ABIM Foundation Recognizes Top Articles on Medical Professionalism

PHILADELPHIA – The ABIM Foundation today announced the winners of its 10^th annual John A. Benson Jr., MD Professionalism Article Prize, recognizing the best articles written in peer-reviewed journals on medical professionalism topics during 2019.

The selected articles included one commentary and three research articles, and explored topics such as implicit and explicit gender bias, handling biased attitudes and behavior among patients, and physician perspectives on discussing the costs of care with patients.

“Professionalism provides an important lens through which we can recognize critical problems in our health care system, and for helping develop tools that address them,” said Richard J. Baron, MD, President and CEO of the ABIM Foundation. “These articles provide important perspectives on the growing importance of health equity in our increasingly diverse society, and on the stress that the high costs of our health system can place on patients and the clinicians trying to serve them.”

The ABIM Foundation first awarded the prize in 2011 to celebrate and encourage outstanding contributions to the literature on medical professionalism. Over the past 10 years, nearly 600 articles have been considered, and 34 have received the award.

The article receiving this year’s prize for commentary is:

The Unicorn, Ofole Mgbako, MD, JAMA (January 2019)

The author, an African-American physician, relates the story of his interaction with a black patient in his 50s who has a history of drug addiction. The patient expresses delight in being treated by a black doctor and returns for a follow-up visit the following day, despite a history of missed appointments. Dr. Mgbako tells this story alongside a description of the disturbingly low—and decreasing—number of black men who are becoming physicians.

The articles receiving this year’s prizes for research articles are:

Estimating Implicit and Explicit Gender Bias Among Health Care Professionals and Surgeons, Arghavan Salles, MD, PhD; Michael Awad, MD, PhD; Laurel Goldin, MA; Kelsey Krus, BS; Jin Vivian Lee, BA; Maria T. Schwabe, MPHS; Calvin K. Lai, PhD, JAMA Network Open (July 2019)

The authors used Implicit Association Tests (IAT) to explore gender bias among health care professionals generally, and surgeons specifically. They found that both groups hold implicit and explicit biases associating men with careers and surgery, and associating women with family and family medicine.

Physician and Trainee Experiences with Patient Bias, Margaret Wheeler, MD; Shalila de Bourmont, BS; Kimani Paul-Emile, JD, PhD; Alana Pfeffinger, MPH; Ashley McMullen, MD; Jeff M. Critchfield, MD; Alicia Fernandez, MD, JAMA Internal Medicine (October 2019)

The authors conducted focus groups with physicians and medical students to learn about their encounters with biased patients. The physicians and students reported a range of biased behavior, including the refusal to accept treatment and explicitly racist, sexist and homophobic remarks. They said that barriers to responding to such behavior included a lack of skills, insufficient support from senior colleagues and their institution, and the perception that responding would do no good. They called for training on how to deal with such patients and clear institutional policies to guide their responses.

U.S. Internists’ Perspectives on Discussing Cost of Care With Patients: Structured Interviews and a Survey, Susan L. Perez, PhD, MPH; Arlene Weissman, PhD; Susan Read, PhD; Cynthia Daisy Smith, MD; Lisa Colello, MPA; Doris Peter, PhD; and Wendy Nickel, MPH, Annals of Internal Medicine (May 2019)

The authors conducted a survey and set of interviews with internal medicine physicians to learn more about the factors that influence how they think about cost during a patient encounter and how they discuss it with patients. They found that physicians have a high awareness that some patients are struggling to afford medical care, rely upon clues from patients to assess whether they are cost-sensitive, and rely on their experience to anticipate what treatments will be particularly costly. Three-quarters of respondents said they consider out-of-pocket costs when making most clinical decisions.

About This Year’s Award

In 2015, the ABIM Foundation named the article prize in honor of American Board of Internal Medicine and ABIM Foundation President Emeritus John A. Benson Jr., MD. For more than two decades, Dr. Benson taught medical students at the University of Nebraska Medical Center, where he also worked to foster inter-professional education, and at Oregon Health & Science University School of Medicine, where he served at the Center for Ethics in Health Care. He has received several honors for his work in medical education and clinical medicine and has written extensively about professionalism.

Articles published in English language, peer-reviewed journals between January 1, 2019, and December 31, 2019 (online or in print), were eligible for the prize. A committee of physicians and other leaders in health care reviewed 16 articles meeting those criteria and selected the winners based on clarity of writing, thoroughness, methodology and contributions to the field and society.

Members of the selection committee included:

• Mercy Adetoye, MD, Resident, University of Michigan
• Louise Arnold, PhD, Professor Emerita, Office of Medical Education, University of Missouri-Kansas City School of Medicine
• John A. Benson Jr., MD, President Emeritus, American Board of Internal Medicine and ABIM Foundation
• Rosemary Gibson, MSc, Senior Advisor, The Hastings Center; Section Editor, Less is More, JAMA Internal Medicine
• Hayley Goldbach, MD, Resident, UCLA
• Lorna Lynn, MD, Vice President, Medical Education Research, American Board of Internal Medicine
• Bernard M. Rosof, MD, MACP, Chief Executive Officer of Quality in Healthcare Advisory Group, LLC
• Daniel Wolfson, MHSA, Executive Vice President and Chief Operating Officer, ABIM Foundation

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About the ABIM Foundation

The ABIM Foundation’s mission is to advance medical professionalism to improve the health care system by collaborating with physicians and physician leaders, medical trainees, health care delivery systems, payers, policymakers, consumer organizations and patients to foster a shared understanding of professionalism and how they can adopt the tenets of professionalism in practice. To learn more about the ABIM Foundation, visit www.abimfoundation.org, connect on Facebook or follow on Twitter.

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