The Future Pediatric Subspecialty Physician Workforce Meeting the Needs of Infants, Children, and Adolescents (2023) / Chapter Skim
Currently Skimming:
1 Introduction
1 Introduction
Pages 19-40
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 19... ...
Primary care clinicians such as general pediatricians, advanced practice providers (e.g., advanced practice registered nurses, physician assistants) , and family medicine physicians work closely with subspecialists in a way that complements the subspecialists' expertise.
|
From page 20... ...
STUDY ORIGIN AND STATEMENT OF TASK Several health care organizations with an interest in pediatric care approached the National Academies of Sciences, Engineering, and Medicine (National Academies) to examine clinical subspecialty workforce trends related to the health care needs of infants, children, and adolescents, and the impact of those trends on child health and well-being as well as trends in the pediatrician-scientist pipeline and the impact on the scope of child and adolescent health research.
|
From page 21... ...
to ensure equitable patient access to pe diatric expertise • Trends in the selection of pediatric residency training and fel lowships in pediatric subspecialties, and factors such as debt burden, cost of training, lifetime earning potential, and others that influence those trends • The impact of reimbursement on the financial stability of pediat ric health care, on pediatrician salaries, and on trainee selection of pediatrics and pediatric subspecialities • Data on other clinicians who provide care for children, such as family medicine physicians, nurse practitioners, and physician assistants • Strategies to better align clinician specialty selection with the ex isting and future medical and behavioral health needs of infants, children, and adolescents • The role of state and federal policies and resources in develop ing and supporting a well-trained pediatric clinical and research subspecialty workforce with appropriate competencies to im prove child health
|
From page 22... ...
. The committee's definition of the term excludes general pediatricians, family physicians, advanced practice providers (e.g., advanced practice registered nurses, physician assistants)
|
From page 23... ...
Waiting times to access care also vary among pediatric subspecialties, from days for some to months for others, and by geographic location. While there are few URiM pediatric subspecialists, some fields have been more successful in advancing diversity.
|
From page 24... ...
, "the establishment of the [NICHD] in 1962 underscored the importance of investigating human development throughout the entire life process, starting even before birth and with a critical role of health in childhood." With substantial improvement in child survival, there has been a conceptual shift to address the needs of children with chronic medical conditions and more recently, children with special health care needs.
|
From page 25... ...
and have great influence on the need for pediatric subspecialty care. Organizations such as AAP have issued policy statements that emphasize the need for strategies to address health and development issues across the pediatric lifespan regarding ethnicity, culture, and circumstance, issues that are critical to reducing health disparities (Trent et al., 2019)
|
From page 26... ...
. The development of pediatric medical subspecialties and the requirements and expectations for training and certification in those subspecialties have reflected the consensus of the pediatric community and specialty organizations on how best to address medical needs of children and advances in their diagnosis and care.
|
From page 27... ...
STUDY FOCUS The committee recognizes the important contribution of many different types of clinicians towards the care of children; however, based on the statement of task and discussions with study sponsors, this report focuses on the medical subspecialty physician workforce. The committee particularly focused on the 15 medical subspecialties certified by the American Board of Pediatrics (ABP)
|
From page 28... ...
Pediatric Critical Care 1987 Care for pediatric patients who require high levels Medicine of inpatient care and monitoring, such as those who have seizures, cardiac failure, or traumatic injuries. Pediatric 1990 Care for pediatric patients to manage their Gastroenterology digestive health.
|
From page 29... ...
, and emerging medical subspecialties. As a secondary focus, the committee discussed the interaction and collaboration between pediatric medical subspecialty physicians and primary care clinicians because these types of physicians commonly collaborate with each other on patient management.
|
From page 30... ...
The committee's task was not to redesign the overall health system of pediatric care delivery, including transitions to adult care, but rather to focus on equitable access to pediatric subspecialty care. Furthermore, the committee recognizes the importance of high-quality primary care as a foundation for high-quality subspecialty care. Although the committee did examine some new models of subspecialist–primary care clinician interaction for patient care, the 2021 National Academies report Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care addresses strategies to improve primary care broadly, including the use of interprofessional teams, and the committee considered its work to build upon that study.
|
From page 31... ...
• Pediatric Critical Care Medicine • Pediatric Emergency Medicine • Pediatric Endocrinology • Pediatric Gastroenterology • Pediatric Hematology/Oncology • Pediatric Hospital Medicine • Pediatric Infectious Diseases • Pediatric Nephrology • Pediatric Pulmonology • Pediatric Rheumatology Other Pediatric Medical • American Osteopathic Board of Subspecialty Physicians Pediatrics–certified subspecialties (Clinicians and • ABP co-sponsored subspecialties Researchers) (certified by another board of the American Board of Medical Specialties [ABMS]
|
From page 32... ...
highlights concerns about a mismatch between population health needs and the specialty makeup of the physician workforce, physicians' geographic maldistribution, insufficient diversity, gaps between new physicians' knowledge and currently required com petencies, and a lack of fiscal transparency (IOM, 2014)
|
From page 33... ...
The speakers provided valuable input on a broad range of topics, including patient and family perspectives, emerging issues in child health, innovative approaches in education and training, early career perspectives on the subspecialty pipeline, meeting community needs, modeling the future subspecialty workforce, the pediatric physician–scientist and research pathway, and innovative clinical practices to improve access. The committee also completed an extensive search of the peer-reviewed literature and the gray literature, including publications by private organizations, advocacy groups, and government entities.
|
From page 34... ...
High-quality pediatric subspecialty care requires a well-supported, superbly trained, and appropriately used primary care, subspecialty, and physician–scientist workforce achieved through effective education and training, well-designed care models, and continued attention to the changing health care and economic landscapes. In addition, all clinicians need to be able to practice at the top of their scope with appropriate reimbursement for their administrative and clinical work.
|
From page 35... ...
Organization of the Report The committee structured its report around the main issues challenging the pediatric medical subspecialty workforce. This introductory chapter has described the study context, charge to the committee, and the scope and methods of the study.
|
From page 36... ...
Chapter 5 considers the factors that influence the choices of physicians to pursue a career in a pediatric subspecialty, and Chapter 6 specifically explores the pediatric subspecialty research workforce. Chapter 7 explores the interface between pediatric subspecialists and the broader child health care workforce, particularly the interface between primary care clinicians and pediatric subspecialists.
|
From page 37... ...
https://www.pedsubs.org/about-cops/subspecialty-descriptions/ hospitalist (accessed April 14, 2022)
|
From page 38... ...
2021. Growth and changes in the pe diatric medical subspecialty workforce pipeline.
|
From page 39... ...
https://hekint.org/2018/03/15/origins-pediatrics-clinical-academic-specialty-United States (accessed April 22, 2023)
|
From page 40... ...
2021. The pediatric workforce: Recent data trends, questions, and challenges for the future.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.