Last week I ran into the office manager for one of Houston’s largest pediatric practices.  New patient visits are way down and their doctors are looking for ways to keep business rolling.  The same day I picked up this piece in the Wall Street Journal which shows declining admissions and doctor visits as a national trend.  This is bad news and shows how our faltering economy is finally working its way more visibly into healthcare.

And apparently we’re making fewer babies – admissions to neonatal intensive care units are down.  This is a problem.  For large tertiary medical centers and hospitals specializing in maternal-child health, babies are the critical customers of a healthy operation.

A few thoughts on what to look for (or dare I say,‘what to expect’) with fewer babies:

Pipelines.  Look for tighter referral relationships between large tertiary centers and the smaller community hospitals that deliver babies in need of specialized care.  Centers already aligned with ready-made networks should be well-positioned for the downturn.

Uninsured.  Look for increasing numbers of young women with poor prenatal care and no health insurance.  Even though numbers are down, the percentage of underinsured is likely to climb.  And responsible tertiary centers bear the cost of care for such mothers.

Pressure.  Look for motivation to keep incubators filled, especially at smaller community hospitals.

Derivative effect. Look for far reaching effects.  Babies grow up to be children.  Beyond the cottage industry of infant care look for the derivative effect on children’s health services that will come if this trend doesn’t let up.

Concerning stuff for a pediatrician.  So hold on to your binky.