The following is an archived pedcast, first posted in March 2015.
Think American pediatric healthcare is in trouble? Try taking a look at the care children in China are getting today and you might think differently.
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I was reading my journals the other day and I came across an article that caught my attention, mostly because it is a very different type of article than the usual I find in pediatric journals. I really have no idea why this article was in a pediatric journal, but it was and it immediately caught my attention. Especially, in light of a recent murder of Boston doctor that was allegedly killed by the son of a patient. If you didn’t hear about this, here is a link.
Anyway, the article I am referring to is titled, Chinese Pediatricians Face a Crisis-Should they Stay or Leave? that appeared in Pediatrics December 2914. This article describes the sad state of pediatric medicine in China. I think if you talk to many pediatricians in this country they would tell you that things are great here in the US. . We pediatricians feel like we are under assault with Electronic medical records, meaningful use, and the growing influence of government and bureaucracy in our daily lives, but nothing like what is being described in China. Let me summarize the state of pediatric medicine in land of the rising sun:
-Let’s start with a fact: the number of pediatricians in China is dwindling.
-Currently there is 4.3 pediatricians/10,000 children as opposed to 14.6 pediatricians/10,000 children in the US.
-Why you ask? Because pediatricians in China are very poorly paid and very much overworked…seeing an average of 90 patients a day.
-Patients wait in line for hours to see a pediatrician which makes for very unhappy patients and families.
-Now here is the really frightening part of the article. Families with children who feel like their child is not getting good pediatric care…well lets just say…they get mad and they act on that anger.
-In fact so mad that in 2006, 831 pediatricians were attacked and in 2013, 15 pediatricians were seriously injured or murdered.
Think this is only a problem in China and could never happen here…think again. Check out this article from Scientific American about violence against healthcare workers in the US. It is actually quite common here in the States as well. I really had no idea.
Fortunately, to my knowledge, pediatricians in the US have been mostly spared in the assault category, unless you wander down the ED. When I worked in the ED as a resident, I was involved in physical restraining patients on quite a few occasions, some with a few pediatrics patients but mostly with adult patients.
So how have we managed to keep 3 times more doctors going into pediatrics here than in China you ask? Pediatricians know going in that they could make more money doing something else so a large salary is not the answer. There are much easier ways to earn a living but they choose pediatrics. No, pediatricians choose pediatrics because they enjoy being around children and they want to improve the lives of children. But if practicing pediatrics becomes dangerous as well as a relatively poorly paid medical specialty, not only will children lose out, but we will all suffer. Keeping our healthcare workers safe, fairly paid in relation to their training, and in adequate numbers, needs to be a priority here or we may just duplicate the Chinese experience.
Interesting article, don’t you think. If you like learning about new things in pediatrics, take a moment to make sure I can notify you of new posts that you might be interested in by subscribing to docsmo.com at my blog. No marketing, no selling your email address, no hanky in the room. Just my way of keeping your pediatric knowledge up to date. Be the best informed parent in the room…go ahead. Subscribe. And don’t forget to check out my new book, Can Doesn’t Mean Should, now on Amazon, iBooks, and Barnes and Nobles as well as many fine bookstores. I know you will enjoy reading it.
This is Dr. Paul Smolen, recording in studio 1E, acknowledging that it would be a shame if when your child needs healthcare, that their child’s doctor just wasn’t there. Until next time.
