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Editorial |

The Concern for Supply-Sensitive Neonatal Intensive Care Unit Care If You Build Them, They Will Come

Aaron E. Carroll, MD, MS1,2
[+] Author Affiliations
1Center for Pediatric and Adolescent Comparative Effectiveness Research, School of Medicine, Indiana University, Indianapolis
2Center for Health Policy and Professionalism Research, School of Medicine, Indiana University, Indianapolis
JAMA Pediatr. 2015;169(9):812-813. doi:10.1001/jamapediatrics.2015.1597.
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When people acknowledge that life expectancy has increased dramatically in the past 5 decades, many mistakenly believe it is because of huge improvements in care for diseases that affect adults and the elderly at the end of their lives. What is missed is that many, if not most, of the gains we have seen are the result of saving the lives of children and infants. Saving an infant adds many more years to overall life expectancy at birth than does prolonging an older person’s life for a few years.

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Further marginlization of the general pediatrician
Posted on July 28, 2015
Abraham Bergman
University of Washington and Harborview Medical Center
Conflict of Interest: None Declared
This is an absolutely wonderful editorial, though perhaps a bit too polite. I don't think gross venality is the chief cause of NICU overuse. Rather it our pediatric educational system decreeing that any sick infant or child has to be seen by some 'ologist. Dyspnea, tachycardia, or high fever is enough to dispatch a patient from the ward to the ICU. All heart murmers must be evaluated by cardiologists, potential abuse victims must be referred to \"abuse specialists,\" and a child with ethical issues referred to \"ethicists.\" Not clergy, not experienced pediatricians. Ethicists! The general pediatrician? Well child care, immunizations, and handing out books.
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