1121 - Exploring the Challenges of Rural Pediatricians in Treating Children with Disabilities and the Need for Pediatric Physiatry: A survey study

There is a nationwide shortage of pediatric physiatrists and an increasing prevalence of childhood disabilities. Children with special healthcare needs (CSHCN) require specialized services, but access is often limited, especially in rural areas. Rural pediatricians face unique challenges in managing CSHCN and may not feel fully prepared to serve as their primary care providers. Identifying these challenges is key to reducing healthcare disparities.

Design:

An anonymous Qualtrics survey was distributed to pediatricians in West Texas to explore:

1. Challenges in managing CSHCN in rural areas.


2. Pediatricians’ residency training and current comfort levels in handling neuromuscular conditions.


3. How pediatricians address gaps in knowledge or skills for treating CSHCN.

The survey gathered data on pediatrician and patient demographics, comfort levels in managing CSHCN, training received, and the relationship between pediatricians and physiatrists.

Results:

Twenty-six pediatricians responded. Pediatricians in rural areas frequently treated conditions such as cerebral palsy, genetic disorders, neural tube defects, and traumatic brain injuries. While they felt comfortable managing enteral feeding systems, many were less confident in handling spasticity and selecting appropriate equipment. Patients often had to travel more than 100 miles to see a pediatric physiatrist. Most pediatricians reported feeling only moderately prepared to manage CSHCN post-residency and relied on colleagues for guidance. Many expressed interest in additional training through conferences or CME credits.

Conclusions:

The shortage of pediatric physiatrists is especially pronounced in rural communities. Providing targeted education on basic physiatry principles to pediatricians may help meet the rehabilitative needs of CSHCN in these areas.