The importance of pediatric specialty care, training

I’m really looking forward to attending the National Association of Children’s Hospitals Family Advocacy Day in Washington next week. As a pediatric lung (and sleep) specialist, I worry sometimes that policy makers do not always appreciate the differences between pediatrics and adult oriented medicine.  For example, while there is a lot of discussion about the imbalance between specialists and primary care physicians (more than 2/3 of doctors in this country are specialists), which is something that has a negative affect on access to care, this is not the case in pediatrics. There has not been a drop in the number of primary care pediatricians: in fact, the opposite is true.  Between 1975 and 2005, the number of primary care pediatricians increased nationwide by more than 240%, growing from 32 to 78 pediatricians for every 100,000 children. However, there is a growing shortage of pediatric subspecialists. For example, there are 1503 practicing pediatric critical care specialists nationwide, 2 for every 100,000 children.  In two states (Wyoming and Montana), where more than 348,000 children live, there are none.  Likewise, in my field of pediatric pulmonology, there are 751 practicing specialists nationwide, 1 for every 100,000 children.  In four states (Alaska, Idaho, Montana, and Wyoming), where more than 941,000 children live, there are none.

Maintaining an appropriate pediatric training framework is critical to making sure that our children continue to receive excellent care. The Children’s Hospitals Graduate Medical Education Program (CHGME) has been very important in funding pediatric training programs. Continuing to fund it is critical to maintaining independent children’s hospitals as centers of excellence that attract and train top notch pediatric specialists who are then able to provide high level care as well as make important discoveries about treating and preventing diseases which affect children.

Children are not “little adults”, as pediatricians know well, and they need and deserve specialized care tailored to their needs in order to grow and develop into healthy adults.

— Dennis Rosen, MD

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