Pediatricians, as the clinicians most intensively trained and experienced in children's health, are the natural leaders of child primary health care within the medical home, an updated American Academy of Pediatrics policy statement says. The statement also encourages policymakers to include pediatricians when they are crafting decisions that affect children.
The policy statement, "Pediatric Primary Health Care: The Central Role of Pediatricians in Maintaining Children's Health in Evolving Health Care Models," which will be published in the February 2022 issue of Pediatrics, notes that pediatric primary health care is of principal importance to the health and development of all children, helping them reach their potential.
Looking out for children's health
"Pediatricians are in a unique position to gauge how children are doing on several levels from a very young age and to begin to treat these issues. We can screen for developmental delays, take note of mental health concerns, monitor for ADHD, uncover food insecurity in the family, detect cardiac conditions, and so much more," said Edward Pont, MD, FAAP, one of the authors of the policy statement, which was written by the Committee on Pediatric Workforce and the Committee on Practice and Ambulatory Medicine.
"There is no typical day for a pediatrician. We experience everything and must be on the lookout for myriad issues. Our role in the community is vital."
Pediatric primary health care always aspires to be continuous, comprehensive, and coordinated care that is accessible and affordable to meet the health needs of the infant, child, adolescent, and young adult by providing family-centered care. Primary pediatric care encompasses diagnosis and treatment of acute and chronic health disorders; management of serious and life-threatening illnesses; and when appropriate, referral of patients with more complex conditions for medical subspecialty or surgical specialty care, the policy statement says.
A medical home for children
Team-based care, with physician leadership, limits the occurrence of fragmented care, such as that received from freestanding or retail-based clinics outside the medical neighborhood. The pediatrician's office, described as the "medical home," serves as the hub of the medical neighborhood, placing the pediatrician at the hub's center.
Given the evolving models of pediatric health care delivery, including the rapid growth of telehealth amid the COVID-19 pandemic, pediatricians, along with their representative national organizations such as the AAP, are the most capable clinicians to guide policy on the local and national stage, according to the statement.
The statement also offers recommendations to policymakers who influence pediatric health decisions:
Recognize that the pediatrician is the best expert to navigate myriad children's health issues that come before health systems, legislatures, executive agencies, and courts.
Include the AAP, which represents more than 60,000 pediatricians, and its relevant state chapters in policy decision making.
Always consider the impact of any policy change on children's health and well-being. As our nation's most vulnerable population, children, especially those experiencing health inequity, are unable to advocate for themselves.
"Pediatricians can and should help set the tone for policy decisions that affect youth in this nation," Dr. Pont said. "Our expertise is valuable. We understand what is happening with families in our communities and should be included in helping to form policy decisions that will have an impact on them."