AAP president-elect candidates pledge change for pediatricians, children

The two president-elect candidates for the American Academy of Pediatrics spoke Saturday about what they would do for the organization and how they would advocate for governmental policies benefiting children and pediatricians, during the first official day of the organization’s annual meeting in Washington.

AAP members can vote for Dr. Fernando Stein, FAAP, of Houston, or Dr. Lynda M. Young, FAAP, of Worcester, Mass., during the voting period from Oct. 23 through Nov. 24.

Dr. Stein spoke first, calling to mind the first meeting of pediatricians in 1929 that eventually led to the formation of the AAP and how different children’s needs and the demands on pediatricians are today.

“Our world has changed, pediatrics has changed, the needs of children have changed, our needs as pediatricians have changed, and if we are to be relevant to our mission, we as individuals and as fellows of the academy must change,” he said.

But Dr. Stein pointed out that pediatricians must now do more and more with less and less support from health systems each day, a status quo that is taking a toll on doctors.

“We chose our profession by our natural altruistic inclinations, and currently by self-report, more than 50% of us are burnt out, empathy exhausted, and compassion fatigued,” Dr. Stein said. “I believe that now is the time for the Academy to take a loud and clear and unmistakable position in defense of the pediatrician. It is no longer sufficient to prioritize children when the pediatrician is hurting,” he said to applause.

One challenge Dr. Stein said he would tackle is the process of maintaining certification, a system that he gleaned from local chapters “is thought to be more of an intermittent threat rather than a lifelong commitment to learning,” a description that provoked laughter and applause.

“We need to remove this as a toxic stress to the pediatrician,” he said, eliciting more laughter as he alluded to the previous day’s presentations on the toxic stress children experience. He pledged to ensure the Academy would amend current requirements for certification and maintenance of certification and to address the cost for both.

Dr. Stein also called for the Academy to build a technology platform for sharing data among members and mentioned his work as chairman of the Council on Sections and the Committee on Membership as helpful to this goal.

The most enthusiastically received message Dr. Stein delivered, however, related to the toll of gun violence in the United States. He cited injuries from all causes, suicide, and homicides as the first, third and fourth leading causes of death of youth aged 5-21 years, ranked above respiratory diseases, infections, and sepsis.

“The gun violence issue is by any definition an epidemic and a public health problem,” he said to applause. “The oversimplification of violence as a problem of social justice is unjustified.”

He noted that any other bacterial, viral, or other agent of infection that killed close to 100 people and injured hundreds more every day would unquestionably be called a public health problem demanding scientific research.

“As president of the AAP, I pledge to challenge the legislative efforts aimed at inhibiting pediatricians and scientific organizations from gathering potentially lifesaving information about firearms just as we did in the past with vaccines,” he said. “Is it not time to approach this with the same vigor of scientific inquiry we undertook for the prevention of communicable diseases?”

Next, Dr. Young opened and closed with the question “What do children need?” and spent her talk describing ways in which the answer is pediatricians themselves, remaining at the forefront of addressing the toxic challenges children face.

“Some days in our offices and our clinics, we’re not just physicians,” she said. “We’re nurses, we’re social workers, we’re pharmacists, we’re health insurance advisers, we’re nutritionists, we’re accountants, we’re teachers – all in the interest of trying to change for the better what children see and hear.”

She praised the advocacy efforts of many pediatricians in the room and described advocacy as a team sport to ensure children have access to care and appropriate essential health benefits, particularly if – and maybe when – children’s health insurance becomes part of health insurance exchanges instead of the Children’s Health Insurance Programs (CHIP).

“I spent a fair amount of time talking to legislators to prioritize children’s needs,” Dr. Young said. “I want funding to continue. No, I want funding to increase significantly for the programs that have proof of effectiveness for kids,” she continued to applause. She mentioned programs such as Women, Infants, and Children (WIC), early intervention and home visits for mothers and children.

“We need federal policy to address practice transformation: e-cigarette regulation, opioid abuse, vaccine refusal, gun control, drug pricing, graduate medical education reform,” Dr. Young said. “There are so many issues.”

She noted past legislative wins, including the Affordable Care Act – which garnered applause – for providing access to care and insurance to more people than ever before, and the CHIP Reauthorization Act, extending CHIP funding through 2017.

After describing challenges she’s heard pediatricians are facing in their practices, Dr. Young said some could become opportunities.

“For us to succeed in meeting children’s needs, we need to address our own concerns,” she said. “We need to ensure that we, primary care, specialty, subspecialty, whether you’re in a small independent practice or a large integrated system, have the resources and information to continue to provide the care for our most vulnerable population.”

Dr. Young suggested that offering virtual visits and partnering with telemedicine companies to maintain patients’ continuity of care might comprise one such opportunity, particularly if these services require payment to increase revenue since pediatricians have been providing after-hours care for free for years. She also suggested partnering with retail-based clinics, providing clinical knowledge and knowledge of the community.

“On the federal level, the Academy needs to remain a strong voice and continue to collaborate with other organized medical associations,” Dr. Young continued. “The Centers for Medicare & Medicaid respond to physician concerns, especially when presented by a unified front of physicians working together.”

She exhorted pediatricians never to forget how important they are to the children and families they care for.

“What do children need? They need us,” Dr. Young said to applause. “We pediatricians have a reputation for fairness, and we focus on the right priorities. Our children need us.”

The two president-elect candidates for the American Academy of Pediatrics spoke Saturday about what they would do for the organization and how they would advocate for governmental policies benefiting children and pediatricians, during the first official day of the organization’s annual meeting in Washington.

AAP members can vote for Dr. Fernando Stein, FAAP, of Houston, or Dr. Lynda M. Young, FAAP, of Worcester, Mass., during the voting period from Oct. 23 through Nov. 24.

Dr. Stein spoke first, calling to mind the first meeting of pediatricians in 1929 that eventually led to the formation of the AAP and how different children’s needs and the demands on pediatricians are today.

“Our world has changed, pediatrics has changed, the needs of children have changed, our needs as pediatricians have changed, and if we are to be relevant to our mission, we as individuals and as fellows of the academy must change,” he said.

But Dr. Stein pointed out that pediatricians must now do more and more with less and less support from health systems each day, a status quo that is taking a toll on doctors.

“We chose our profession by our natural altruistic inclinations, and currently by self-report, more than 50% of us are burnt out, empathy exhausted, and compassion fatigued,” Dr. Stein said. “I believe that now is the time for the Academy to take a loud and clear and unmistakable position in defense of the pediatrician. It is no longer sufficient to prioritize children when the pediatrician is hurting,” he said to applause.

One challenge Dr. Stein said he would tackle is the process of maintaining certification, a system that he gleaned from local chapters “is thought to be more of an intermittent threat rather than a lifelong commitment to learning,” a description that provoked laughter and applause.

“We need to remove this as a toxic stress to the pediatrician,” he said, eliciting more laughter as he alluded to the previous day’s presentations on the toxic stress children experience. He pledged to ensure the Academy would amend current requirements for certification and maintenance of certification and to address the cost for both.

Dr. Stein also called for the Academy to build a technology platform for sharing data among members and mentioned his work as chairman of the Council on Sections and the Committee on Membership as helpful to this goal.

The most enthusiastically received message Dr. Stein delivered, however, related to the toll of gun violence in the United States. He cited injuries from all causes, suicide, and homicides as the first, third and fourth leading causes of death of youth aged 5-21 years, ranked above respiratory diseases, infections, and sepsis.

“The gun violence issue is by any definition an epidemic and a public health problem,” he said to applause. “The oversimplification of violence as a problem of social justice is unjustified.”

He noted that any other bacterial, viral, or other agent of infection that killed close to 100 people and injured hundreds more every day would unquestionably be called a public health problem demanding scientific research.

“As president of the AAP, I pledge to challenge the legislative efforts aimed at inhibiting pediatricians and scientific organizations from gathering potentially lifesaving information about firearms just as we did in the past with vaccines,” he said. “Is it not time to approach this with the same vigor of scientific inquiry we undertook for the prevention of communicable diseases?”

Next, Dr. Young opened and closed with the question “What do children need?” and spent her talk describing ways in which the answer is pediatricians themselves, remaining at the forefront of addressing the toxic challenges children face.

“Some days in our offices and our clinics, we’re not just physicians,” she said. “We’re nurses, we’re social workers, we’re pharmacists, we’re health insurance advisers, we’re nutritionists, we’re accountants, we’re teachers – all in the interest of trying to change for the better what children see and hear.”

She praised the advocacy efforts of many pediatricians in the room and described advocacy as a team sport to ensure children have access to care and appropriate essential health benefits, particularly if – and maybe when – children’s health insurance becomes part of health insurance exchanges instead of the Children’s Health Insurance Programs (CHIP).

“I spent a fair amount of time talking to legislators to prioritize children’s needs,” Dr. Young said. “I want funding to continue. No, I want funding to increase significantly for the programs that have proof of effectiveness for kids,” she continued to applause. She mentioned programs such as Women, Infants, and Children (WIC), early intervention and home visits for mothers and children.

“We need federal policy to address practice transformation: e-cigarette regulation, opioid abuse, vaccine refusal, gun control, drug pricing, graduate medical education reform,” Dr. Young said. “There are so many issues.”

She noted past legislative wins, including the Affordable Care Act – which garnered applause – for providing access to care and insurance to more people than ever before, and the CHIP Reauthorization Act, extending CHIP funding through 2017.

After describing challenges she’s heard pediatricians are facing in their practices, Dr. Young said some could become opportunities.

“For us to succeed in meeting children’s needs, we need to address our own concerns,” she said. “We need to ensure that we, primary care, specialty, subspecialty, whether you’re in a small independent practice or a large integrated system, have the resources and information to continue to provide the care for our most vulnerable population.”

Dr. Young suggested that offering virtual visits and partnering with telemedicine companies to maintain patients’ continuity of care might comprise one such opportunity, particularly if these services require payment to increase revenue since pediatricians have been providing after-hours care for free for years. She also suggested partnering with retail-based clinics, providing clinical knowledge and knowledge of the community.

“On the federal level, the Academy needs to remain a strong voice and continue to collaborate with other organized medical associations,” Dr. Young continued. “The Centers for Medicare & Medicaid respond to physician concerns, especially when presented by a unified front of physicians working together.”

She exhorted pediatricians never to forget how important they are to the children and families they care for.

“What do children need? They need us,” Dr. Young said to applause. “We pediatricians have a reputation for fairness, and we focus on the right priorities. Our children need us.”

The two president-elect candidates for the American Academy of Pediatrics spoke Saturday about what they would do for the organization and how they would advocate for governmental policies benefiting children and pediatricians, during the first official day of the organization’s annual meeting in Washington.

AAP members can vote for Dr. Fernando Stein, FAAP, of Houston, or Dr. Lynda M. Young, FAAP, of Worcester, Mass., during the voting period from Oct. 23 through Nov. 24.

Dr. Stein spoke first, calling to mind the first meeting of pediatricians in 1929 that eventually led to the formation of the AAP and how different children’s needs and the demands on pediatricians are today.

“Our world has changed, pediatrics has changed, the needs of children have changed, our needs as pediatricians have changed, and if we are to be relevant to our mission, we as individuals and as fellows of the academy must change,” he said.

But Dr. Stein pointed out that pediatricians must now do more and more with less and less support from health systems each day, a status quo that is taking a toll on doctors.

“We chose our profession by our natural altruistic inclinations, and currently by self-report, more than 50% of us are burnt out, empathy exhausted, and compassion fatigued,” Dr. Stein said. “I believe that now is the time for the Academy to take a loud and clear and unmistakable position in defense of the pediatrician. It is no longer sufficient to prioritize children when the pediatrician is hurting,” he said to applause.

One challenge Dr. Stein said he would tackle is the process of maintaining certification, a system that he gleaned from local chapters “is thought to be more of an intermittent threat rather than a lifelong commitment to learning,” a description that provoked laughter and applause.

“We need to remove this as a toxic stress to the pediatrician,” he said, eliciting more laughter as he alluded to the previous day’s presentations on the toxic stress children experience. He pledged to ensure the Academy would amend current requirements for certification and maintenance of certification and to address the cost for both.

Dr. Stein also called for the Academy to build a technology platform for sharing data among members and mentioned his work as chairman of the Council on Sections and the Committee on Membership as helpful to this goal.

The most enthusiastically received message Dr. Stein delivered, however, related to the toll of gun violence in the United States. He cited injuries from all causes, suicide, and homicides as the first, third and fourth leading causes of death of youth aged 5-21 years, ranked above respiratory diseases, infections, and sepsis.

“The gun violence issue is by any definition an epidemic and a public health problem,” he said to applause. “The oversimplification of violence as a problem of social justice is unjustified.”

He noted that any other bacterial, viral, or other agent of infection that killed close to 100 people and injured hundreds more every day would unquestionably be called a public health problem demanding scientific research.

“As president of the AAP, I pledge to challenge the legislative efforts aimed at inhibiting pediatricians and scientific organizations from gathering potentially lifesaving information about firearms just as we did in the past with vaccines,” he said. “Is it not time to approach this with the same vigor of scientific inquiry we undertook for the prevention of communicable diseases?”

Next, Dr. Young opened and closed with the question “What do children need?” and spent her talk describing ways in which the answer is pediatricians themselves, remaining at the forefront of addressing the toxic challenges children face.

“Some days in our offices and our clinics, we’re not just physicians,” she said. “We’re nurses, we’re social workers, we’re pharmacists, we’re health insurance advisers, we’re nutritionists, we’re accountants, we’re teachers – all in the interest of trying to change for the better what children see and hear.”

She praised the advocacy efforts of many pediatricians in the room and described advocacy as a team sport to ensure children have access to care and appropriate essential health benefits, particularly if – and maybe when – children’s health insurance becomes part of health insurance exchanges instead of the Children’s Health Insurance Programs (CHIP).

“I spent a fair amount of time talking to legislators to prioritize children’s needs,” Dr. Young said. “I want funding to continue. No, I want funding to increase significantly for the programs that have proof of effectiveness for kids,” she continued to applause. She mentioned programs such as Women, Infants, and Children (WIC), early intervention and home visits for mothers and children.

“We need federal policy to address practice transformation: e-cigarette regulation, opioid abuse, vaccine refusal, gun control, drug pricing, graduate medical education reform,” Dr. Young said. “There are so many issues.”

She noted past legislative wins, including the Affordable Care Act – which garnered applause – for providing access to care and insurance to more people than ever before, and the CHIP Reauthorization Act, extending CHIP funding through 2017.

After describing challenges she’s heard pediatricians are facing in their practices, Dr. Young said some could become opportunities.

“For us to succeed in meeting children’s needs, we need to address our own concerns,” she said. “We need to ensure that we, primary care, specialty, subspecialty, whether you’re in a small independent practice or a large integrated system, have the resources and information to continue to provide the care for our most vulnerable population.”

Dr. Young suggested that offering virtual visits and partnering with telemedicine companies to maintain patients’ continuity of care might comprise one such opportunity, particularly if these services require payment to increase revenue since pediatricians have been providing after-hours care for free for years. She also suggested partnering with retail-based clinics, providing clinical knowledge and knowledge of the community.

“On the federal level, the Academy needs to remain a strong voice and continue to collaborate with other organized medical associations,” Dr. Young continued. “The Centers for Medicare & Medicaid respond to physician concerns, especially when presented by a unified front of physicians working together.”

She exhorted pediatricians never to forget how important they are to the children and families they care for.

“What do children need? They need us,” Dr. Young said to applause. “We pediatricians have a reputation for fairness, and we focus on the right priorities. Our children need us.”