Summary of presentation from Mark DelMonte with the American Academy of Pediatrics at the 2025 PMI Conference
In a rapidly changing world marked by shifting demographics, political polarization, and evolving healthcare needs, the field of pediatrics stands at a critical juncture. Recent discussions at the American Academy of Pediatrics (AAP) have centered around how pediatricians can “separate the signal from the noise” and remain focused on children’s health amidst a cacophony of external pressures, from public health policy and economic trends to disinformation campaigns and payment challenges. This comprehensive look explores the current pediatric landscape – summarizing key data trends, the importance of advocacy, financing strategies, and powerful messaging – while offering actionable tips for practicing pediatricians and those who support them.
Recent conversations have underscored the significant demographic changes affecting pediatrics. The proportion of children in the U.S. population has steadily declined, from 36% in 1960 to just 22% today. Birth rates have reached historic lows, and replacement-level birth rates are no longer being met, which has clear implications for public policy, funding allocations, and the support structure for entitlements like Social Security. At the same time, there is a notable increase in the percentage of immigrant children and growing population diversity. Income inequality is widening, and households with children are increasingly impacted by these disparities. Pediatricians must adapt to a future where these interlinked demographic trends directly influence the needs of their patients and the communities they serve.
The external environment for pediatricians is fraught with challenges. Public trust in government, media, and traditional institutions has declined, particularly since the COVID-19 pandemic. Deepened partisan divides are reflected in sharply different levels of trust in agencies like the CDC, NIH, and HHS depending on political affiliations. Encouragingly, despite these divisions, trust in individual physicians remains high across the political spectrum. This presents an opportunity: pediatricians retain a powerful voice and unique credibility, positioning them to be effective advocates, educators, and sources of reliable information during times of widespread misinformation.
Advocacy and clear, focused messaging are stronger than ever within the pediatric community. Under the leadership of the AAP and its current president, Dr. Sue Kressly, the Academy has used social media, direct congressional engagement, and strategic storytelling to highlight urgent issues like childhood immunizations and immigration policy. These campaigns have resulted in unprecedented engagement and reach, such as a recent statement on immigrant children garnering 400,000 impressions in 48 hours and a follow-up message on vaccines reaching over a million views in just one day. Testimonials and real-world stories from pediatricians on the frontlines have played a key role in influencing public opinion and policymakers, emphasizing the life-saving importance of vaccines and robust public health policy.
Financial sustainability and payment issues remain a day-to-day concern for pediatric practices. The AAP’s committees and advisory groups work tirelessly to advocate for pediatric-friendly policies in the Medicare Physician Fee Schedule, fight for fair payment for new and existing services (including telehealth and new immunizations like nirsevimab), and develop user-friendly tools like the coding and payment hotline. Price transparency laws present new opportunities, but also challenges, as vast new data sets require effective education and advocacy to turn into practical benefit for pediatricians. The AAP is also launching new online resources and policies to guide practices through the maze of financing, value-based care models, and payment reforms.
In adapting to this new landscape, pediatricians must remain nimble and agile, leveraging their trusted status to “flood the zone” with good information and positive messaging. Successful examples include the RSV public service campaign, which in its first month reached 36 million people and drove a spike in website traffic. Besides advocating for immunizations and equitable care, pediatricians are urged to adopt new language and engaging narratives to break partisan barriers and encourage policy support for all children, not just one’s own. Workforce challenges, payment models, and attacks on safety net programs are real – but so is the collective power of a unified, optimistic, and persistent pediatric community.
**5 Practical Takeaways for Pediatricians and Practice Managers:**
1. **Focus Your Messaging**: In an era of misinformation and noise, clearly and repeatedly communicate the most critical messages—such as the benefits of vaccinations and the importance of pediatric health equity—to your patients, parents, and community. Use stories to make your message memorable and impactful.
2. **Leverage Trusted Resources**: Make use of tools like the AAP’s coding and payment hotline, real-time immunization access maps, and the soon-to-launch financial resource websites. Sharing common challenges through these channels helps identify trends and drive systemic solutions.
3. **Advocate Systematically**: Contribute to advocacy efforts by sharing patient stories, responding to AAP engagement campaigns, and supporting legislative outreach on pediatric issues. Participating in or encouraging others to take RUC (Relative Value Scale Update Committee) surveys is essential for fair payment policy development.
4. **Stay Informed on Payment Transparency**: Familiarize yourself with new price transparency data and educate your team about how local payment variances may affect your practice and negotiations with payers. Knowledge is power in contract negotiation and can help influence payer policies.
5. **Strengthen Your Practice Through Community**: Engage with colleagues, AAP committees, and local pediatric chapters to stay connected, share insights, and amplify your advocacy. The challenges are significant, but paddling together in the “bigger boat” of organized pediatrics ensures you’re not navigating these waters alone.
By maintaining focus, embracing innovation, and working collectively, pediatricians can continue to advance child health and adapt successfully to today’s rapidly evolving healthcare environment.