Presentation File

Why Pediatrics??Why Pediatrics??George Johnson, MDGeorge Johnson, MD

Professor of PediatricsProfessor of Pediatrics

This is Why

What You Need to Do(as a pediatrician)

• Get useful information from crying babies and children (their distraught parents) when they are ill

• Examine these same kids• Teach - children, parents, grandparents,

teachers, and government officials• Help families and kids through or beyond the

rough parts of their lives• Have to be able to function as part of a team

Downside of Pediatrics• Dealing with parents of terminally ill

children is difficult, but you can do a great deal for the families by your approach

• It can be very hard to overcome your own discomfort in the death or disability of a child

Benefits of Pediatrics• Most kids get better• Can’t take yourself too seriously - Get to

wear goofy cloths• Play with kids’ toys• Play with the kids - this is a must• Even on your worst day you can play with a

kid and make them smile (usually)

How Do You Become a Pediatrician? - Residency• Three-year residency training, about

50% in ambulatory settings• Certification by the American Board of

Pediatrics based on written exam• Subspecialty residency training

(fellowships) typically are a minimum of three years

Pediatric Subspecialties• Adolescent Medicine• Allergy• Cardiology• Child Psychiatry• Critical Care Pediatrics• Developmental-

Behavioral Pediatrics• Emergency Pediatrics• Endocrinology

• Gastroenterology• Genetics• Hematology/Oncology• Immunology• Infectious Diseases• Nephrology• Neurology• Pulmonology• Rheumatology

Pediatric Practice Career Paths

• General Pediatrics • Subspecialty Practice• Private Practice• Academic Practice• Public Health Related Practice• Child Advocacy

Why Choose Pediatrics?• Great impact on children’s lives• The mundane parts of general pediatric

practice (care) have more health benefit than any other health care activity other than public health measures such as clean water and sewage treatment

• Immunizations, SIDS reduction (sleep position counseling), injury prevention education

Why Choose Pediatrics?

Your Career Path

Distribution of Pediatricians

J Pediatrics 2004;144:723-8

Pediatric Workforce Projection 2001-2020

J Pediatrics 2003;143:507-5

Pediatrician Demographics and Pediatrician Demographics and Practice CharacteristicsPractice Characteristics

Compiled by

the AAP Division of Graduate Medical Education and Pediatric Workforce and

the AAP Division of Health Policy Research for the

AAP Committee on Pediatric Workforce, Subcommittee on Women in Pediatrics

Female

Male

Gender: All Physicians by Percentage

75.4%24.6%

Adapted from AMA, Physician Characteristics and Distribution in the US. 2003-2004 Edition.

Female

Male

Gender: Pediatricians by Percentage

50.4%

49.6%

Adapted from AMA, Physician Characteristics and Distribution in the US.2003-2004 Edition.

Gender: Pediatricians

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

1970 1980 1990 2001

Total FemaleMale

Adapted from AMA, Physician Characteristics and Distribution in the US. 2003-2004 Edition.

Age and Gender: Pediatricians

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

TotalPEDS

Under 35 35-44 45-54 55-64 65+

TotalPEDSFemale

Male

Adapted from AMA, Physician Characteristics and Distribution in the US.2003-2004 Edition.

0

2000

4000

6000

8000

10000

12000

26 to 3031 to 3536 to 4041 to 4546 to 5051 to 5556 to 6061 to 6566 to 7071 to 7576 to 8081 to 8586 to 90> 90

Age Group

# in Age Group

Note: While the number of certified diplomates is 82,270, this variable is calculated on only those who provide birth year information. There are 9,965 diplomates whose age is not available.

General Pediatrics Certified Practitioners by Age

ABP Workforce Data 2004-2005

0

10

20

30

40

50

60

70

Source: American Academy of Pediatrics, Division of HealthPolicy Research, Periodic Survey of Fellows #47 thru #50, 2001

148.3% of all pediatricians are Male; 51.7% are Female. Residents are 11.2% of all pediatricians

p<.01

Percent

Post-residentsResidents

Male Female

Gender and Status of All Pediatricians 1

91%

9%

88%

12%

Female59%

Male41%

Gender of Current Residents

n % Female % MaleGeneral Pediatrics 2137 67 33Adolescent Medicine 15 80 20Developmental-Behavioral 11 64 36Cardiology 83 43 57Critical Care Medicine 73 55 45Emergency Medicine 80 44 56Endocrinology 46 63 37Gastroenterology 60 53 47Hematology-Oncology 94 65 35Infectious Diseases 40 63 37Neonatal-Perinatal Medicine 146 57 43Nephrology 37 57 43Neurodevelopmental 41 68 32Pharmacology-Toxicology 1 0 100Pulmonology 22 50 50Rheumatology 18 44 56Sports Medicine 4 25 75Total 2908

Note: General Pediatrics includes General Pediatrics, Med/Peds, and Ambulatory Pediatrics. The remaining career selections not included in the above table spanned 14 non-ABP specialties (n=135), "Other" (n=2) andthose who left the question blank (n=61).

General Pediatrics and Subspecialty by Gender

2004 General Pediatrics ExaminationFirst-Time Applicants (n=3106)

2004 ABP Examination General and Subspecialty by Gender


Percent of Pediatricians by Age Group

Source: American Academy of Pediatrics,Division of Health Policy Research, PeriodicSurvey of Fellows #47 thru #50, 2001

Male

Female

p<.001 for M v F

25%

42%

23%

8%

1%

12%

29%

33%

21%

5%

50 40 30 20 10 0 10 20 30 40 50

Percent

55 - 64 yrs

45 - 54 yrs

35 - 44 yrs

< 34 yrs

> 65 yrs

Percent of Male/Female PediatriciansWithin Age Group


31% 69%

40% 60%

58% 42%

71% 29%

83% 17%

0% 20% 40% 60% 80% 100%

> 65 yrs

55 - 64 yrs

45 - 54 yrs

35 -44 yrs

< 35 yrs

MaleFemale

p<.001 for M v F

0

20

40

60

80

100MaleFemale

Percent of Time

GeneralPediatrics

Subspecialty

Average Percent of Time Spent inGeneral Pediatrics and Subspecialties:

Source: American Academy of Pediatrics, Division of Health Policy Research, Periodic Survey of Fellows #47 thru #50, 2001

61%

73%

38%27%

p<.001 for M v F

Non-Pediatric Specialty

4%Other0%

Pediatric Subspecialty

25%

Missing2%

General Pediatrics69%

Pediatric Career Plans


Female Male AMG IMG Total TotalGeneral Pediatrics 67.4% 32.6% 81.0% 19.0% 2137 68.8%Pediatric Subspecialty 55.6% 44.4% 73.5% 26.5% 771 24.8%Non-Pediatric Specialty 58.5% 41.5% 83.0% 17.0% 135 4.3%Other 100.0% 0.0% 50.0% 50.0% 2 0.1%Missing 52.5% 47.5% 77.0% 23.0% 61 2.0%Total 3106 100.0%


Career Plans

Pediatric Career Plans by Gender


0

500

1000

1500

2000

2500

3000

3500

1998 1999 2000 2001 2002 2003 2004

Year

Number in Training

Note: Data prior to 1998 is not included as full tracking data was not available. The total values include only the 13 subspecialties that the ABP administers. In addition, only the first three years of training are included.

Pediatric Subspecialists in Training


Pediatric Subspecialists in Training by Gender

Year Total AMG IMG Male Female1998 1863 57.4% 42.6% 52.8% 47.2%1999 2004 57.0% 43.0% 51.1% 48.9%2000 2154 59.7% 40.3% 50.5% 49.5%2001 2256 63.2% 36.8% 50.4% 49.6%2002 2466 66.1% 33.9% 50.7% 49.3%2003 2622 67.8% 32.2% 49.4% 50.6%2004 2867 67.9% 32.1% 47.6% 52.4%

Pediatric Subspecialties TrackingTotal Number of Subspecialists in Training


0102030405060708090

100110120130140150

Adolescent MedicineDevelopmental-Behavioral

Cardiology

Critical Care MedicineEmergency Medicine

EndocrinologyGastroenterology

Hematology-OncologyInfectious Diseases

Neonatal-Perinatal Medicine

Nephrology

Neurodevelopmental

Pharmacology-Toxicology

PulmonologyRheumatologySports Medicine

# of Applicants

Male

Female

General Pediatrics Examination Subspecialty by Gender (2004)


0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

1998 1999 2000 2001 2002 2003 2004

Year

Percent

Male

Female

Note: Data prior to 1998 is not included as full tracking began in 1998. The total values include only the 13 ABP subspecialties. In addition, only the first three years of training are included.

Pediatric Subspecialists in Training by Gender


Academic Faculty

9%

Continuing Residency

30%

Practice45%

Military/National Health Service

3%

Other11% Unknown

2%Industry

0%

Pediatric Career Placement Completing Residency


Female Male AMG IMG Continuing Residency 57.2 42.8 75.1 24.9 920 29.6%Academic Faculty 65.0 35.0 82.5 17.5 280 9.0%Practice 66.4 33.6 80.0 20.0 1387 44.7%Military/National Health Service 48.5 51.5 94.9 5.1 99 3.2%Industry 100.0 0.0 50.0 50.0 4 0.1%Other 76.0 24.0 79.9 20.1 354 11.4%Unknown 53.2 46.8 75.8 24.2 62 2.0%Total 3106 100%

Note: The values for Practice combine five practice settings provided in the survey. These settings are solo, group, HMO/PPO, Hospital-Based, and Free-Standing ER. The gender and AMG/IMG breakdown for these settings is provided in a separate table.

%

by Gender and AMG/IMG


Career Placement for Upcoming Year

Percentage Total Number


Pediatric Career Placement Completing Residency by Gender

21%

29%

38%

12% 13%

36%

28%

23%

Men Women

Urban, inner city

Urban, not inner city

Suburban

Rural

Practice Location(percent of pediatricians)


17% 16%

45% 44%

29% 28%

9% 12%

0

20

40

60

80

100

Percent of Pediatricians

Employment Setting

Solo / Two- Group Practice/ Medical School/ Other Physician Staff HMO Hospital/ Clinic Practice

Male

Female


p<.05 for M v F

HMO, PPO, etc.5%

Hospital-Based Practice

18%

Free-Standing ER1%

Solo Practice3%

Group Practice73%

Pediatric Employment Setting


Female Male AMG IMG Solo Practice 53.7 46.3 65.9 34.1 41 3.0%Group Practice 67.3 32.7 80.3 19.7 1015 73.2%HMO, PPO, etc. 66.2 33.8 84.6 15.4 65 4.7%Hospital-Based Practice 64.4 35.6 79.4 20.6 253 18.2%Free-Standing ER 76.9 23.1 92.3 7.7 13 0.9%Total 1387 100%

Note: The categories above represent the five individual practice settings in the career survey. These categories were combined into a single category "Practice" in a previous table thatsummarizes all possible (not just practice) settings.


Type of Practice Setting for Upcoming Year

Percentage Total Number

by Gender and AMG/IMG

%

Employment Setting by Gender


0 10 20 30 40 50 60Hours

Male

Direct patient care (self employed)

Direct patient care (not self employed)

Administration

Academic medicine

Research

Fellowship training

Average Number of Hours per Week inProfessional Activities


Female

21 17 6 4 2 2

13 20 3 4 2 2

MaleFemale


Full-time Part-time

Employment Status(self-designated)

Source: American Academy of Pediatrics, Division of Health Policy Research, Periodic Survey of Fellows #43, 2000

96

72

4

28

0102030405060708090

100

p<.001 for M v F

MaleFemale

Hours per Week

Full-time Part-time

Average Number of Hours Per Week in AllProfessional Activities by Employment Status


57 56

3732

0

10

20

30

40

50

60

70

Male

42

8

2119

2421

8 8

23

33

15

86

0

10

20

30

40

Income of Full-time and Part-time Pediatricians(after expenses and before taxes)

< $50k $50k - $75k - $100k - $125k - $150k - > $200k $75k $100k $125k $150k $175k

Percent

21 21

7

14

21

14

0

26

32

22

14

13

10

10

20

30

40

Full-time Employment

Part-time Employment

< $50k $50k - $75k - $100k - $125k - $150k - > $200k $75k $100k $125k $150k $175k


Percent

Female

MaleFemale

p<.05 for M v F

p<.001 for M v F

Male

33

2

63 4

31

4 4 4

.3 .9 .7.4.70

10

20

30

40

Average Hours Per Week in Patient Care Activities(Office-based Pediatricians Only)

Office Emergency Operating/ Hospital Consulting Record Other patient room Delivery rounds w/patients keeping activity care room &others

Hours

Female


18

232021 21

17

23

27

2324

05

10152025303540

Length of Preventive Care Visit by Patient Age Group 1(Office-based Pediatricians only)

Birth - 2 yrs 3 - 5 yrs 6 - 11 yrs 12 - 17 yrs > 18 yrs

MalePediatricians


Minutes

Patient’s Age

FemalePediatricians

1 Includes all care given and services performed by ALL personnel

17% 16%

45% 44%

29% 28%

9% 12%

0

20

40

60

80

100


Employment Setting

Solo / Two Group Practice/ Medical School/ Other Physician HMO Hospital

Male

Female


p<.05 for M v F

60% 62%

35% 33%

5% 6%

0

20

40

60

80

100

Percent of Patients

Estimated Percent of Patients in Managed Care v.Non-managed Care Insurance Plans

Managed Care Non-managed Uninsured Care

Male

Female


Data Sources

AMA, Physician Characteristics and Distribution in the US. 2003-2004 Edition

American Academy of Pediatrics, Division of Health Policy Research:

Periodic Survey of Fellows #43, 2000

Periodic Survey of Fellows #47-50, 2001

American Board of Pediatrics Workforce Data 2004-2005 (www.abp.org)

(www.aap.org)

Presentation File

Documents

health policy research

physician characteristics

choose pediatrics

pediatricians adapted

children

pediatrics

6 adapted

pediatricians