The Doc Is In

Instructions:

1. Top of visualization has control bar to swith between Instructions and the visualization dashboards.
2. Main control: Primary Filters
   • ​Located on the top  of all dashboards
   • It allows for user to narrow the graphical summaries to selected data
   • Narrow summary graphs by selecting single or multiple options within each filter:
     • Region
     • Years Experience
     • Employer Type
     • Academic Affiliation
     • Clinical Time
     • Administrative Time
     • Research Time
3. ​​​Other filters:
   • Some of the other graphics will also allow for narrowing of summaries by selecting individual or multiple bar(s)
   • These other interactive graphics are marked with a '(v)' after the graphic title
   • Within these selection can be made by clicking on desired portion of graphic, if multiple selctions are desired, then'shift' or 'command' can be used with the click
   • To deselect a selection within one of these graphs, click again on the item, or to reset all selection within that graph click in white space of graph.
4. Additional Information
   • Hover arrow over any point to get more information about the label, data point, or distribution​

Definitions:

Regions of the United States:

• Great Lakes: IL, IN, MI, OH, WI
• Mid-Atlantic: DC, DE, MD, NJ, PA, VA, WV
• North Central: IA, KS, MO, ND, NE, SD
• Northeast: CT, MA, ME, NH, NY, RI, VT
• Northwest: ID, MT, OR, WA, WY​
• South Central: AR, OK, TX
• Southeast: AL, FL, GA, KY, LA, MS, SC, TN
• ​Southwest: AZ, CO, NM, NV, UT​
• West: AK, CA, HI

Years Experience:

• Early Career (<11 years from Fellowship Training)
• Mid-Career (11 to 25 yeats from Fellowshiip Training)
• Later Career (>25 years from Fellowship Training)

Employer Type:

• Hospital or Health System
• Private Practice Single-Specialty Group​
• Private Practice Multi-Specialty Group
• Military or Federal Government​
• ​Other ​

Clinical Time:

• Divided into quartiles based on clinical hours worked per year

Administrative Time:

• Divided into quartiles based on weeks of administrative duties per year

Research Time:

• Divided into quartiles based on weeks of protected research time per year
  ​​

Instrument: 

The 70-item anonymous REDCap questionnaire used for this project expanded on our previous work, and examined key variables in three main categories: employer factors, professional duties, and social factors.  See Table 1.  This revised survey was pretested with a diverse convenience sample of 15 United States neonatologists to assess face validity.  Their pretest responses were not included in the final data set.  The study was approved by the Boston Children’s Hospital Institutional Review Board for IRB exemption. 

Study Setting and Participants: 

This study utilized a national anonymous REDCap survey distributed to all members of the AAP Section on Neonatal-Perinatal Medicine during the month of February 2018.  The Section on Neonatal-Perinatal Medicine is a member subsection of the American Academy of Pediatrics, and represents over 70% of the total US American Board of Pediatrics Neonatal-Perinatal Medicine Delegates.  All participation was voluntary, and completion of the survey was demonstration of consent.  The demographics of the study sample was compared to the American Board of Pediatrics (ABP) data base, see Table 2. 

Data Analysis: 

Data visualization of the responses is presented here using Tableau Public (Tableau, Seattle, WA - https://public.tableau.com/en-us/s/) for a collection of over 100 interactive graphical visualizations. ​

Limitations:

Limitations of this study include the response rate of 15.7%, although similar to other survey studies of compensation and of physician providers, but does raise concern for selection bias, nonresponse bias, and aggregation bias. In addition, these data were collected by anonymous self-report which does not allow for validation of data obtained or provide a means for follow-up to obtain additional information or clarification.  Nevertheless, we developed these measures utilizing standard survey design techniques to produce questions with strong face validity that were refined through convenient sampling validation and compared to the data obtained from prior surveys. ​

​Your video guide to discover what DOC IS In can share with you​​

View Tutorial

• ​These are formatted for viewing on all device types, but if viewing on computer I recommend going to the bottom right corner of the visualization of interest and clicking on the icon there to make the visualization full screen
• Top bar contains filters that can be applied.  All are set to allow selection of all or some of the options.  The filters include:
  
  • Full or Part-Time Employment
  • Career Phase – defined as time since completing fellowship
  • Principal Career Path – respondent self-identified their primary career role is a: Clinician, Administrator, Researcher, or Educator
  • Academic Rank
  • Employment Type
  • Employer Group
  • Geographic Region:
    • ​Great Lakes: IL, IN, MI, OH, WI
    • Mid-Atlantic: DC, DE, MD, NJ, PA, VA, WV
    • North Central: IA, KS, MO, ND, NE, SD
    • Northeast: CT, MA, ME, NH, NY, RI, VT
    • Northwest: ID, MT, OR, WA, WY
    • South Central: AR, OK, TX
    • Southeast: AL, FL, GA, KY, LA, MS, SC, TN
    • Southwest: AZ, CO, NM, NV, UT
    • West: AK, CA, HI
  • ​Level of Nursery (where primarily perform clinical duties)
    Gender Identity
  • If identify as a racial or ethnic group underrepresented in medicine
  • AAP Membership Status
• The top right box shows the size of the sample/sub-set generating the visualizations (ie. at first if says 2112, but once you use the filters that number will always be less)
• If you hover your curser over the area of interest on the graphic, you will get numbers. If numbers don't appear, click on the box, and then hover again (on phone tap graphic with finger).  I have also added the number of respondents for that metric to aid in data transparency and honesty.
• You can also select groups in the filters to get a sub-set type, ie. if one wanted academic vs non, got to academic rank and deselect all, then select Instructor - Professor for academic; and 'not' for non-academic.  Also, if you select 'null' it should give you the data on non-responders to that question powering the filter (my goal is transparency and honesty)

Instrument:

• The 122-item anonymous SurveyMonkey questionnaire used for this study expanded upon previous work by these authors and the AAP Research Department, and examined key variables in three main categories: employer factors, professional dut​ies, and social factors. This study was approved by the American Academy of Pediatrics Institutional Review Board for IRB exemption.

Study setting and participants:

• This study utilized a national anonymous Survey Monkey survey distributed to all United States board certified or eligible neonatologists from July into November 2021. The potential participant list was obtained from the American Board of Pediatrics. All participation was voluntary, and completion of the survey was demonstration of consent.

Calculated Values:

• Work hours were not directly reported, but were calculated from information given by respondents. Clinical hours were determined by multiplying number of in-house clinical shifts by the hours reported for the duration of those shifts for each individual respondent. Out of house call was not included in this calculation. Hours spent in administrative, research, or teaching duties were derived by multiplying the reported number of weeks spent in these tasks by the average number of hours worked in a typical work week. Total annual hours is the sum of these values within each respondent.
• ​wRVU is calculated based on an average wRVU for patient acuity (non-critical, intensive, critical care, etc) multiplied by the number of daytime clinical sessions.  This calculation does not account for significant difference in admission vs subsequent care codes, nighttime work, and does not account for procedures often performed while receiving NICU care.