A Snapshot of Pulmonary Medicine at the Turn of the Century ...

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A Snapshot of Pulmonary Medicine at the Turn of the Century: the American

Thoracic Society Membership

Lynn M. Schnapp MD1, Melissa Matosian2, Idelle Weisman MD3, Carolyn H. Welsh MD4

1Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, University of Washington, Seattle, WA

2Former Director, Membership Services & Marketing, American Thoracic Society, NY, NY

3Dept. of Clinical Investigation and Pulmonary Critical Care Service, William Beaumont Army Medical Center, El Paso TX

4Pulmonary Division, Denver VA Medical Center, Denver, CO, University of Colorado Health Sciences Center, Denver, CO.

Address correspondence to:

Lynn M. Schnapp MD Box 359640 325 Ninth Ave Harborview Medical Center University of Washington Seattle, WA 98104 [email protected]

ATS membership survey Subject category: 155: professional education and training Word count: 2,988 This article has an online data supplement, which is accessible from this issue’s table of content online at www.atsjournals.org

Copyright (C) 2003 by the American Thoracic Society.

AJRCCM Articles in Press. Published on January 9, 2003 as doi:10.1164/rccm.200203-186OC

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ABSTRACT To describe the characteristics of the American Thoracic Society, the Membership Committee

developed a survey to assess demographics, training, professional activities and needs of a diverse

membership with a growing international segment. It also provided an opportunity to determine

how the Society reflects the current state of pulmonary medicine in the United States. A self-

administered survey was mailed to active members. Of responding members, 80% reside in the US

or Canada; the remainder come from 90 different countries. The majority of North American

respondents (1%) were white, non-Hispanic. Seventeen percent of respondents were female.

Female respondents were younger with mean age of 42 years, compared to 47 years for males.

Sixty-five percent of respondents identified clinical practice, 20% research, and 5% teaching as

their major activity. More women (33%) than men (22%) identified themselves as researchers.

The majority of respondents (69%) have a medical school faculty affiliation. The American

Thoracic Society represents a global organization with diverse clinical expertise and scientific

interests. The majority of respondents are clinicians; however, the membership has a strong

academic bent with most reporting academic affiliation, and describing teaching as a secondary

activity.

Keywords (MESH): questionnaires, career choice, pulmonary disease (specialty), medical faculty

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INTRODUCTION

A century ago, practice in pulmonary medicine was primarily that of diagnosing and monitoring

infection. Tuberculosis was rampant, and infectious diseases were common killers. The American

Thoracic Society, originally named the American Sanatorium Society, was formed at the turn of the

nineteenth century, in 1905, as a division of the American Lung Association and focused on the

medical aspects of tuberculosis (1). In 1960, the name of the society was changed to its current one

to better reflect clinical practice (2). In recent years, the Society has expanded its scope of

activities to meet the needs of its growing international membership and to encompass areas

including critical care, sleep, nursing, and behavioral science. In 2000, the American Thoracic

Society became an independently incorporated society. At that time, the American Thoracic

Society conducted a survey of its membership to understand better the changing demographics and

activities of the membership. The survey was designed to obtain information about the

demographics, work practices, and areas of specialization of members, as well as to elicit responses

regarding the satisfaction with the Society activities. This represents the first comprehensive survey

of pulmonary physician practices, and includes both United States and international members.

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METHODS

Survey Development: The ATS Membership Committee was charged with developing a survey to

address issues related to demographics, training and professional activities, type of practice, and

faculty affiliation of its membership. In November 1998, Phase I of the ATS Membership Survey

was initiated. A 6-page, self-administered survey was sent to 13,598 members (3,113 international,

and 10,485 United States and Canada). A reminder postcard was sent three weeks after the initial

mailing, and a second mailing was sent to all non-responders one month later . Survey replies were

accepted through April 1999. At the completion of Phase I, a preliminary data analysis was

conducted. From this initial analysis, thirteen items were deleted from the questionnaire in an effort

to increase the response rate and the revised questionnaire was mailed out to non-responders (Phase

II). Results from the Phase II data collection was similar to the Phase I data and thus the data were

pooled. The questionnaire was divided into the following issue areas: Training and Professional

Activities, (8 questions), Member Benefits (5 questions), Postgraduate and Continuing Medical

Education (2 questions), Annual International Conference (4 questions), Journals (2 questions),

Technology (5 questions), Overall Satisfaction (3 questions), Demographic information (4

questions), and a section with questions specific only to the international members (7 questions).

For complete set of survey questions see Figure E1 in the online data supplement.

Statistical Analysis: The responses were analyzed using SPSS for Windows, version 10 (SPSS, Inc.

Chicago IL). Data were scanned and entered in an Access database by Survey and Ballot Systems,

Inc. (Eden Prairie, Minnesota) and then converted to SPSS data sets. Demographics, work setting,

practice information and board certification data were analyzed with a descriptive program. The

chi-square test was used to test gender-specific comparisons and compare North American (USA

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and Canada) to International responses with a two-tailed test for significance (3). A Fisher exact

test was used when appropriate.

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RESULTS

From combined Phase 1 and Phase 2 mailings sent to the 13,598 active members in the organization

at the time of the survey, 126 were returned undelivered, and 6,973 responses were received for the

final analyses . An initial 5,660 surveys were returned (42.0% response rate) with Phase 2 yielding

an additional 1,313 responses out of 7,938 surveys sent (16.5%) for a total response rate of 51.8%

(6,973/13,472) .A complete set of responses is available on the online data supplement

Demographics:

Nineteen percent (n=1320) of survey respondents were from the international community, and 81%

were from North America. The international members of the Society come from more than 90

different countries in all continents except Antarctica. Ethnicity was analyzed for the North

American members only. Self-classification of ethnicity of North American respondents showed

that the majority of members (79%) were white, non-Hispanic (Table 1). Eighty-three percent

(5,566) of respondents were male and 17% (1,116) female. Female members were younger than

male members with a mean age of 42 for women and 47 for men. The majority of the membership

(51.6%) was between the ages of 40-54 years old (Figure 1).

The survey asked members to categorize their principal professional activity, defined as more than

50% of time in that activity. Sixty five percent of respondents listed clinical practice as their major

activity (Figure 2). Twenty percent identify themselves as primarily researchers, either in basic

science or clinical research. When analyzed in terms of gender, women were more likely to identify

themselves as researchers than men (p<0.001) (Table 2). The principal activities of International

members were not statistically different from US/Canadian members (see Table E25 in the online

data supplement.). Teaching was considered a primary or secondary activity for 69% of

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respondents. Thus, although the majority regard themselves as clinicians, society members retain

an educational and academic orientation to their careers.

We next assessed whether age was associated with career choice differently for men and women.

The percent of men identifying themselves as clinician is the same for those younger than 45 years

(78.1%) compared to men at least 45 years old (78.5%) (p =0.743). In contrast, for woman younger

than 45 years, 69.6% identify themselves as clinicians, whereas for woman older than 45 years old,

a smaller proportion, 62.5%, identify themselves as clinicians (p=0.039) (Table 2). Thus, younger

women are more likely to identify themselves as clinicians than their older counterparts.

Training and certification:

As expected, the majority of members hold an MD degree or its equivalent. Only 11.7% of

responding members were not physicians. Nurses represent 1.4% of respondents (n=97). Fifteen

percent of respondents have the PhD degree. Of these, 8.0% have MD/PhD degrees, 6.3% have

non-nurse/non-MD doctorates, and 0.4% are nurse PhDs.

To understand the prior training of our physician members, we asked about primary and secondary

board certification. The primary specialties listed for the majority of physician members are

internal medicine (74%) and pediatrics (14%). Other primary specialties include surgery (1.6%),

anesthesiology (1.5%), pathology (1.1%), preventive medicine (1.0%), family practice (0.5%),

physical medicine and rehabilitation (0.3%), and radiology (0.3%). The secondary (subspecialty)

certifications for members are listed in Table 3. Members have subspecialty certification in

numerous areas with many members having subspecialty certification in more than one field. As

expected, physician members are most likely to identify their area of practice as pulmonary

medicine, including critical care (78%). Critical care medicine and sleep medicine are relatively

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new areas of subspecialization. To assess the impact of these areas on physicians’ clinical

activities, we asked what percentage of time physicians spent in those areas. The majority of

physician members (77%) spend some time in critical care medicine although only 14% spend more

than half of their time in critical care (Table 4). The time currently spent in sleep medicine is more

limited, with 90% of clinicians spending less than 25% of their time in sleep medicine and only

2.3% spending more than half of their time in sleep medicine (Table 4).

Work Setting:

Work setting was assessed for members, and analyzed according to geographical and gender

differences (Table 5). Significant differences in practice setting were noted for both criteria.

International members were more likely to practice in a university setting than North American

members 39.6% vs. 31.5%, p<0.0001). Female members were also more likely to practice in a

university setting than male members (41.5% vs. 31.6%, p<0.0001).

Consistent with the majority of respondents reporting teaching as a primary or secondary activity,

69% of respondents report faculty affiliation with a medical school. This number includes full and

part-time salaried faculty as well as volunteer faculty. Overall faculty affiliation rates are higher

for international members than for North American respondents and there are differences with

respect to faculty rank. Specifically, for North American respondents, there are proportionately

fewer full professors compared to international respondents (25% vs. 30%, p < 0.0001). For North

American and International respondents, fewer women than men have reached the full professors

level (12% vs 28.6%, p< 0.0001) (see Table E24 in the online data supplement). For both groups,

there is a gender discrepancy at the assistant professor level with 41.1% of women and only 29.9%

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of men holding this rank (p < 0.0001). Similarly, proportionately more women are at an academic

level junior to assistant professor (20.5% vs 14.6%, p < 0.0001).

Technology

We determined member access to different technologies. The overwhelming majority of

respondents use a computer, either at home or at work (Table 6). International members were more

likely than North American members to use a computer only at work, (29.8% vs. 20.1%) (Table 6).

Internet access and email capability are common, with > 90% of total respondents reporting access

to both, although international members were less likely to have either (Table 7). Overall, the

preferred method of receiving communication from the American Thoracic society was mail (67%).

However, when responses were analyzed by location, there were significant differences with respect

to how respondents preferred to receive communication. For US members, 65% preferred mail and

30.9% preferred email; for international members, 46.4% preferred mail while 44.8% preferred

email.

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Discussion: The response generated from this survey, the first survey of practitioners of pulmonary and critical

care medicine, provided the American Thoracic Society with valuable insight into the needs of

Society members. Not only were opinions on Society services, publications, and meetings

compiled but the survey has also provided detailed demographics, training, and practice information

as presented here. A strength of this survey compared to similar surveys of other physician groups

is the inclusion of a sampling of both North American and international members. Other surveys of

professional organizations have examined US members, Canadian members, or European members,

but such surveys have not compared data across nations (4-10); this survey is unique in this regard.

Our findings illustrate that ethnicities other than Caucasian are under-represented in the North

American membership. In particular, African-American membership is sparse, as African-

Americans comprise approximately 11% of the US population, but only 1.5% of the ATS

respondents. This low percentage of minorities is not unique to pulmonary medicine. Overall,

African-Americans represent 2.6% of all physicians in the US. Only 3.6% of physicians in internal

medicine, 2.2% in pulmonary diseases, and 1.5% in neurology are African-American (11). The lack

of minority physicians has important ramifications since minority physicians are more likely to

provide medical care for minority patients and underserved populations (12-15). Current data

indicate that minority students are selecting careers other than medicine (16,17). If so, the paucity

of minority members in the ATS will persist for a long time. To improve this, recruitment strategies

such as targeting prospective students with an interest in medicine at a high school, college, and

medical school level, focusing on mentorship support during pulmonary training, and promotion of

monetary support/scholarship programs are needed.

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The mean age of the membership is young, which may reflect this as an organization with a

younger age than the majority of physicians in practice. In particular there is a preponderance of

females in the younger age groups, consistent with the younger age of women physicians in the

United States. According to the American Medical Association (AMA), females currently comprise

22.8% of all US physicians (177,030 of 777,859) (12). Per the AMA database, 45% of US

physicians are older than 45 years (mean age 47.5 years), but 65% of female physicians are younger

than 45 years and only 39% of male physicians are younger than 45 years (11)

Women comprise a small proportion of pulmonary physicians. As of 1999, 11% of board-certified

pulmonary physicians in the US were women (direct communication, American Board of Internal

Medicine). American Thoracic Society respondents, however, show a higher percentage of women

(17%). There are several possible explanations for this: first, our membership may reflect younger

physicians, where the percentage of women is higher. Secondly, women may have been more

likely than men to respond to the survey. However, the percentage of women respondents is

identical to the percentage of women in the ATS membership database. Thirdly, non-physicians

within the society may skew these proportions. However, non-physicians account for a small

proportion of respondents (11%). Although women comprise 17% of American Thoracic Society

membership, they appear to be entering pulmonary specialization from internal medicine at a lower

rate than women completing internal medicine residency programs. In 1998-1999, 23% of the first-

year fellows in pulmonary/critical care were women while in 1997-1998, 35% of internal medicine

graduates were women (18). Investigation into subspecialty choice of women residents may be

informative.

In terms of academic position, results of the survey show that a lower percentage of women are full

professors than men, despite the fact that older women were more likely than comparably aged men

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to identify themselves as researchers, particularly for the North American members. The lower

success rates of women in scaling the academic ladder are similar to other reports of women

physicians and women scientists (6, 19-23). A recent cohort study of medical school graduates

showed that women pursue an academic career more often than men, however the number of

women who advanced to associate and full professors was significantly lower than expected (19).

In 1987, the first added qualification was offered in critical care medicine. In 1994, as an indication

of the increasing involvement of pulmonary physicians in critical care medicine, the official journal

of the American Thoracic Society changed its name from the American Review of Respiratory

Diseases (1959-1993) to the American Journal of Respiratory and Critical Care Medicine .

Although the majority of our members spend some time in the critical care field, few spend the

majority of their time doing critical care. This may represent self-selection of our membership:

pulmonary physicians who spend the majority of time in critical care medicine may choose

membership in other professional organizations such as the Society of Critical Care Medicine. The

same may hold true with physicians involved in sleep medicine; physicians with a strong interest

and concentration in sleep may select other professional organizations. Sleep medicine is also a

relatively new field of study with a board certification first offered in 1978. Of interest, in 1990,

only 54 of 320 (17%) professional recruitment advertisements in the then American Review of

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Respiratory Disease requested sleep expertise; in 2000, 187 of 397 (47%) advertisements in the

American Journal of Respiratory and Critical Care Medicine requested sleep expertise. It will be

of interest to track practice activities over time to determine whether the areas of sleep and critical

care medicine become the domains of a select group of pulmonary physicians or whether these

areas will be integrated into a general pulmonary medicine practice.

The rapid growth of computer-based communication and electronic transfer of information is

evident in access to these technologies by the respondents. The use of technology by respondents

parallels increasing use throughout the US. As of 2001, 56.4% of all US households owned a

computer and 50.4% had Internet access. For households with incomes >$75,000, 89% owned

computers, and 85.4% had Internet access (24). Despite the prevalence of Internet and email access,

the majority of respondents preferred mail as the method of communication. As Internet use

continues to grow at a record pace (25, it will be important to determine if electronic

communication is embraced by more members over time.

There are a number of potential biases to these data. First, surveys employ self-reporting which

may be less accurate than observational studies. The response rate for the survey at 52% was

comparable to other large sample surveys looking at a minimum of 1,000 physicians [26,27,28].

However, non-responders may have different characteristics from responders. We attempted to

validate our results by comparing responses from Phase I to responses obtained from Phase II.

Identical results were obtained from both phases, which suggests that non-responders may be

similar to responders. Furthermore, other studies of physicians have shown that survey responders

and non-responders share similar demographic profiles perhaps because physicians are a more

homogenous group than the general populations (26,27,28). We also compared the survey

demographic data to the ATS membership database and found similar breakdown of gender, age,

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ethnicity, work settings, principal activities and board certification, suggesting that the survey

responders are representative of the current ATS membership. For North American members,

American Thoracic Society membership might be considered representative of board-certified

pulmonary physicians. Within the United States, this is a reasonable assumption as the American

Thoracic Society membership represents 85% of the 9102 board certified adult pulmonary

physicians (direct communication with American Board of Internal Medicine, 1999 data).

There have been many changes in medicine during the last century, including development of the

specialty of pulmonary medicine and the formation of the American Thoracic Society. The number

of pulmonary physicians has dramatically increased in the past century, and the focus of clinical

activities has continued to expand and evolve. The survey has provided a snapshot of the current

activities and practices and demographics of pulmonary physicians. Some of the findings, such as

the lack of ethnic diversity, small numbers of women choosing pulmonary or critical care medicine

compared to internal medicine and slow academic progression of women illustrate findings that are

similar to those reported in other professional societies (9,10,29,21). Other findings such as the

strong educational ties of the membership were gratifying, suggesting that clinical and academic

endeavors are important to ATS membership. With the large number of international members and

members in numerous subspecialties, we are an increasingly diverse group. Knowledge of the

membership facilitates strategic planning for the Society. The organization can be strengthened by

focusing on the clinical interests of its membership, and by improving representation of minorities,

women, and international members. In addition to identifying the current demographics and

activities of our members and by extension, pulmonary physicians, the survey results provide a

benchmark to measure changes in the profession as we continue into the twenty-first century.

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Acknowledgements: We thank Drs. Beth Kolko and J. Randall Curtis for advice and review of the

manuscript, and Chris Keron for statistical expertise.

Current address for Melissa Matosian:

Manager Ovation Research Group 600 Central Avenue, Highland Park, IL 60035 [email protected]

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Figure Legends

Figure 1: Percent of members in each age group by gender. A total of 6639 respondents, 5534 male

and 1105 female are included. Age is divided into 5-year increments except for the 20-29, and 65

and older groups. Mean age of men is 47 years and of women is 42 years. Solid bars represent male

and open bars female members.

Figure 2: For the survey respondents, self-described principal activity is pictured. Clinical and

research together comprise the principal activity for 84.8% of members.

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Table 1: Primary ethnic identification for North American (US and Canada) respondents

Ethnicity Percent of North American

Members

White, non-Hispanic 79.4%

Asian, Asian American 7.8%

Indian or Pakistani 4.5%

Hispanic 3.9%

Arabic 1.5%

African American, Black 1.5%

Other 0.9%

Pacific Islander, Native

American or Alaskan Native

0.2%

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Table 2: Principal Activities stratified by Age and Gender

Male Female

Total < 45 years

n=2123

> 45 years

n=2298

Total < 45 years

n=566

> 45 years

n=269

Clinician 78.3% 78.1% 78.5% 67.5% 69.6% 62.5%

Researcher 21.7% 21.9% 21.5% 32.5% 30.4% 37.5%

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TABLE 3: Subspecialty certification for US and Canadian physicians

Certification Percent of physician members Number of members

Pulmonary Disease 71% 3694

Critical Care 37% 2098

Allergy and Immunology 8% 443

Pediatric pulmonary 8% 419

Sleep medicine 6% 335

Neonatology 2% 134

Infectious disease 2% 120

Thoracic surgery 2% 89

Occupational medicine 1% 79

Pediatric critical care 1% 69

Cardiovascular disease 1% 49

Geriatrics 1% 45

Others (combined) 2% 122

Note: Totals exceed 100% as persons may have more than one field of certification

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Table 4: Physician Time in Sleep and Critical Care Medicine

% tim in area Sleep Medicine

(n=5,672)

Critical Care Medicine

(n=5,991)

0 42.6% 22.6%

<25 44.6% 31.4%

25-50 7.7% 32.1%

51-75 1.5% 9.1%

>75 .8% 4.8%

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Table 5: Primary Work Setting Total US/Canada International Male Female Full time staff in HMO 1.7% 1.8% 1.2% 1.7% 1.5% Practice, clinical or hospital 47.5% 49.3% 39.9% 49.4% 37.6% University 33.0% 31.5% 39.6% 31.6% 41.5% Government Federal, non-VA 2.3% 1.3% 6.8% 2.2% 2.2% Veterans affairs 3.3% 4.0% 0.2% 3.3% 3.3% Military 1.3% 1.4% 0.7% 1.3% 1.6% State/local 2.7% 1.8% 6.4% 2.6% 3.3% Industry 2.9% 3.0% 2.6% 2.7% 3.5% Other 5.3% 5.9% 2.6% 5.2% 5.3%

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Table 6. Do you use a computer?

Total US International

Yes, at work 21.9% 20.1% 29.8%

Yes at home 13.4% 15% 6.7%

Both at work and home 61% 61% 61.%

No, I don’t have a computer 3.6% 3.9% 2.3%

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Table 7. Technology Access

Do you have: Total US International

CD-ROM 89.5% 90.8% 84.2%

Soundcard 64.7% 68% 51.5%

Modem 79.2% 83% 63%

E-mail 92.5% 93.9% 86.6%

Internet Access 91.7% 93.4% 84.6%

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A Snapshot of Pulmonary Medicine at the Turn of the Century: the American

Thoracic Society Membership

Lynn M. Schnapp MD, Melissa Matosian, Idelle Weisman MD, Carolyn H. Welsh MD

ONLINE DATA SUPPLEMENT

SECTION I. MEMBER BENEFITS

Table E1A. Rating of Current ATS Services (Mean Rank, 5= Extremely Valuable; 1= not at all

valuable)

US/Canada International Male Female Clinician Researcher

AJRCCM 4.3 4.55 4.35 4.35 4.35 4.38

AJRCMB 2.29 3.07 2.38 2.62 2.05 3.64

ATS Journals On-Line 3.24 3.65 3.26 3.59 3.24 3.65

ATS Website 2.92 3.28 2.93 3.27 2.97 3.07

ATS News 2.74 2.64 2.69 2.88 2.71 2.66

On-Line Roster 2.41 2.71 2.43 2.71 2.37 2.83

Printed Roster 2.98 3.04 2.97 3.14 2.87 3.34

International Conference 3.89 4.41 3.93 4.27 3.84 4.47

Advoc/Pub. Policy office 3.21 2.04 3 3.34 3.01 3.09

CME from ALA or ATS 3.56 3.08 3.44 3.72 3.65 3

ATS Policy Statements 3.81 3.29 3.7 3.92 3.83 3.39

TABLE E1B. RANK ORDER OF CURRENT ATS SERVICES

Mean

AJRCCM 4.36

International Conference 3.99

ATS Policy Statements 3.73

CME from ALA or ATS 3.50

ATS Journals On-Line 3.34

Advoc/Pub Policy office 3.03

ATS Website 2.99

Printed Roster 2.98

ATS News 2.70

On-Line Roster 2.48

AJRCMB 2.43

Table E2. Rating of potential benefits (Mean rank, 5= extremely valuable; 1= not at all valuable)

US/Canada International Male Female Clinical Researcher

Research Funding 3.57 3.74 3.51 4.02 3.57 3.74

Enhanced Networking 3.33 3.53 3.28 3.74 3.33 3.53

Mentoring Programs 3.1 3.1 3 3.58 3.1 3.1

Clinical Practice Guidelines 3.91 4.2 3.95 4.07 3.91 4.2

Speakers Bureau 3.05 2.71 2.96 3.24 3.05 2.71

Increased CME Opportunities 3.54 2.8 3.41 3.62 3.54 2.8

Other 3.47 2.95 3.19 4.19 3.47 2.95

Table E3. ATS Satisfaction (Mean rank, 5=exteremely satisfied, 1=not at all satisfied)

US/Canada International Male Female Clinical Researcher

Ease of access to ATS

leadership

3.16 3.15 3.14 3.29 3.04 3.41

Responsiveness of ATS

leadership to member

concerns

3.15 3.09 3.12 3.31 3.03 3.38

Advocacy efforts of ATS 3.33 3.19 3.28 3.53 3.24 3.42

Dissemination of ATS

Board activities

3.28 3.25 3.24 3.45 3.22 3.35

TABLE E4. PARTICIPATION IN LEADERSHIP POSITION WITHIN ATS

US/Canada International Male Female

Yes 9.3% 5.4% 8.3% 11%

No 90.7% 94.6% 91.7% 89%

SECTION II. ANNUAL INTERNATIONAL CONFERENCE

TABLE E5. NUMBER OF ATS INTERNATIONAL CONFERENCES ATTENDED IN THE

PAST 5 YEARS

US/Canada International Male Female Clinician Researcher

None 12 7 12 7 13 2

1-2 34 33 34 32 40 20

3-4 31 39 32 35 33 34

5 23 21 22 25 14 44

TABLE E6. VALUE OF ATS INTERNATIONAL CONFERENCE

US/Canada International Males Females Clinician Researcher

Not at all valuable 7% 1% 7% 3% 8% 1%

Somewhat valuable 10% 3% 9% 7% 10% 4%

Moderately valuable 14% 9% 14% 10% 14% 8%

Very valuable 23% 28% 24% 21% 25% 21%

Extremely valuable 46% 59% 46% 59% 43% 66%

TABLE E7 ATS INTERNATIONAL CONFERENCE (Mean rank, 5= Extremely important, 1=

Not at all important)

Reasons to attend US/Canada International Male Female Clinician Researcher

Meeting location 3.25 2.96 3.21 3.11 3.40 2.71

Travel costs 3.17 3.26 3.15 3.29 3.29 2.87

Educational opportunities 3.96 3.66 3.86 4.09 4.08 3.50

Content of scientific

programs

4.05 4.22 4.07 4.10 3.95 4.39

Content of clinical

program

3.94 3.87 3.93 3.98 4.23 3.22

Networking opportunities 3.07 3.10 3.02 3.32 2.88 3.51

Opportunity to present an

abstract or poster

3.13 3.84 3.18 3.57 2.91 4.02

Reasons NOT to attend

Location 2.97 2.73 2.94 2.85 3.09 2.38

Travel costs 3.07 3.26 3.06 3.28 3.17 2.77

Content of scientific 2.78 3.26 2.81 2.95 2.77 3.10

programs

Content of clinical

program

2.83 2.99 2.83 2.96 3.02 2.33

Work schedule conflicts 3.85 3.42 3.78 3.85 3.96 3.31

SECTION III. JOURNALS

TABLE E8A. VALUE OF AJRCCM

Overall US/Canada International

Not at all valuable 1% 1% 0.1%

Somewhat valuable 4% 5% 1%

Moderately valuable 11% 12% 5%

Very valuable 29% 29% 29%

Extremely valuable 55% 53% 64%

TABLE E8B. VALUE OF AJRCCM SECTIONS (Mean rank, 5= Extremely valuable, 1= Not at

all valuable)

US/Canada International Male Female Clinician Researcher

Original Articles 4.09 4.41 4.15 4.19 4.09 4.32

Brief

Communications

3.60 3.75 3.61 3.69 3.57 3.76

Case Reports 3.28 3.30 3.26 3.44 3.40 2.84

Editorials 3.96 4.10 4.00 3.91 4.06 3.77

State of the Art 4.62 4.68 4.63 4.67 4.69 4.48

Clinical

Commentaries

3.94 3.76 3.92 3.87 4.07 3.42

Pulmonary

Perspectives

3.95 3.85 3.93 3.96 4.05 3.59

ATS Statements

and Position

Papers

4.30 4.04 4.23 4.36 4.36 3.87

Workshop

Summaries

3.60 3.61 3.56 3.79 3.57 3.65

Correspondence 2.73 2.86 2.73 2.84 2.77 2.68

Announcements 2.83 2.67 2.77 2.97 2.77 2.87

Professional

Recruitment

2.53 2.03 2.40 2.71 2.40 2.58

TABLE E8C. RANK ORDER OF AJRCCM SECTIONS

Mean

State of the Art 4.63

ATS Statements and Position Papers 4.25

Original Articles 4.15

Editorials 3.99

Pulmonary Perspectives 3.93

Clinical Commentaries 3.91

Brief Communications 3.62

Workshop Summaries 3.60

Case Reports 3.29

Announcements 2.80

Correspondence 2.75

Professional Recruitment 2.44

TABLE E9A. VALUE OF AJRCMB

Overall US/Canada International

Not at all valuable 35% 38% 19%

Somewhat valuable 28% 29% 28%

Moderately valuable 14% 12% 21%

Very valuable 10% 10% 14%

Extremely valuable 13% 11% 17%

TABLE E9B. VALUE OF AJRCMB SECTIONS (Mean rank, 5= Extremely valuable, 1= Not at

all valuable)

US/Canada International Male Female Clinician Researcher

Editorials 2.93 3.57 3.04 3.25 2.84 3.59

Rapid Communications 2.90 3.49 2.98 3.28 2.68 3.77

Original Articles 3.12 3.77 3.21 3.56 2.88 4.11

Workshops 2.70 3.19 2.76 3.10 2.57 3.35

Perspectives 2.82 3.32 2.87 3.19 2.66 3.52

Minireviews 3.21 3.74 3.27 3.62 2.99 4.06

TABLE E9C RANK ORDER OF AJRCMB SECTIONS

Mean

Minireviews 3.33

Original Articles 3.27

Editorials 3.07

Rapid Communications 3.03

Perspectives 2.93

Workshops 2.81

TABLE E10A AJRCCM should include more: (Mean rank; 5=strongly agree, 1=strongly

disagree)

US/Can International Male Female Clinician Researcher

Original clinical

studies

3.93 4.03 3.94 4.00 4.03 3.66

Original basic science

studies

2.91 3.24 2.96 3.04 2.77 3.62

Reviews of clinical

issues

4.36 4.26 4.34 4.34 4.47 3.93

Reviews of basic

science

3.44 3.62 3.45 3.56 3.34 3.88

TABLE E10B. Rank order for AJRCCM

Mean

Reviews of clinical issues 4.34

Original clinical studies 3.95

Reviews of basic science 3.47

Original basic science studies 2.97

TABLE E11A. AJRCMB should include more: (Mean rank, 5= strongly agree, 1=strongly

disagree)

US/Can Internationa

l

Male Female Clinician Researcher

Original basic science

studies

3.53 3.82 3.59 3.66 3.39 4.04

Reviews of basic

science

3.98 4.12 4.01 4.01 3.89 4.31

Bench to bedside

review

3.96 3.96 3.95 4.03 4.03 3.89

State of the art 4.15 4.28 4.17 4.23 4.18 4.24

TABLE E11B Rank order for AJRCMB

Mean

State of the art 4.18

Reviews of basic science 4.01

Bench to bedside reviews 3.96

Original basic science studies 3.60

SECTION IV TECHNOLOGY

TABLE E12. USEFULNESS OF ATS WEBSITE (Mean rank; 5=extremely useful, 1=not at all

useful)

US/Canada International Male Female Clinician Researcher

Ease of navigation 3.08 3.13 3.07 3.20 3.11 3.06

Information about the

organization

2.83 2.78 2.79 2.96 2.82 2.84

ATS Journals online 3.47 3.70 3.50 3.63 3.49 3.69

International conference

information

3.25 3.50 3.26 3.55 3.24 3.60

Registration for

international conference

3.20 3.39 3.19 3.54 3.15 3.62

Accessing roster

information

2.77 2.73 2.74 2.87 2.71 2.97

Calendar of events 2.98 3.02 2.95 3.19 2.99 3.06

Updates of ATS news 2.76 2.84 2.75 2.91 2.83 2.68

Downloading statements

and position papers

3.31 3.43 3.31 3.46 3.42 3.14

Viewing assembly

websites

2.75 2.78 2.74 2.87 2.77 2.74

Critical care journal club 2.77 2.73 2.76 2.78 2.89 2.47

Links to other websites 2.89 2.91 2.87 3.02 2.93 2.78

SECTION V. OVERALL SATISFACTION

TABLE E13. SATISFACTION WITH ATS MEMBERSHIP (mean rank; 5=extremely

satisfied, 1=not at all satisfied)

Mean Rank

US/Canada 3.32

International 3.42

Male 3.33

Female 3.36

Clinician 3.27

Researcher 3.5

TABLE E14A. DO YOU PLAN TO RENEW YOUR MEMBERSHIP NEXT YEAR?

Yes 92%

No 2.2%

Maybe 5.8%

TABLE E14B If No, why? (More than one answer may be checked)

Membership dues too high 58%

Benefits of membership no

longer suit me

21%

No longer in pulmonary

medicine

18%

Another organization better

represented their interests

18%

SECTION VI. ADVOCACY AND LOCAL SOCIETY INVOLVEMENT (US CITIZENS

ONLY)

TABLE E15. PRIORITY OF ALA/ATS WASHINGTON OFFICE

Rank Order of Advocacy issues (Mean rank, Lowest priority=1; highest priority = 5)

Tobacco Control Policy 3.85

Health Care Policy 3.85

Medical Reimbursement Policy 3.55

Research Funding 3.45

Environmental Policy 3.41

TABLE E16. PARTICIPATION IN ADVOCACY EFFORTS

Yes 27.67

No 72.33

TABLE E17. Washington office information obtained from (more than one answer may be

checked):

ATS News 58.2%

ATS Washington Letter 14.5%

ATS Website 5.4%

Unaware of communications 23.5%

TABLE E18. MEMBERSHIP IN LOCAL THORACIC SOCIETY

Overall Clinician Researcher

Yes 52.7% 55.8% 39.3%

No 47.3% 44.2% 60.7%

TABLE 19. LEADERSHIP POSITION IN LOCAL THORACIC SOCIETY

Yes 23.5%

No 76.5%

TABLE E20. VOLUNTEER FOR LOCAL LUNG ASSOCIATION

Yes 16.6%

No 83.5%

SECTION VII. INTERNATIONAL MEMBERS SECTION

TABLE E21 General Information

Yes No

Is the International Conference well designed to meet your needs 87.4% 12.6%

Do you receive ATS information in a timely manner? 77.2 % 22.8 %

Are you aware that ATS co-sponsors educational opportunities

with other societies?

84.7% 15.3%

TABLE E22. SATISFACTION WITH INTERNATIONAL REPRESENTATION WITHIN

THE SOCIETY (Mean rank, 5=extremely satisfied, 1=not at all satisfied)

Not at all Satisfied 17.7

Somewhat Satisfied 28.2

Satisfied 39.4

Very Satisfied 12.2

Extremely Satisfied 2.3

TABLE E23. VALUE OF JOINT MEMBERSHIP ARRANGEMENTS (Mean rank,

5=extremely valuable, 1=not at all valuable)

Not at all valuable 10.1%

Somewhat valuable 17.5%

Valuable 27%

Very Valuable 27.4%

Extremely Valuable 18.1%

SECTION VIII. PROFESSIONAL ACTIVITIES

TABLE E24. CURRENT ACADEMIC APPOINTMENT

Male Female US/Canada International

Junior* N 535 138 497 197

% 14.6 20.5 13.7 23.7

Assistant Professor N 1095 277 1217 179

% 29.9 41.1 33.5 21.5

Associate Professor N 987 178 1000 204

% 26.9 26.4 27.5 24.5

Full Professor N 1047 81 920 252

% 28.6 12 25.3 30.3

Total N 3664 674 3634 832

% 100 100 100 100

*Junior includes trainee, postdoctoral fellow, and instructor

TABLE E25. PRINICPAL PROFESSIONAL ACTIVITY

Male Female US/Canada International

Clinician N 3480 569 3274 885

% 78.3 67.5 76.1 78.3

Researcher N 962 274 1028 245

% 21.7 32.5 23.9 21.7

TABLE E26 Usage of Continuing Medical Education Programs*

Clinician Researcher US/Canada International

Offerings at

International Conference

58.3% 80.5% 61.4% 65.2%

ATS State of the Art

Review Course

23.3% 20.2% 20.9% 28.6%

Local chapter CME

conferences

20.3% 13.9% 22.8v 3.3%

ATS-sponsored audio

conferences

2.8% 1% 2.6% 1.5%

CD-ROMS 34.3% 23.1% 28.8% 42.6%

CME courses through

other societies

44.6% 19.7% 43.9% 14.8%

Audio or Video

conferences through

other societies

14% 6.9% 12.9% 9.3%

Other 6% 4.9% 7.2% 4.3%

*Respondents may choose more than one response