• Issue Brief
  • August 1, 2012

Pediatric Specialist Physician Shortages Affect Access to Care

Children’s hospitals across the country continue to experience significant shortages in some pediatric specialties. Causes include limited supply of specialists, rising debt burden, noncompetitive salaries, changing lifestyles and a decline in physicians seeking specialty training.

Children’s Hospitals’ Pediatric Specialist Shortages

According to the children’s hospitals that responded to a May 2012 Children’s Hospital Association survey (n=69), the pediatric specialist shortages that most affect their ability to deliver care are:
  • Pediatric Neurology
  • Developmental Pediatrics/Behavioral Medicine
  • Pediatric Gastroenterology
  • Pediatric Surgery
  • Pediatric Neurosurgery
Specialties with the most frequently reported vacancies of 12 months or longer in children’s hospitals are:
  • Pediatric Neurology
  • Pediatric General Surgery
  • Developmental Pediatrics/Behavioral Medicine
  • Pediatric Gastroenterology
  • Pediatric Pulmonology
  • Pediatric Rheumatology

Pediatric Specialty Shortages Burden Children and Families

The pediatric specialty shortages affect children and their family’s ability to receive timely, appropriate care. The prevailing benchmark in children’s hospitals for clinic wait times to schedule appointments is two weeks. However, for certain pediatric specialties experiencing physician shortages, the wait time far exceeds this standard. Children’s hospitals report the following wait times, on average, for scheduling appointments:
  • Developmental Pediatrics, the average wait time is 14.5 weeks.
  • Genetics, the average wait time is 10.8 weeks.
  • Pediatric Neurology, the average wait time is 8.9 weeks.
  • Pediatric Rheumatology, the average wait time is 7.9 weeks.
  • Pediatric Dermatology, the average wait time is 7.7 weeks.
  • Child and Adolescent Psychiatry, the average wait time is 7.5 weeks.
  • Pediatric Endocrinology, the average wait time is 7.3 weeks.3
For surgical specialties, the average wait time for elective/non-emergency cases for hospitals participating in this survey is two weeks. However, for certain surgical specialties, the wait time far exceeds this standard.

Children’s hospitals report the following wait times, on average, for scheduling surgeries:
  • Pediatric Urology, the average wait time is 4.1 weeks.
  • Pediatric Orthopedic Surgery, the average wait time is 3.8 weeks.
  • Pediatric Plastic Surgery, the average wait time is 3.4 weeks.
  • Pediatric Otolaryngology, the average wait time is 2.6 weeks.

Recruitment Difficulties Remain

In spite of efforts to address the shortages, children’s hospitals still face difficulties recruiting pediatric specialists. The impact varies from hospital to hospital.
  • 77.6 percent of the hospitals report delayed and/or lost clinic visits.
  • 67.2 percent of the hospitals report increased recruitment costs.
  • 64.2 percent of the hospitals report lost referrals (children referred to other providers who are adult clinicians).
  • 56.7 percent of the hospitals report decreased staff morale.
  • 55.2 percent of the hospitals report increased salaries.
  • 52.2 percent of the hospitals report delayed and/or lost surgeries and reduction in level of service.
Pediatric specialist shortages are due to two economic disincentives to choosing a career in pediatric specialty care: the longer training times (two to three years on average) and an average Medicaid reimbursement that is nearly 30 percent less than Medicare (1 in 3 children are covered by Medicaid making it the largest payer of children’s health care services.) 

Additional information can be found in the attached fact sheet.

Association Contact: John Knapp, (202) 753-5366