Values Versus Optimal Care in Primary Care Pediatrics

Abstract

During my years of private pediatric practice from 1977–2002, I saw Medicaid patients without stipulation. I was able to put my money where my mouth was regarding disparities in access to pediatric care. But doing so today may be impossible for many pediatricians because of the economic realities of private practice. Trying to maintain equal access in a private practice is difficult because physicians in private practice must pay their overhead before themselves. Private practice pediatricians’ income is dependent on the services they render. They have no income stream from academia, no grants, and no access to research funds. Today a business policy that reflects the …