Julie Silver

• MD
• Chair at Harvard Medical School

Background The authors of clinical practice guidelines (CPGs) are considered topic experts and specialists. Studies to date have disproportionately found that women are underrepresented in CPG authorship, but no studies have investigated CPGs on spasticity published in the recent literature. Objective To determine the gender composition of author...

Background: The attrition of health care professionals from institutions has historically been high, with reports of higher rates in women than men. High attrition jeopardizes the institution's financial stability, quality of patient care, and scholarly contributions to advancing health care. The disproportionate loss of women reduces the diversity...

Objective: Attrition of women health care professionals is high, threatening patient care and advances in health care sciences. Women health care professionals have often reported experiencing challenges in the workplace that lower their sense of belonging and may precipitate their attrition. The current study sought to identify dimensions of workp...

Importance Women account for only 28% of current US medical school deans. Studying the differences between women and men in their preparation to becoming deans might help to explain this discrepancy. Objective To identify differences in the leadership development experiences between women and men in their ascent to the medical school deanship. De...

Background and Objectives: Clinical practice guidelines (CPGs) have significantly influenced medical practice worldwide. Nevertheless, the authorship of CPGs produced by several medical societies has not been representative of the field and population they address, as women and individuals from racial and ethnic minority groups have been underrepre...

Visual Abstract

The retention of physicians and other health care professionals in rehabilitation medicine is a critical issue that affects patients' access to care and the quality of the care they receive. In the United States and globally, there are known shortages of clinicians including, but not limited to, physicians, nurses, physical therapists, occupational...

Objective: Underrepresentation of women on editorial boards of biomedical journals has occurred for decades. The JAMA Network Journals have substantial and broad impact on advances in the biomedical sciences. We sought to determine the current status of gender representation on editorial boards of the 12 JAMA Network Journals. Methods: The gender o...

Radiation therapy (RT) is a central component of cancer treatment with survival and long-term quality-of-life benefits across a spectrum of oncologic diagnoses. However, RT has been associated with varying levels of fatigue, pain, weight loss, and changes in mental health both during and post-treatment. Prehabilitation aims to optimize health prior...

Cancer rehabilitation has grown over the past three decades due to the increasing number of cancer survivors with disease- and treatment-related impairments. Palliative cancer rehabilitation includes rehabilitation interventions at the end of life or when no further cancer-directed treatments will be offered. Hematologic malignancy patients, due to...

Objectives: To assess the gender composition of upper-level specialty-specific editor positions among United States (U.S.) medical society-affiliated journals and to evaluate the equitable inclusion of women and women physicians. Materials and Methods: The gender composition of upper-level (e.g., editor-in-chief, deputy) specialty-specific editor p...

Background: The inequitable representation of women and members of racial and ethnic minority groups in leadership positions within academic medicine is an ongoing challenge with practical and realistic solutions. The purpose of this study was to assess the race and ethnicity of individuals in leadership positions among the 24 Member Boards of Dire...

This cross-sectional study analyzes inequities in the gender of editors for 3 major pediatric journals.

Objective To determine whether gender and racial inequities exist among Lasker Award recipients. Design Observational, cross sectional analysis. Setting Population based study. Participants Recipients of four Lasker Awards from 1946 to 2022. Main outcome measures Gender and race (non-white categorized as racialized v white categorized as non-ra...

Context.— United States' clinical practice guidelines (CPGs) are often produced by professional societies and used worldwide in daily medical practice. However, studies in various medical specialties demonstrate underrepresentation of women and racial and ethnic minority groups in CPGs. The representation of authors by gender, race, and ethnicity o...

Home cooking is an emerging strategy to improve nutrition; however, the literature lacks reports about patient expectations from culinary interventions. Personalized medicine utilizes knowledge about a person's genes; yet, behavioral factors, such as participant "readiness" to make a change, may also impact treatment preferences and outcomes. The p...

UNSTRUCTURED Abundant disparities for women in medicine contribute to many women physicians considering leaving medicine. There is a strong financial and ethical case for leaders in academic medicine to focus on strategies to improve retention. This article focuses on five immediate actions that leaders can take to enhance gender equity and improve...

Abundant disparities for women in medicine contribute to many women physicians considering leaving medicine. There is a strong financial and ethical case for leaders in academic medicine to focus on strategies to improve retention. This article focuses on five immediate actions that leaders can take to enhance gender equity and improve career satis...

The challenging circumstances of the COVID-19 pandemic caused a regression in baseline health of disadvantaged populations, including individuals with frail syndrome, older age, disability, and racial-ethnic minority status. These patients often have more comorbidities and are associated with increased risk of poor postoperative complications, hosp...

The coronavirus disease-2019 pandemic exposed and expanded upon preexisting health care disparities. Individuals with disabilities and those who identify with racial/ethnic minority groups have been disproportionately adversely impacted. These inequities are likely present in the proportions of individuals impacted by post-acute sequelae of severe...

Objectives Gender inequities in editorial board representation and physician compensation are well documented, but few studies have focused on how editors of journals are compensated. Methods In this cross-sectional study, we examined industry-related compensation (from 2014 to 2020) among physician editors of 35 pathology journals using publicly...

Objective: To assess the gender composition of the American Board of Medical Specialties' (ABMS) member boards and evaluate the equitable inclusion of women and a subset of women physicians. Methods: The gender of individuals on 24 boards as of March 1, 2022, was assessed. Two benchmarks-parity (50:50 representation) and equity (compared to the pro...

Many organizations persist in working with others that engage in known, remediable structural discrimination. We name this practice interorganizational structural discrimination (ISD) and argue it is a pivotal contributor to inequities in science and medicine. We urge organizations to leverage their relationships and demand progress from collaborat...

Background : Climate change has been described as the largest public health concern of the 21st century. In response to climate change over 50 countries have pledged to go carbon neutral in the provision of health care service and telemedicine can be an integral part of decreasing emissions related travel associated with health care. While telemedi...

Purpose To characterize delivery features and explore effectiveness of telehealth-based cancer rehabilitation interventions that address disability in adult cancer survivors. Methods A systematic review of electronic databases (CINAHL Plus, Cochrane Library: Database of Systematic Reviews, Embase, National Health Service’s Health Technology Assess...

Purpose of Review Multimodal prehabilitation aims to improve preoperative health in ways that reduce surgical complications and expedite post-operative recovery. However, the extent to which preoperative health has been affected by the COVID-19 pandemic is unclear and evidence for the mitigating effects of prehabilitation in this context has not be...

Purpose: This report investigated physician compensation studies by gender, race, and ethnicity. Methods: Published U.S. physician compensation studies were assessed. Results: Of the 47 data sets within 46 studies, 36 analyzed compensation by gender and 32 (88.9%) found disparities. Thirteen and eight analyzed for race and ethnicity, with dispariti...

Reports have demonstrated that women overall and women physicians in particular, are underrepresented as authors of clinical practice guidelines (CPGs). This analysis used publicly available information to explore the diversity of rehabilitation-related CPG authors by gender, race, and ethnicity. Primary analysis identified authors' gender, race, e...

Objective To describe differences in traumatic brain injury patient characteristics and outcomes by inpatient rehabilitation facility profit status. Design Retrospective database review utilizing the Uniform Data System for Medical Rehabilitation® (UDSMR). Setting Inpatient rehabilitation facilities. Participants Individual discharges (n = 53,63...

Objectives: The aims of the study were to determine the prevalence of burnout in physical medicine and rehabilitation residents in the United States and to identify the personal- and program-specific characteristics most strongly associated with residents reporting burnout. Design: This was a cross-sectional survey of US physical medicine and re...

As the proportion of women in the physician workforce increases, burnout in this population warrants further investigation. Exercise is an often-proposed strategy to combat burnout. Evaluating physical activity across a cohort of women physicians can assess associations of health behaviors with burnout. Cross-sectional study of women attending phys...

The coronavirus pandemic enforced social restrictions with abrupt impacts on mental health and changes to health behaviors. From a randomized clinical trial, we assessed the impact of culinary education on home cooking practices, coping strategies and resiliency during the first wave of the COVID-19 pandemic (March/April 2020). Participants (n = 28...

Introduction Representativeness of research populations impacts the ability to extrapolate findings. The Burn Model System (BMS) National Database is one of the largest prospective, longitudinal, multi-center research repositories collecting patient-reported outcomes after burn injury. Objective To assess if the BMS Database is representative of t...

Background: Gender disparities in academic promotion and leadership are well documented. Scholarly impact is essential for promotion. The Hirsch-index (h-index) is a measure of impact using number of publications and citations. We sought to (i) evaluate breast surgery fellowship faculty in North America by academic rank and research impact using th...

Objective To investigate which factors, from demographics to work–life integration, are associated with burnout symptoms among self-declared active women physicians practising in the USA. Methods Cross-sectional study of those actively engaged in a social media group for women physician runners. Electronically surveyed using 60 questions covering...

Background: The Council of Faculty and Academic Societies (CFAS) comprises representatives from medical schools and professional societies who guide the Association of American Medical Colleges (AAMC). Given the AAMC's stated mission to improve diversity and inclusion, we used gender-related representation on journal editorial boards as a proxy for...

The field of cancer survivorship has significantly advanced person-centered care throughout the cancer continuum. Within cancer survivorship, the last decade has seen remarkable growth in the investigation of prehabilitation comprising pre-treatment interventions to prevent or attenuate the burden of oncologic therapies. While the majority of evide...

This study evaluated Women Physiatry Facebook group members’ perceptions of the value of an online community. The authors hypothesized that members would find the group protective against burnout, and early career participants would be more likely to use the group for education and networking. This was a cross-sectional survey study of women physic...

The incidence of leptomeningeal disease (LMD) is believed to be increasing in part because of more effective chemotherapy treatments allowing cancer progression behind the blood-brain barrier. However, little has been published about the rehabilitation of this growing patient population. In this study, impairments and rehabilitation utilization by...

Prehabilitation is a clinical model that introduces components of rehabilitation to patients prior to undergoing intensive medical interventions, such as surgery, in order to optimize function and improve tolerability to the intervention. Cancer care introduces a continuum of sequential or concurrent intensive anti-neoplastic medical interventions...

Purpose: This study investigated the magnitude and consequences of educational debt for women physicians. Methods: Participants in a women's leadership course were surveyed. Results: Of the 185 U.S. physician respondents, 152 (82%) and 85 (46%) reported past debt and current debt, respectively. A total of 164 (89%) perceived a relationship between...

The Association of Academic Physiatrists (AAP) convened a Women's Task Force in 2016, under the leadership of then AAP President Gerard Francisco, MD, to evaluate data and metrics pertaining to the representation and inclusion of women physiatrists in the society. An initial published report focused on a retrospective analysis of data in categories...

Objective To investigate the contribution of financial stress to physician burnout and satisfaction among women physiatrists. Relationships among education debt and compensation with demographic, sociologic, and workplace factors were also assessed. Design This was a cross‐sectional survey study of women physicians in the field of physical medicin...

Importance Disparities in representation between sexes have been shown at multiple career stages in medicine despite increasing representation in the overall physician workforce. Objective To assess sex representation of applicants to the Canadian R-1 entry match for postgraduate training programs from 1995 to 2019, comparing distribution between...

Background: Our aim was to evaluate differences in reported citizenship tasks among women physicians due to personal or demographic factors and time spent performing those tasks for work. Materials and Methods: Attendees of a national women physician’s leadership conference (Brave Enough Women Physicians Continuing Medical Education Conference) re...

Guidelines promote high quality cancer care. Rehabilitation recommendations in oncology guidelines have not been characterized and may provide insight to improve integration of rehabilitation into oncology care. This report was developed as a part of the World Health Organization (WHO) Rehabilitation 2030 initiative to identify rehabilitation‐speci...

Objective To determine whether women have been equitably represented among plenary speakers at the American Academy of Neurology (AAN) annual meeting by counting and categorizing speakers and comparing outcomes to AAN membership and US neurology workforce data. Methods Lists of plenary speakers between 1958 and 2019 (62 years) were obtained from t...

The field of physical medicine and rehabilitation should strive for a physician workforce that is ethnically/racially, sex, and ability diverse. Considering the recent realities of disparities in health outcomes related to COVID-19 and in racial injustice in the United States, we are called to be champions for antiracism and equity. The specialty o...

Racial health disparities continue to disproportionately affect Black persons in the United States (US). Black individuals also have increased risk of worse outcomesassociated with social determinants of health including socioeconomic factors such as income, education and employment. This narrative review included studies originally spanning a peri...

The current COVID‐19 pandemic has rapidly affected a large number of people across the world. In the US, New York and Massachusetts were two states significantly affected early on in the pandemic. Many individuals infected with COVID‐19 require hospitalization and following discharge, a subset develop longer‐term rehabilitation needs. To address th...

It is well documented that women are underrepresented in leadership within academic medicine. In biomedical sciences, they account for almost half of postdoctoral fellows but only 19% of tenured senior investigators.¹ Cardiology lags behind other internal medicine specialties with regard to women entering the field and achieving leadership position...

In the past decade, stroke medicine has evolved from discovery of innovative diagnostic tools to implementation of new treatments. These advances are projected to increase the demand for stroke neurologists in academic and clinical practices, but hopefully with equitable opportunities for everyone across the gender spectrum. Academic medicine provi...

The COVID-19 pandemic transformed healthcare delivery, including rapid expansion of telehealth. Telerehabilitation, defined as therapy provided by physical therapy, occupational therapy and speech and language pathology, was rapidly adopted with goals to provide access to care and limit contagion. The purpose of this brief report was to describe fe...

SARS-CoV-2 is a novel and highly contagious coronavirus that has been a major threat to the public's health. As the pandemic has spread across the United States, it has become abundantly clear that vulnerable populations include not only the elderly and individuals with disabilities but also those who are homeless or incarcerated, Latinx Americans,...

The primary aim of this study was to compare ethnic/racial diversity in academic Physical Medicine and Rehabilitation (PM&R) to all other medical specialties in academia. The secondary aim was to characterize ethnic/racial diversity of current PM&R program directors. Self-reported ethnicity/race information was collected from the Association of Ame...

Cancer is one of the most common, disabling, and costly diagnoses that affects people living in the USA and worldwide. However, even though there is an increase in the overall 5-year survival rate, survival is not necessarily disease free, and often people live with cancer as a chronic condition. Historically, cancer rehabilitation was not well int...

The benefits of exercise are well articulated across the cancer continuum from the point of diagnosis through end-of-life care. The timepoint from diagnosis until the initiation of antineoplastic treatments, historically dedicated to disease staging and medical treatment planning, is gaining recognition as an important timepoint to introduce exerci...

Introduction The global pandemic due to SARS‐CoV‐2 has resulted in an expansion of telemedicine. Measures of quality and barriers for rapid use by patients and physicians are not well described. Objective To describe results from a quality improvement initiative during rapid adoptive phase of telemedicine during the pandemic. Design Patient and p...

To the Editor The interesting study by Shinall et al¹ used a novel operative stress score to classify surgical interventions by the amount of physiologic stress imposed on a patient. Irrespective of a procedure’s operative stress score, the authors established that patients who are deemed either frail or very frail, based on the Risk Analysis Index...

Background Prior studies of inpatient rehabilitation of patients with brain tumor demonstrate similar functional gains as compared to other rehabilitation populations. There are few studies specifically examining the rehabilitation of patients with glioblastoma. Objective To compare functional outcomes between matched patients admitted to acute in...

The novel coronavirus pandemic is resulting in an accelerated conversion of in‐person physician visits to virtual visits. As barriers to adoption of telemedicine are rapidly decreasing, it is important to recognize the need for practical and immediately deployable information that can improve doctor‐patient interactions, facilitate accurate documen...

As physicians specializing in rehabilitation medicine consider sequelae from the novel coronavirus pandemic that began in 2019, one issue that should be top of mind is the physiologic effect that large scale social distancing had on the health of patients in general, but more specifically on pre-operative patients who had their surgeries delayed or...

This cross-sectional study examines the representation of women in authorship and dissemination of analyses of physician compensation.