The Pediatrician Workforce: Current Status and Future Prospects

Abstract

ABSTRACT. The effective and efficient delivery of children's health care depends on the pediatrician workforce. The number, composition, and distribution of pediatricians necessary to deliver this care have been the subject of long-standing policy and professional debate. This technical report reviews current characteristics and recent trends in the pediatric workforce and couples the workforce to a conceptual model of improvement in children's health and well-being. Important recent changes in the workforce include (1)

Supply and Utilization of Pediatric Subspecialists in the United States

“…However, these analyses were limited due to the large number of children with multiple chronic diagnoses and the lack of subspecialty-specificutilizationordiseasespecific outcomes. Future work examining disease-specific utilization and outcomes among children with specific diagnoses 17 or health needs 44 may be valuable in identifying consequences of variation in subspecialty access that are not apparent in our current analysis.…”

“…[17][18][19] We used the Area Resource File to count pediatricfocused specialists such as pediatric neurologists and dermatologists in addition to American Board of Pediatricscertified pediatric subspecialists. Because of known imprecision in counting and locating physicians, [17][18][19][20] we used quintiles of supply to examine relative supply rather than specific counts.…”

“…We did not have data on additional factors that could moderate the effective local subspecialty supply, such as outreach/satellite clinics or telemedicine availability. Additionally, limitations exist generally in the measurement of subspecialty supply, [17][18][19][20] prompting us to examine relative density of providers rather than specific numerical counts. We examined countylevel supply because no standardized market area exists for ambulatory pediatric subspecialty care.…”

A survey of the current neonatal nurse practitioner workforce

“…Historically, surveys of the neonatology workforce have focused on physician providers and have neither gathered data about NNPs, nor have they considered their potential impact on the overall neonatology workforce. [10][11][12] Although the number of fellows in training has increased significantly over the past decade, it is unclear whether additional neonatologists are necessary, based on clinical needs. 11,13 The impact of graduating fellows on the current or future NNP workforce is unknown.…”

“…[10][11][12] Although the number of fellows in training has increased significantly over the past decade, it is unclear whether additional neonatologists are necessary, based on clinical needs. 11,13 The impact of graduating fellows on the current or future NNP workforce is unknown. Given the 2003 mandated decrease in resident hours in the neonatal intensive care units (NICUs), NNPs have been employed in rising numbers to provide NICU coverage, 13,14 teach and supervise pediatric residents.…”