Pediatric specialty shortages cause long waits for care

Shortages of pediatric specialists mean that many young patients must wait weeks and sometimes months to get an appointment, according to data released July 23 by the Children’s Hospital Assn.

The organization surveyed 69 children’s hospitals nationwide and found that physician shortages are causing long waits for patients and lost referrals for doctors. For hospitals, the shortages mean widespread vacancies in needed specialties and rising recruitment costs.

The effect on families can be devastating, said Mark Wietecha, president and CEO of the Children’s Hospital Assn., which represents 220 children’s hospitals nationwide.

“Many children wait far too long to get needed services to diagnose, treat and manage all kinds of diseases,” he said. “When children don’t get timely care, they miss school, they can fall behind, their parents miss work, creating more family stress.”

For primary care physicians, the shortages create difficulties in trying to refer young patients for specialty care. Sixty-four percent of surveyed hospitals said physician shortages have caused them to lose patient referrals, and 78% said they have delayed or lost clinic visits (link).

Hospital officials cited shortages in pediatric neurology, developmental and behavioral medicine, pediatric gastroenterology, pediatric surgery and pediatric neurosurgery as most affecting their ability to provide care. Thirty-nine percent of hospitals reported shortages in pediatric neurology, 30% in pediatric general surgery and 28% in developmental-behavioral medicine.

Waiting for weeks

Ideally, children who need to see a specialist would have to wait no longer than two weeks. But the survey showed that patients must wait an average of nine weeks to see a pediatric neurologist, 11 weeks to see a genetics specialist and 15 weeks to see a developmental-behavioral medicine specialist.

Federal funding of about $265 million annually through the Children’s Hospitals Graduate Medical Education Payment Program provides for training of half of all pediatricians and pediatric specialists, but the program has faced $50 million in cuts since fiscal year 2010, Wietecha said.

Threats of reduced funding for Medicaid could further restrict access to care, he said. The program provides coverage to about one in every three children, according to the association.

Shortages in pediatric specialties have been a chronic problem in the past decade, Wietecha said. Some parts of the country are worse off than others. For example, Alaska has only one pediatric neurologist.

“Demand for these kind of physicians has gone up at the same rate that we have been able to train these doctors, so we’re really treading water,” he said.

If the situation doesn’t improve, access to care for children will continue to worsen, Wietecha said. Meanwhile, the country is facing increasing rates of autism, diabetes and allergies.

“Children deserve better,” he said. “More needs to be done to ensure they’re getting the care they need, when they need it and in the right care setting.”