Pediatrics Doctors Suffer Shortage of Available Physicians and Influx In Caseloads
By: Cory Ellerd
Submitted: 2010-04-13 15:17:58 | Word Count: 890
HEALTH INSURANCE REFORM
The never ending saga of health reform having an impression on all specialties. Until it becomes apparent precisely what is being altered and how that will shape each party the market will be constrained. Indecisiveness affects spending on development and hiring at all stations of health services.
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Some attributes of the bill are trying to focus on shortages in primary care. The Senate bill contains a measure that would fund a loan-forgiveness program for pediatric sub-specialists, easing the monetary burden of medical-school costs. The federal Medicare program funds instructional programs for adult medicine. Five years ago, Congress endorsed funding for pediatric specialty training, but the funds must be re-authorized every year.
Pediatric groups are pressuring for to more funding for residents. The cost of pediatric residency is going higher (see California!) and yet the earnings for primary care is not competetive with many other physician specializations. There may be a need to get reimbursement for training or higher reimbursement for residents specializing in pediatrics, in the hope of encouraging more doctors-in-training to enter the field. Specialization normally requires up to three years of training beyond a general pediatrics residency programs and usually can pay salaries half or less than the going rate of adult specialty medicine.
GROWING DEMAND
The want for more pediatric sub-specialists is continuing to escalate for the following reasons:
* More Educated individuals requesting sub-specialists for treatment
* Alarming obesity rates among children
* Fellowship programs not meeting the current small boom in number of children
Many general pediatric residents are pursuing pediatric subspecialty training. The number of subspecialty training opportunities has not adequately increased during this last decade.
RISING NEED MEANS RISING
For a while time now there have been guesses of shortcomings of physicians of many specialties in the US. For pediatricians the issue seems to be with the subspecialties like neurology, gastroenterology, and pediatric developmental and behavioral medicine and surgeons. As a result of this deficit, remuneration rates have outpaced other medical specialties. The deficiency is large enough that the salaries for some of these sub specialties is about to reach that of adult specialties for the for the first time in history. According to the MGMA Physician Compensation Surveys pediatric sub-specialists pay have risen significantly and for one of the first times, pediatric surgeons in all actuality earn more than their adult surgeon counterparts.
DOCTOR DEFICIT
This greater demand is on top of the fact that pediatric units report that jobs for the better Pediatric specialties are remaining vacant; reporting vacancies in pediatric-rehabilitation medicine, cardiology, and hematology and oncology. For the children, that often means waiting for months to see a specialist and incurring heavy travel and lodging costs to find the right care.
DEMOGRAPHICS
An overriding issue is the demographics of the US. The main bulk of the inhabitants in the US is the baby boom age bracket which is now approaching retirement age. The "boomers" cause a number of problems; 1) this means the lion's share of physicians are retiring just when they will be required most, 2) as we age we require more health care services. Higher demand for services will cause an even greater financial burden on the government through increased dependence on Medicare. Finally, a "good news bad news" is they may live longer then any age group before but this will further straining the budget with burden on Social Security and Medicare. Even though the boomer issue does not directly impact pediatrics, it does indirectly in that their increased need will mean higher salaries for those specializations 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.
ALTERNATIVES:
To cope with the crisis, many hospitals are turning to telemedicine : remote consultations using two-way video systems-and mobile vans that may drive hundreds of miles to set up temporary practices in under-served areas. Hospitals are also more often resorting to adult specialists instead of pediatricians to treat children, though not all are willing to do so since their post-doctoral education is for adult physiology rather than childrens.
Even with the health reform finally signed into law its effect on our health care is not known. By 2014 their will be an increase in the enrollment into health care insurance programs. This increase when, combined with the long term aging of the populace, should push demand for services and as a result cost higher. However, no one yet knows what will happen to recompense rates from Medicare and this new program. The question is will there be rate a cut of reimbursement rates for different medical disciplines by Medicare and this new program that may conversely become a decreasing factor of the income of all specialties including Pediatrics, its related specialties, and subspecialties.
