US Faces Shortage Of Pediatric Subspecialists

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Despite an increase in the number of specialty pediatricians over thepast decade, there is a nationwide shortage of pediatricsubspecialists, particularly in rural areas, the Houston Chronicle reports. According to the American Board of Pediatrics,about 1,200 freshman fellows were enrolled in pediatric subspecialtiesin 2006 -- about twice the number enrolled in 1997 -- but the number ofavailable pediatric subspecialists is not enough to meet the growingdemand for their services. Ralph Feigin, chief physician at Texas Children's Hospital,said, "The numbers are minuscule," noting, "We need one-third moresubspecialists in general than we have, but that number varies markedlyfrom specialty to specialty."

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According to pediatricians,lengthy training without pay required of subspecialists has contributedto the shortage. Giuseppe Colasurdo, chief physician at Children's Memorial Hermann Hospital and chair of pediatrics at University of Texas Medical School-Houston,said, "Unless you're committed to an academic career, most peopleprefer to end their training after three years and go into generalpractice and make some money." Specialists can undergo up to 10 yearsof medical school, residency and training before being paid, "whichisn't always feasible for doctors trying to support a family," the Chronicle reports.

Feiginalso noted that one-third of the prospective subspecialists trained inthe U.S. are foreign students, who are required to return to their homecountries for a period of time before they can work in the U.S. Inaddition, some specialty positions pay less than general pediatric jobsbecause insurers tend to reimburse more for procedures than forcognitive disciplines. According to Beth Pletcher, chair of the American Academy of Pediatrics'pediatric workforce committee, distribution of subspecialists also is aproblem because specialists tend to live in large cities near academicinstitutions.

Peggy McManus, director of a Maternal & Child Health Policy Research Centerteam studying the issue, said aggressive recruiting and new funding arekey to solving the shortage problem. She said, "We need to make thepediatric subspecialties a little more attractive," adding, "If youdon't bring any money in the form of loans and grants, it's going to behard to attract them" (Grant, Houston Chronicle, 9/23).

Reprinted with permission from kaisernetwork.org. Youcan view the entire Kaiser DailyHealth Policy Report, search the archives, and sign up for email deliveryat kaisernetwork.org/email. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, afree service of The Henry J. Kaiser Family Foundation.

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