The Struggle to Prioritize Prevention and Early Diagnosis in Pediatrics Working in a pediatric office can be extremely rewarding but also challenging when it comes to preventive care. As clinicians and #pediatricians, we understand the importance of preventive services like screening, counseling, and early intervention. However, implementing these services effectively often takes a backseat due to significant barriers: 1) Time Crunch: The realities of running a busy practice leave little room to devote sufficient time to preventive care. Between addressing acute issues, managing a full patient load, and handling administrative tasks, there's rarely enough bandwidth for in-depth preventive counseling and screening. 2) Financial Constraints: Preventive services are often inadequately reimbursed, making it difficult for practices to allocate resources and staff towards implementation. The focus inevitably shifts to revenue-generating services that keep the lights on. 3) Knowledge Gap: Staying up-to-date on the latest preventive guidelines and evidence-based approaches requires ongoing education and training, which can be challenging amidst ever-increasing clinical demands. 4) Workforce Shortages: The shortage of pediatricians, pediatric sub-specialists, and support staff exacerbates the time crunch, leaving even less capacity for preventive and early diagnosis care initiatives. 5) Difficult Conversations: Providers may experience anxiety about delivering potentially upsetting news, such as discussing mental health concerns, early diagnosis of disease without a cure, or unhealthy behaviors with families. While these barriers may seem daunting, they are not insurmountable. To better support preventive care in pediatrics, we need systemic changes. This could include improved reimbursement models that value preventive care, better integration of preventive services into workflows, increased training opportunities to stay updated on the latest guidelines, and addressing workforce gaps. A multi-pronged approach is required, and each of us has a role to play in this. Prevention is key to promoting children's health and well-being. By acknowledging and addressing these barriers head-on, we can work towards a future where preventive care is seamlessly integrated into pediatric practice, leading to healthier outcomes for our youngest patients. We are leaving #children behind when we don't diagnose #autism, #T1D, #suicidality early and intervene to change the natural history of the disease. This is cruel in a society that is one of the world's wealthiest countries. #CollaborativeChange #PediatricCare #HealthInnovation #wearepediatricians #usa #pediatrician #pediatrics #stories #autismawareness #T1D Anthony Orsini, D.O. Luigi Meneghini, MD, MBA George Rogu MD CPE MBA Ge Bai Rinad Beidas, PhD Susan Sirota Kathleen Wania Lia Gaggino, MD, FAAP Ilan Shapiro MD MBA FAAP FACHE Scott Krugman Scott C Grant, MD, MPH
As a Pediatric Neurologist who shares the struggles of families with the above dx, it has increasingly become very taxing. Reimbursements keep on falling and one insurance provider told me to “adjust”. I have stopped seeing children for initial dx of Autism and do see them for symptomatic management which often comes late because families are trying to get the dx to get therapies going. Families don’t realize that my giving a dx does not get them ABA and many insurance companies now depend on school evaluation for educational dx of Autism which delays it for years.
Pediatrician/CEO/Managing Partner at RBK Pediatrics and Urgent Care. Also the President of Independent Pediatric Collaborative of Long Island a Private Clinically Integrated Network.
6moSo how is a PCP supposed to in a routine office visit of 15 minutes supposed to go over the results and tell a parent a devastating diagnosis? I just do not see it.