Commentary: Benchmarks for Work Performance of Pediatric Psychologists

In “Benchmarks for Work Performance of Pediatric Psychologists by Opipari-Arrigan, Stark, and Drotar (2005)” from a previous issue of the Journal of Pediatric Psychology (doi:10.1093/jpepsy/jsj068), the authors provide a timely update on the field and a challenge for the future. This is the first such benchmarking effort since the survey by Drotar and colleagues 11 years ago (Drotar, Sturn, Eckerle, & White, 1993). Clearly, the information provided suggests the need for benchmarking at more frequent intervals, possibly every 5 years. Although the response rate from full division members (45% returned and only 34% usable) was disappointing, the results, recommendations, and accompanying commentaries, challenge all of us to determine future goals/directions, identify needed resources, and guide strategic planning as a professional organization. Over the past 11 years, the health care environment has changed dramatically. Concurrently, the Society of Pediatric Psychology, Division 54 of the American Psychological Association (APA), representing pediatric psychologists, has solidified its relationship with the American Academy of Pediatrics (AAP) working together as a team to set policy and advise members on key intervention and assessment guidelines (i.e., ADHD, violence/injury prevention, care for the dying child, website at www.aap.org/). There is a clear belief in the value of pediatric psychologists’ involvement in the entire range of care from primary care to care of chronically ill children. Despite national discussions regarding health care reform, many of the nation’s poor and disadvantaged are without health care benefits. During this same timeframe, the presence of psychologists in medical schools and academic health centers increased, and their influence broadened. Results from a national survey of psychologists in medical settings coordinated by APA in collaboration with the Association of Medical School Psychologists suggested that there are more than 3900 psychologists working in these settings since 1997 (Pate & Kohout, 2005). At the same time, managed care has altered billing procedures and payment for services rendered by psychologists, whereas resources for research funding have decreased significantly. Numerous articles (i.e., Rae, 2004) have addressed these issues elsewhere and for this reason will not be repeated here. Despite the “erosion of the financial infrastructure that once supported hospital-based pediatric psychologists” described by Opipari-Arrigan and colleagues, most of the respondents to the current survey (63%) continue to work in a hospital setting. This speaks to the solid base of support for the contributions of pediatric psychologists by medical colleagues and administrators. Two-thirds of this hospital-based group report being on an academic track, with one-third actually holding tenure track appointments. Given then that over one-third of the respondents are in nonacademic medical settings, the relative value of the academic track versus nonacademic appointments for pediatric psychologists for income, job flexibility, mobility, and quality of life is unclear. Although this was beyond the scope of the current survey, future benchmarking efforts should explore this issue, especially given the numbers of pediatric psychologists in nonacademic positions. Interestingly, the current survey documents a change in salary for those in research versus clinical positions once they achieve associate professor status. Initially, those with clinical appointments make slightly higher salaries than those in research positions, but the shift begins at the associate professor level, with an even more dramatic difference at full professor. However, the respondents in these categories were small in number, thereby limiting specific conclusions that might be made. Length of time in position may also explain this salary difference and should be included in subsequent surveys. Further differentiating tenure line faculty from