Title : Primary care pediatrics: The answer to the world’s health problems
Abstract:
Primary Care Pediatrics is critical to, and directly impacts population health goals. Obesity in early childhood that continues into the early teens is associated with increased risk of Type II Diabetes in adulthood. High blood pressure in adolescence is associated with early-onset adult hypertension. Half of adult mental illness begins in the teenage years. Early childhood developmental competence not only directly impacts educational success but also is a key determinant of future health and well-being. With all this evidence, is healthcare funding, public health initiatives and preventative care moving upstream to the young? Primary Care Pediatrics is different from “Specialty” Pediatrics, which as a “specialty”, by default, is sickness-focused or hospital-based. Primary Care Pediatrics, while also including sick care, provides preventative care, anticipatory guidance and a medical home. It is first-contact, comprehensive care. Continuity of care and coordination of care are its other attributes. Its goals and foundation are a Public Health one, while its practice overlaps with “Specialty” Pediatrics and Family Medicine. This talk looks at how evidence-based Primary Care Pediatrics practice achieves the well-being of infants, children, adolescents in physical, psychosocial, and mental health – so that they may achieve their highest possible potential as adults. This is foundational to building a healthy nation. To ensure appropriate, current and evidence-based care delivery, clinicians who provide child and adolescent primary care must be clinically and academically trained in Primary Care Pediatrics, ideally by clinicians who have likewise been trained. This talk raises for thoughtful consideration obstacles that have to be overcome, for transformation of child and adolescent health care delivery. Indeed, with rapidly aging populations in many First World nations and the double burden of disease in developing nations, the focus of many nations is that of sickness care especially in the elderly because of the consequent escalating healthcare costs. In addition, establishing expensive specialty and sub-specialty services are often the focus of not only for-profit health organizations, but even not-for-profit institutions. Not only that, physician compensation for Pediatrics and Primary Care is among the lowest across the different fields in Medicine. Then there is the old adage that change takes time. But Gabriela Mistral (1889-1957) said it best: "Many things we need can wait. The child cannot. Now is the time his bones are being formed, his blood is being made, his mind is being developed. To him we cannot say tomorrow, his name is TODAY"
Audience Take Away:
• Appreciate the difference in child, adolescent care delivery by Primary Care Pediatrics-trained clinicians
• Recognize that pediatric care ranges from mental to physical to social health
• Understand the components and importance of well baby/child/adolescent checks
• Recognize the difference between developmental surveillance and developmental screening in detecting early childhood behavioral-developmental concerns
• Appreciate some of the obstacles but also some of the opportunities presented in any healthcare transformation
