| other states in the country, the average | | | | increased during this last decade. |
| Pediatrician in Texas is undergoing many of the | | | | RISING DEMAND RISING INCOME |
| same rough patches as other specialties. Of the | | | | For some time now there have been assumptions |
| roughly sixty-three thousand doctors in the Alamo | | | | of shortfalls of physicians of many specialties in |
| state, almost 4700 specialize in Pediatric medicine. | | | | the US. For pediatricians the issue seems to be |
| For many of the 800 Texas urologists the | | | | with the subspecializations like neurology, |
| forseeable future is uncertain. Of those nearly | | | | gastroenterology, and developmental and |
| forty seven hundred Pediatricians, 4466 are M.D.'s | | | | behavioral medicine and pediatric surgeons. As a |
| and 173 are D.O.'s. While there may be some | | | | result of this shortage, incomes have outpaced |
| differences in training, both M.D.'s and D.O.'s are | | | | other medical specializations. The lack is vast |
| equally accredited and able to become a physician | | | | enough that the salaries for some of these sub |
| of Pediatrics. A Pediatrician medical doctor | | | | specialties is approaching that of adult specialties |
| generally has at least ten to twelve years of | | | | for the first time. According to the MGMA |
| instruction including a undergraduate degree in a | | | | Physician Compensation Surveys pediatric |
| healthcare or science related area, a medical | | | | sub-specialists salaries have gotten bigger greatly |
| doctorate (graduate, Alleopathic or Osteopathic), | | | | and for one of the first times, pediatric surgeons |
| and an accredited Pediatrics residency | | | | actually earn more than their adult surgeon |
| (post-graduate). | | | | counterparts. |
| HEALTH CARE REFORM | | | | SHORTAGES |
| The continual saga of health reform having an | | | | This enlarged demand is on top of the fact that |
| impression on all specializations. Until it becomes | | | | institutions report that jobs for the top Pediatric |
| unmistakable just what is being changed and how | | | | specialties are going unfilled; reporting unfilled in |
| that will shape each partaker the market will be | | | | pediatric-rehabilitation medicine, hematology and |
| hamstrung. Uncertainty affects spending on | | | | oncology, and cardiology. For families, that often |
| expansion and hiring at all levels of health care. | | | | means waiting for months to see a specialist and |
| Some stipulations of the law are trying to tackle | | | | incurring heavy travel costs to find suitable care. |
| shortages in primary care. The Senate bill includes | | | | DEMOGRAPHICS |
| a measure that would sponsor a loan-forgiveness | | | | A massive concern is the demographics of the |
| program for pediatric sub-specializations, easing | | | | United States. The main mass of the inhabitants in |
| the financial difficulties of medical-school costs. The | | | | the United States is the baby boom generation |
| federal Medicare program funds training programs | | | | which is now entering retirement age. The |
| for adult medicine. Congress five years ago | | | | "boomers" cause several problems, one this |
| authorized funding for pediatric specialty training, | | | | means the bulk of physicians are retiring just |
| but the funds must be re-authorized every year. | | | | when they will be needed most, two as we age |
| Pediatric groups go on with pressing for to more | | | | we expect more health care services. Greater |
| funding for post graduate training. The cost of | | | | want for services will cause an even greater |
| training is going higher (see California!) and yet the | | | | financial pressure on the government through |
| income for primary care is not on a par with | | | | bigger dependence on Medicare. Finally a good |
| many other disciplines. There may be a need to | | | | news / bad news is they may live longer then |
| get reimbursement for training or elevated | | | | any generation before but this will further distress |
| reimbursement for pediatric residents, in the hope | | | | the budget with demands on Social Security and |
| of encouraging more doctors-in-training to enter | | | | Medicare. Even though the boom problem does |
| the arena. Sub-specialization typically requires up | | | | not directly impact pediatrics, it does indirectly in |
| to three years of education beyond a general | | | | that their increased need will mean higher salaries |
| pediatrics residency and historically can give | | | | for those specialties that care for them and less |
| salaries less than half the rate of adult specialty | | | | for pediatrics. To further confuse the issue there |
| medicine. | | | | is a mini baby boom going on now that will directly |
| INCREASED DEMAND | | | | increase demand for all pediatric specializations. |
| The demand for pediatric sub-specialists is | | | | Solutions: |
| continuing to increase for the following reasons: | | | | To cope with the setback, many hospitals are |
| * More Educated people requesting sub-specialists | | | | turning to telemedicine, remote consultations using |
| for treatment | | | | two-way video systems-and mobile vans that |
| * Amplified obesity rates among children | | | | may drive 100's of miles to set up clinics in |
| * Fellowship programs not meeting the current | | | | under-served areas. Hospitals are also more often |
| mini boom in population of kids | | | | shifting to adult specialists to treat kids, though |
| Many general pediatric residents are pursuing | | | | not all are willing to do so since their training is for |
| pediatric sub-specialty training. The number of | | | | adult physiology rather than childrens. |
| subspecialty training openings has not adequately | | | | |