Practice of pediatric pulmonology: Results of the Future of Pediatric Education Project (FOPE)

In 1996, the Future of Pediatric Education (FOPE) Project of the American A cademy of Pediatrics (AAP) developed surveys to describe the nature of pedi atric practices, recent trends in clinical practice, and anticipated workfo rce needs for both pediatric generalists and pediatric sub-specialists. A s urvey was specifically developed to describe the features of pediatric pulm onology as self-reported by pediatric pulmonologists. The survey was distri buted to members of the AAP Pulmonology Section, the Pediatric Assembly of the American Thoracic Society, and certified pediatric pulmonologists recog nized by the American Board of Pediatrics. Of the 535 respondents (67% of t hose invited to respond), the responses of 388 certified and 94 trained but not board-certified pulmonologists were included in the results. The characteristics of certified and non-certified respondents were the sam e for most survey questions. Clinical activities occupy 73 +/- 29% of profe ssional time. Most pulmonologists work in urban, inner city, or suburban se ttings and 85% are affiliated with a medical school. One third are in priva te practice. As a group, research activities occupy less than 15% of their time. Most pediatric pulmonologists maintain a referral practice and use ph ysician extenders to provide care. Patients with asthma and cystic fibrosis comprise 60-70% of patient volume. Both the volume and complexity of patie nts are increasing, as is competition for pediatric sub-specialty services. Pediatric pulmonary practices vary in size and in volume of patients that they manage in various settings. Forty percent of respondents identify alle rgists and other pediatric pulmonologists as sources of competition. Sixty- nine percent of respondents do not believe that there is a current need for additional pediatric pulmonologists in their respective communities. Only 15% of respondents plan to retire in the next decade. Pediatr Pulmonol. 200 0; 30:190-197. (C) 2000 Wiley-Liss, Inc.