My ONE Yearly Pediatric Research Meeting

famous view at the Convention Center

A little time for a walk in the countryside

the view from my hotel

On the surface, it seemed like just another Pediatric Academic Society Meeting.  A horde of well dressed and exuberant young people scurrying around with rolled up posters, schmoozing with one another and with their senior faculty members and mentors who were hobbling around, hunched over and struggling to navigate the roomy corridors of the convention center with their broken down frames.  And so it is of course common to recognize someone I have seen for decades….looking twice as old and twice as run down as the last remembrance.  And it seems that nothing really changes otherwise as I witness them pontificating their wisdom relentlessly to the younger generation of research want-to-be’s and to other colleagues ostensibly demanding to be heard.  Maybe I’m jealous I’m not still engaged….sour grapes?

And you have to factor in the usual effect of my aging on my perception of how young everyone else looked at the meeting except of course the old guard like me.  Nevertheless there were a few impressions this year worth highlighting that I think reinforce those of the recent past and others seen more severely than in the past.

I’m told that 75% of those training in Pediatrics are now women, and so it seemed as though the largest band of new researchers at the meeting appear to confirm this notion.  Well dressed, articulate, knowledgeable, women in Pediatrics are clearly in charge of the field, certainly for the future if not in the present.   Where have all of the eager young men gone?  Surgery, Internal Medicine, or out of Medicine all together? 

Another observation was the disproportionate large number of East Indian Physicians presenting at the meeting.  It’s clear that Pediatrics is well represented by this group of physicians, hard working as they are, intelligent and focused on being successful US academics.  This year - as my hearing is further declining with age, I found it harder to filter out their heavy home-styled accents - although maybe it was also the acoustics of the cavernous conference ballroom that added to the background cacophony.

Finally as in the past, I found it more than ironic that the OBESITY conference sessions I attended, the proportion of overweight and obese presenters mirrored those of the general US population.  At least I would be embarrassed to be researching a problem that I was striving to become an expert in that I was concomitantly plagued by. 

I suppose the aspect of the meeting that bothered me the most was a sense of despair with the flow, flavor and taste of the meeting in general.  It seemed like the groups representing and contributing to this meeting, the American Academy of Pediatrics, Pediatric Academic Society, the American Pediatric Society, etc, etc were out of touch with present day reality.   An aspect that I have valued throughout my career, the sense of optimism and ownership that Pediatricians have for the lives and health of children seemed to be conveyed in a shallow and hollow manner, the rhetoric outdated, unrealistic and even seemingly insincere.

 

So many aspects of our society are broken, our economy is drowning in debt, hospitals and universities are subjecting every potential expenditure to microscopic scrutiny, and physicians have never been unhappier with medicine in general.  The problem is global: we are unhappy with our government’s intrusion ala Obama Care and the time wasted filling out piles of useless forms, third party carriers and shrinking reimbursements, the student bills that gnaw on our every waking moment, the impatience and unrealistic expectations of some of our patients, the restrictive demands and increasing meddling of our employers, etc.

Back to PAS: much of what I personally attended at the meeting was old, outdated or so minimalistic it could be hardly considered research, let alone groundbreaking research - which this most prominent of national Pediatric meetings is supposed to represent.  What ails most of American health including Pediatric health is not a mystery, and it is clearly not fixable with the kind of short-term research meant to further the careers of young researchers trying to get ahead in their university. 

But its not their fault, it’s the fault of the system that parses out small grants that last 1, 3, the most 5 years to deal with conditions that are increasingly chronic in nature.  Indeed, how can you even conceive of a method of showing progress in addressing Type 2 Diabetes, Asthma, overweight and obesity, substance abuse, suicide, etc, from research grants that fund you for only a few years and you have to spend most of that time gearing up and then writing your next grant while diverting your attention and focus away from the research at hand.

And we consistently have little to show for our research efforts in the grand scale of American healthcare.  Our health indices in infant mortality, population longevity, obesity and overweight, etc continue to lag way behind other developed countries, despite spending much more on healthcare and research. In fact, it is acknowledged that the dollars we waste on healthcare is more than some countries spend altogether, not something any American wants to gloat about. We are simply not facing the facts that our system is increasingly broken and needs fixing.  This is where our research efforts should be focused on.

I do not want to exit on a negative thought.  And truthfully, as ironic as it may seem after stating the above, I can’t help but feel that America still has the best medical care in the world, which must reflect the system in some way that I’m baffled to explain.  It maybe true that the global public health issues are not being addressed adequately, but somehow the most advanced medical and surgical care in the world is still here for the taking.  I can’t think of any condition – medical or surgical that you could not find the world’s most celebrated doctor available somewhere in the country.  Many of these doctors have thrived through word of mouth aided by glamorous websites.  They continue to attract patients from around the country and around the world who are willing to pay their prices.  This care is obviously not for everyone……………..as their charges are sometimes oppressively high and increasingly independent of the system of reimbursements that are doled out by 3^rd party and government insurance carriers.  As always in life, it seems that at least some of the time, you get what you pay for.