Journal of general internal medicine
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Comparative Study
Race and gender differences in general internists' annual incomes.
Specialty, work effort, and female gender have been shown to be associated with physicians' annual incomes; however, racial differences in physician incomes have not been examined. ⋯ During the 1990s, both black race and female gender were associated with lower annual incomes among General Internists. Differences for females were substantial. These findings warrant further exploration.
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Bedside rationing by physicians is controversial. The debate, however, is clouded by lack of information regarding the extent and character of bedside rationing. ⋯ Bedside rationing is prevalent in all surveyed European countries and varies with physician attitudes and resource availability. The prevalence of physician bedside rationing, which presents physicians with difficult moral dilemmas, highlights the importance of discussions regarding how to ration care in the most ethically justifiable manner.
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A profound and moving spirituality provided emotional and psychological support for most terminally ill patients at Grady Memorial Hospital. The authors were able to trace the roots of these patients' spirituality to core beliefs described by African-American theologians. ⋯ Importantly, almost all patients were willing to share their beliefs with the authors in long bedside interviews. This willingness to share indicates that physicians can learn about and validate such patients' spiritual sources of support.
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Multicenter Study Comparative Study
Persistent depression affects adherence to secondary prevention behaviors after acute coronary syndromes.
The persistence of depressive symptoms after hospitalization is a strong risk factor for mortality after acute coronary syndromes (ACS). Poor adherence to secondary prevention behaviors may be a mediator of the relationship between depression and increased mortality. ⋯ Persistently depressed patients were less likely to adhere to behaviors that reduce the risk of recurrent ACS. Differences in adherence to these behaviors may explain in part why depression predicts mortality after ACS.
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Comparative Study
Prevalence of basic information technology use by U.S. physicians.
Information technology (IT) has been advocated as an important means to improve the practice of clinical medicine. ⋯ In early 2004, the majority of physicians did not regularly use basic, inexpensive, and widely available IT tools in clinical practice. Efforts to increase the use of IT in medicine should focus on practice-level barriers to adoption.