CORR Insights®: What is the Geographic Distribution of Women Orthopaedic Surgeons Throughout the United States?

Anthony E Johnson
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Abstract

It is estimated that by 2050, there will no longer be any clear racial and ethnic majority in the United States. Indeed, Americans of Hispanic and Asian descent comprise of the fastest-growing population segments [5]. As the US population becomes more diverse, the need for diversity and multi-culturalism in medicine will become ever-more essential. The characteristics of many clinical encounters today, including time pressure, cognitive complexity, and cost-containment measures, increase the likelihood of care poorly matched to minority patients’ needs [14]. Additionally, minority patients may experience a range of other obstacles to accessing care, including barriers of language, geography, and cultural familiarity [14]. In addition to race and gender, workplace diversity includes variation in age, ethnicity, physical attributes, educational background, sexual orientation, geographical location, socioeconomic status, marital and parental status, spiritual practice, and previous work experience. Any organization’s growth and success depend upon its ability to understand and effectively meet the needs of an increasingly diverse customer-patient population. Diverse organizations also benefit from enhanced: (1) Adaptability to fluctuating conditions and patient demands, (2) skillsets and competencies extending the range of potential customers-patients, and (3) idea pools and innovative solutions [6, 7, 19]. The Council on Graduate Medical Education first expressed concern about the growing disparity between the physician specialty and geographic maldistribution in 1988, despite an increasing aggregate supply of physicians within the United States. It found that “the composition of the Nation’s physicians [did] not reflect the general population” contributing to a “crisis in health care delivery” [9]. In 2011, the Association of American Medical Colleges (AAMC) reported a continued maldistribution of physicians by specialty and geography [1]. Men far outnumber women in nearly all surgical subspecialties, and surgeons of color are underrepresented across the board in medicine—a disparity that is even more severe in surgery [11, 12]. This is problematic for many reasons, not least of which is that patient-physician raceconcordance has been demonstrated to have higher patient satisfaction ratings; the same has been shown for patientphysician gender concordance [22]. Definite signs of progress are visible in medical schools and in some subspecialties during residency for women and under-represented minorities. For instance, women have increased from 48% to 51% of medical school matriculants since 2002. Women also account for the majority of graduate medical education trainees in obstetrics and gynecology, pediatrics, dermatology, internal medicine/ pediatrics, familymedicine, pathology, and psychiatry [2, 12]. Moreover, from 1995 to 2010, the percentage of women faculty members in orthopaedic departments has nearly doubled (from 4.9% to 8.1%), as did black This CORR Insights is a commentary on the article “What is the Geographic Distribution ofWomenOrthopaedic Surgeons Throughout the United States?” by Chapman and colleagues available at: DOI: 10.1097/CORR.0000000000000868. The author certifies that neither he, nor any members of his immediate family, have any commercial associations (such as consultancies, stock ownership, equity interest, patent/ licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. The opinions expressed are those of the writer, and do not reflect the opinion or policy of CORR or The Association of Bone and Joint Surgeons. A. E. Johnson MD, FACS, FAOA (✉), Dell Medical School/UTHealth Austin, University of Texas at Austin, 1701 Trinity Street, MC Z0800, Austin, TX 78712, USA, Email: AJ. Johnson@austin.utexas.edu
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CORR Insights®:美国女性骨科医生的地理分布情况如何?
据估计,到2050年,美国将不再有任何明显的种族和族裔占多数。事实上,西班牙裔和亚裔美国人构成了增长最快的人口群体。随着美国人口变得越来越多样化,医学对多样性和多元文化的需求将变得越来越重要。今天许多临床遭遇的特点,包括时间压力、认知复杂性和成本控制措施,增加了与少数民族患者需求不匹配的护理的可能性[10]。此外,少数族裔患者在获得护理方面可能会遇到一系列其他障碍,包括语言、地理和文化熟悉程度方面的障碍。除了种族和性别,工作场所的多样性还包括年龄、种族、身体特征、教育背景、性取向、地理位置、社会经济地位、婚姻和父母状况、精神实践和以前的工作经验。任何组织的成长和成功都取决于其理解和有效满足日益多样化的客户-患者群体需求的能力。不同的组织也受益于增强:(1)对波动条件和患者需求的适应性,(2)扩大潜在客户-患者范围的技能和能力,以及(3)想法池和创新解决方案[6,7,19]。1988年,研究生医学教育委员会首次表达了对医师专业之间日益扩大的差距和地域分布不均的关注,尽管美国医生的总供应量不断增加。报告发现,“全国医生的构成并没有反映总体人口”,这导致了“医疗服务危机”。2011年,美国医学院协会(Association of American Medical Colleges, AAMC)报告称,医生在专业和地域上的分布依然不均衡。在几乎所有的外科专科中,男性的人数远远超过女性,而在医学领域,有色人种的外科医生人数不足,这种差距在外科领域更为严重[11,12]。这是有问题的,原因有很多,其中最重要的是,医患种族一致性已被证明有更高的患者满意度评级;在医患性别一致性方面也有同样的结果。在医学院校和妇女和代表性不足的少数民族住院期间的一些专科,可以明显看到进步的迹象。例如,自2002年以来,医学院新生中女性的比例从48%增加到51%。在妇产科、儿科、皮肤病学、内科/儿科、家庭医学、病理学和精神病学等研究生医学教育的受训者中,女性也占大多数[2,12]。此外,从1995年到2010年,骨科女教员的比例几乎翻了一番(从4.9%到8.1%),黑人也是如此。这篇文章是对《全美女骨科医生的地理分布情况如何?》,可在:DOI: 10.1097/CORR.0000000000000868。提交人证明,他本人及其直系亲属均无任何可能与所提交文章产生利益冲突的商业协会(如咨询公司、股票所有权、股权、专利/许可安排等)。所表达的观点是作者的观点,不反映CORR或骨关节外科医生协会的观点或政策。A. E. Johnson MD, FACS, FAOA (), Dell医学院/UTHealth Austin, University of Texas at Austin, mcz0800, Texas Austin, 78712, USA, Email: AJ。Johnson@austin.utexas.edu
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CORR Insights®: What is the Geographic Distribution of Women Orthopaedic Surgeons Throughout the United States? What Are the Rates and Trends of Women Authors in Three High-Impact Orthopaedic Journals from 2006-2017? CORR Insights®: Chair Versus Chairman: Does Orthopaedics Use the Gendered Term More Than Other Specialties? CORR Insights®: Does the Proportion of Women in Orthopaedic Leadership Roles Reflect the Gender Composition of Specialty Societies? Women Are at Higher Risk for Concussions Due to Ball or Equipment Contact in Soccer and Lacrosse.
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