American

Academy of

Pediatrics

Volume 6,

Number 1

January 1999

should be primarily based in academic centers.
The document partially contradicts itself when a
later comment states that there is a role in large
pediatric groups for individuals with special
interests in certain sub-specialty areas.

The commentary in the document referred to
such individuals as "hobbyists". Dr. Outwater
pointed out that hobbyists would not have an
important role in critical care.

FOPE II

Reimbursement Issues

1999 Section Meeting

Educational Issues

Policy Statements

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2

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Continued on Page 2

Dr. Goldstein introduced Dr. George Gregory of
the University of California-San Francisco as
recipient of the 1998 Distinguished Career
Award. Dr. Gregory invented CPAP for
respiratory distress syndrome. Dr. Gregory's
inspiration came from a paper showing that
grunting improves blood gases in distressed
infants. His introduction of CPAP vastly
increased the effectiveness of mechanical
ventilation for respiratory distress syndrome.
Dr. Gregory is also credited with developing the
standard of treatment for meconium aspiration
syndrome that we use today. Dr. Gregory has
been a pioneer the respiratory and
cardiovascular physiology of fetuses, neonates
and infants. He founded the Pediatric
Anesthesiology Program at UCSF in the 1960's.
He still attends at UCSF.

Dr. Gregory's address discussed parochialism in
Intensive Care Units. <

Dr. Yeh began the meeting with a review of
events at the AAP Executive Committee
Meeting. At that meeting, the preliminary
statement on the Future of Pediatric Education
II was discussed.

This is the report of a wide-ranging task force
on pediatric education. David Jardine and Curt
Steinhart represented the Section on Critical
Care.

The preliminary statement recommends that
sub-specialist education should lead to a
fellowship, and that graduating sub-specialists
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The entire FOPE II document is on the World
Wide Web at http://www.aap.org/profed/fope222.htm.

Dr. Yeh encourages members to comment to
him and to the Academy.

Harold Amer suggested profiling practices and
reimbursement recurrently over time. He
proposed an anonymous survey developed with
an epidemiologist to be distributed
electronically to members. The survey would
track how we work, our workload, our value and
our compensation This may lead to benchmark
information on salaries and job descriptions
This information may be useful in negotiations.

The impression of many attendees is that
Pediatric Intensivists have worth that is not
measured by their billing or their
reimbursement. Mary Lieh-Lai reported that
NACHRI has a task force determining what an
Intensivist was worth. It may still be important
for the section to accumulate its own data.

Dr. Yeh discussed recommendations that the
section on Perinatology made for the current
revision of CPT. The Perinatal Section
recommended that neonates be defined as
infants less than 44 weeks post-conception.
This would limit the use of the neonatal daily
care codes, 99295 through 99297, to such
infants. After that age, practitioners would need
to bill using critical care or basic evaluation and
management codes.

This new definition of a neonate may have an
adverse impact on the billing practices of many
pediatric intensivists. Currently, the neonatal
daily codes are commonly used by intensivists
performing care of young infants. Some
intensivists use these codes to bill for the care of
infants up to one year of age.
To ensure that the Section maintains its voice in
reimbursement matters, Dr. Yeh reassembled an

RBRVS subsection. Stephanie Storgion will
chair this group. Volunteers were enlisted from
attendees at the 1998 Business Meeting.

Dr. Yeh introduced Dr. Niranjan Kissoon as the
program Chair for the upcoming meeting. Dr.
Kissoon is recruiting volunteers for abstract
reviewers and session moderators.

The Critical Care portion of the 1999 AAP
meeting will include two joint sessions of one
half day each. These sessions are with the
Section on Home Health and the Section on
Cardiology.

The ability of the Section to garner funds for the
Young Investigator Award has been limited.
Instead of a commercial sponsor, the Section
obtained a $10,000.00 grant from the Friends of
Children fund for the current year. The Section
itself will likely need to fund a grant in the
future.

Dr. Goldstein proposed an interactive casebook
CD-ROM on Pediatric Critical Care. The
Oregon Health Sciences University has
developed one on general Pediatrics, and that
publication would be our model. The CD-ROM
would be distributed as a Section Member
benefit. To fund this exercise, Dr. Yeh proposed
allocating $10,000 from the Section, $10,000
from the American Academy of Pediatrics and
$10,000 from the Oregon Health Sciences
University.

Dr. Outwater announced that AAP Sections are
now able to issue statements as committees
always could.

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CALL FOR NOMINATIONS
The 1999 Annual Distinguished
Career Award

Submissions to Critical Care News

Members of the Critical Care Section may
submit announcements and articles to Critical
Care News. Priority will go to articles of
current interest to pediatric critical care
practitioners.

American Academy of Pediatrics

141 Northwest Point Boulevard

Post Office Box 927

Elk Grove Village, Illinois 60009-927

1-800-433-9016

or (847) 228-5005

Fax:(847) 228-5097

http://www.aap.org

This award carries with it a plaque honoring
the recipient and an honorarium of $1,000.
Past recipients were Drs. I. David Todres,
John Downes, Peter Holbrook and George
Gregory.

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