Doximity Data: Why Foreign-Born Doctors Have Lower Mortality Rates

Feb 16, 2017 - Doximity Blog


As the nation’s attention has recently turned to immigration, a spotlight has fallen on U.S. doctors – many of whom were either born or trained overseas. While we’re not politicians, and will leave the debate on immigration to them, Harvard researchers recently used Doximity data to shed light on the value of foreign-born doctors to the U.S. medical system.

In this instance, our data science helped illuminate some important findings. As published in the prestigious journal BMJ, the Harvard team conducted a study that found U.S. patients treated by foreign doctors actually had lower mortality rates than patients cared for by doctors trained here in the United States. This unique observation led to headlines across the country, from the Wall Street Journal to Reuters, as well as WebMD.com.

Harvard researchers Yusuke Tsugawa, Anupam Jena, John Orav, and Ashish Jha analyzed Doximity’s extensive network of physicians, which includes nearly 70 percent of all doctors licensed to practice in the U.S., to conclude that foreign physicians meet and exceed very high standards. (Researchers also compared data from 100% Medicare Inpatient Files, 20% Medicare Carrier Files, and the American Hospital Association annual survey on hospital characteristics).

The lead author, Tsugawa, speculated that the various barriers foreign doctors must overcome to practice in the United States may lead us to attract only the most motivated, saying, “I think we are selecting the best and brightest from the world.”

Additionally, on the popular website FiveThirtyEight, four Harvard researchers, including study co-author Anupam Jena, further mined Doximity data to understand how doctors might be affected by a travel ban on immigrants from seven Muslim-majority countries. Of the doctors evaluated, 8,243 were trained in those seven countries, or about 5 percent. They noted:

“Our research finds that foreign-trained doctors play an even larger role than their share of the physician workforce would suggest because of the areas and specialties in which they often practice: rural, underserved regions and specialties facing a large shortage of practitioners.”

Doximity is already the fastest growing and most popular network for doctors, and we’re proud of our contribution to leading edge research projects, such as the work produced by the Harvard team. As we grow, we look forward to developing our own research insights, in addition to continuing to support academic efforts, and are proud to play a foundational role in research that helps provide crucial context for a national conversation.

What would you do? Shortness of Breath, Heart Palpitations, and No Patient Records

Jan 23, 2017 - Doximity Blog


In the past year, some staggering facts on issues related to patient safety have come to light.

One of the most disappointing pieces of news in 2016 was the study by researchers at John Hopkins Medicine saying medical errors rank as the third leading cause of death in the United States. These medical errors are defined as anything from surgical complications that go unrecognized, to mix-ups with doses or types of medications that patients receive.

Based on an analysis of prior research, the study estimated that more than 250,000 Americans die each year from medical errors.

Most of these deaths are preventable, and there are factors surrounding medical mistakes that we can modify and improve to minimize the chance for medical errors.

We spoke to Kaustubh Dabhadkar, a Cardiology fellow at Brown University, about his experiences with patient safety.

“Every day, we see many instances where patient safety could be improved,” he began. “Unfortunately, most of them relate to provider communication.

Last week I cared for a young female who switched her care to me from a different healthcare system. She had surgery on her heart as a kid. Due to the nature of her job, she has lived in three states over last two years. Every time she switches a cardiologist, she has to make sure her records are sent over, and unfortunately this time, the records were not transmitted over. In the clinic, she complained of episodic shortness of breath and palpitations over the last month. The cardiologist who had treated her before could not be reached during the clinic visit. So I had to start her workup and treatment without knowing details of her heart surgery. Eventually, I received a 95-page fax three days after requesting her records. After digging through that, I found the four pages that I cared most about.

Very often, and this is the case more so with specialists, patients show up without any records. We are left to make our study and examinations without basic knowledge of the patient’s medical history.

Quite often this is urgent. We spend a lot of time in the emergency room, and when a patient comes in with a heart attack, we need to look at their prior records. A lot of hospitals don’t have their own catheterization labs, and when patients get transferred, all their records are pulled, and we are on the phone on the other side, faxing things, forwarding to hospitals, etc. This is an everyday thing, and some of those records don’t make it back to us soon enough. They’re faxed to someone in the office, who then tries to reach me, and I end up with no access to records.”

In moments of emergency, provider communication and technology success is vital. However, it is also critically important in non-emergency situations. Misinformation and lack of information, especially in regards to patient records, can start workflows that lead to endangering patient safety.

“It still baffles all physicians that in this day and age of connectivity, it is difficult to communicate efficiently with another healthcare system or physician,” Dabhadkar remarked.

“Despite the tremendous progress in the procedural field, the medical community is resistant to communication technology. As an example, most physicians still carry a pager and trust it more than a smartphone. Some of us still prefer paper charts to electronic health records. Part of the reason is - the technology is sometimes developed without considering physician workflow.”

In order to take steps toward improving miscommunication and other medical errors, some hospitals are working with organizations like the Patient Safety Movement Foundation.

“Hospitals that attain zero preventable deaths in areas like healthcare-associated infections plan for it for it by implementing processes like our Actionable Patient Safety Solutions (APSS),” said Joe Kiani, Founder of the Patient Safety Movement Foundation.

“80% of serious medical errors involve miscommunication during hand-off between clinicians. The implementation plan and solutions we note are key for accurate, complete, and effective handoff communication” said Kiani.

Medical errors are a leading cause of death in America, and both the catalyst and the solution seem to revolve around communication.

“After all,” Dabhadkar expresses, “we are all working towards a shared goal of patient safety.”

Doximity is proud to be supporting one of the strongest advocates of ending medical errors, the Patient Safety Movement Foundation, whose mission is to achieve “zero preventable deaths by 2020.” Toward that goal, they are kicking off 2017 with the fifth annual World Patient Safety, Science & Technology Summit.

The Summit will bring together international leaders from hospitals, medical and information technology companies, the patient advocacy community, public policy makers and government officials to discuss solutions to the leading challenges that cause preventable patient death in hospitals. Their keynote speaker is President Bill Clinton. For the agenda, click here, and for a link to live steam, click here.

To learn more about the Patient Safety Movement, click here.

How to Get Multiple Job Offers After Residency

Jan 13, 2017 - Doximity Blog


When it comes to looking for your first job out of training, the task might seem like a bigger job than residency itself. There are so many decisions to be made - where do you want to live and what kind of practice setting do you want? How do you put together a CV? Not to mention, where do you even start looking for jobs?

The truth is, the current job hunt process for residents is painfully antiquated. Whether it’s calling your target institutions or looking in the classifieds of a journal, finding a job as a physician is about as up-to-date as your pager. With this in mind, we came up with something better. So easy that some of our doctors on staff wish they could go back to residency... almost.

Career Match is an online job matching platform that connects you to top employers in locations of your choice. Once you’ve told us about the job you want, we’ll bring the interview offers to you. And if you’ve got any questions, you’ll be assigned to a personal career advocate who guides you from start to finish.

So how does Career Match work?

  1. You tell us about your ideal job.
  2. We match you with multiple opportunities.
  3. You pick the job you like best.

Once you place, we’ll even give you $3000 to help you get settled into post-residency life. Let us do the job hunting for you, so you can get back to being a resident - what’s not to love about never ending rounds, night shifts and cafeteria food?

Get started

6 Physician Gripes of 2016

Dec 22, 2016 - Doximity Blog


As the new year approaches, we took a look back at 2016 to pick out the top 6 headaches that physicians faced throughout the year - as well as potential ways to address them.

  1. “I need to call my patient, but I don’t want to give out my personal number by using my cell phone. And if I use * 67 to call my patient from a blocked number, they won’t pick up.”
    Our new, free app Doximity Dialer allows you to call patients from your cell phone, without using *67. They will see your office line in the Caller ID.

  2. “I’m graduating residency and I want the tools to start my career off right.”
    With Career Match, you can gain insight into salary trends, alumni networks and contract negotiations. You'll also receive offers to interview, and access to a talent advocate to guide you through the process. If that wasn't enough, you'll also receive a $3,000 bonus as a thank you when you land your dream job through us.

  3. “It’s impossible to filter through and keep up with medical news every day.”
    The Doximity newsfeed provides you with daily, curated medical news in one place, as well as weekly email digests tailored to your specialty. You can read it online, or for those clinicians on the go, you can also read it on your phone.

  4. “I want to make sure I’m being compensated fairly, especially in comparison to other physicians in my area.”
    Our Career Navigator tool gives Doximity members free access to salary data from tens of thousands of physicians, PAs, nurse practitioners, medical groups, hospitals and healthcare organizations worldwide.

  5. “My license renewal is coming up and I need CME credits but I don't have time for a conference”
    On Doximity, you can earn Category 1 CME at no cost - simply by reading CME-eligible articles for free.

  6. “I can’t believe it is the end of 2016 and I’m still regularly using a fax machine.”
    With Doximity’s free fax and digital signature on our mobile app, you can go digital even if the rest of healthcare is relying on 1980’s technology.

We look forward to seeing what new features and apps we can create for clinicians to help meet their needs in 2017. Have a great end to your 2016, and we will see you in the new year!

Elderly patients have better outcomes when treated by female doctors, new study shows

Study shows difference in outcomes between male and female physicians

Dec 21, 2016 - Doximity Blog


A new study reveals that 32,000 less patients would die per year if treated by female physicians compared to male physicians. The study, which linked 4 years of Medicare data for 1.5 million patients aged 65 and older to professional and demographic physician data from the online professional network Doximity, shows a significant decrease in patient readmissions and patient deaths after 30 days for those treated by female internists.

“We know from prior work that female physicians earn about 80 cents on the dollar compared to male physicians, but whether outcomes of patients treated by female physicians differ has never been studied,” study co-author Anupam B. Jena, MD, PhD, the Ruth L. Newhouse Associate Professor at Harvard Medical School. Dr. Jena has used Doximity’s data to study how physician characteristics influence patient outcomes and gender differences in promotion in academic medicine.

These new findings show that patients treated by female physicians experienced almost a half a percentage point decrease in mortality rate within a month of hospitalization, as well as a comparable drop in the chance that patient would return to the hospital. While these gains could be considered unsubstantial, these figures are akin to successful improvements in large scale national quality movements that have occurred over the last decade.

Researchers point out that primary care ‘female physicians are more likely to practice evidence-based medicine, perform as well or better on standardized examinations, and provide more patient-centered care.’ But, it is unclear if these characteristics led to the better patient outcomes witnessed in the study.

The authors acknowledge that a limitation of the study’s results is that they were unable to identify “why” these observed differences between male and female physicians occurred, and therefore could not link gender directly to certain outcomes. Rather, the hope moving forward is that additional investigation can uncover more specifically which care patterns account for these improved outcomes and how to best apply the learnings for the betterment of all patients.