from the AAP Department of Research
The average number of hours worked weekly among U.S. pediatricians in primary care
practice dropped 13% over the past 23 years,
according to research drawing on the AAP
Periodic Survey of Fellows. The results were
presented at the 2017 Pediatric Academic Societies meeting in San Francisco.
In 1993-’95, primary care pediatricians reported working an average of 49.6 hours per
week, which dropped to an average of 43 hours
per week in 2014-’ 16. The reported hours in
direct patient care declined 18%, from an average of 44 hours per week in 1993-’95 to 36. 1
hours per week in 2014-’ 16.
A similar pattern of reduced work hours in
primary care practice was found for both men
and women (see figure). For women, the average
number of hours worked dropped 7%, from 43. 7
hours per week in 1993-’95 to 40. 7 hours in 2014-
’ 16; for men, average hours declined 12%, from 53.9
hours per week in 1993-’95 to 47.6 hours per week
in 2014-’ 16.
The trend in reduced hours was found across age
groups. The largest proportional decline was found
for pediatricians in their 40s at the time of the survey,
with an 18% reduction in weekly hours, and the
smallest decline for those in their 60s at the time of
the survey, with a 6% reduction in weekly hours.
The data were drawn from the Periodic Survey,
the national survey of AAP members that gathers
information to assist AAP leadership in developing programs and policies. Since 1987, three to
four surveys of a unique random sample of about
1,600 non-retired members have been conducted
Sixty-nine surveys were pooled for this analysis,
with an average response rate of 58%, resulting in
a total of 32,527 cases. In each survey, respondents
were asked to estimate hours worked in a typical
week. In this study, analysis was limited to those who
practice at least 60% of their time in primary care.
For more information about the study or the
Periodic Survey, contact Blake Sisk, Ph.D., in the
AAP Department of Research, at 847-434-7630 or
firstname.lastname@example.org. Additional information about AAP
research using the Periodic Survey is available at
1999-’01 2002-’04 2005-’07 2008-’ 10 2011-’ 13 2014-’ 16
Trends in weekly hours worked among U.S.
primary care pediatricians by gender: 1993-2016
Source: AAP Periodic Survey
Presented: Pediatric Academic Societies meeting 2017
from the Food and Drug Administration’s Office
of Pediatric Therapeutics, Division of Pediatric &
Maternal Health, and Division of Dermatology and
The Food and Drug Administration (FDA) recently approved Enbrel (etanercept), a tumor necrosis factor (TNF) inhibitor, as the first systemic
treatment for chronic moderate to severe plaque
psoriasis in patients 4 years of age and older. Enbrel
is given once a week as a subcutaneous injection.
Other drugs approved for pediatric patients with
chronic plaque psoriasis are limited to topical agents,
and they are not labeled for use in children under
12 years of age.
Psoriasis is a chronic inflammatory disease primarily affecting the skin and joints. Plaque psoriasis is
the most common subtype. Approximately 20% of
patients have moderate to severe disease.
Multiple co-morbidities exist, including depres-sion/suicide, autoimmune disease, cardiovascular
disease and metabolic syndrome. The impact on
patients’ quality of life has been found to be comparable to that associated with cancer, arthritis and
other serious chronic diseases. Childhood-onset psoriasis correlates with impaired social development,
sleep problems and substance abuse.
Enbrel’s approval for pediatric plaque psoriasis was
supported by a 48-week randomized, double-blind,
placebo-controlled efficacy trial in 211 subjects ages
4-17 years. After 12 weeks of therapy, more Enbrel than placebo-treated subjects (57% vs. 11%;
p<0.0001) achieved a 75% reduction in their baseline Psoriasis Area and Severity Index score.
The observed adverse reactions were similar in
frequency and type to those seen in adults, which
included infections and injection site reactions. No
deaths, malignancies or opportunistic infections
The drug label includes a warning for serious infections and for lymphoma and other malignancies,
some fatal, in children and adolescents treated with
TNF blockers, including Enbrel. The manufacturer conducts enhanced postmarketing surveillance
for malignancies in patients under 30 years of age,
which the FDA requires for all TNF blockers.
FDA approves TNF inhibitor to treat children with chronic plaque psoriasis
• For more information on Enbrel including product labeling, visit http://bit.ly/2rfz8AZ.
• The FDA Drug Safety Communication on Tumor Necrosis
Factor (TNF) blockers and risk for pediatric malignancy
is available at https://www.fda.gov/Drugs/DrugSafety/
Study: Primary care pediatricians working fewer hours