The toll of hidden, uncompensated work for pediatricians

A Response to NYT's "Why Doctors Aren’t Going into Pediatrics”

Yesterday, The New York Times published an Op-Ed titled “Why Doctors Aren’t Going into Pediatrics.” The statistics tell a story that should alarm parents of young children in this country. There’s a growing gap in vacancies in pediatric residencies, partly due to the lack of financial resources for pediatricians. Private insurance or Medicaid doesn't pay them enough to compensate for their many years of medical debt. In short, there is a crisis in pediatrics with no end in sight.

At Summer Health, we see this trend playing out every day. Pediatricians are eager to join our platform to make extra income, and we currently have a long waitlist. Other pediatricians utilize Summer Health to provide after-hours and on-call care to support their practice, services which are not typically compensated. Parents flock to our platform to build a relationship with pediatricians because 33% of counties in the US lack primary care pediatricians. We know this because we’re solving a key problem of this pediatric crisis: paying physicians for the hidden, uncompensated labor they undertake daily.

Unlike many of their peers in other medical specialties, pediatricians do a significant amount of work for which they receive no financial compensation. In particular, insurance providers find it challenging to reimburse message-based interactions, including responding to non-clinical patient inquiries, addressing developmental questions, and managing administrative tasks. On average, pediatricians spend an additional two hours daily on these activities, significantly contributing to high burnout and career dissatisfaction.

Pediatric care is increasingly complex, often more so than caring for adults. Pediatricians are primary care providers and coordinate care across multiple specialties, including occupational therapy, nutrition, and mental health. The fragmented healthcare system exacerbates this challenge, especially in rural areas that have few specialists, making the pediatrician's role even more demanding and stressful.

Our health system lacks the technological tools to automate these systems, adding to the administrative burden pediatricians bear. Importantly, unlike adults, pediatric patients can’t always articulate or describe  what’s causing them pain or discomfort. We need the best and brightest in pediatrics, but we aren’t making it easy or enticing for medical school graduates to make that choice.

Evolving expectations from parents also contribute to pediatrician burnout and make it less appealing to pursue a pediatric residency. Modern, tech-savvy parents are more informed and involved in their children's well-being, resulting in higher expectations for immediate and comprehensive responses from their pediatricians. This shift means pediatricians are expected to provide families with medical, emotional, and educational care, often without adequate resources or support. Other pediatric specialties and developmental resources are also in short supply, so parents lean on their pediatricians for support, even though they may not have the necessary education to provide it.

At Summer Health, we believe that part of the solution lies with private and public health plans and that they must reimburse pediatricians for this hidden work. Federal and state Medicaid agencies should also pave the regulatory path for fairer pay. Pediatricians: We want to compensate you better. By embracing codes for asynchronous care, payors can reduce their overall cost of care while increasing pay for pediatricians. Only with this change can pediatrics become a desirable place for promising medical students to lend their talents. At Summer Health, we are building a network of experts that can support pediatricians, such as nutritionists, sleep experts, and feeding specialists.

Supporting innovative platforms like Summer Health is just one step in the right direction, but we need more. We need systemic change to help evenly distribute the workload, improve job satisfaction, and ultimately ensure that our families receive the care they deserve. By investing in financial and systemic support for pediatricians, we can make strides toward a more sustainable and effective pediatric healthcare system that benefits individuals from childhood into adulthood and improves health outcomes for everyone.