4 Ways To Manage The Pediatric Physician Shortage

It’s no secret that the demand for pediatric care in the US has steeply outgrown the number of practicing physicians.1 “Our next appointment is four weeks from now” has become a familiar refrain at pediatric offices across the country.

The statistics help tell the story:

The shortage is, in part, a reflection of the fact that becoming a pediatric physician takes about 6 years of additional training. But a pediatrician may well earn less than a specialist, a fact that makes medical students think twice before they specialize in pediatrics.

Faced with this pediatric physician shortage, your practice might need to take creative approaches to meeting young patients’ healthcare needs. Here are 4 strategies to consider.

1. Remove Barriers For Non-MD Providers4

From a patient’s perspective, “doctor” generally means a physician with an MD. However, many nurse practitioners (NPs) are trained as primary care providers in pediatric care.5

Not only have nurse practitioners been providing many primary care services to pediatric patients, they’ve also expressed willingness to take the lead in patient-centered medical homes.6

Hiring NPs might ease some pressure on your office, particularly during the winter months as more patients present with viral illness symptoms.

Another option: medical assistants, who can perform advanced medical duties, such as:7

  • Serving as a contact person for patients with chronic diseases
  • Providing customized health education for parents
  • Serving as a “health coach” for older children (e.g., young athletes)

Practices are recognizing this opportunity, with perhaps surprising results. For instance, New Jersey’s Atlanticare Special Care Center (a practice for adult patients) reduced emergency room visits percent8 by adopting a medical home model that uses medical assistants as health coaches.

2. Let Doctors Be Doctors

It’s a problem that keeps growing for physicians nationwide: administrative tasks take too much time away from patients. This is when practice management strategies become critical.

In our last blog, we talked about ways to improve management at your practice to save time and deliver better care. For example:

  • Add synchronized, bundled prescription renewal through your patient portal
  • Use visual aids to explain medical concepts, which can save time
  • Leverage your website to answer patient questions and reduce the amount of time your staff spends on the phone

Keep seeking out strategies like these and, if necessary, consider hiring a practice consultant. Even a few minutes of time saved per day can significantly add up on a monthly or yearly basis.

3. Embrace Telemedicine

Telemedicine9 may be another low-cost solution to help manage the pediatric physician shortage. And, its technology evolves, providers may be able to diagnose a wider range of issues more accurately.

Telemedicine is already addressing a major root of the shortage problem — uneven geographic distribution of providers. It’s often difficult for rural hospitals to support many specialists.

Telemedicine allows small hospitals or practices to connect to bigger medical centers and make more specialists available to their patients.

The American Academy of Pediatrics supports the increased use of telemedicine10, touting its potential for:

  • Improving access to care
  • Increasing communication among providers
  • Enhancing continuous care by linking primary and specialty care providers

4. Make An Impact On Education And Training

Medical school enrollment is increasing every year, but many students make their residency choices out of practical necessity instead of personal preference.

This might drive them away from pediatrics, a field that doesn’t generally offer as many residency programs as other primary care fields, such as family medicine, general surgery, and obstetrics/gynecology.11

Medical practices could emulate some private organizations and consider establishing scholarship and fellowships to encourage more young physicians to pursue pediatrics.

All of these steps combined may help reduce the physician shortage in pediatrics and make excellent care available to more young patients nationwide.

[INSERT ALSO READ]

  • 4 Time-Saving Strategies For Your Medical Practice
  • What Do Healthcare Consumers Value Most? 4 Key Insights
1, 2 Health Capital (March 2014)
3 American Academy of Pediatrics (June 2014)
4 Wall Street Journal (June 2013)
5 New England Journal of Medicine (June 2013)
6 New England Journal of Medicine (May 2013)
7, 8 Fortune (August 2015)
9 Becker’s Hospital Review (January 2013)
10 American Academy of Pediatrics (June 2015)
11 Residency Place

December 2018 Pediatric Population Health News & Resource Round-Up

The field of pediatric population health is constantly evolving. To help pediatricians stay on top of new developments, here are some of the latest news and resources to be aware of:

Population Health (American Academy of Pediatrics)

This AAP resource highlights practical applications of population health interventions for pediatric practices to consider.

Quality Management (CHN Care Management & Clinical Collaboration Committee)

This pdf provides an overview of HEDIS (Healthcare Effectiveness Data and Information Set) and the importance of tracking quality measurements.

Integrated Care for Kids (InCK) Model (Centers for Medicare & Medicaid Services)

CMS recently announced the Integrated Care for Kids Model, which aims to both lower expenditures and increase the quality of care for children “through prevention, early identification, and treatment of behavioral and physical health needs” at the state and local levels.

Webinar: Integrated Care for Kids (InCK) Model – Overview (Centers for Medicare & Medicaid Services)

This webinar provides an overview of the Integrated Care for Kids Model.

How Mobile Technology Can Drive Care Management [Podcast]

In today’s technology-dominated world, social media and the internet are playing an increasingly larger role in healthcare. But what does this mean for physician practices and care management?

Brad Brabec, M.D., Chairman of Children’s Health Network and President of Complete Children’s Health, an independent physician practice, shares his thoughts on the relationship between the internet and healthcare for both providers and patients.

Topic Breakdown

1:06—Dr. Brabec on social media and what’s next for Children’s Health Network
1:50—The role of physicians in an internet-dominated world
7:00—Challenges physicians face with electronic medical records
7:45—Managing your online reputation as a healthcare provider

Takeaways

  • The spread of misinformation online is a challenge physicians must confront head-on by engaging patients in conversations and involving them in the medical decision-making process.
  • Maintaining electronic medical records can be challenging for practices as certain systems become obsolete — but the benefits of electronic access for patients are numerous, especially if a child has complex medical needs.
  • Technology can help streamline pre-appointment information gathering, which gives providers more time to help patients in-office.
  • Online reputation management is important for providers — but not something that medical schools necessarily prepare new physicians for.

Transcript

CHN News: Hello, everyone. Welcome to the CHN podcast. We are speaking with Dr. Brad Brabec.

Dr. Brabec, can you give us an introduction to who you are and what you do?

Brad Brabec, M.D.: Absolutely. I’m a general pediatrician in a private practice, here in Lincoln, Nebraska. The practice is called Complete Children’s Health, which I first founded coming on 22 years ago, back in 1995, after having been in private practice for six years in Seattle, and having trained out there at a children’s hospital and medical center.

With regards to this practice, we have taken it from one office location to, currently, four office locations. We have plans to expand to a fifth office location in the next couple of years here in Lincoln, Nebraska.

The Evolving Role Of Physicians In A Digital World

CHN News: Our topic for this podcast is how mobile technology can drive care management. How are you seeing your patients and families use mobile apps, social media to be patients or to be healthcare consumers?

Dr. Brabec: We’re obviously seeing that more and more nowadays. Families come in and say, “Well, I was on the internet and …” Or “What about this, Dr. Brabec? I read this on the internet …” Or, unfortunately, the things that steer patients in the wrong directions — in our opinion — sometimes with their medical decision-making, such as choosing to not vaccinate their child.

It is something that we have to constantly learn to deal with. Probably the most important piece of information I could give anybody is just to make sure you develop as close of a working, medical professional relationship that you can with your families.

And also guide them in their decision-making and care. All too often, I’ll hear families say, “This doctor I went to for my care as an adult basically gave me some choices and options and left it up to me.” I try to help guide the patient’s decisions, ultimately, in terms of what they decide to do with their child.

Now, mind, you, the discussion regarding the choice to not vaccinate, I give my strong beliefs. But, ultimately, families have to make a choice and decision about what they’re going to feel most comfortable with in regards to their child. I respect that, but I also let them know that we firmly believe in the need to vaccinate, as an example.

But I think when it comes to that knowledge out there, having that relationship with your patient families is most important. Discussing in a congenial manner the information that they’ve found on the internet can help them make the best choice they can for the healthcare they’re going to receive.

There are many apps and websites out there. As a provider, I think you just have to be ready and develop a style for how you’re going to address that when it comes to you.

The Dangers And Benefits Of Technology In Healthcare

CHN News: There are some ways that your practice is using technology to understand patients better. You probably have an electronic records system. Tell me how you guys are using technology to understand your patient population and make care management decisions.

Dr. Brabec: The rudimentary Facebook we have is up and going. And I think, again, the key with that is making sure you have people who know how to use Facebook and deal with the comments as they come in from patients. I think a good, knowledgeable user who can manage that is most important as well.

After 22 years at this practice here in Lincoln, we’re actually getting ready to go to new electronic medical records. This has always been a stressful thing for physicians in terms of trying to find the ideal electronic medical records system to use in your office.

Sometimes the product that you thought was going to be around forever has been bought by a large company that is going to be shelving the product and driving practices to their product. We decided against that and spent close to 10 months looking for a new product that we’re getting ready to evolve toward that as well.

What we want to do here in our practice — and again, this has to do with the amount of time patients have to spend getting off of work to come into the office — is to drive more of the information gathering process that we all experience to before the office visit.

Things like giving your insurance card, filling out a two- or three-page form that updates demographic information, filling out a form about the child’s check-up that day — we’re hoping to drive a lot of that data gathering pre-office visit through our website or other mobile devices.

This will allow us to streamline the process and spend more time when they come into the office educating them and talking to them about their medical problems, rather than most of the visit being about collecting the data.

So for us, what’s going to be key is using the website and various apps that interact with our electronic medical record system to provide that information gathering ahead of time, so we can improve on the patient experience and the care they receive when they come in the office.

Likewise, we also have to — through federal mandates and initiatives — allow our patients access to their medical records, which will be done through the website or apps that link in with the electronic medical records.

This allows them more portability with their medical information, so that whether they’re in Lincoln or whether they’re in Orlando, Florida, if their child gets sick and has medically complex needs and medications, they are able to easily pull that information up and extend that information to other healthcare providers who may otherwise not be familiar with that child’s care.

Then, they can provide the best quality medical care, even though they’re not the child’s regular provider.

CHN News: You may have already answered this question about the greatest dangers and benefits surrounding technology and medical care. It sounds like the danger can be the misinformation that can be spread when it’s not vetted by your actual pediatrician.

Dr. Brabec: Yeah, the misinformation is huge. We all know about that because we’ve all used the internet to search for information and resources. So, first of all, misinformation is a big concern.

But another big concern is social media management of your reputation online. That’s another huge, huge issue and concern that probably drives some practices and physicians away from wanting to be involved with social media and utilizing it for their practices or themselves individually.

There are so many resources out there — Healthgrades.com is one example — where all it takes is for one negative comment to pop up and that can mean a lot for your reputation.
And it may be a situation where you provided adequate medical care but yet for some reason somebody was dissatisfied with the care or the outcome. That’s a huge concern that we’re going to have to learn to manage more and more as time goes on as well.

Transparency is something that’s being put out there more and more by everybody —including the federal government — and I don’t think there’s anything wrong with transparency. It’s just you have to be prepared to manage that.

But, when it comes to medical school, none of us were prepared for that. For those of us who have been in practice for several years now, things have evolved. These are aspects of medical education that need to occur through time.

And then when it gets to residency, more education about the business of medicine and what it means for you if you’re in private practice or working for a larger hospital system. And again, social media management is something that is going to have to be implemented within our medical education system as well.

CHN News: Absolutely. Well, we look forward to getting tweets from you soon.

Dr. Brabec: We’ll start working on that, maybe, next week.

CHN News: You’ve been listening to the Children’s Health Network podcast. That was Dr. Brad Brabec, President of Complete Children’s Health in Omaha, NE, and Chairman of Children’s Health Network.

Thanks so much for listening.

This podcast was brought to you by Children’s Health Network.

The Business Of Healthcare: Should Physicians Get An MBA?

Patients are often referred to as “healthcare consumers,” so it’s hardly surprising that hospitals and medical practices have shifted from a “practice of medicine” mindset to a “business of healthcare” approach.

Physicians have adopted this mindset as well.1 Combined MD/MBA programs have more than doubled since 2000, and more physicians than ever before are returning to school to earn an MBA after years of practice.

An MBA is costly, to be sure: It can easily reach over $100,000, depending on the school. But for physicians who are eager to launch their own practice, an MBA can make the process easier and even improve the likelihood of success.

For physicians who are in private practice — and are not looking to open a new business — an MBA may have different benefits.

If you are an independent physician, here are 7 signs that it may be time to hit the books and receive a formal business education.

1 The American Journal of Managed Care (June 9, 2016)

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