Physician Training

The University of Iowa trained 61 percent of Iowa's general pediatricians and 54 percent of all pediatricians in the state.

General Pediatrics

Community Involvement: making a difference for children

Many of the major determinants of children's health are not directly related to the medication, surgical or medical procedures, or even the direct medical care we provide. Physicians can no longer afford the luxury of caring for only those children that come to our offices. We can make a bigger difference for more children by getting out into our communities and by advocating for children's needs at the state and national level.

1. Healthy Kids, Community Care: School Based Health Clinic

Several years ago the Iowa City Community School District (ICCSD) made a request to the University to assist in providing for the unmet health needs of children in our school district. The demographics of Iowa City has changed dramatically over the past decade so that, for the first time, poverty and crime and children with huge unmet health care needs are now part of what our community and our schools are dealing with daily. Nearly two years ago volunteer pediatricians from the UIHC and from the community founded a new collaborative community initiative, Healthy Kids Community Care, a school based clinic to provide health care services, vaccinations, sports physicals, acute and chronic disease care and some dental care, on-site at local schools, for any child (or their younger siblings) in the ICCSD who lack access to health care for any reason. Due increasing need, plans are being developed to expand the clinic hours of operation. Pediatric and nurse practitioner staff not only provide care in the school setting, but they arrange referrals for medical specialty care and surgical procedures when needed and assist with financial arrangements to help families pay for this care. This is true community collaboration with both Mercy Hospital and UIHC as well as local businesses and private individuals donating time and money to ensure that these children receive the care they need.

2. WILD kids project (Wellness is Learning and Doing) originated as a project to address the increasing problem of childhood obesity, beginning with young children and their families. This is another collaborative project involving the UI Children's Hospital and the Neighborhood Centers of Johnson County which serve high risk, low income families in Johnson Country through services provided within their neighborhoods. From this small grant, a culture of education and outreach has extended to the children, the families, local schools and, more recently, to the entire community. In January 2008 a community conference: Obesity Summit; Roadmap to Change was held to involve all community groups who are stakeholders in a healthy community. This included healthcare, urban planning and design, local and state elected officials, the schools, public health, local industry and others, in order to develop a strategic plan to address the growing problem of obesity in our community.

3.   Some of the health services that children need most are those that pediatricians are least prepared to provide; oral health and development and mental health care. Iowa is a designated Oral Health Shortage Area, particularly in rural areas and especially for children under the age of 3 (particularly those with Medicaid). Collaboration between pediatricians, the Oral Health Bureau of the IDPH and with the pediatric dentistry program at the UI college of Dentistry is developing a training program for Primary Care Providers in oral health. In 2007 and early 2008 distance learning was provided through teleconferences to 11 communities across the state.   This year we are developing web-based modules (with continuing education credit) that health care providers can access at any time. This group also works to facilitate a link between dentists and physicians at conferences, in curriculum development for medical school and residency programs and in the community.

Another huge unmet need within the state is the provision of developmental, mental and behavioral assessment, screening, care and appropriate referral. A group of pediatricians and family physicians, led by UIHC physicians, has been working to develop training programs for primary care providers in developmental and behavioral assessment and referral. This is currently being conducted in medical offices and will soon involve web based training and local physician mentors to support other primary care providers in their local areas as they become familiar with screening tools, diagnosis and appropriate referral of children in their practices with developmental or behavioral problems.

4. Health policy child advocacy from physicians at UIHC recently resulted in a revision to Iowa Code regarding HIV testing that now aligns more closely with CDC recommendations that make HIV testing more routine in health care settings and to reduce the stigma of HIV and of HIV testing. This reduces requirements for counseling and written consent for testing and changed Iowa. Iowa has also changed from an "opt-in" system of prenatal screening, where pregnant women had to elect to be tested, to an "opt-out" system where HIV testing is now included as part of the routine panel of prenatal tests unless the woman chooses not to be tested. This is an important change. The rate of perinatal transmission of HIV can be decreased from 25-35% to less than 2-3% with appropriate diagnosis and treatment of HIV infected pregnant women. This change in Iowa Code should result in much higher rates of prenatal screening.

5. Pediatricians are involved with many state level committees and policy organizations such as the Iowa Early Childhood Initiative and the associated health policy organization,  "Off to a Good Start: Framing Policy for Early Childhood Health Systems Integration." This group holds a conference annually, involving regional and national speakers with attendees representing health care, education, dental care, public health, legislators and heads of agencies and committees that make policy decisions for children. The goal is to develop a children's agenda that will inform and help to define quality health care and education, improve the lives and optimize outcomes for children in Iowa.  

6. We have pediatricians on a number of state committees & task forces, on community Empowerment Boards, on the boards of local childcare centers and many other organizations that work to assure the children of Iowa are safe and healthy and ready to learn when they enter school and to ensure optimal growth and development for our children so they have the opportunity to become our future leaders regardless of gender, cultural heritage, income or immigration status.