Too Many Kids Don't Have a Doctor

A commentary on how to find healthcare for children when options are lacking.


One million American children don't have access to pediatricians and family doctors in their home towns making it difficult for their parents to find them good healthcare.

And that's not because there aren't enough doctors to go around. The nationwide supply of pediatricians increased by 51 percent between 1996 and 2006, and the number of family doctors increased by 35 percent. At the same time, the number of children in the United States rose by just 9 percent.

The problem is that doctors all too often don't live where many children do; in small towns, rural areas, and in lower-income neighborhoods. That's the grim news from a new study in Pediatrics, which compared databases of doctors and children, and came up with these distressing results. The study authors proposed solutions, such as giving doctors financial incentives to practice in underserved areas. But those are long-term goals that won't help desperate parents now. What's more, parents can have an even harder time finding a doctor who takes their health insurance, whether it's private or Medicaid. Or the doctor takes their insurance, but hasn't taken new patients in years.

If you're in that kind of pickle, here are six strategies to help you find healthcare for your family:

  1. Find a healthcare center. Federally funded healthcare centers provide well child care, immunizations, and care for sick children with or without insurance. The federal Health Resources and Service's Administration's Find a Health Center search page is the fastest way to see if there's a clinic near you. (I found five listed within a few miles of my parents' home in rural Oregon.)
  2. Check out med schools. Practices attached to medical schools tend to have more openings, since they use residents to provide care.
  3. Try a PA or nurse practitioner. Look for a physician's assistant or nurse practitioner in a standalone practice or affiliated with an MD. They are trained to deliver comprehensive care, and are often under less pressure than MDs to keep visits short.
  4. Ask your local hospital for help. Hospitals often have physician referral services; they know your local market.
  5. Check state listings. Some states have databases of doctors; here's a link to the Massachusetts doctor finder.
  6. Don't be afraid to beg or plead. Doctors went into medicine so they could care for people; they hate to turn away someone who needs help. Explain your situation politely and ask if they can squeeze you in.

Lack of access to primary care isn't just a problem for kids; adults struggle too, as I detailed in a 2008 report on the lack of primary care in America. Primary care doctors earn much less than specialists, and often work longer hours. Insurers pay for procedures, rather than for the time spent getting to know patients and discussing their concerns. It's that time with patients, though, that makes for good preventive medicine and well child care. The Affordable Care Act will eventually put more funding into preventive medicine and federally funded health clinics, but for now, many families are left struggling to find medical care their children need to stay healthy.