Becker's Hospital Review

70 CMO / CARE DELIVERY Which Female Physicians Earn Most? By Emily Rappleye M ale physicians still earn more than their female counterparts in both primary and specialty care — though a survey from Medscape suggests this gap is closing. e "Medscape Female Physician Compensation Report 2016" indicates female primary care physicians earn an average of $192,000 per year, compared to male PCPs, who earn an average of $225,000 annually. Female specialists earn $242,000 to male specialists' $324,000, according to Medscape. e good news is women's earnings are growing at a faster pace than men's. Female PCP compensation is up 36 percent in 2016 compared to Medscape's 2012 survey, while male PCP compensation grew 29 percent. Female specialist compensation grew 40 percent compared to 2012, while male specialist compensation grew 34 percent. Although women in medicine still take home below-average earnings across the board, here is how the specialties rank for female compensation, according to Medscape. 1. Radiology — $342,000 2. Cardiology — $339,000 3. Dermatology — $335,000 4. Anesthesiology — $317,000 5. Gastroenterology — $303,000 6. Oncology — $285,000 7. Emergency medicine — $279,000 8. General surgery — $257,000 9. (tie) OB/Gyn — $256,000 9. (tie) Pathology — $256,000 11. Ophthalmology — $242,000 12. Neurology — $214,000 13. Psychiatry — $205,000 14. Internal medicine — $202,000 15. HIV/Infectious diseases — $200,000 16. Endocrinology — $189,000 17. Family medicine — $183,000 18. Pediatrics — $182,000 n CMS Officials to Hospitals: Stop Misusing HCAHPS Measures By Heather Punke I n an opinion piece in JAMA in May, three officials from CMS urged hospital leaders to stop disaggregating measures from HCAHPS for internal use. According to Lemeneh Tefera, MD; William Lehrman, PhD; and Patrick Conway, MD, all from CMS, HCAHPS "provides valid and reliable measures of hospital quality that can compel hospitals to assess and improve patient experience" — when used correctly. However, the authors note many hospitals are taking HCAHPS responses, disaggregating them and then linking them to financial incentives for individual physicians or physician groups. "This is contrary to the survey's design and policy aim," the authors wrote. "HCAHPS is not suitable for evaluating or incentivizing individuals or groups within a hospital." Instead, the survey is designed to evaluate the entire hospital experience. Drs. Tefera, Lehrman and Conway also addressed the allegations that HCAHPS' pain control questions have urged physicians to prescribe more opioids, contributing to the opioid addiction crisis in the U.S. They vehemently denied such an effect, saying "there is no empirical evidence the failing to prescribe opioids lowers a hospital's HCAHPS scores." Overall, the opinion piece urged hospital officials to use HCAHPS results "responsibly" because failing to do so "entail[s] risk." n Why are Physicians More Likely to Prescribe Antibiotics Later in the Day? 5 Things to Know By Morgan Haefner A s the day concludes, so does mental strength. As a result, physicians tend to prescribe more antibiotics, according to athenaInsight. Here are five findings from athenahealth network data: 1. Stressful work schedules and frequent decision making means physicians are particularly prone to decision fatigue, according to athenaInsight. Throughout the day, decisions become tougher as mental strength and willpower decrease. 2. An analysis of 175,000 interactions between physicians and non-elderly patients with acute respiratory infections found physicians were 13 percent more inclined to prescribe antibiotics by the 13th appointment. 3. By the 24th appointment, those physicians were 19 percent more likely to prescribe antibiotics. 4. Thirteen percent of all outpatient visits, about 154 million every year, conclude with antibiotic prescriptions, according to a Pew Charitable Trust analysis. 5. Medical Director Ann Thomas of Oregon Health Authority's Alliance Working for Antibiotic Resistance Education said physicians may be less likely to make tough discussions about antibiotics after a long day of negotiating against antibiotic use, according to athenaInsight. Mrs. Thomas does not think decision fatigue is the sole culprit, but rather negotiation and "talking with patients all day fatigue" affects decision making, according to athenaInsight. n

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