DNPs and Urgent Care Clinics - What do they mean for pediatrics?

[DrIsh]

Hello guys,

I am a 3rd year medical student and I have always had peds in the back of my mind. I always think I have my mind set to do something other than peds but it's always short lived and I eventually come back to thinking about peds. One thing that is concerning me, however, is that some of the alternative medical professions (RN and now DNPs) are breaking into family practice and their moving into pediatrics seems logical and very feasible. Do you guys think that this will be a real issue in the future? With reimbursements already so low, and patient volume exceeding 50 a day (on the outpatient peds rotations I have been on anyway), what do you think the future looks like?

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[Complications]

Hello guys,

I am a 3rd year medical student and I have always had peds in the back of my mind. I always think I have my mind set to do something other than peds but it's always short lived and I eventually come back to thinking about peds. One thing that is concerning me, however, is that some of the alternative medical professions (RN and now DNPs) are breaking into family practice and their moving into pediatrics seems logical and very feasible. Do you guys think that this will be a real issue in the future? With reimbursements already so low, and patient volume exceeding 50 a day (on the outpatient peds rotations I have been on anyway), what do you think the future looks like?

How about store based clinics as well? I think it will likely change the marketplace ... the question is how? Some store based clinics are starting to fail ... maybe that's just a quick trend, that will die. I think it's quite possible that in the future we will use a lot of NPs for well-child visits, and rely on MDs/peds specialists for sick kids.

There will always be a place for us though.

 

[14022]

At one of the national peds academic conferences this year, they talked about the future of primary care in the US. Many people seem to think that primary care (adult and peds) is going to be in the hands of NP's and PA's. In terms of pediatrics, the role of the general pediatrician will be to coordinate care for medically complex children. A significant problem in peds is the growing number of the severely premature infants that are NICU graduates with significant medical problems...CP, chronic lung disease requring trach/vents, short gut syndrome from NEC, etc...and finding follow-up primary care for these children. On top of that, take kids who are cancer survivors and have effects of chemo/radiation, palliated congenital heart disease, multiple congenital anomalies or other genetic syndromes, and an array of other complex medical conditions. No family practice doctor can take care of these kids. No NP/PA can primarily take care of these kids. As long as we are doing Norwood's, administering chemo and radiation, and resuscitating 23 weekers, these complex children are going to need a medical home, and that will be the primary role of the general pediatrician in 10 years.

 

[Amgen1]

i think this should be a significant concern for those in peds. at tch, the junior peds faculty start at 110K for general peds and about 125k for subspecialty peds. the faculty work fairly hard (approx 50hrs/wk). nps in the nicu make approx 85k and work 15 shifts/month.

for some reason the hospitals are willing to pay the midlevels more to work less and the physician salaries continue to drop.

i think in peds this becomes more evident b/c of the low base salary of the pediatricians