ACL Rehabilitation

Pediatrics May Not Have A Precise Future In the Future

Elsewhere in the country, Pediatrics in Texas is experiencing many of the same difficulties as other specialties. Of the 62966 physicians in the Alamo state, almost forty seven hundred specialize in Pediatrics. For many of the 800 Texas urologists the future is uncertain. Of those 4639 Pediatricians, about four thousand and sixty-six are M.D.’s and 173 are D.O.’s. While there may be some differences in training, both M.D.’s and D.O.’s are equally accredited and able to become a Pediatrician / medical doctor. A Pediatrician physician typically has at least between ten and thirteen years of training including a undergraduate degree in a healthcare or science related area, a medical doctorate (graduate, M.D. or D.O.), and an accredited Pediatrics residency (post-graduate).

HEALTH CARE REFORM

The continuing story of health reform having an impact on all medical disciplines. Until it becomes obvious exactly what is being changed and how that will affect each party the market will be hamstrung. Indecisiveness affects spending on expansion and hiring at all levels of health care.

Some stipulations of the reform are attempting to address shortages in primary care. The Senate bill contains a measure that would finance a loan-forgiveness program for pediatric sub-specializations, easing the financial hardships of medical-school costs. The federal Medicare program funds training programs for adult medicine. Congress five years ago authorized funding for pediatric specialty training, but the funds must be re-authorized every year.

Pediatric institutions go on with pressing for to more funding for residents. The cost of residency is going higher (see California!) and yet the income for pediatrics is not on a par with many other specializations. There may be a need to get reimbursement for training or upper reimbursement for pediatric residents, in the hope of encouraging more doctors-in-training to enter the field. Sub-specialization typically requires up to three years of education beyond a general pediatrics residency and historically can compensate salaries less than half the rate of adult specialty medicine.

INCREASED DEMAND

The demand for pediatric sub-specialists is continuing to increase for the following reasons:
* More Educated people requesting sub-specialists for treatment
* Elevated obesity rates among kids
* Fellowship programs not meeting the current mini boom in population of children

Many general pediatric residents are pursuing pediatric sub-specialty training. The number of subspecialty training openings has not appropriately increased during this last decade.

RISING DEMAND RISING INCOME

For some time now there have been forecasts of shortfalls of physicians of many specialties in the US. For pediatricians the issue seems to be with the subspecializations like neurology, gastroenterology, and developmental and behavioral medicine and pediatric surgeons. As a result of this shortage, incomes have outpaced other medical disciplines. The lack is vast enough that the salaries for some of these sub specialties is approaching that of adult specialties for the first time. According to the MGMA Physician Compensation Surveys pediatric sub-specialists salaries have gotten larger greatly and for one of the first times, pediatric surgeons truly earn more than their adult surgeon counterparts.

SHORTAGES

This enlarged demand is on top of the fact that institutions report that jobs for the top Pediatric specialties are going unfilled; reporting unfilled in pediatric-rehabilitation medicine, hematology and oncology, and cardiology. For families, that often means waiting for months to see a specialist and incurring heavy travel costs to find appropriate care.

DEMOGRAPHICS

An overriding topic is the demographics of the United States. The main form of the populace in the United States is the baby boom age bracket which is now entering retirement age. The “boomers” cause several problems, one this means the bulk of physicians are retiring just when they will be needed most, two as we grow older we expect more health care services. Greater request for services will cause an even greater financial pressure on the government through bigger dependence on Medicare. Finally a good news / bad news is they may live longer then any generation before but this will further distress the budget with demands on Social Security and Medicare. Even though the baby boom problem does not directly impact pediatrics, it does indirectly in that their increased need will mean higher salaries for those specialties that care for them and less for pediatrics. To further confuse the issue there is a mini baby boom going on now that will directly increase demand for all pediatric specialties.

Solutions:

To cope with the difficulty, many hospitals are turning to telemedicine, remote consultations using two-way video systems-and mobile vans that may drive 100′s of miles to set up clinics in under-served areas. Hospitals are also more often deferring to adult specialists to treat kids, though not all are willing to do so since their instruction is for adult physiology rather than childrens.