Pediatric Medicine’s Struggle with Labor Shortages and Other Limitations

Pediatric medicine supports some of the most vulnerable members of society. This makes shortages in the space even more concerning. Unfortunately, the same shortages of resources and professionals that plague the rest of the healthcare industry also impact pediatric medicine.

For leaders in this area, it means having to free up revenue so they can invest in solutions through options like working with pediatric medical billing companies or examining their relationships with pediatric medical billing and coding services.

To help you understand the forces that are driving these considerations, we’ve compiled some of the top challenges in pediatric medicine today.

Pediatric Hospital Beds Are Limited
Today, the number of hospitals that offer pediatric services has dropped from 42% a decade ago to just 37% [1].

For at least 10 years, the number of pediatric beds available has been trending downward. As of 2018, one in four American children were traveling greater distances for a bed compared to their trips in 2009, according to the journal Pediatrics. This was largely due to a decrease in the number of children who needed care before the COVID-19 pandemic. Compared to 2017, 2019 saw around 200,000 fewer pediatric discharges. But overall, care has improved in helping children with conditions like cystic fibrosis and sickle cell, and prevention has improved for problems like meningitis and pneumonia through vaccination programs.

As anyone working with pediatric medical billing and coding services will know, pediatrics is seasonal, with patient numbers falling in the summer and rising again during respiratory virus season in the winter. But, at the beginning of the pandemic, daycares and schools closed, which meant COVID and other infectious diseases were spreading more slowly among children, decreasing the need for hospital beds. In many cases, beds that had been dedicated to children were shifted to care for adults. 

Childrens’ Hospitals Are Struggling
Nursing shortages have hit some of the most vulnerable providers. Even before the COVID-19 pandemic, children’s hospitals were being threatened by workforce shortages. Nursing school enrollment was falling short while at the same time, there was a shortage of faculty to help train new nurses. Some hospitals have even reported retirement rates that doubled in 2021. Many nurses were working through the pandemic, enduring waves of shortages, then inactivity. In the midst of all this, they were deciding as to whether it was a good time for them to finally leave the workforce. Just like nurses in general, nurses in the children’s hospital space want work life balance and are taking advantage of opportunities in contract work. 

The nurse turnover rates for Children’s hospitals are severe. According to data out of PROSPECT, a leading financial and operational data set in pediatrics, the quarterly turnover rate increased more than 76% for registered nurses when comparing the first quarter of 2019 to quarter three of 2021 [2]. The critical shortage of pediatric nurse practitioners has been a point of concern as far back as 2019. 

These hospitals have also reported that travel nursing is especially effective in luring nurses away since it allows nurses to pay off student loans and other debt. This means that for hospitals to stay competitive, they should be willing to increase pay rates. This is a good reason for children’s hospitals to consider pediatric medical billing services to help ensure that their cash flows are as healthy as possible and that they have strong revenues to provide the higher compensation that is attractive to pediatric nurses. 

Pediatricians and Pediatric Specialists Are Hard to Find
The country is facing a shortage of pediatricians. As far back as 2021, it was estimated that the US could experience a shortage of thousands of physicians in pediatrics [3]. Some states are having particular struggles, such as Florida, which has a worsening need for pediatricians. 

Pediatric medical subspecialists are critical to the health of children since they treat patients with special needs. When there are shortages of these professionals, patients have to travel long distances for care. Some wait multiple weeks or even months, sometimes skipping care or being forced to get care from providers who don’t have the appropriate training. 

The American Academy of Pediatrics reports on shortages around the country. These reports are broken down by state and include information on driving distances. Some of the subspecialties covered include [4]:

  • Pediatric cardiology
  • Pediatric infectious diseases
  • Sports medicine
  • Child abuse pediatrics
  • Neonatal-perinatal medicine

One of the potential suggestions on the fact sheet is loan repayment for pediatric subspecialists to ease access to additional training and encourage more doctors to specialize in treating children with special health needs. 

The common theme among these challenges is that forms of compensation such as pay and other financial support is important to countering these shortages and attracting talent. For providers, this means that it is critical to invest in the health of the pediatric revenue cycle today. This can be done multiple ways, including working with pediatric medical billing companies, and investing in pediatric medical billing and coding services. To learn more about how you can address these concerns, contact us today

[1] C. Zdanowicz, “Pediatric hospital beds are in high demand for ailing children. Here’s why,” Cable News Network, 17 March 2023. Available:
[2] M. M. Busenbark, “Children’s Hospitals Work to Address Nursing Staffing Challenges,” 26 April 2022. Available:
[3] AAMC, “AAMC Report Reinforces Mounting Physician Shortage,” 11 June 2021. Available:
[4] American Academy of Pediatrics, “Pediatric Subspecialty Shortages Fact Sheets,” 26 March 2021. Available:

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