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Background: Fewer physicians are pursuing careers in internal medicine due to workload, work-life integration, and documentation pressures. Integrated health systems like the Department of Veterans Affairs (VA) offer an alternative work model that may affect physicians' experiences differently compared to the private sector.
Objective: To examine and compare the self-reported workplace experiences among VA and non-VA internists.
Design: A cross-sectional survey.
Participants: A random sample of 1421 internal medicine physicians across the USA, with oversampling of hospitalists and VA physicians. Surveys were completed between June 2023 and May 2024. Of the total of 629 (44.3%) physicians responding, 618 indicated working in a VA or non-VA hospital.
Main Measures: Our primary outcomes were several professional environment factors. Multivariable logistic regression was used to assess relationships between professional environment factors and practicing at the VA (vs. non-VA). All models were adjusted for sex, race, and years practicing as an internist.
Key Points: The odds of time engaging with health insurance companies (OR = 0.26; P < 0.001), medical record issues (OR = 0.44; P < 0.001), and malpractice concerns (OR = 0.56; P < 0.001) were significantly lower among VA internists compared with non-VA internists. VA internists were significantly less likely to report issues concerning work-life balance (OR = 0.63; P = 0.01).
Conclusions: VA internists had reduced odds of some non-clinical administrative tasks and greater odds of better work-life balance. The VA's minimal engagement with insurance tasks and litigation concerns appears to present a compelling work environment.
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http://dx.doi.org/10.1007/s11606-025-09797-9 | DOI Listing |
JCI Insight
September 2025
Department of Pharmacology, University of Michigan, Ann Arbor, United States of America.
Cardiac hypertrophy is a common adaptation to cardiovascular stress and often a prelude to heart failure. We examined how S-palmitoylation of the small GTPase, Ras-related C3 botulinum toxin substrate 1 (Rac1), impacts cardiomyocyte stress signaling. Mutation of the cysteine-178 palmitoylation site impaired activation of Rac1 when overexpressed in cardiomyocytes.
View Article and Find Full Text PDFJ Clin Invest
September 2025
Department of Cellular and Molecular Medicine, UCSD, La Jolla, United States of America.
3-O-sulfation of heparan sulfate (HS) is the key determinant for binding and activation of Antithrombin III (AT). This interaction is the basis of heparin treatment to prevent thrombotic events and excess coagulation. Antithrombin-binding HS (HSAT) is expressed in human tissues, but is thought to be expressed in the subendothelial space, mast cells, and follicular fluid.
View Article and Find Full Text PDFInt J Syst Evol Microbiol
September 2025
School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland.
Two yeast strains, PYCC 10015 and PYCC 10016, were isolated from soil from an Irish forest. Sequence analysis of the internal transcribed spacer (ITS) region (ITS1-5.8S-ITS2) of the rRNA gene repeat, and the D1/D2 domain of the LSU rRNA gene, showed that they belong to the and genera of the order , but they did not exactly match any known species.
View Article and Find Full Text PDFProc Natl Acad Sci U S A
September 2025
Department of Biochemical Pathophysiology, Medical Research Laboratory, Institute of Integrated Research, Institute of Science Tokyo, Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
Adrenal lipomas are benign tumors containing ectopic adipose tissue in the adrenal gland, an organ that normally lacks both adipocytes and their progenitors. The origin of this ectopic fat remains enigmatic, and the absence of a genetic animal model has hindered its investigation. Phosphatidylinositol 3,4,5-trisphosphate [PI(3,4,5)P], a key signaling lipid that regulates cellular growth and differentiation, is tightly regulated by the lipid phosphatases PTEN (phosphatase and tensin homolog) and SHIP2 (SH2-containing inositol phosphatase 2).
View Article and Find Full Text PDFJAMA Netw Open
September 2025
Department of Psychiatry, Psychosomatics, and Psychotherapy, University of Lübeck, Lübeck, Germany.
Importance: Patients with inflammatory rheumatic diseases (IRDs) frequently experience psychological distress; however, access to psychological support remains limited.
Objective: To investigate the effectiveness of a digital psychological intervention for individuals with IRDs.
Design, Setting, And Participants: Participants aged 18 years or older were recruited across Germany between February 22 and June 4, 2024, if they had been diagnosed with rheumatoid arthritis, psoriatic arthritis, or systemic lupus erythematosus and reported psychological distress and reduced quality of life.