The Future of Pediatrics: A Call to Action
As we prepare to meet in Orlando with the leaders of pediatrics, we find ourselves at a critical inflection point. Our children are hurting, and our specialty faces unprecedented challenges. It's time to change the paradigm and address the core issues that threaten the foundation of pediatric care in America.
The Current Landscape
Recently, we published an episode highlighting the urgent need to focus on payment reform. The stark reality is that there will be no access to care without adequate compensation. This isn't just about fair wages; it's about the sustainability of our entire profession and the health of our nation's children.
In an upcoming episode, set to release in early October, we'll feature a conversation with the new Chair of Workforce—an individual whose mind and prose I deeply admire. This discussion will further illuminate the challenges we face and the innovative solutions we must consider.
Change is Difficult But Necessary
For many years, organized medicine advocated for children but forgot to build the infrastructure to support those of us who care for them. We've reached the end of that road. To illustrate our predicament, consider these analogies:
- What good is an elementary school with cutting-edge technology and free lunches without teachers because they're burned out or can't afford to pay their bills?
- How likely is a newborn to thrive without a mother to nurture and love them?
We must stop letting politics and talking points lead a conversation that has brought us to this precarious position.
A New Vision: The Quintuple Aim
I propose we adopt a new framework—the Quintuple Aim (borrowed from our friend Dr. Birch and inspired by Costa Rica):
1. Healthy
2. Happy
3. Safe
4. Literate
5. Citizens
To achieve this, we must abandon the misconception that "value-based medicine" exists in prevention. Prevention demands investment that can't be converted into short-term profits. This is the essence of what a school teacher, a mother, and a pediatrician provide.
The Canvas Before Us
We have before us in every child an empty canvas with the potential to change the world. We are called to keep this canvas strong so that the masterpiece meant to be can be revealed and celebrated.
To realize this vision, we must ask our fellow citizens and leaders to move beyond the "Medicaid for all" approach that has led to such low payments that pediatric hospitals, maternity wards, pediatric emergency rooms, offices, subspecialists, dieticians, and mental health professionals are scarce.
Instead, we must collaborate on making education, nutrition, and health accessible to all children in their neighborhoods. Yes, this will require significant investment, but we must ask ourselves: what will become of this grand experiment called the United States of America if we don't?
A Call to Action
The time for incremental change has passed. We must:
1. Advocate for fair and sustainable payment models for pediatric care
2. Invest in prevention and long-term health outcomes
3. Build robust infrastructure to support pediatric healthcare clinicians
4. Collaborate across sectors (education, healthcare, nutrition) to support child well-being
5. Engage policymakers in reimagining how we fund children's healthcare
The future of our children—and indeed, our nation—depends on our actions today. Let's seize this moment and create a healthcare system that truly serves the needs of our youngest and most vulnerable citizens.