The Specialty of Pediatrics in the USA
Workforce Shortage and Moral Injury
Pediatrics is a critical field of medicine that focuses on the health and well-being of children. Unfortunately, there is a growing shortage of pediatricians in the United States, leading to a significant burden on the healthcare system. Moreover, women pediatricians face a higher risk of burnout, a considerable concern for the healthcare sector. This blog will discuss the pediatric workforce shortage and women pediatricians’ burnout and its impact on the healthcare industry.
Pediatric Workforce Shortage
The pediatric workforce shortage is a growing concern in the United States. According to the American Academy of Pediatrics (AAP), there is a significant shortage of pediatricians in the country, which is expected to worsen in the coming years. The AAP estimates that by 2030, there will be a shortage of 4,100 to 27,000 pediatricians in the country. The deficit is caused due to several factors, such as an aging population, increased demand for pediatric services, moral injury, poorly designed financial incentives, and a decline in the number of medical students choosing pediatrics as their specialty.
In addition, medical school is a long and arduous endeavor. Today's medical student is female, spending 11 years to become a pediatrician, incurring a debt of over $300,000, and can't afford to join a medical home that can't offer loan forgiveness and a salary of less than $160,000.
The shortage of pediatricians has significant implications for the healthcare system. It can lead to longer appointment wait times, increased workload for pediatricians, and decreased access to care, particularly in rural and underserved areas. Furthermore, the shortage may cause pediatricians to work longer hours and take on more patients, which can lead to burnout.
Women Pediatrician’s Burnout and Moral Injury
Burnout and moral injury are significant concerns among healthcare professionals, and women pediatricians are particularly at risk. According to a study by the AAP, women pediatricians are more likely to experience burnout than their male counterparts. The study found that female pediatricians reported higher levels of emotional exhaustion, depersonalization, and reduced personal accomplishment than male pediatricians.
The reasons for burnout among women pediatricians are complex and varied. Women pediatricians often face challenges balancing their personal and professional lives, leading to stress and burnout. Additionally, women pediatricians may face discrimination, bias in the workplace, and the polarized social wars of USA society, which can contribute to burnout.
Impact on Healthcare Industry
The pediatric workforce shortage and women pediatricians' burnout have significant implications for the healthcare industry. The shortage of pediatricians will lead to increased costs, decreased access to care, and reduced quality of care. Furthermore, burnout among women pediatricians can lead to decreased job satisfaction, decreased productivity, and increased turnover rates.
Turnover and moral injury have been made worse by the mega-consolidation of health systems that act as oligopolies and are focused on margins and not on the mission. We hear the story repeated in the podcast of women pediatricians who give up after 4 to 7 years of working for these big money-making machines, and some pediatricians are asked to see 60 patients in 12 hours in clinics backed by Private equity. As we saw in the 2022 winter, Children's Hospitals could not keep up with volume as the community hospitals are abandoning pediatric inpatient, pediatric Emergency Rooms, and even radiology services for children in favor of high-margin Medicare and surgical patients.
To address these issues, healthcare organizations must take steps to support and retain women pediatricians. This includes providing flexible work arrangements, addressing discrimination and bias in the workplace, and providing resources for work-life balance. Additionally, healthcare organizations must work to address the pediatric workforce shortage by increasing the number of medical students choosing pediatrics as their specialty.
To achieve this goal, we need diverse practice models that include community-based solutions that provide a medical home to all children with all problems, like direct primary care, concierge, private practice, rural health clinics, and strong partnerships with mission-driven pediatric tertiary hospitals. But none of this can become a reality if the laws, policies, regulations, and finance of healthcare continue to favor high margins procedures and do not value and pay for prevention and early diagnosis of disease in a medical home.
Conclusion
The pediatric workforce shortage and women pediatricians' burnout are significant concerns for the healthcare industry. The shortage of pediatricians can lead to decreased access to care, increased costs, and decreased quality of care. Furthermore, burnout among women pediatricians can lead to reduced productivity, increased turnover rates, and decreased job satisfaction. Society must address these issues to ensure children's continued health and well-being in the United States.
This is very important. Women make up of >50% of medical students, and in pediatrics, the residents have been reported somewhere around 75%. The AAP in 2017 published data showing 63% of AAP members were women. It's even larger today. And women pediatricians do not have the same opportunities for advancement in their careers, don't have pay equity, and often struggle with balancing caring for themselves, their own families, their patients and practices. We MUST look at this problem with the seriousness it deserves. Much of our own "unwellness" comes from systemic pressures that prevent us from having the appropriate resources for caring for our patients. We feel moral injury every day when we go to work and feel like we aren't doing enough to help those in need. To my colleagues who feel that way: I SEE you, hear you and value you. You matter! You matter to many and make a difference every day. Yet it feels like it's never enough and we are losing ground. We need healthcare reform...and lots of it. It's time to stop saying the system is broken...let's heal it, and in the process heal ourselves and allow us to be the healers we were called to be. We will need creative solutions. Let's create them.
Time to lean into the fact that we need team based primary care and need to blow up the current patriarchal or matriarchal physician only model. Pediatricians in primary care are the last to adopt that the demands of healthcare are changing and have been for decades. Isn’t it ironic how negative pediatricians are toward np’s…. 90% are women…. How about how we treat practice managers, women executives in pediatrics etc… majority women. Even “women in pediatrics” is exclusive to women pediatricians …. And then you can ask how we treat the growing minority of men in the field. Time to sweep in front of our own doors …. My take as someone who loves to live outside the siloes that blind so many in healthcare.