Critical shortage of specialty pediatricians highlights need for federal action: Anisha Bhatia Attawala, Jason Jackson and Emily Miller
COLUMBUS, Ohio — More than 10% of babies in Ohio are born prematurely and require long-term, coordinated care from highly trained pediatric specialists for complex medical conditions and chronic diseases. As neonatologists in Ohio, we specialize in caring for these babies. Our ability to provide safe, long-term care for our infants in Ohio is hampered by a shortage of our pediatric specialist colleagues, exposing families to long waits and long travel distances for their child’s doctor appointments.
Wait times for pediatric specialists are up to 10 times longer than for adults who need to see specialists. The average wait time for a family to see a developmental pediatrician is nearly five months. The average waiting time is two and a half months for a child and adolescent psychiatrist and two months for a pediatric neurologist.
Even in Ohio, which is home to three nationally renowned children’s hospitals, many children are unable to access treatment for their chronic conditions in a timely manner or possibly never. In Ohio, on average, families must drive more than 50 miles to see a doctor in more than 15 different child health areas, such as cardiology.
The American Board of Pediatrics shows that fewer physicians are choosing careers in pediatric subspecialties and mental health, while the aging workforce is rapidly retiring with no inbound replacements.
It is not surprising that fewer pediatricians choose this work. Pediatric subspecialists need at least three years more training than general pediatricians. Unlike in adult medicine, pediatric subspecialists are paid less and have lower net pay compared to general pediatricians, which are already the lowest paid branch of medicine.
According to one study, getting a subspecialty pediatric education leads to a lifetime loss of income of up to $1.6 million.
This, combined with the skyrocketing cost of vocational training, leads to financially strained doctors who are forced to delay payments for their mounting student debt during their training. With the average medical school graduate owing more than $200,000 in student loans, doctors taking subspecialty training eventually take five to seven more years to pay it off, at which point the amount is two to three times the original loan amount. .
For most, these considerations drive pediatricians into primary care as a means of debt reduction and family planning, and only 7% of medical school graduates choose a pediatric subspecialty. The financial barriers are causing staff shortages and inequalities in access to care, and children in need of specialized care carry the burden.
This national problem has not escaped federal attention. In 2010, Congress established a program to provide pediatric subspecialists and mental and behavioral health specialists with loans to attract more physicians into these specialties. Physicians who agree to work full-time in a medically deprived area for at least two years would receive up to $35,000 in loan repayment for each year of service, for a maximum of three years.
Despite the program being established more than a decade ago, Congress never funded it, exacerbating the problem as the demand for pediatric subspecialists continues to grow and making it even more difficult for our patients to get the unique care they need. .
This year, more than 60 major medical organizations — including the American Academy of Pediatrics, Council of Pediatric Subspecialties and Children’s Hospital Association — are urging Congress to provide funding to implement this urgently needed program. By guaranteeing funding, we can reduce the burden these staff shortages place on families like those we care for.
Fortunately, the members of the House of Representatives listened. The health spending bill recently passed by the US House included $25 million to kick-start this program. Now the Senate must follow.
Our patients are too young and medically vulnerable to have a voice, so it’s up to pediatricians, parents, and families to speak up for important programs like this that can benefit all children in Ohio and across the country.
dr. Anisha Bhatia Attawala is a neonatologist and assistant professor of pediatrics at Northeast Ohio Medical University. dr. Jason Jackson is a neonatologist at Nationwide Children’s Hospital and assistant professor of pediatrics at Ohio State University. dr. Emily Miller is a neonatologist at Cincinnati Children’s Hospital and assistant professor of pediatrics at the University of Cincinnati.
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