Pediatrics in the Year 2020 and Beyond: Preparing for Plausible Futures

Abstract

Although the future of pediatrics is uncertain, the organizations that lead pediatrics, and the professionals who practice within it, have embraced the notion that the pediatric community must anticipate and lead change to ultimately improve the health of children and adolescents. In an attempt to proactively prepare for a variety of conceivable futures, the board of directors of the American Academy of Pediatrics established the Vision of Pediatrics 2020 Task Force in 2008. This group was charged to think broadly about the future of pediatrics, to gather input on key trends that are influencing the future, to create likely scenarios of the future, and to recommend strategies to best prepare pediatric clinicians and pediatric organizations for a range of potential futures. The work of this task force led to the development of 8 “megatrends” that were identified as highly likely to have a profound influence on the future of pediatrics. A separate list of “wild-card” scenarios was created of trends with the potential to have a substantial influence but are less likely to occur. The process of scenario-planning was used to consider the effects of the 8 megatrends on pediatrics in the year 2020 and beyond. Consideration of these possible scenarios affords the opportunity to determine potential future pediatric needs, to identify potential solutions to address those needs, and, ultimately, to proactively prepare the profession to thrive if these or other future scenarios become realities.

The Lifelong Effects of Early Childhood Adversity and Toxic Stress

“…88,89 The pediatric medical home of the future could offer more than the early identification of concerns and timely referral to available programs, as enhanced collaboration between pediatricians and community-based agencies could be viewed as a vehicle for testing promising new intervention strategies rather than simply improving coordination among existing services. With this goal in mind, science tells us that interventions that strengthen the capacities of families and communities to protect young children from the disruptive effects of toxic stress are likely to promote healthier brain development and enhanced physical and mental wellbeing.…”

“…It will require a deep investment in the development, testing, continuous improvement, and broad replication of innovative models of cross-disciplinary policy and programmatic interventions that are guided by scientific knowledge and led by practitioners in the medical, educational, and social services worlds who are truly ready to work together (and to train the next generation of practitioners) in new ways. 88,89 The sheer number and complexity of underaddressed threats to child health that are associated with toxic stress demands bold, creative leadership and the selection of strategic priorities for focused attention. To this end, science suggests that 2 areas are particularly ripe for fresh thinking: the child welfare system and the treatment of maternal depression.…”

Blueprint for Action: Visioning Summit on the Future of the Workforce in Pediatrics

“…Through surveys of working groups, the planning committee, and FOPO board of directors, these trends were ranked by degree of impact on the future and degree of likelihood they would actually occur. 2,3,8,11 As a result of this process, 5 megatrends emerged. Megatrends are long-term changes that affect governments, societies, economies, or systems permanently over a long period of time.…”

“…Consistent with gaps identified in the IOM report, elements forming the foundation of pediatric care are undergoing changes, including population demographics, health care delivery system, pediatrician demographics, and the speed with which medical advances occur. 2,3 Therefore, the field of pediatrics and its workforce must adapt to meet challenges created by such changes to optimize the health of children who will become healthy adults.…”

Looking to the future: Framing the implementation of interprofessional education and practice with scenario planning

“…As far as we are aware, the use of scenarios has not been used in planning for the implementation of IPE/IPP, although it has been used in other health strategic planning, including: The Steering Committee on Futures Health Scenarios, in the Netherlands; [9] The Hemingford Scenarios, UK; [10] Plausible futures for paediatrics, USA; [11] The International Campaign to Revitalise Academic Medicine (ICRAM), [12] and Future Residential Requirements for People with Mental Health Problems, the Netherlands. [13] In this paper, the methods and outcomes of a workshop to explore and evaluate the use of scenario planning as a means of exploring mental models and perspectives and framing organisational strategic planning for implementing IPE and IPP are described.…”