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Policy Memo Presentation Grading Rubric
NAME: ________________________________________________________________________
Topic (10 pts)
• Presenter has sent presentation topic before expected deadline.
• Presenter has uploaded the presentation video before expected deadline.
Organization & Presentation of Information (35 pts)
• Information is presented in a logical way which can be easily followed.
• Decision maker is clearly presented
• Problem is clearly described, including essential background information.
• Policy options and criteria are well-described and analysis is presented clearly, including any
scoring or ranking.
• Presentation materials (slides, graphics, and/or handouts) add to the meaning and visual appeal
of the presentation.
Critical Thinking (30 pts)
• Presentation demonstrates comprehensive analysis of the identified public health problem with
appropriate decisionmaker, options, criteria, and recommendation.
• Judgments are based on evidence and reasoning is clearly articulated.
Presentation Skills (25 pts)
• Presentation video includes slides and presenter’s face.
• Speaker demonstrates mastery of the subject matter.
• Speaks clearly and at an understandable pace
• Speaker uses a clear, audible voice.
• Delivery is poised, controlled, and smooth.
• Speaker uses body language appropriately.
• Visual aids are well prepared, informative, effective, and not distracting.
• Length of presentation is within the assigned time limits.
• Information is well communicated.
Grade: ____________/100
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To:
From:
Re:
Date:
Improving Access to Pediatric Specialists for All Children
Problem Statement
One of the major issues that affect the health of children in the United States, especially
those with chronic health conditions, is access to pediatric specialists. The American Academy of
Pediatrics notes that there are many shortages of pediatric subspecialties, which have reached
alarming levels, and consequently, patients have to wait long for appointments, have long trips,
and, in some cases, there is no care available for some conditions [1]. Grineski et al. (2020) in a
study identified the geographical disparities in the diagnosis of pediatric leukodystrophies, and it
was noted that children from health professional shortage areas are 0.86 times less likely to be
diagnosed with the disease than their more privileged counterparts in other areas [4].
Additionally, children who are visiting the specialized centers have 1.73 times higher chances of
being identified, and thus, this shows how crucial such a provision of care is. This data highlights
the urgent need for policy interventions to address the gap in pediatric specialist care, posing the
question: How can strategies be developed to enhance access to children’s specialists so that we
have the right outcome for every child?
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Background
There is a shortage of pediatric specialists throughout the United States. This is due to the
demand that cannot be satisfied due to a lack of supply of doctors, geographical distribution
disparities, and systemic problems in healthcare delivery. As a key issue that deserves attention,
major healthcare organizations have identified these shortages as a key one [1,3], such as the
Children’s Hospital Association (CHA) and the American Academy of Pediatrics (AAP). Both
bodies have emphasized the need for pediatricians in a specialty that will make things easier for
children. Their view is that the health care system should be fully staffed with pediatricians in a
professional specialty.
The recent data trends have shown the importance of targeted investment in the pediatric
workforce. For example, the number of pediatric subspecialty fellows has increased,
demonstrating a response to the growing need for specialized care. Nevertheless, the overall
proportion of graduate students in pediatric training has been decreasing, from 9.7% in 2010 to
8.2% in 2018, which may indicate the persisting difficulties in drawing new people to this field
[7].
Besides the shortage of pediatric specialists, the geographical imbalance of pediatric
specialists is another reason as families need to travel longer distances, sometimes wait much
more for their appointments, or even worse, have no access to the specialty care they need. The
AAP has presented state-specific fact sheets that highlight the impact these shortages have on
children’s access to healthcare as they demonstrate the distance and locations the families might
need to travel to reach the pediatric specialized treatments. This issue is also made worse by
administrative and systemic problems like the focus on relative value units, which may lead to
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the provision of more services with less quality and thus may contribute to making the shortage
more severe by misallocating the resources and attention away from pediatric specialty care.
Options
The task of finding the best policy options to increase access to pediatric specialists for
all children involves a variety of evaluation criteria against the background of effectiveness,
feasibility, and equitability. Considering the complex nature of the issue, which includes regional
variations, structural barriers, and the need for specific care options, it is important to explore
solutions that can deal with the challenges comprehensively.
Option 1: Telehealth Expansion
Telemedicine has become a viable alternative for accessing pediatric specialists through
the Internet or mobile communication platforms that have made it possible to overcome
geographical barriers and waiting times for appointments. This entails increasing infrastructure,
training providers, and reforming rules to create a suitable framework for the wide adoption of
telehealth service delivery. First, children from low-population areas can get the opportunity to
talk to the experts without having to go through a long journey. A study by Uscher-Pines et al.
(2022) showed that among pediatric subspecialties, genetics, behavioral health, pulmonology,
and endocrinology account for 38.8%-73.0% of telehealth visits [6]. Secondly, the initial outlay
of funds for technology and training is required, but savings from the decrease in physical
facilities and the potential for broader insurance coverage can make telehealth profitable.
Thirdly, telehealth can be used to make pediatric specialist care more equitable so that it can be
brought to populations that previously had limited access to such services. Nevertheless, this will
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remain a challenge until the digital divide is bridged, that is when all families will have the
technology and internet to use.
Option 2: Incentivize Specialty Training
This option seeks to remedy this shortfall by providing incentives to medical personnel to
pursue subspecialty training. Amongst these may be loan forgiveness, scholarships, and
guaranteed posts in underserved areas upon completion of the training. For instance, financial
and career incentives can increase the number of people specializing in pediatrics, which will
help address the supply side of access problems. When it comes to feasibility, setting up
incentive programs needs sufficient financial support and collaboration among educational
institutions. Lastly, by focusing on incentives to provide services to the areas with a shortage of
health providers, this option can be very helpful in overcoming the geographic and
socioeconomic barriers to healthcare access.
Option 3: Strengthen Primary Care Coordination
The coordination between primary care providers and pediatric specialists can be
enhanced through integrated care models and referral systems, which will result in more efficient
use of specialist services and will also ensure that all children have improved access to them [5].
First, high coordination can lead to improved care management, a decrease in unnecessary
referrals, and timely access to specialists. Secondly, in terms of feasibility, this strategy makes
use of the existing healthcare structure but needs to be adapted to new practice patterns,
reimbursement models, and developing new collaborative networks. Therefore, increased care
coordination will benefit all children by improving the system’s ability to respond to the
children’s needs.
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In weighing these options against the criteria, it becomes clear that none of them is
sufficient by itself. Telehealth Expansion is among the most effective and equitable approaches,
yet it demands a substantial initial capital expenditure and continued support to deal with the
digital divide. The incentive structure of specialty training can be seen to address the cause of the
specialist shortage directly and could be effective, but this might lead to some problems due to
the need for massive funding and long-term commitment. Among all the plausible reforms,
perhaps the most achievable and actionable is to strengthen primary care coordination, which can
immediately improve efficiency and equity, but that depends on the availability of the specialists.
A comprehensive approach that blends the best of the three options might be the best way
forward.
Recommendations
The best choice is to increase telehealth services. This recommendation is based on the
understanding of the recognized opportunity for telehealth to increase access to specialized
pediatric care, especially for disadvantaged and geographically isolated populations [6]. As for
this choice, telehealth offers a scalable solution that can be quickly deployed to bring specialist
services closer and overcome geographical barriers and long waiting times. It provides a
practical solution to the issue of international health equity by ensuring that pediatric specialty
care is readily available to children in rural and underserved urban areas who otherwise would
not have such access.
Additionally, some of the costs associated with implementing telehealth infrastructure
and training staff are upfront, but the savings from reduced travel needs, lower costs for
healthcare providers, and prevention of advanced disease through early intervention make it a
cost-effective option. As a tool for widening access to quality care, telehealth has strong support
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from the American Academy of Pediatrics and ensures alignment with pediatric healthcare goals
[2].
Implementing this recommendation involves the allocation of specific resources for the
technology, the regulatory changes for the telehealth states’ support, and the initiatives of digital
literacy and access among all populations. The provision of telehealth services to all requires
dealing with the digital divide and provision of resources to families with no internet or
necessary devices. This strategic focus on pediatric telehealth expansion will have a tremendous
and immediate impact on improving access to specialized pediatric care by catering to the urgent
need to provide every child with the specialized care that they deserve.
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Works Cited
1. American Academy of Pediatrics (2021). Pediatric Subspecialty Shortages Fact Sheets.
Available from: https://www.aap.org/en/advocacy/pediatric-subspecialty-shortages-factsheets/.
2. American Academy of Pediatrics (2021). American Academy of Pediatrics Addresses
How Telehealth Can Increase Patient Access to Quality Care, Dismantle Barriers.
Available from: https://www.aap.org/en/news-room/news-releases/aap/2021/americanacademy-of-pediatrics-addresses-how-telehealth-can-increase-patient-access-to-qualitycare-dismantle-barriers/.
3. Children’s Hospital Association (CHA) (2023). Pediatric Workforce Shortages Factsheets.
https://www.childrenshospitals.org/content/public-policy/fact-sheet/pediatric-workforceshortages-factsheet.
4. Grineski, S., Morales, D. X., Collins, T., Wilkes, J., & Bonkowsky, J. L. (2020).
Geographic and specialty access disparities in US pediatric leukodystrophy
diagnosis. The Journal of pediatrics, 220, 193-199.
https://doi.org/10.1016/j.jpeds.2020.01.063.
5. Roman, S. B., Dworkin, P. H., Dickinson, P., & Rogers, S. C. (2020). Analysis of care
coordination needs for families of children with special health care needs. Journal of
Developmental & Behavioral Pediatrics, 41(1), 58-64.
https://doi.org/10.1097/DBP.0000000000000734.
6. Uscher-Pines, L., McCullough, C., Dworsky, M. S., Sousa, J., Predmore, Z., Ray, K. &
Schulson, L. (2022). Use of telehealth across pediatric subspecialties before and during
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the COVID-19 pandemic. JAMA Network Open, 5(3), e224759-e224759.
https://doi.org/10.1001/jamanetworkopen.2022.4759.
7. Vinci, R. J. (2021). The pediatric workforce: recent data trends, questions, and challenges
for the future. Pediatrics, 147(6). https://doi.org/10.1542/peds.2020-013292.
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