Copyright 1999 Globe Newspaper Company
The Boston
Globe
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August 23, 1999, Monday ,City Edition
SECTION: OP-ED; Pg. A11
LENGTH: 811 words
HEADLINE:
Helping children's teaching hospitals;
PHILIP A. PIZZO;
Philip A. Pizzo
is physician-in-chief at Children's Hospital and Thomas Morgan Rotch Professor
of Pediatrics at Harvard Medical School.
BYLINE: By
Philip A. Pizzo
BODY:
During 25
years as a pediatrician I have witnessed dramatic improvements in the health of
children.
In my specialties of pediatric oncology and infectious
diseases, cancer has gone from a nearly incurable disease to one in which nearly
75 percent of the children diagnosed are likely to survive and even be cured.
Equally important, just in the past 10 years, therapies have commuted the "death
sentence" for children with HIV infection and AIDS to the possibility of
long-term survival. We are also able to virtually prevent the transmission of
HIV from mother to child with antiviral drug therapy. Such dramatic
accomplishments do not happen by accident. They are born out of teaching
hospitals where senior clinicians and scientists work with young doctors
undergoing graduate medical education in pediatrics and
pediatric specialties.
It is these interns and residents who become the
pediatricians, specialists, and scientists of tomorrow and who will bring us the
miracles of the 21st century. A cure for cancer, new vaccines, gene therapy,
tissue engineering are all possibilities.
The path to leadership in
children's health care is neither easy nor cheap. Pediatricians must train three
to eight years beyond medical school. Fortunately, during this period, these
young men and women are not only learning but also contributing to improving the
lives of children at the bedside and in the research laboratory. Unfortunately,
these contributions are in peril as a result of a funding gap unique to
independent children's hospitals.
In recent weeks the media have
reported on the devastating impact of the current and planned reductions in
Medicare on teaching hospitals as a consequence of the 1997 Balanced Budget Act.
Due to market changes, Medicare has become the remaining stable and significant
source of support for physician training at teaching hospitals. Missing from
this dialogue, however, is the fact that independent children's teaching
hospitals, including Boston's Children's Hospital, receive virtually no federal
support for their teaching programs because they treat children, not the
elderly.
The federal government invests on average per resident nearly
200 times as much through Medicare to train doctors in all teaching hospitals as
it does to train them in free-standing children's hospitals. If Boston's
Children's Hospital were supported for its mission in graduate medical
education at the same level as adult teaching hospitals, it would
receive approximately $30 million a year. Instead, it receives
$2 million to $3 million from Medicaid and
virtually nothing from Medicare or private insurers.
The independent
children's hospitals in this country train nearly 30 percent of the nation's
pediatricians and nearly half of its pediatric specialists and researchers. The
lack of adequate educational funding jeopardizes this future pool of
pediatricians and research breakthroughs.
Focused solely on
children, Boston's Children's Hospital has had the commitment to remain at the
forefront of pediatric health care. When treatments are not available,
physicians and research scientists at Children's Hospital create them.
For example, when I began training at the hospital in 1970, my
colleagues and I witnessed numerous cases of deadly meningitis caused by
Hemophilus influenza. Because of the pioneering work of Children's researchers,
whose team included a number of pediatric trainees, a vaccine for this infection
was developed. So in the mid-1990s, when my own daughter began her pediatric
internship, neither she nor her classmates saw a case of H. flu meningitis.
Similar discoveries have led to new operations and less invasive ways to
correct or repair damaged hearts, limbs, and other organs as well as novel ways
to diagnose and treat disorders such as epilepsy and cystic fibrosis. Many
discoveries have happened because treating and curing children is our only
priority.
With all that has been achieved, there is much more to be
done. Too many children still suffer and die. Fortunately, President Clinton has
introduced a proposal for interim support in his budget this year, but this
critical assistance will come only if the bills before the House and Senate are
passed. In addition, both Republicans and Democratic leaders, including the
entire Massachusetts delegation, are sponsoring legislation called the
Children's Hospitals Education and Research Act to fund
pediatric graduate medical education. We hope that members of
Congress throughout New England will be as supportive so that critical financial
relief is provided to children's hospitals. This assistance will come only if
the bipartisan bills before the House and Senate are passed.
As the plea
to help our teaching hospitals echoes nationwide, the quieter voices of our
children must not go unheard.
LOAD-DATE: August 23,
1999 
