Browsing by Author "Lall, Michelle D."

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    Overcoming barriers to promotion for women and underrepresented inmedicine faculty in academic emergency medicine
    (Wiley, 2021-12-21) Oh, Laura; Linden, Judith A.; Zeidan, Amy; Salhi, Bisan; Lema, Penelope C.; Pierce, Ava E.; Greene, Andrea L.; Werner, Sandra L.; Heron, Sheryl L.; Lall, Michelle D.; Finnell, John T.; Franks, Nicole; Battaglioli, Nicole J.; Haber, Jordana; Sampson, Christopher; Fisher, Jonathan; Pillow, M. Tyson; Doshi, Ankur A.; Lo, Bruce; Emergency Medicine, School of Medicine
    Equity in the promotion of women and underrepresented minorities (URiM) is essential for the advancement of academic emergency medicine and the specialty as a whole. Forward‐thinking healthcare organizations can best position themselves to optimally care for an increasingly diverse patient population and mentor trainees by championing increased diversity in senior faculty ranks, leadership, and governance roles. This article explores several potential solutions to addressing inequities that hinder the advancement of women and URiM faculty. It is intended to complement the recently approved American College of Emergency Physicians (ACEP) policy statement aimed at overcoming barriers to promotion of women and URiM faculty in academic emergency medicine. This policy statement was jointly released and supported by the Society for Academic Emergency Medicine (SAEM), American Academy of Emergency Medicine (AAEM), and the Association of Academic Chairs of Emergency Medicine (AACEM).
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    Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US
    (American Medical Association, 2021-08-02) Lall, Michelle D.; Bilimoria, Karl Y.; Lu, Dave W.; Zhan, Tiannan; Barton, Melissa A.; Hu, Yue-Yung; Beeson, Michael S.; Adams, James G.; Nelson, Lewis S.; Baren, Jill M.; Surgery, School of Medicine
    Importance: The prevalence of workplace mistreatment and its association with the well-being of emergency medicine (EM) residents is unclear. More information about the sources of mistreatment might encourage residency leadership to develop and implement more effective strategies to improve professional well-being not only during residency but also throughout the physician's career. Objective: To examine the prevalence, types, and sources of perceived workplace mistreatment during training among EM residents in the US and the association between mistreatment and suicidal ideation. Design, setting, and participants: In this survey study conducted from February 25 to 29, 2020, all residents enrolled in EM residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) who participated in the 2020 American Board of Emergency Medicine computer-based In-training Examination were invited to participate. A multiple-choice, 35-item survey was administered after the examination asking residents to self-report the frequency, sources, and types of mistreatment experienced during residency training and whether they had suicidal thoughts. Main outcomes and measures: The types and frequency of workplace mistreatment and the sources of the mistreatment were identified, and rates of self-reported suicidality were obtained. Multivariable logistic regression models were used to examine resident and program characteristics associated with suicidal thoughts. Results: Of 8162 eligible EM residents, 7680 (94.1%) responded to at least 1 question on the survey; 6503 (79.7%) completed the survey in its entirety. A total of 243 ACGME-accredited residency programs participated, and 1 did not. The study cohort included 4768 male residents (62.1%), 2698 female residents (35.1%), 4919 non-Hispanic White residents (64.0%), 2620 residents from other racial/ethnic groups (Alaska Native, American Indian, Asian or Pacific Islander, African American, Mexican American, Native Hawaiian, Puerto Rican, other Hispanic, or mixed or other race) (34.1%), 483 residents who identified as lesbian, gay, bisexual, transgender, queer, or other (LGBTQ+) (6.3%), and 5951 residents who were married or in a relationship (77.5%). Of the total participants, 3463 (45.1%) reported exposure to some type of workplace mistreatment (eg, discrimination, abuse, or harassment) during the most recent academic year. A frequent source of mistreatment was identified as patients and/or patients' families; 1234 respondents (58.7%) reported gender discrimination, 867 (67.5%) racial discrimination, 282 (85.2%) physical abuse, and 723 (69.1%) sexual harassment from patients and/or family members. Suicidal thoughts occurring during the past year were reported by 178 residents (2.5%), with similar prevalence by gender (108 men [2.4%]; 59 women [2.4%]) and race/ethnicity (113 non-Hispanic White residents [2.4%]; 65 residents from other racial/ethnic groups [2.7%]). Conclusions and relevance: In this survey study, EM residents reported that workplace mistreatment occurred frequently. The findings suggest common sources of mistreatment for which educational interventions may be developed to help ensure resident wellness and career satisfaction.
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    Unconditional care in academic emergency departments
    (Wiley, 2020-05-14) Kline, Jeffrey A.; Burton, John H.; Carpenter, Christopher R.; Meisel, Zachary F.; Miner, James R.; Newgard, Craig D.; Quest, Tammie; Martin, Ian B. K.; Holmes, James F.; Kaji, Amy H.; Bird, Steven B.; Coates, Wendy C.; Lall, Michelle D.; Mills, Angela M.; Ranney, Megan L.; Wolfe, Richard E.; Dorner, Stephen C.; Emergency Medicine, School of Medicine
    Recent news stories have explicitly stated that patients with symptoms of COVID-19 were "turned away" from emergency departments. This commentary addresses these serious allegations, with an attempt to provide the perspective of academic emergency departments (EDs) around the Nation. The overarching point we wish to make is that academic EDs never deny emergency care to any person.