Faculty Bibliography

Physicians, nurses, and other health care providers initiated the #GetMePPE movement on Twitter to spread awareness of the shortage of personal protective equipment (PPE) during the coronavirus disease (COVID-19) pandemic. Dwindling supplies, such as face masks, gowns and goggles, and inadequate production to meet increasing demand have placed health care workers and patients at risk. The momentum of the #GetMePPE Twitter hashtag resulted in the creation of a petition to urge public officials to address the PPE shortage through increased funding and production. Simultaneously, the GetUsPPE.org website was launched through the collaboration of physicians and software engineers to develop a digital platform for the donation, request, and distribution of multi-modal sources of PPE. GetUsPPE.org and #GetMePPE were merged in an attempt to combine public engagement and advocacy on social media with the coordination of PPE donation and distribution. Within 10 days, over 1800 hospitals and PPE suppliers were registered in a database that enabled the rapid coordination and distribution of scarce and in-demand materials. One month after its launch, the organization had distributed hundreds of thousands of PPE items and had built a database of over 6000 PPE requesters. The call for action on social media and the rapid development of this digital tool created a productive channel for the public to contribute to the health care response to COVID-19 in meaningful ways. #GetMePPE and GetUsPPE.org were able to mobilize individuals and organizations outside of the health care system to address the unmet needs of the medical community. The success of GetUsPPE.org demonstrates the potential of digital tools as a platform for larger health care institutions to rapidly address urgent issues in health care. In this paper, we outline this process and discuss key factors determining success.

Female physicians in the USA achieve associate and full professor rank at numbers disparate to their representation within emergency medicine (EM). The authors describe a novel curriculum aimed at developing women speakers as a step on the journey towards academic recognition. In this pilot programme, four female physicians at a single academic emergency department participated in a year-long Speaker Development Programme (SDP), and all presented in at least one national EM conference at SDP completion. Participants reported improved speaking skills, confidence and drive to present externally. Elements to success were mentor engagement, encouragement by the departmental chair and creation of a growth and belonging mindset within the cohort. Future steps include creating a framework for maintaining the SDP beyond the pilot phase, such as ensuring access to curriculum materials, and retaining an experienced external mentor over time.

BACKGROUND:The purpose of this study was to complete a comprehensive analysis of gender differences in faculty rank among U.S. emergency physicians that reflected all academic emergency physicians. METHODS:We assembled a comprehensive list of academic emergency medicine (EM) physicians with U.S. medical school faculty appointments from Doximity.com linked to detailed information on physician gender, age, years since residency completion, scientific authorship, National Institutes of Health (NIH) research funding, and participation in clinical trials. To estimate gender differences in faculty rank, multivariable logistic regression models were used that adjusted for these factors. RESULTS:Our study included 3,600 academic physicians (28%, or 1,016, female). Female emergency physicians were younger than their male colleagues (mean [±SD] age was 43.8 [±8.7] years for females and 47.4 [±9.9] years for males [p < 0.001]), had fewer years since residency completion (12.4 years vs. 15.6 years, p < 0.001), had fewer total and first/last author publications (4.7 vs. 8.6 total publications, p < 0.001; 4.3 vs. 7.1 first or last author publications, p < 0.001), and were less likely to be principal investigators on NIH grants (1.2% vs. 2.9%, p = 0.002) or clinical trials (1.8% vs. 4.4%, p < 0.001). In unadjusted analysis, male physicians were more likely than female physicians to hold the rank of associate or full professor versus assistant professor (13.7 percentage point difference, p < 0.001), a relationship that persisted after multivariable adjustment (5.5 percentage point difference, p = 0.001). CONCLUSIONS:Female academic EM physicians are less likely to hold the rank of associate or full professor compared to male physicians even after detailed adjustment for other factors that may influence faculty rank.

OBJECTIVE: A 2010 survey identified disparities in salaries by gender and underrepresented minorities (URM). With an increase in the EM workforce since, we aimed to 1) Describe the current status of academic EM workforce by gender, race and rank, and 2) Evaluate if disparities still exist in salary or rank by gender. METHODS: Information on demographics, rank, clinical commitment, and base and total annual salary for full-time faculty members in U.S. academic EDs were collected in 2015 via the Academy of Administrators in Academic Emergency Medicine (AAAEM) Salary Survey. Multiple linear regression was used to compare salary by gender while controlling for confounders. RESULTS: Response rate was 47% (47/101), yielding data on 1371 full-time faculty; 33% women, 78% white, 4% black, 5% Asian, 3% Asian Indian, 4% other, and 7% unknown race. Comparing white race to nonwhite, 62% vs. 69% were instructor/assistant, 23% vs. 20% were associate, and 15% vs. 10% were full professors. Comparing women to men, 74% vs. 59% were instructor/assistant, 19% vs. 24% were associate, and 7% vs. 17% were full professors. Of 113 Chair/Vice-Chair positions, only 15% were women, and 18% were nonwhite. Women were more often fellowship trained (37% vs. 31%), less often core-faculty (59% vs. 64%), with fewer administrative roles (47% vs. 57%) (all p<0.05) but worked similar clinical hours (mean 1069 vs. 1051 hours). Mean overall salary was $278,631 (SD +/- 68,003). The salary of women was $19,418 (SD +/- 3,736) less than men (p < 0.001), even after adjusting for race, region, rank, years of experience, clinical hours, core faculty status, administrative roles, board certification, and fellowship training. CONCLUSIONS: In 2015, disparities in salary and rank persist among full-time U.S. academic EM faculty. There were gender and URM disparities in rank and leadership positions. Women earned less than men regardless of rank, clinical hours, or training. Future efforts should focus on evaluating salary data by race and developing system-wide practices to eliminate disparities.

Background: In 2010, disparities were shown in salaries of women and underrepresented minorities (URM) in academic EM. We aimed to describe the current state of academic EM work force a) by gender and race/ ethnicity and b) their salary distribution and c) rank. Methods: Data represent demographics, rank/position, clinical hours, and annual salary for full-time faculty members in U.S. academic EDs collected in 2015 via the AAAEM Salary Survey. Descriptive data were used to describe participants by gender, race/ethnicity, rank, and position. Multiple logistic regression was used to compare total annual salary by gender while controlling for confounders. Pediatric EM faculty were included. Results: Of 101 departments, 47 reported data (46.5%), yielding salary data on 1599 faculty. Of these, 1371 worked full time, 33% were women. Race distribution was 78% white/non-Hispanic, 4% black, 5% Asian, 3% Asian Indian, 4% other, and 7% unknown. Comparing rank among whites vs. nonwhites, 62% vs. 69% were instructor/assistant, 23% vs. 20% vs. were associate, and 15% vs. 10% were full professors. In women vs. men, 74% vs. 59% were instructor/assistant, 19% vs. 24% were associate, and 7% vs. 17% were full professors. Of the 113 Chair/Vice chair positions, 15% were filled by women and 18% by nonwhites. More women than men were fellowship trained (37% vs 31%), worked more hours (1069 vs. 1050) but had less administrator duties (47% vs. 57%) or were core faculty (59% vs. 64%). Mean total salary was $278,631 (SD 68,003). On average, women made $19,462 (+/-3,741) less than men (p < 0.001), even after adjusting for race, geographic region, rank, years of experience, total clinical hours, core faculty status, administrative duties, board certification or fellowship training. Starting salary was lower for women compared to men at each rank (p < .05). This relationship persisted when assessing salaries among fellowship trained physicians and when comparing salaries for each quartile of clinical commitment (p < .05). Conclusion: In 2015, previously described disparities in salary persist among full-time academic EM faculty in the U.S. Female physicians earned less than men regardless of rank, clinical hours or training. We also found gender and URM disparities in rank and leadership positions. Future efforts should focus on evaluating data by race, as well as system-wide practices to eliminate disparities

Background: Dyspnea is a common complaint leading to activation of EMS and transport to the Emergency Department (ED) in the elderly residing at skilled nursing facilities (SNFs). Prehospital use of non-invasive positive pressure ventilation (NIPPV) can reduce mortality and hospital admission. We examined the impact of the use of NIPPV by an Emergency Telemedicine Service (ETS) at SNFs to reduce the need for EMS and ED visits. Methods: Staffs at two SNFs were trained to activate an ETS to evaluate and treat patients who otherwise would be considered for transport to the ED. Encounters were performed with aid of SNF staff and emergency care technicians in the facility. Staff was trained to initiate NIPPV. Data was retrospectively collected from the electronic health record over a 10-month period. Chief complaints (CC) were categorized using the Coded Chief Complaints for Emergency Department Systems schema. The primary outcome was avoidance of EMS transport with secondary outcomes of reduction in respiratory rate (RR) and increase in oxygen saturation (SpO2). All encounters were monitored for delay in care and adverse events. Descriptive statistics, confidence intervals and paired t-tests were calculated. Results: There were a total of 859 encounters, of these, 70% (CI 67-73) avoided transport to the ED. 16% (n=137) had a CC of "difficulty breathing", of which 19% (n=26) received NIPPV. 73% (n=19) of those treated with NIPPV avoided EMS transport. There was a mean reduction in RR of 6 breaths/min (p < 0.001) and a mean increase in SpO2 of 9.1% (p < 0.001) in those treated with NIPPV. No significant delays in care or serious adverse events resulting from medical error occurred. Conclusion: The use of an ETS led to a reduction in EMS transports from SNFs. NIPPV was safely implemented and managed via telemedicine physicians for patients with respiratory distress. Use of NIPPV significantly improved quantitative metrics (RR, SpO2) and may help prevent need for EMS transport. Additional research is needed to fully understand the efficacy, scope and cost saving benefits of an ETS and the use of NIPPV at SNFs

Background: Disparities in engagement, retention, and promotion of women in emergency medicine (EM) are well described. These disparities are partly due to lack of resources, mentorship, and a community of support for physicians of both genders. Objective: FemInEM was created to provide resources and guidance for engaging women in EM in all stages of life and career. Its mission is to address gender disparities proactively through peer support and positive promotion. Innovation Design: FemInEM launched in September 6, 2015 as a free, open-access online community resource. Biweekly blog posts are at the core of FemInEM. The website also hosts an on-line job board, a searchable database of female speakers and a section dedicated to honoring women's achievements. FemInEM has grown its network through a multi-faceted social media implementation strategy. The site and its operating costs are entirely funded by targeted sponsorship and job advertisement. Outcome Information: 75 contributing authors, of both genders, have contributed content to the site in the past year. In the first year, there were 200,000 page views by 120,000 unique visitors in 186 countries. FeminEM has 1500 subscribers to its biweekly digest, 1600 Twitter followers (@feminemtweets) and 1200 members of the FemInEM Facebook group.149 female physicians in EM are featured in the Speakers' Bureau and 18 invitations to speak locally or nationally have been a direct result of the listing. Conclusion: Gender parity in EM is achievable with attention to the needs of both men and women in EM. FemInEM has approached issues and biases surrounding the advancement of women in a new and innovative way. FemInEM provides a forum to discuss timely and sensitive issues related to gender equity in the workplace, connects mentors with mentees, highlights achievements of women in medicine and publicizes a list of talented females interested in speaking opportunities. FemInEM has the potential to help develop female leaders, support women, and raise awareness of the many talented women in our field

INTRODUCTION: Although a relatively young specialty, emergency medicine (EM) is popular among medical students and is one of the most competitive large specialties. Consequently, students increasingly seek more opportunity to differentiate themselves from their colleagues by pursuing more clerkships at the cost of taking out additional loans: this despite the fact that those who match in EM typically do so in their top three choices. We sought to ascertain what factors EM program directors seek in their typical candidate. METHODS: We recruited EM program directors via the Council of Emergency Medicine Residency Directors email listserv to participate in an anonymous survey regarding the United States Medical Licensing Examination (USMLE), the number of standardized letters of evaluation (SLOE), and the number of EM rotations during the fourth year. RESULTS: 135 respondents completed the anonymous survey: 59% of respondents stated their program did not have a minimum USMLE Step 1 score, but 39% reported a minimum score of 210 or higher; 95% of programs do not require Step 2 to grant an interview, but 46% require it to place the student on the rank list; 80% require only one EM rotation to grant an interview and none require more than two; 95% of programs will accept two SLOEs for both application and rank list placement. CONCLUSION: For the typical EM applicant, there is likely little benefit to performing more than two rotations and obtaining more than two SLOEs. Students can defer USMLE Step 2 but must complete it by the time rank lists are due. Our study was limited by the anonymity of the survey, and comments by the respondents revealed the questions did not account for some nuances programs apply to their application review process.