I often am reminded of Maya Angelou’s wisdom in her poem “Human Family”: “We are more alike, my friends, than we are unalike.” She expands in comment, “And the minute we begin to understand, just the slightest part of that, we recognize ourselves as family.”
As I travel around the country and speak with many of you, two things are clear:
- While we have unique challenges in our practices and communities, our commitment to the Academy’s mission to serve every child grounds our collective work.
- We have more impact when we work together to find common ground and come together enriched by our diverse opinions and priorities.
While there is much work to do and each of us has our interests and priorities, almost every pediatrician I speak with talks about Medicaid, workforce and pediatrician safety and wellness. To fulfill the mission of the Academy, pediatricians need appropriate payment, a strategy for strengthening our workforce and changes to health care delivery.
Medicaid
The face of Medicaid is well-known to us but is not well-appreciated by society at large. We all can champion children when we remind everyone that Medicaid is the single biggest health insurance payer for the nation’s children, and nearly half of all infants, children and adolescents in this country are covered by Medicaid or the Children’s Health Insurance Program. Coverage varies significantly by state, with 18% of kids in Utah covered, while nearby New Mexico ranks the highest with 71% of children enrolled in a Medicaid program. This variability correlates with several factors, including the level of poverty and state policies. For many pediatricians who serve the poorest communities, lower payments lead to inadequate resources to deliver appropriate care.
For advocacy efforts to be successful, everyone — not just those in health care or policymakers — needs to understand the importance of supporting and strengthening the Medicaid program. The economic strength of every state, military readiness and a healthy workforce depend on healthy children growing into healthy adults. With so many children on Medicaid, the health and strength of the country’s future depends on the Medicaid program. Please join the Academy’s advocacy efforts in this area. Our voice is stronger when we speak together.
Pediatric workforce
When we look at strategies to strengthen the pediatric workforce, we must start with data. Children make up a declining portion of our population (currently 22% down from 36% in 1960). Every sector is focused on capturing as many of the prospective workers as possible.
We know that any solution to bolster the pediatric workforce has to include reduced debt burden and increased lifetime earnings.
In my opinion, we must plant seeds early to have the pediatric teams we need. We have a unique opportunity: A significant portion of children come through our offices and organizations every day. What are we doing to invite our patients to become our future team members? Do we demonstrate the joy that comes with pediatric care? Do we invite them to dream of working with us?
To spark interest in future pediatricians, we also need support to be successful personally and professionally.
Safety and well-being
Pediatrician safety and well-being starts with feeling respected for who we are: highly trained professionals who have sacrificed much for the privilege of providing excellent health care to infants, children, adolescents and young adults. We come from different backgrounds and have varied interests and expertise, but we all are dedicated to ensuring every child has the best chance of achieving optimal well-being. We also are people whose ability to lead with empathy must start with feeling safe.
If the health care delivery system is not committed to pediatricians, we will not be in a position to bring our best selves to the table, and children and our communities will bear the impact. An investment in pediatricians is an investment in the health of our nation. The children we serve represent 100% of the future.
I look forward to recommendations from the Task Force on Pediatrician Safety and Wellbeing in the months ahead. In the meantime, let’s apply what we know from trauma-informed care to our profession. Can we define what adverse pediatric experiences look like? Should we develop strategies for primary, secondary and tertiary prevention to address pediatrician well-being?
Who is your safe, stable, nurturing relationship to help buffer the stress and build resilience? For me, it’s you. Meeting and connecting with you and witnessing the amazing work you do for kids in enormously challenging circumstances brings me hope.
Who would you call at 2 a.m. if you needed someone to lean on? If your phone rings in the middle of the night, it might be me.
