chicago Ave., Chicago, IL, 60611-2637, USA
| | - Sean Shenghsiu Huang
- Department of Health Systems Administration, Georgetown University, Washington, DC, 20057, USA
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