Growing pains in pediatric dermatology: Workforce shortage

Up to 30% of pediatric primary care visits include a skin-related complaint, but the longstanding shortage of providers continues, due to a combination of factors which include:

• a still-new system of certification,

• lower pay than colleagues in other sub-specialties,

• a lack of exposure of the field to medical students,

• and therefore a sometimes arduous path to training.

Pediatric dermatology is a comparatively young sub-specialty – it’s possible to date it back to the first International Symposium of Pediatric Dermatology, held at the iconic San Angel Inn in Mexico City in October 1972. At that meeting, the International Society of Pediatric Dermatology was founded. The Society for Pediatric Dermatology was created 18 months later; the journal Pediatric Dermatology was launched in 1982; and the American Academy of Pediatrics created a Section on Dermatology in 1986.

In 2010, we compared pediatric dermatology to a start-up, and in many ways the analogy holds true seven years later.

This month, Elaine Siegfried, M.D., professor of pediatrics and dermatology, St. Louis University, presented a poster on the U.S. pediatric dermatology workforce at the World Congress of Pediatric Dermatology. (Brea Prindaville, M.D., UMass Memorial Health Care, was the lead author on the workforce shortage poster.) The poster data corresponds to a publication in Pediatric Dermatology on “Pediatric Dermatology: Past, Present, and Future,” as well as one in The Journal of Pediatrics on “Understanding the Pediatric Dermatology Workforce Shortage: Mentoring Matters” which Dr. Siegfried co-authored.

“The bottom line is, we’re still a very under-represented specialty,” she notes, “serving an under-served population.” Most pediatric dermatologists serve exclusively pediatric patients, are based in large cities, and practice full-time. Nearly all of those surveyed accepted Medicaid, and about half of their population was Medicaid-insured, which is slightly higher thanaverage.

In the published study, respondents “noted mentorship as the most important influence on their decision to pursue a career in pediatric dermatology” and cited “financial hardship and resistance of some dermatology programs to accept applicants previously trained in pediatrics.”