Becker's Hospital Review

79 FINANCE CMO / CARE DELIVERY 70% of Physician Assistants Are Women, Yet Gender Pay Gap Still Persists By Leo Vartorella A new study from the American Academy of Phy- sician Assistants has found that for every dollar a male PA earns, his female counterpart earns 89 cents. This pay disparity exists even though physician assistants represent one of the fastest growing fields in healthcare and 70 percent of physician assistants are women. The study examined data on pay from 1998 to 2014. "As a PA educator, I feel keenly the burden of student debt. One way to think about the impact of the gen- der pay gap is in the context of the $150,000 in stu- dent loans facing a typical PA upon graduation," said L Gail Curtis, president and chair of the AAPA Board of Directors. "A male PA earning $10,000 a year more than his female PA counterpart could use that extra money to pay off his student loan debt in 15 years. The disparate treatment of women in the PA profes- sion is simply unacceptable." n Survey Finds Patients Want More Time With Physicians By Emily Rappleye W hile 9 in 10 patients believe the patient-phy- sician relationship is the most essential component of high-quality healthcare, just 1 in 10 patients feel they get enough face time with their physicians, according to a survey commissioned by The Physicians Foundation. The survey, conducted by Regina Corso Consulting, polled nearly 1,750 American adults ages 27 to 75 in June 2017. Participants had at least two visits with the same physician in the past year. The survey indicated patients are overall extremely satisfied with their primary care physicians (95 per- cent), but the majority (65 percent) said time is always or often short during visits. Just over half of patients (53 percent) believed physicians were at capacity in terms of workload. The results also indicated patients want their physi- cians to take a greater role in their care and in health- care reform in general. Most patients (87 percent) said they felt physicians should have the most influence over their care, but 69 percent said payers actually had the most influence. Meanwhile, 90 percent of patients wanted to see physicians at the forefront of discussions on healthcare quality, cost and access. n 7 Things to Know About the History and Science Behind Opioid Addiction By Brian Zimmerman R ecreational opiate use and opiate addiction has taken many forms throughout history, according to PBS Newshour. Now, with the rise of prescription painkillers, the introduction of ex- tremely potent synthetic opioids and the resurgence of heroin, the nation is locked in an ongoing overdose epidemic some have called the worst public health crisis in modern American history. In 2016, 53,332 people in the U.S. died of an opioid overdose, according to PBS Newshour. Here are seven things to know about the history and science of opioid ad- diction. The history 1. e desire for opioid-induced euphoria has been a part of societies for centuries, dating back to around 3400 B.C., when ancient Sumerians called opium poppies "the joy plant." 2. e invention of morphine during the Civil War spurred widespread ad- diction among U.S. military veterans treated with the painkiller aer being wounded. e condition was referred to as "Soldier's Disease." 3. Heroin was initially created as a cough syrup meant to curb morphine addiction in the late 1800s. The science 4. e human body reacts to peripheral pain — like a cut or burn — by releasing natural opioids called endorphins. ese neural pathways can be- come overloaded when experiencing chronic pain, limiting the body's abil- ity to reduce pain, which could drive an individual to regularly seek relief through medication. 5. e most crucial nervous system receptor for opioids is the Mu receptor. e Mu receptor facilitates the effect of opioids on the body. "e depression, the analgesia, the constipation and the euphoria — if you take away the Mu-opioid receptor, and you give morphine, then you don't have any of those effects," Chris Evans, PhD, director of Brain Research Institute at UCLA in Los Angeles, told PBS Newshour. 6. Addiction takes hold of opioid users aer their neurons adapt to the medications. e brain adjusts to the presence of opioids by producing in- creased levels of the neurological messenger cyclic adenosine monophos- phate. ese molecules continue to fire communicative electrical pulses at heightened levels even aer opioid use ceases. Instead of sending messages of opioid-induced happiness, these pulses flood the prefrontal cortex with feelings of dysphoria and anxiety. While other drugs like alcohol and co- caine spur addictive behaviors by altering the brain's pleasure system, the intense surge of withdrawal aer discontinued use is unique to opioids. 7. Experts believe opioid addiction is partly driven by users' moods, as mood disorders have the potential to exacerbate withdrawal symptoms. Patients with mood disorders experience 40 percent less pain relief from the drug than in- dividuals without mood disorders, according to a 2005 study published in the journal Pain. "So, not only does a mood disorder affect a person's addiction potential, but it also influences if the opioids will successfully treat their pain," Cathy Cahill, PhD, a pain and addiction researcher at UCLA, told PBS Newshour. n

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