By guest blogger Larry McAndrews, president and CEO, NACHRI
A January 12 article in the Wall Street Journal by Laura Landro on the national shortage of pediatric subspecialists has generated a lot of buzz in the medical community. It effectively summarizes why some families experience barriers when trying to access specialty care for their children, and highlights what policy makers might consider right now to address these barriers through final health reform legislation.
Most of the feedback we’ve received validates what the article reports. However, questions have been raised about a data graphic in the article that indicates some states lack at least one pediatric subspecialist in one or more of 13 subspecialties.
The data that NACHRI provided for the chart was gathered by the American Board of Pediatrics (ABP). As with any data set, there are limitations – outlined below. In providing the data to the Wall Street Journal, we did not clearly articulate these limitations and we regret this inadvertent oversight. The data set includes:
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pediatric subspecialists who have been certified by ABP
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pediatric subspecialists under the age of 66 years (if the age of the subspecialist was not available, it was treated as missing data)
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pediatric subspecialists with a known address on record as of 12/31/2008
A data research check indicates that there are two pediatric rheumatologists in Georgia and one pediatric rheumatologist in New Hampshire. NACHRI apologizes for missing these errors. Also, based on the limitations of the data, there may be board-certified physicians in specific pediatric subspecialties who are indeed currently practicing in states that were listed in the article as lacking subspecialists. (While no physician database is 100 percent complete, the ABP database provides the most robust data available on the number of ABP-certified pediatric subspecialists.)
Yet the data limitations do not negate what families across the country are experiencing when they confront long wait times for specialty appointments or are required to travel long distances to see a subspecialist. The barriers to accessing care are real. In fact, children’s hospitals responding to a December 2009 NACHRI survey report significant shortages in high-demand pediatric subspecialties and long wait times for families seeking appointments. These findings together with alarming pediatric subspecialty workforce trends demand a concerted response by the pediatric community, teaching hospitals, state and federal legislators.
We must do everything possible – at the practitioner level, the hospital level and by strengthening federal support for pediatric care – to ensure sure children can get the right care at the right time and in the most appropriate setting.
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