Hostname: page-component-848d4c4894-hfldf Total loading time: 0 Render date: 2024-05-31T10:45:44.863Z Has data issue: false hasContentIssue false
  • English
  • Français

Workforce demographics and unit structure in paediatric cardiac critical care in the United States

Published online by Cambridge University Press:  03 December 2021

Robin V. Horak Open the ORCID record for Robin V. Horak [Opens in a new window] ,
Shasha Bai ,
Bradley S. Marino ,
David K. Werho Open the ORCID record for David K. Werho [Opens in a new window] ,
Leslie A. Rhodes ,
John M. Costello ,
Antonio G. Cabrera ,
David S. Cooper ,
Yubo Tan  and
Sarah Tabbutt
...Show all authors
Robin V. Horak*
Affiliation:
Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Department of Anesthesia Critical Care, Children’s Hospital Los Angeles, Los Angeles, CA, USA
Shasha Bai
Affiliation:
Biostatistics Resource at Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
Bradley S. Marino
Affiliation:
Department of Pediatrics, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland Clinic Children’s, Cleveland, OH, USA
David K. Werho
Affiliation:
Department of Pediatrics, University of California San Diego School of Medicine, Rady Children’s Hospital, San Diego, CA, USA
Leslie A. Rhodes
Affiliation:
Department of Pediatrics, University of Alabama at Birmingham, Children’s Hospital of Alabama, Birmingham, AL, USA
John M. Costello
Affiliation:
Department of Pediatrics, Medical University of South Carolina College of Medicine, MUSC Shawn Jenkins Children’s Hospital, Charleston, SC, USA
Antonio G. Cabrera
Affiliation:
Department of Pediatrics, University of Utah College of Medicine, The Heart Center, Intermountain Primary Children’s Hospital, Salt Lake City, UT, USA
David S. Cooper
Affiliation:
Department of Pediatrics, University of Cincinnati College of Medicine, The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Yubo Tan
Affiliation:
Biostatistics Resource at Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
Sarah Tabbutt
Affiliation:
Department of Pediatrics, University of California San Francisco School of Medicine, Benioff Children’s Hospital, San Francisco, CA, USA
Catherine D. Krawczeski
Affiliation:
Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children’s Hospital, Columbus, OH, USA
*
Author for correspondence: R. Horak, MD, Department of Anesthesiology, Critical Care Medicine, Children’s Hospital Los Angeles, 4650 Sunset Blvd. MS #3, Los Angeles, CA90027, USA. Tel: 323-361-8202; Fax: 323-361-1001. E-mail: rhorak@chla.usc.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To assess current demographics and duties of physicians as well as the structure of paediatric cardiac critical care in the United States.

Design:

REDCap surveys were sent by email from May till August 2019 to medical directors (“directors”) of critical care units at the 120 United States centres submitting data to the Society of Thoracic Surgeons Congenital Heart Surgery Database and to associated faculty from centres that provided email lists. Faculty and directors were asked about personal attributes and clinical duties. Directors were additionally asked about unit structure.

Measurements and main results:

Responses were received from 66% (79/120) of directors and 62% (294/477) of contacted faculty. Seventy-six percent of directors and 54% of faculty were male, however, faculty <40 years old were predominantly women. The majority of both groups were white. Median bed count (n = 20) was similar in ICUs and multi-disciplinary paediatric ICUs. The median service expectation for one clinical full-time equivalent was 14 weeks of clinical service (interquartile range 12, 16), with the majority of programmes (86%) providing in-house attending night coverage. Work hours were high during service and non-service weeks with both directors (37%) and faculty (45%).

Conclusions:

Racial and ethnic diversity is markedly deficient in the paediatric cardiac critical care workforce. Although the majority of faculty are male, females make up the majority of the workforce younger than 40 years old. Work hours across all age groups and unit types are high both on- and off-service, with most units providing attending in-house night coverage.

Keywords

Paediatric cardiac intensive carepaediatric intensive careattending physicianCHDhealth servicesdemography
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 10 , October 2022 , pp. 1628 - 1632
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Horak, RV, Griffin, JF, Brown, AM, et., al. Growth and changing characteristics of pediatric intensive care 2001-2016. Crit Care Med 2019; 47: 1135–1142.CrossRefGoogle ScholarPubMed
Morrow, DA, Fang, JC, Fintel, DJ, et al. Evolution of critical care cardiology: transformation of the cardiovascular intensive care unit and the emerging need for new medical staffing and training models: a scientific statement from the American Heart Association. Circulation 2012; 126: 1408–1428. DOI 10.1161/CIR.0b013e31826890b0.CrossRefGoogle ScholarPubMed
Horak, RV, Alexander, PM, Amirnovin, R, et al. Pediatric cardiac intensive care distribution, service delivery, and staffing in the United States in 2018. Pediatr Crit Care Med 2020; 21: 797–803.CrossRefGoogle ScholarPubMed
US Census Bureau: Geography Atlas – Regions. Retrieved April 2020, from https://www.census.gov/programs-surveys/geography/guidance/geographic-areas-reference-manual.html.Google Scholar
Maxwell, AR, Riley, CL, Stalets, EL, Wheeler, DS, Dewan, M. State of the unit: physician gender diversity in pediatric critical care medicine leadership. Pediatr Crit Care Med 2019; 20: e362–e365.CrossRefGoogle Scholar
American Board of Pediatrics: Data of Subspecialty Fellows by Demographics and Program Traits. Retrieved March 2020, from https://www.abp.org/content/data-subspecialty-fellows-demographics-program-traits.Google Scholar
Jena, AB, Khullar, D, Ho, O, Olenski, AR, Blumenthal, DM. Sex differences in academic rank in US medical schools in 2014. JAMA 2015; 314: 1149–1158.CrossRefGoogle ScholarPubMed
Lautenberge, D, Dandar, VM, Raezer, CL, Sloane, RA. The State of Women in Academic Medicine: The Pipeline and Pathways to Leadership. Association of American Medical Colleges, Washington, DC, 2014.Google Scholar
Sullivan, L. Missing Persons: Minorities in the Health Professions, a Report of the Sullivan Commission on Diversity in the Healthcare Workforce. 2004.Google Scholar
Okike, K, Utuk, ME, White, AA. Racial and ethnic diversity in orthopaedic surgery residency programs. J Bone Joint Surg Am 2011; 93: e107. DOI 10.2106/JBJS.K.00108.CrossRefGoogle ScholarPubMed
Landry, AM, Stevens, J, Kelly, SP, Sanchez, LD, Fisher, J. Under-represented minorities in emergency medicine. J Emerg Med 2013; 45: 100–104. DOI 10.1016/j.jemermed.2012.11.064.CrossRefGoogle ScholarPubMed
Onumah, C, Kimmel, PL, Rosenberg, ME. Race disparities in U.S. nephrology fellowship training. Clin J Am Soc Nephrol 2011; 6: 390–394. DOI 10.2215/CJN.04450510.CrossRefGoogle ScholarPubMed
Higgins, MC, Hwang, WT, Richard, C, et al. Underrepresentation of women and minorities in the United States IR academic physician workforce. J Vasc Interv Radiol 2016; 27: 1837–1844.e2. DOI 10.1016/j.jvir.2016.06.011.CrossRefGoogle ScholarPubMed
Powers, BW, White, AA, Oriol, NE, Jain, SH. Race-conscious professionalism and African American representation in academic medicine. Acad Med 2016; 91: 913–915.CrossRefGoogle ScholarPubMed
Peek, ME, Kim, KE, Johnson, JK, Vela, MB. “URM candidates are encouraged to apply”: a national study to identify effective strategies to enhance racial and ethnic faculty diversity in academic departments of medicine. Acad Med 2013; 88: 405–412.CrossRefGoogle ScholarPubMed
Andriole, DA, McDougle, L, Bardo, HR, Lipscomb, WD, Metz, AM, Jeffe, DB. Postbaccalaureate premedical programs to promote physician-workforce diversity. J Best Pract Health Prof Divers 2015; 8: 1036–1048.Google ScholarPubMed
Alexander, C, Chen, E, Grumbach, K. How leaky is the health career pipeline? Minority student achievement in college gateway courses. Acad Med 2009; 84: 797–802.CrossRefGoogle ScholarPubMed
Greenwood, BN, Hardeman, RR, Huang, L, Sojourner, A. Physician-patient racial concordance and disparities in birthing mortality for newborns. Proc Natl Acad Sci U S A 2020; 117: 21194–21200. DOI 10.1073/pnas.1913405117.CrossRefGoogle ScholarPubMed
US Bureau of Labor Statistics. Retrieved April 2021, from https://www.bls.gov/charts/american-time-use/emp-by-ftpt-job-edu-h.htm.Google Scholar
Shanafelt, TD, West, CP, Sinsky, C, et al. Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2017. Mayo Clin Proc 2019; 94: 1681–1694. DOI 10.1016/j.mayocp.2018.10.023.CrossRefGoogle ScholarPubMed
Supplementary material: PDF

Horak et al. supplementary material

Horak et al. supplementary material 1

Download Horak et al. supplementary material(PDF)
PDF 65.5 KB
Supplementary material: PDF

Horak et al. supplementary material

Horak et al. supplementary material 2

Download Horak et al. supplementary material(PDF)
PDF 76.7 KB