Shetal Shah, MD, FAAP
DeWayne Pursley, MD, MPH, FAAP
Shetal Shah MD, FAAP is neonatologist at Maria Fareri Children’s Hospital and Immediate Past President of the NYS AAP-Chapter 2. He is Chair of the Pediatric Policy Council. DeWayne Pursley, MD, MPH, FAAP is Chief of Neonatology and Director of the Slarman Family Neonatal Intensive Care Unit at Beth Israel Deaconess Medical Center. He is a member of the Pediatric Policy Council. This op-ed was published in Tampa Bay Times on March 8, 2022.
Time is Running Out for Critical Children’s Programs
The clock is ticking for children. Time runs out this Friday, which is when the short-term spending bill keeping the federal government open expires. As Congress finalizes funding proposals for federal agencies and programs, we urge lawmakers to make strong investments that support the health and well being of our nation’s children, such as opportunities to improve access to health care, help find cures for pediatric cancers, and prevent gun violence.
Children’s hospitals train half of America’s pediatricians, and the significant expense of funding pediatric training has been supported by the federal Children’s Hospital Graduate Medical Education Program. Unlike a similar Medicare program for physician training, when adjusted for inflation and the number of pediatricians-in-training, financial support of this essential program has decreased over the past two decades.
In our country, there already are significant areas of child health physician shortages, particularly in rural areas. The pandemic made clear the devastating consequences for patients when doctors are in short supply. For some parents, failing to support children’s hospitals potentially means no doctor for their child, no one to call when their infant has a high fever, and no one to evaluate their baby’s heart murmur. Congress cannot miss the opportunity to fund this program.
Access to subspecialty pediatricians – doctors specially trained in treating children with complex health care needs – is also faltering. Unlike adult specialists, many pediatric specialists earn less than their generalist colleagues. This means fewer pediatricians, who average more than $200,000 in medical education debt, pursue such careers. The result is long wait times, especially for children who need infectious disease, developmental-behavioral, or psychiatric specialists. Nationally, the average wait time for a child with a suspected autism diagnosis is four months, which means a toddler could spend almost 20 percent of his lifetime waiting to be seen after their primary doctor suspects the diagnosis.
Congress has the critical opportunity to address these shortages through funding the Pediatric Subspecialty Loan Repayment Program. This program will help bolster the pediatric workforce and ensure that children can receive the specialized care they need when they need it.
It is also important that Congress funds research that supports and promotes child health. For instance, the National Institutes of Health plays a pivotal role in investigating cures and treatments for pediatric diseases. In fact, the patients who we care for are born premature and critically-ill newborns, and much of the care we provide has been informed by NIH-funded research.
Research funding can also help prevent firearm injuries. At the onset of the pandemic, unintended guns deaths increased 31 percent, according to Everytown for Gun Safety, the largest gun violence prevention organization in the country. And those increases came on top of gun deaths that were already far too high. For example, in 2016, the New England Journal of Medicine reported that 3,143 children died from firearm-related injuries, including homicide and suicide.
Researchers at the National Institutes of Health and Centers for Disease Control and Prevention are now investigating the safest ways to prevent firearm injuries by identifying children at highest risk, studying what gun safety measures are most effective, and even how to best treat children in the event of a shooting. Congress must continue to show its strong support for this research so that we can end preventable deaths caused by gun violence.
Together, we call on lawmakers to put the needs of children first and invest in programs that will help children to thrive. With the Friday deadline quickly approaching, the time to act is now.