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President-elect candidates discuss top issues facing pediatricians :

February 12, 2020

Editor’s note:Candidate biographies, position statements and AAP election rules are available (login required). Voting begins May 26 and ends June 9.

What is one of the most important issues facing today’s pediatricians, and how would you work with the board and CEO to address it? 

Dr. RathoreMobeen H. Rathore, M.D., FAAP

Jacksonville, Fla.

Wellness is the most important issue facing pediatricians. Increasing pediatrician burnout is multifactorial, including financial stresses, insurance company challenges, lack of services for children (including mental health services) and the burden of electronic medical records (EMRs).

Financial challenges due to poor reimbursement and the fact that pediatricians receive the lowest compensation among medical specialties while still accruing enormous student loan debt can be difficult to handle. This combination is placing pediatricians at high personal stress and professional financial risk. Pediatrician wellness hinges on addressing these fiscal stresses.

Pediatricians are particularly affected by the increasing number of uncompensated mandates, constantly changing rules for reimbursement and the insurance marketplace, and unnecessary insurance company roadblocks. Pediatricians from rural to urban areas, in primary or specialty care, or academia are experiencing burnout.

Stress caused by EMRs also contributes to decreased satisfaction and burnout. Many of us are spending hours in the evenings, sometimes even at home, eating into the precious little personal and family time we have. This is certainly negatively impacting pediatricians’ work-life balance.

As a profession, we must address pediatrician burnout. Focusing on pediatrician wellness will only have a positive impact on the care of children. To accomplish this, I will raise a task force, co-chaired by the CEO and the president-elect, which will generate a comprehensive strategic framework for pediatrician wellness. This multiyear roadmap will offer specific recommendations on plans to improve reimbursement, decrease uncompensated care mandates, demand insurance reform and to give pediatricians the ability to practice without interference from insurance companies.


Dr. SzilagyiMoira A. Szilagyi, M.D., Ph.D., FAAP

Marina Del Rey, Calif.

Our country’s 75 million children are 20% of our population but 100% of our future. They are being reared in a demanding, stressful world for a future that often seems in peril. Nearly half live in poverty; 64% have experienced more than one adverse childhood experience. They face new challenges such as climate change, vaping and social media. Addressing these cumulative adversities is incredibly challenging but of critical importance to pediatricians because toxic stress, regardless of cause, can become biologically embedded resulting in poor outcomes now, throughout life and across generations.

As AAP president, I would work closely with the AAP’s CEO, board, chapter leadership and Washington office to implement the AAP Agenda for Children by:

  • Supporting the work of pediatricians. Pediatricians do vital family-centered work to promote healthy growth, development and resilience, ameliorating the negative impact of stressors. Financing must be aligned to pay for the scientifically based preventive and therapeutic work we do and to support integrated care.
  • Advocating for vulnerable children. The power of our advocacy is its foundation in science and demonstrated successes. With partners, we can address poverty, bias and discrimination, climate change, and negative social determinants of health, and promote equity in access and workforce diversity.
  • Promoting pediatrician and staff wellness. Massive transformations in health care require that we support wellness across generations and specialties through team-based care, streamlined technology, improved financial margins and programs to reduce burnout.

We pediatricians have a crucial role as healers who promote resilience and buffer stress.

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