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Strapped Parents and Irked Pediatricians

Strapped Parents and Irked Pediatricians

Picture of Barbara Feder Ostrov

While reading New York Times health reporter Tara Parker-Pope's recent blog post about children's health care, I was struck by the comment of a doctor named Elise:

"I have practiced pediatrics in the military, a small rural town, and now a small city. We have noticed more parents asking for medication samples and now even canceling well-child appointments.Another ominous but little-noticed development is the suggestion that pediatricians start providing dental treatments to children who are unable to find a dentist that accepts their government insurance."

There are two intriguing story ideas here for health reporters.

First, are doctors in your community seeing what Elise is seeing? Are parents increasingly asking for medication samples, postponing immunizations, or canceling well-child visits? And what about adults? How is their health affected? Check out this Boston Globe story by Stephen Smith for a good example of localizing this issue. Feel free to post similar stories to the comments section, or email them to me. I'll round them up in a future posting.

Second, it's worth asking pediatricians if they feel pressure to provide basic dental services in their offices, particularly to children with government health insurance such as SCHIP (known as Healthy Families in California) or Medicaid (known as Medi-Cal in California). A number of reports have documented the shocking lack of dental care for children with Medicaid and the dearth of pediatric dentists willing to serve the poor. A federal Medicaid official explains some of the problems here. Elise described as "ominous" the prospect of providing dental care in her office, perhaps by a dental hygienist. Her concern is understandable since Medicaid reimbursement for it is dismally low and pediatricians aren't usually set up to become dentists.What do other pediatricians - and parents - think about this? Check out the Children's Dental Health Project and our useful resources guide on dental care for more sources and data.

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