Published online September 1, 2006
PEDIATRICS Vol. 118 No. 3 September 2006, pp. 1200-1206 (doi:10.1542/peds.2006-0051)
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SPECIAL ARTICLE

Family Physicians in the Child Health Care Workforce: Opportunities for Collaboration in Improving the Health of Children

Robert L. Phillips, Jr, MD, MSPHa, Andrew W. Bazemore, MD, MPHa, Martey S. Dodoo, PhDa, Scott A. Shipman, MD, MPHb and Larry A. Green, MDa

a Robert Graham Cente4 for Policy Studies in Family Medicine and Primary Care, Washington, DC
b Department of Pediatrics, Oregon Health & Science University, Portland, Oregon

Pediatric workforce studies suggest that there may be a sufficient number of pediatricians for the current and projected US child population. These analyses do not fully consider the role of family medicine in the care of children. Family physicians provide 16% to 26% of visits for children, providing a medical home for one third of the child population, but face shrinking panels of children. Family medicine's role in children's health care is more stable in rural communities, for adolescents, and for underserved populations. For these populations, in particular, family medicine's role remains important. The erosion of the proportion of visits to family medicine is likely caused by the rapid rise in the number of pediatricians relative to a declining birth rate. Between 1981 and 2004, the general pediatrician population grew at 7 times the rate of the US population, and the family physician workforce grew at nearly 5 times the rate. The number of clinicians caring for children meets or exceeds most estimates of sufficiency; however, the workforce distribution is skewed, leaving certain populations and settings underserved. More than 5 million children and adolescents live in counties with no pediatrician. Unmet need, addressing health in the context of families and communities, and tackling "millennial morbidities" represent common ground for both specialties that could lead to specific, collaborative training, research, intervention, and advocacy.

Key Words: child health workforce • diversity • family medicine • geographic distribution • health manpower • nonphysician clinicians • physician workforce • pediatrics • pediatric medical subspecialists

Abbreviations: AAP—American Academy of Pediatrics • FP—family physician • NAMCS—National Ambulatory Medical Care Survey • MEPS—Medical Expenditure Panel Survey • GP—general practitioner • FTE—full-time equivalent • NP—nurse practitioner • PA—physician assistant • CHC—Community Health Center

Accepted Apr 10, 2006.




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