Pediatric hospitalists ponder training, certification options
Dr. Erin Stucky Fisher, who runs the pediatric hospital medicine fellowship program at Rady Children’s Hospital in San Diego, offered her views while the committee was gathering comments. She said there’s a need for codified, credible training for everyone who cares for hospitalized children. That would let hospitals and patients know that training in pediatric hospital medicine results in a certain specific set of skills.
"That’s what I think kids need. We need to ask, ‘What is best for the hospitalized child?’ " Dr. Fisher said.
But while that training could lead to subspecialty board certification, it doesn’t have to, she said. However, the training program does need to teach the core competencies of the specialty. What a program looks like, and what form of certification should be considered, is under review, she said. The only option she would rule out is doing nothing.
"Staying still is hard and isn’t what pediatric hospitalists have done," Dr. Fisher said.
But Kenneth Pituch, director of the division of pediatric hospital medicine at C.S. Mott Children’s Hospital in Ann Arbor, Mich., is on the other end of the spectrum. He told the committee it’s too early to consider carving out a certification pathway that potentially requires 2 or 3 additional years of training. "We’re not quite there yet for a couple of reasons," he said.
For instance, requiring additional years of training for pediatric hospital medicine could make the specialty significantly less attractive to young doctors, he said. That would put a drain on the workforce needed to care for sick children in the hospital.
He’s also concerned about widening the gap in training between pediatricians working in the hospital and those in the outpatient setting at a time when collaboration in the care of chronically ill children is so important.
Right now, there are outpatient physicians who see a high volume of relatively healthy children, and pediatric hospitalists who care for acutely ill children. The problem is that there is little going on to address the care for the chronically ill children who bounce back and forth between the two settings, Dr. Pituch said. There could be a role for pediatric hospitalists in improving that care, but moving forward now with certification could make it more difficult to figure out what this other model would look like, he said.
"I’m just saying, let’s hold off," he added.
