Publications by authors named "Mary Ann Gilligan"
Background And Objectives: Faculty development (FD) is required for medical educators, yet few studies address its long-term career impact on graduates. This project presents the impact of FD on career development, as perceived by physician faculty graduates of a longitudinal primary care FD educator program, compared to nonenrollees.
Methods: Between 2011 and 2016, 33 physician faculty from three departments participated in monthly half-day in-class FD for 20 months, emphasizing educator skills and career development.
Objective: To explore leadership perspectives on how to maintain high quality efficient care that is also person-centered and humanistic.
Methods: The authors interviewed and collected narrative transcripts from a convenience sample of 32 institutional healthcare leaders at seven U.S.
Background: Changes in the organization of medical practice have impeded humanistic practice and resulted in widespread physician burnout and dissatisfaction.
Objective: To identify organizational factors that promote or inhibit humanistic practice of medicine by faculty physicians.
Design: From January 1, 2015, through December 31, 2016, faculty from eight US medical schools were asked to write reflectively on two open-ended questions regarding institutional-level motivators and impediments to humanistic practice and teaching within their organizations.
The authors describe the first 11 academic years (2005-2006 through 2016-2017) of a longitudinal, small-group faculty development program for strengthening humanistic teaching and role modeling at 30 U.S. and Canadian medical schools that continues today.
View Article and Find Full Text PDFObjective: Major reorganizations of medical practice today challenge physicians' ability to deliver compassionate care. We sought to understand how physicians who completed an intensive faculty development program in medical humanism sustain their humanistic practices.
Methods: Program completers from 8 U.
Health numeracy is associated with increased understanding of cancer risk reduction information and improved control of chronic disease. A cross-sectional survey was conducted among a primary care population to evaluate the effect of health numeracy on breast, cervical, and colorectal cancer screening. No association was found between health numeracy and cancer screening.
View Article and Find Full Text PDFOur objective of this study is to develop a conceptual framework for the construct of health numeracy based on patient perceptions, using a cross-sectional, qualitative design. Interested participants (n=59) meeting eligibility criteria (age 40-74, English speaking) were assigned to one of six focus groups stratified by gender and educational level (low, medium, high). Fifty-three percent were male, and 47% were female.
View Article and Find Full Text PDFBackground: The effect of combined hormone therapy on breast cancer detection is not established.
Methods: We examined the effect of combined hormone therapy on breast cancer detection in the Women's Health Initiative trial, which randomized 16,608 postmenopausal women to receive conjugated equine estrogens (0.625 mg/d) plus medroxyprogesterone acetate (2.
Background: A relationship between higher surgeon volume and lower mortality has been described for breast cancer, but selection bias has not been rigorously evaluated. We studied potential bias in the surgeon volume-outcome relationship by comparing the relationship of surgeon volume to breast cancer mortality and to mortality from other causes of death.
Methods: We conducted an observational cohort study from tumor registry and Medicare claims data on 12 216 women, 66 years or older, with stage I or II breast cancer, who were operated on by 1856 surgeons.
Objective: Decision-making at menopause remains a challenge for women and their health care providers as the paradigm for hormone therapy continues to evolve. The role of decision-support for this process remains to be defined.
Methods: A randomized controlled trial of a computer-based hormone therapy (HT) decision-aid versus a control intervention consisting of a printed pamphlet among 177 post-menopausal women receiving care in a Veterans Affairs Medical Center.
Objectives: We examined the association between number of breast cancer operations performed in a hospital (hospital volume) and all-cause and breast cancer-specific mortality using a national database and statistical methods appropriate for clustering and reducing confounding.
Methods: In a retrospective cohort study, we linked Surveillance, Epidemiology, and End Results tumor registry data with Medicare claims data. The cohort included 11225 Medicare patients who had undergone surgery for early-stage breast cancer from 1994 to 1996 in 457 different hospitals.
Hypothesis: Adherence to National Institutes of Health consensus statement recommendations for early-stage breast cancer will vary by surgeon characteristics.
Design: Secondary data analysis using the Surveillance, Epidemiology, and End Results national tumor registry linked with Medicare claims data. Logistic regression was used to analyze data on a cohort of 1045 surgeons who operated on 9449 Medicare patients with early-stage breast cancer.
Background: Physician volume of at least 15-30 annual breast cancer operations has been associated with higher 5-year survival rates. The authors sought to determine whether surgical volumes for breast cancer in the United States frequently reach this threshold.
Methods: The authors conducted a retrospective cohort study of 987 surgeons who operated on 8105 Medicare patients with breast cancer during 1994-1995 in 6 areas in the Surveillance, Epidemiology and End Results tumor registry.
A multi-attribute utility (MAU) decision model for menopausal hormone replacement therapy (HRT) was developed using structured interviews (n=40) to identify decision factors, and a telephone survey (n=97) to ascertain utility scores. Utility scores for individual factors and composite scores reflecting the HRT decision were compared according to HRT use. Composite utility scores (range of -1.
View Article and Find Full Text PDFContext: The Women's Health Initiative trial of combined estrogen plus progestin was stopped early when overall health risks, including invasive breast cancer, exceeded benefits. Outstanding issues not previously addressed include characteristics of breast cancers observed among women using hormones and whether diagnosis may be influenced by hormone effects on mammography.
Objective: To determine the relationship among estrogen plus progestin use, breast cancer characteristics, and mammography recommendations.
Background: Use of breast-conserving treatment (BCT) has previously demonstrated variability by sociodemographic factors.
Objective: To determine whether variation in use of BCT by age, race, county income, county education, and population density declined between 1983 and 1996.
Design: Trends in use of BCT over time were modeled with logistic regression.