Sunday, July 3, 2016 12:00 AM

Increased access to pediatric subspecialists elevates outcomes

For children with complex and chronic health conditions having access to pediatric subspecialists reduces the time they spend in a hospital, complications from treatments and their healthcare costs. That access also improves their quality of life and survival rates. However, California lags behind the nation in the number of pediatric subspecialists for children who need them, and the Valley lags far behind the rest of California with one pediatric subspecialist for every 10,000-18,000 children, according to a study by the UCLA Center for Health Policy Research.

UCSF pediatric resident Dr. Nicole Barbera gets her patient Dominic Bledsaw to take a deep breath during a visit to the cystic fibrosis clinic at Community Regional while UCSF faculty member Dr. John Moua observes.

Statewide, children have access to three times as many subspecialists as children do in the Valley.
It’s a situation Community Medical Centers is trying to remedy by strengthening a 40-year partnership with the University of California, San Francisco, Medical School to train doctors at Community’s clinics and hospitals here in the Valley. Since signing a 10-year agreement in September 2015 with UCSF Medical Center to increase women’s and children’s services here in the Valley, Community has added 26 pediatric subspecialists to its downtown Fresno campus and is recruiting more.
As part of the agreement, Community Regional Medical Center is set to open a 10-bed inpatient pediatric intensive care unit in August and the pediatric medical/surgical unit is expanding to 26 beds. In May, the hospital broke ground on a five-story 181,000-square-foot medical office building that will house pediatric clinic space and subspecialists among other things.
Eighteen-month-old Liam Espinosa sees a pediatric pulmonologist and pediatric gastroenterologist at Community’s Children’s Health Center for frequent checkups to keep him thriving and gaining weight with cystic fibrosis. His mother Natalie Espinoza likes the convenience of Community’s new cystic fibrosis program near her Fresno home and the access to UCSF experts. The program, which is the only one between Sacramento and Los Angeles accredited to take care of both children and adults, did the newborn screening that identified Liam’s condition early. So, despite two hospitalizations for respiratory distress, Liam is chubby and gaining weight steadily because he had access early to life-saving medications and treatments to help him digest his food and breathe easier.

Eighteen-month-old Liam Espinosa eyes Pediatric Pulmonologist John Moua while his mother Natalie Espinosa watches.

Because of the strengthened partnership, local children have increased access to specialists not only in the clinic but via telemedicine which connects them to subspecialists and UCSF pediatric faculty members who have been practicing at top-ranked UCSF Benioff Children’s Hospital campuses. UCSF Benioff is among the nation's premier children's hospitals in nine pediatric specialties, according to 2015-2016 U.S. Best Children's Hospitals rankings.
More than 16,000 children in Fresno, Madera, Tulare, Kings and Kern counties are enrolled in California Children’s Services because of their financial needs and chronic disabling medical conditions such as cancer, diabetes, cystic fibrosis, cerebral palsy, birth defects or conditions that arose from a premature birth. Statewide, 34% of families with children with special healthcare needs report difficulty accessing pediatric subspecialty care.

Reported by Erin Kennedy. She can be reached at