paediatric neurology :: Article CreatorThe CEO Of The Children's Hospital Association On Gender-Affirming Care, Covid, And More
Recently, longtime hospital executive Matthew Cook moved to DC for a new job as CEO of the Children's Hospital Association, the trade group for more than 200 of the nation's pediatric hospitals. He spoke with us about what he wants to achieve. "Kids are the future of this country," he says, "so we should be investing more in them, not less."
What are the main healthcare issues facing children today?
One is the mental-health crisis, which has been steadily growing for a decade. But right now, the leading cause of death for kids is actually guns. And that's important when we also have this mental-health crisis, because we certainly don't want kids that have thoughts about suicide having easy access to a firearm.
What obstacles do hospitals face when they're trying to take care of children?
Most kids in this country are covered by Medicaid, and that makes financial sustainability really challenging for children's hospitals, because the reimbursement rate is really low. It's difficult when your primary insurance program is one that produces a loss on every patient, so you have this real issue of financial sustainability.
We also have significant workforce issues in children's hospitals. There are specialties where there's just a handful of people coming out of training programs in any given year—pediatric neurology, genetics, child and adolescent psychiatry—and you have an entire country trying to recruit that very limited number of specialists. We just don't have a workforce that meets the needs of the country, and we need to figure out how to get there.
Providing gender-affirming care has been thorny for children's hospitals. Have you worked on that?
It's a really complicated issue. A number of states have restricted gender-affirming care, but we operate more at the federal level. Where we have been active is that there were some attempts by certain law-makers, primarily in the House, to tie funding for [a pediatric workforce program] to gender-affirming care—essentially, that you couldn't receive the workforce funds if you were providing gender-affirming care. Our position was that this is a workforce program; don't confuse it with views on very specific medical decisions. We think [gender-affirming care] is an issue between patients and families and their physicians.
What was Covid like for children's hospitals?
The pandemic impacted children's hospitals very differently than adult hospitals. Covid wasn't as big of an issue for children—they were not as sick as adults. And so children's hospitals really struggled during the pandemic because their patients went away. Everybody stayed home. Then children's hospitals weren't included initially in the provider relief funding that went to hospitals. Those dollars largely went to adult hospitals. So the pandemic really had a detrimental impact on the financial sustainability of children's hospitals, and it's persisting to this day. We have a lot of children's hospitals that have very, very tight operating margins, and they're really struggling to figure out what the path forward is.
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Sharief Taraman M.D.
About
Sharief Taraman, M.D., is an Associate Clinical Professor at the University of California-Irvine School of Medicine and an Affiliate Professor at Chapman University. Dale E. And Sarah Ann Fowler School of Engineering. He is a neurologist, president of the American Academy of Pediatrics-Orange County Chapter, board member of AAP-California, and advisor to the International Society for Pediatric Innovation. He served as Division Chief of Pediatric Neurology for Children's Health of Orange County. He researches intelligence-based healthcare innovations in practice and development and served on the founding leadership team of Mi4, the Sharon Disney Lund Medical Intelligence, Information, Investigation, and Innovation Institute. Taraman completed his medical education at Wayne State University School of Medicine. He is also chief executive officer of Cognoa, which develops AI-based technologies to enable early and equitable diagnosis and care for children living with developmental and behavioral health conditions.
Read more about Sharief Taraman M.D.
Rady Children's Appoints Praveen Raju, MD, PhD, As The Nathan Gordon Chair And Medical Director Of Neuro-Oncology Program
SAN DIEGO, April 2, 2024 /PRNewswire/ -- Rady Children's Hospital-San Diego, one of the nation's top pediatric health care systems, and the University of California San Diego are pleased to announce that Praveen Raju, MD, PhD, will be appointed as Medical Director, Pediatric Neuro-Oncology Program, Rady Children's Hospital-San Diego; and Director, Pediatric Neuro-Oncology Program, and Associate Physician Diplomate, Neurosciences, at UC San Diego School of Medicine. At Rady Children's, Dr. Raju has also been named the Nathan Gordon Chair in Neuro-Oncology, established in 2021 to honor the memory of Nathan Gordon, who was diagnosed with a rare tumor in his spinal cord when he was just 15 months old. As part of Rady Children's nationally recognized care team, Dr. Raju will spearhead the growth of the Neuro-Oncology Program and advance research efforts on pediatric brain and spinal tumors.
Praveen Raju, MD, PhD
By incorporating subspecialty expertise into the Neuro-Oncology Program, Dr. Raju aims to address the different forms and distinct molecular subtypes of pediatric brain and spinal tumors. Coming to Rady Children's from Mount Sinai Kravis Children's Hospital, he previously worked as a pediatric neurologist and directed the Laboratory for Pediatric Brain Tumor Research at the Icahn School of Medicine as well as established the Children's Brain and Spinal Tumor Center at that institution. His research focuses on studying the developmental origins of medulloblastoma and other pediatric brain tumors in addition to advancing novel drug delivery strategies that enhance treatment efficacy and minimize the toxicities that can impact the developing child.
"Neuro-oncology is a specialty that overlaps with many departments. From my perspective, entering the operating room equipped with relevant, up-to-date research is nonnegotiable, especially when operating on complex central nervous system tumors. To have a skilled physician on staff focused on undertaking this critical research is vital." said Michael Levy, MD, PhD, Chief of Pediatric Neurosurgery at Rady Children's and clinical professor of neurological surgery at UC San Diego School of Medicine. "We are thrilled to welcome Dr. Raju, an experienced clinician-scientist in child neurology, to lead research efforts through our growing Neuro-Oncology Program."
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The Rady Children's Neuro-Oncology Program is the only program in the San Diego region providing comprehensive care to more than 750 children and young adults with brain and spinal cord tumors. The multidisciplinary team — which works closely with Rady Children's Institute for Genomic Medicine for diagnosis and treatment — is leading the way in personalizing therapy based on the molecular and functional characteristics of each patient's tumor, resulting in improved outcomes for children with these devastating diseases.
"Pediatric brain and spinal tumors can be difficult to diagnose at times and often have poor outcomes. I chose this specialty because I wanted to change those outcomes and give families hope," said Dr. Raju, who is board certified in neurology with special qualifications in child neurology. "Research will be the foundation of this advancement, yet current studies often do not address the translational hurdles that limit bridging exciting laboratory findings with clinical care. Through increased collaboration with the biotechnology industry in San Diego, I'm optimistic that we can dramatically improve patient care."
"Unfortunately, brain and spinal tumors are the leading cause of cancer-related death in children thus emphasizing the unmet need in this area. Dr. Raju's focus on investigative research into the perplexing origins of medulloblastomas is critical for changing the outcomes of pediatric patients," said William Roberts, MD, Medical Director of Hematology/Oncology at the Peckham Center for Cancer & Blood Disorders at Rady Children's and clinical professor of pediatrics at UC San Diego School of Medicine "I look forward to the advancement of his research and the undoubtedly positive impact it will have on the patients at Rady Children's."
Dr. Raju obtained his medical degree from the University of Pennsylvania School of Medicine, where he also earned his doctorate in cell and molecular biology and genetics as an NIH-funded MSTP fellow. He completed his residency in pediatrics at Babies & Children's Hospital of New York and subsequently finished his pediatric neurology training at Boston Children's Hospital. Prior to establishing his independent research program, he completed additional research fellowship training as part of the NIH-funded Pediatric Scientist Development Program at Memorial Sloan Kettering Cancer Center.
Media contact:Carlos Delgadocdelgado@rchsd.Org(619) 261-8392
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SOURCE Rady Children's Hospital-San Diego
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