Show Your Pediatrician Some Love!

So many pediatric articles and updates land in my email inbox each day. It’s the nature of medicine in the 21st century … the pile of paper journals by my bed is smaller, but their electronic equivalents just keep coming.

I almost never share the verbatim professional versions with our readers. The language is deliberately obtuse, so they can be dry and difficult to slog through, and more often than not they focus on minutiae that even the most avid fan-of-all-things-medical would find to be … well … a snooze-fest. No reason you couldn’t read them — there’s just too much shop talk.

What follows is an exception. This is an essay that was included in my Medscape Pediatrics update, and I wanted you to see it. OK, so maybe it’s a bit self-congratulatory, and it’s not exactly written in ‘grab you by the guts’ style, but it does a good job of laying out our view of the new medical landscape.

We pediatricians care for the young and powerless who can’t vote. They usually can’t follow our instructions, so we depend on mothers and fathers to be our eyes and ears. They don’t have well-funded lobbyists and they can’t pay our bills. But ask any pediatrician you meet why they chose it as a specialty, and the answer will include some version of because we’re different.

We like having at least two patients at every visit. We like walking into a room that’s full of anxiety (even the screaming kind), and walking out of one that’s filled with relief. And we love following a family through a lifetime of growing years, feeling like we’re part of it, and helping to navigate through the rough patches.

So take a look at this piece written by a member of the clan, for members of the clan. It offers a glimpse into why we do it proudly.

Pediatricians Have Accomplished More With Less for Years — See What We Do!

Geoffrey R. Simon, MD
Although the devil is in the details, the greatest beneficiaries of the healthcare reform bill are children, whether insured privately or through public insurance, ie, Medicaid. The evidence is irrefutable that investing in children’s health, both in prevention and in managing chronic childhood diseases, such as diabetes mellitus and asthma, early in life results in improved quality of life for children and the adults that they grow up to be. The long-term costs savings of preventive care, the greatest return on investment of healthcare dollars, resides within pediatrics. However, for too long children have been regarded as second-class citizens.
Consider that, for years, most states have been paying only 40%-70% of Medicare rates to physicians caring for children covered by Medicaid, so that most pediatricians or pediatric subspecialists lose money caring for these children. Does this mean that, to our American society, a child’s life is worth less than half of his grandfather’s life? Shameful! The reform bill takes a first step in bringing Medicaid rates up to parity with Medicare. Although this is only guaranteed for the first 2 years, it is a beginning.

For privately insured children, the issue of pre-existing conditions resulting in uninsurability or in exclusion of coverage related to those conditions has been a big problem. With the new reform bill, children cannot be excluded from coverage or charged a premium for pre-existing conditions. Numerous times I have had families in which parents lose jobs and thus insurance, or they might start a small business and are unable to get insurance for their children. Such families may pay $1200 to $1700 per month, but because their child has asthma, still cannot get coverage for any care or medications related to asthma for the first 2 years of the policy. So the child stops taking the asthma medication and ends up having a severe exacerbation resulting in a trip to the emergency department, which costs $3500. To add insult to injury, because this is a non-covered benefit, they have to pay list price.
Finally, with more children having access to insurance, including mandated coverage for preventive care, more insured patients will be provided to pediatricians who can benefit from our expertise in treating patients within the medical home. By doing so, we can further demonstrate financial and health benefits — the greatest return on investments of any specialty in medicine. In pediatrics, we accomplish more with less every day. With a little more resources, we can accomplish even greater things for our children and our future as a nation.

So if you’ve been unsure about what you think of healthcare reform, consider looking at it from a kid’s perspective. And if you feel like it, show your pediatrician some love!

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Rachel Zahn, MD is a pediatrician turned health writer who had three kids during medical school and pediatric training—crazy, huh?


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