NEONATOLOGY'S WOES
Multiple conflicting factors have, in recent years, contributed to a sense of disempowerment of the specialty of neonatology. Economic fingers point to a disproportionate use of medical resources by neonatal intensive care units (NICUs) and a disproportionate share of morbidity in surviving patients. We have fallen out of favor with pediatric residency training programs that point to our man-eating use of resident hours and continue to decrease the number of months such individuals should spend in the newborn intensive care unit (ICU) during their training. Health maintenance organization (HMO) groups barter for lower and lower capitation rates. For the first time, many units are faced with laying off neonatologists. Finally, a pluralistic society, which has become more verbal, tells us that our choices are not theirs.
