Last month, Dr. James M. Perrin, a professor of pediatrics at Harvard Medical School and the Massachusetts General Hospital for Children, became the president-elect of the American Academy of Pediatrics, a professional group of 60,000 doctors. A primary care physician, Perrin is particularly interested in addressing chronic childhood illness during his three years of leadership at the academy, first as president-elect, then president, then president emeritus.
What do you think are the biggest health issues facing today’s kids?
Childhood obesity and other chronic health conditions: the continuing growth in childhood asthma, and the tremendous growth in mental health conditions and developmental conditions like autism. We’ve got three or four major epidemics really growing among children and adolescents in America.
As head of the pediatrics academy, how much power do you really have? Is it primarily a bully pulpit or can you shape policy and direct research?
I think we can shape research only to a degree. I think what we really want to be working on is recognizing that all of these conditions have grown tremendously in their prevalence over the last decade or so — things like obesity, asthma, mental health conditions like depression and ADHD, and things like autism and other neurodevelopment disorders. We want to make sure we’re much better able to provide the kind of care that these children and their families need. I see that as a major role for the academy right now.
Do you think that the Affordable Care Act is good for pediatricians?
I think that this notion of building teams of providers to work together is really critical. There’s a lot of interest in making this happen. A major role of the president [of the American Academy of Pediatrics] is to advocate to make these changes.
What do you think isn’t working about the current payment system?
We’ve been trying to improve the diagnostic and treatment side of things like Attention Deficit Hyperactivity Disorder [ADHD]. To do that right, it takes time. You can’t make that diagnosis in a 10- to 15-minute office visit. So, we want to make sure people are appropriately paid to do it right. I think that’s absolutely critical at this point.
Do you have any suggestions for improving the quality of care?
[In Massachusetts,] the state provides backup for primary care physicians who are treating children and adolescents with mental health conditions. We now have it across the state and 20 other states are trying to do similar programs. It’s that kind of backup that makes me feel comfortable making a change in a child’s medications, and knowing that I’m doing it intelligently. This has really enhanced our ability to do mental health care in primary care. I think we can do that more broadly for other chronic conditions.
