Maintaining a comprehensive communitywide pediatric health care system is increasingly challenging for many reasons. The economics of pediatric health care can be fragile, with reimbursement for some services below the actual cost of care. Physicians who choose to specialize in pediatrics must often train for several addi-tional years with relatively little compensation, and the number of medical students and residents seeking advanced pediatric training is declining nationally. In fact, the demand for pediatric subspecialist physicians far exceeds the supply, and there are thousands of vacant jobs for pediatric specialists throughout the nation.
