The AAP National Nominating Committee has named Jay E. Berkelhamer, M.D.,FAAP, and Charles W. Linder, M.D., FAAP, as candidates for AAP president-elect. Here, each candidate responds to the nominating committee question: “How can the AAP best address the fiscal crisis members are facing as a result of lower reimbursement and escalating malpractice fees?”

A frequent concern I hear in listening to pediatricians around the country is the increasing difficulty of sustaining a financially sound practice. Lower payment in the face of rising costs is causing stress as pediatricians seek ways to increase productivity while maintaining high quality patient care and satisfaction. Academic departments are facing similar problems, and the challenges are especially real for younger pediatricians who are just beginning their practice careers and are likely saddled with large debts.

In addition to professional liability insurance, there are increasing costs associated with regulations such as CLIA and HIPAA. More effort...

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