A Workforce Survey on Developmental-Behavioral Pediatrics
Carolyn Bridgemohan1, Nerissa S Bauer2, Britt A Nielsen3
1Department of Medicine, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; carolyn.bridgemohan@childrens.harvard.edu.
Insights
The developmental-behavioral pediatric workforce faces significant challenges meeting demand due to long wait times and clinician burnout. Strategies are needed to expand the workforce and improve efficiency.
Area of Science:
- Pediatric Subspecialties
- Healthcare Workforce Analysis
- Child Development
Background:
- Developmental-behavioral conditions affect approximately 15% of US children.
- Increasing prevalence and complexity of these conditions strain existing resources.
- Long wait times and a limited provider pipeline exacerbate access issues.
Purpose of the Study:
- To assess current practices within the developmental-behavioral pediatric (DBP) workforce.
- To identify workforce trends and future needs in DBP.
- To understand the challenges faced by DBP providers.
Main Methods:
- An electronic survey was distributed to 1568 members of key professional organizations.
- The survey targeted physicians and nurse practitioners in developmental-behavioral pediatrics.
- A response rate of 48% was achieved.
Main Results:
- The DBP workforce reported long appointment wait times and clinician burnout.
- Respondents noted increased patient complexity and significant non-reimbursed clinical care time.
- Physicians are nearing retirement, while nurse practitioners are earlier in their careers.
- Female subspecialists dedicated more time to both billable and non-billable clinical activities.
Conclusions:
- The DBP workforce is struggling to meet service demands.
- Addressing long wait times, patient complexity, and non-reimbursed care is critical.
- Future planning must consider sex-based practice differences and implement strategies for workforce sustainability and burnout prevention.
Background And Objectives:
Developmental-behavioral conditions are common, affecting ∼15% of US children. The prevalence and complexity of these conditions are increasing despite long wait times and a limited pipeline of new providers. We surveyed a convenience sample of the developmental-behavioral pediatric (DBP) workforce to determine current practices, workforce trends, and future needs.
Methods:
An electronic survey was e-mailed to 1568 members of the American Academy of Pediatrics Section on Developmental and Behavioral Pediatrics and Council on Children with Disabilities, the Society for Developmental and Behavioral Pediatrics, and the National Association of Pediatric Nurse Practitioners Developmental and Behavioral Mental Health Special Interest Group.
Results:
The response rate was 48%. There were 411 fellowship-trained physicians, 147 nonfellowship-trained physicians, and 125 nurse practitioners; 61% were women, 79% were white, and 5% were Hispanic. Physicians had a mean of 29 years since medical school graduation, and one-third planned to retire in 3 to 5 years. Nurse practitioners were earlier in their careers. Respondents reported long wait times for new appointments, clinician burnout, increased patient complexity and up to 50% additional time spent per visit in nonreimbursed clinical-care activities. Female subspecialists spent more time per visit in billable and nonbillable components of clinical care.
Conclusions:
The DBP workforce struggles to meet current service demands, with long waits for appointments, increased complexity, and high volumes of nonreimbursed care. Sex-based practice differences must be considered in future planning. The viability of the DBP subspecialty requires strategies to maintain and expand the workforce, improve clinical efficiency, and prevent burnout.
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