The View from the Developmental and Behavioral Pediatrics Trenches: A Workforce Survey
LewisFirst, MD, MA, Editor in Chief, Pediatrics
Given the ever-increasing need to have experts available to help children with behavioral,
developmental, and mental health issues, it is sad developmental and behavioral pediatric
(DBP) specialists are not overflowing with applicants for fellowship training. Who
is practicing DBP, how satisfied are they with their careers, and what can we do to
grow the workforce? To answer that question, Bridgemohan et al. (10.1542/peds.2017-2164) provide us with the results of an AAP survey sent to members of the AAP’s Section
on DBP and other DBP member organizations. 48% of the 1568 surveyed responded, of
which 411 were DBP fellowship trained, and 147 pediatricians were not along with 125
nurse practitioners. Sadly, one-third planned to retire in 3 to 5 years and the mean
age of being in the field was 29 years post medical school graduation, suggesting
that this is an aging specialty. The report of burnout is discouraging as well
as the time spent in non-reimbursable clinical care activities—all concerning findings.
This study points to opportunities for those in DBP to overcome these barriers.
But how best to do that? We asked DPB specialists Dr. Laurel Leslie and Rebecca Baum
along with American Board of Pediatrics researcher Adam Turner to assess these results
and provide suggestions for enhancing the workforce numbers in this specialty. In
their accompanying commentary (10.1542/peds.2017-4132), they compare the AAP survey findings with data at the American Board of Pediatrics
(where Dr. Leslie is also the Vice President of Research) and suggest that despite
the 48% response rate, the results are likely generalizable across the specialty.
They call for a more integrated, collaborative model involving use of interdisciplinary
models of care including primary care providers, psychologists, social workers, community
health workers, and parent peer navigators to reenergize the specialty as to enhance
DBP care delivery to more children and families. Take a time out and read both the
study and commentary and then reflect on how you might better integrate the model
described in the commentary into your practice.