Kudos to the authors of the special articles in this issue of Pediatrics regarding the future of pediatrics and those who have reported survey results on the roles and scope of practice.1,2 Their unprecedented analyses of sentinel trends and needs that affect child health and the profession of pediatrics are insightful, and their message is clear: with us or without us, change is proceeding with increasing frequency and speed. These articles constitute a “call to action” for pediatrics to use its knowledge and resources to actively and effectively lead change and create the future. To this end, the American Academy of Pediatrics (AAP), through our Agenda for Children and the Vision of Pediatrics 2020 project, is aligning our strategic priorities with the megatrends presented and actively working to provide our members with the skills and resources necessary to thrive in the future.
Most recently, the academy's strategic priorities have focused on the megatrends related to health system reform, reducing health disparities, early brain and child development, mental health, and children in foster care. Health reform, not surprisingly, has been front and center, and the AAP has been a strong and trusted presence in the recent evolution of the US health care system. The academy will continue that presence through the implementation phase of health reform and lead the way in designing models for medical homes and accountable care organizations (ACOs) in pediatrics. In fact, the AAP has already established a work group to focus on how children will be cared for and the role of pediatricians and the medical home in ACOs. The word “accountable” indicates the importance that quality care and metrics will play in the future.
Another megatrend focuses our attention on the workforce of the future. Existing and anticipated shortages and maldistribution of medical and surgical pediatric subspecialists may persist even with the potential gains related to implementation of the Affordable Care Act (ACA). The AAP played a key role in shaping a section of the ACA that provides loan repayment for fellowship-trained pediatric subspecialists who agree to practice in certain geographic locales. Another element of the workforce megatrend is the necessity to move to a team-based approach of delivering child health care. The practitioner surveys included in this issue of Pediatrics outline the challenges that will be a part of this evolution. The pediatric workforce will need to intersect effectively with the maturation of the medical home model, yielding a team approach. If done correctly, vulnerable children will greatly benefit as their families are better connected to community resources.
The AAP is also addressing the megatrends of consumerism in health care and advances in health care technology. We designed and recently launched HealthyChildren.org, a virtual extension of the medical home. This site is an excellent “first step” toward helping parents obtain accurate and timely information on issues that are of critical importance to them. It also serves as a resource for pediatricians in guiding families toward a source of support that can be consistently trusted to deliver content that will help and not harm. As families become more astute and cost-conscious shoppers for health care, this site will provide them with the information and tools needed to navigate the health care system. It also can aid parents in storing and managing their child's health information and serve as a creative step toward linking to their child's electronic health record stored in the medical home.
Finally, the academy's mission is to “attain optimal physical, mental, and social health and well-being for all infants, children, adolescents, and young adults”3 and support the professional needs of its members as they strive to accomplish this goal. As highlighted in the future-of-pediatrics article, AAP leadership recognizes that established medical and preventive services are playing less of a role in ensuring that a child has a bright future. In fact, the US Department of Health and Human Services Healthy People 2010 document indicates that medical services account for only 10% of all factors that influence child health; psychosocial behaviors, environmental influences, and genetics are responsible for the remaining 90%.4 The future of our profession may well be defined by how well we embrace and address that 90%.
It is also important to note that the AAP mission applies to all children, not just those who live within US borders. The academy, actively engaged internationally and considered a world leader in pediatric health care and child advocacy, is well-positioned to pursue its mission worldwide.
The AAP is committed to having a strong hand in leading and shaping the future of our profession. I agree, however, with the authors of the special articles. The future will never truly be realized from the helm; it will be realized organically by each practitioner embracing the future and making it real. The AAP exists to help you succeed in this endeavor for the grandest of causes—the health of our children.
- Accepted August 27, 2010.
- Address correspondence to Marion Burton, MD, Clinical Affairs, University of South Carolina School of Medicine, 15 Medical Park, Suite 300, Columbia, SC 29203. E-mail:
Opinions expressed in this commentary are those of the author and not necessarily those of the American Academy of Pediatrics or its Committees.
FINANCIAL DISCLOSURE: The author has indicated he has no financial relationships relevant to this article to disclose.
- AAP =
- American Academy of Pediatrics
- Starmer AJ,
- Duby JC,
- Slaw KM,
- Edwards A,
- Leslie LK
- Leslie LK,
- Slaw KM,
- Edwards A,
- Starmer AJ,
- Duby JC
- 3.↵American Academy of Pediatrics. Core values, vision, and mission statement. Available at: www.aap.org/member/memcore.htm. Accessed September 27, 2010
- 4.↵US Department of Health and Human Services. Healthy People 2010. Available at: www.healthypeople.gov/publications/. Accessed September 27, 2010
- Copyright © 2010 by the American Academy of Pediatrics