Rebuilding Pediatrics: Who Will Bring Investment, Care, and Outcomes Back to What Works?

Pediatrics is in crisis. While innovation has brought new tools and expanded access to care, it has also led to fragmentation, where continuity, relationships, and comprehensive outcomes are sacrificed in favor of convenience and immediacy. Direct-to-consumer (DTC) models, concierge pediatrics, text-based and virtual-only providers, and a growing number of urgent and after-hours clinics have reshaped the landscape—often bypassing the foundations of what actually works: strong, relationship-based primary care.

The question we must ask is: Who will step up to bring investment, care, and outcomes back toward sustainable, high-quality pediatric primary care?

The answer is not simple. Rebuilding pediatrics will require a coordinated effort from physicians, health systems, payers, policymakers, and even parents themselves. It will take a fundamental shift in how we value and invest in primary care. Without this shift, we risk losing the very essence of what makes pediatrics effective: continuity, trust, and the ability to care for the whole child—not just in bits and pieces, but over time, in the context of their family and community.

How Pediatrics Became a Fragmented System

The erosion of primary care pediatrics didn’t happen overnight. A combination of financial pressures, workforce challenges, and the rise of on-demand care models has led to the current situation.

1. Financial Undervaluation of Primary Care Despite being the foundation of long-term health, primary care receives only a small fraction of healthcare investment compared to specialty care and hospital-based services. Many pediatric practices struggle financially due to low reimbursement rates, leading to physician burnout and practice closures. As a result, pediatricians are increasingly forced to see more patients in less time, which erodes the depth of care.
2. Convenience-Driven Disruption The rise of direct-to-consumer (DTC) telemedicine, concierge models, and urgent care clinics has changed how families seek care. Parents are often drawn to fast, convenient solutions—whether it’s a text-based doctor, a same-day virtual visit, or a late-night urgent care clinic. While these services provide short-term access, they do not replace the role of a trusted pediatrician who knows the child’s history, development, and family dynamics.
3. Workforce Struggles & Pediatrician Burnout Pediatricians are burning out at alarming rates. Many are leaving traditional primary care due to overwhelming administrative burdens, long hours, and insufficient compensation. Meanwhile, new medical graduates are increasingly choosing specialties over primary care because of the financial realities. Without major changes, the pipeline for future pediatricians will continue to shrink.
4. The Growth of Fragmented, Episodic Care A child today may see multiple providers in different settings—urgent care, retail clinics, telehealth services—without a central figure tracking their overall health. This fragmentation means missed diagnoses, inconsistent care plans, overprescription of medications (especially antibiotics), and lack of preventive care coordination. The long-term health of children suffers as a result.

Policymakers and Investors Are Forgetting Kids—And Pediatric Innovators Must Do Better

A critical issue fueling this crisis is that children’s healthcare is being deprioritized at every level. As policymakers continue to overlook children in healthcare reform, investors follow suit, directing funding toward high-margin adult-focused models rather than sustainable pediatric care.

Take Medicaid, which insures over 40% of U.S. children but remains underfunded, leading to low reimbursement rates that make pediatric primary care unsustainable. While policymakers debate healthcare priorities, children’s needs are often left out of the conversation—resulting in fewer resources, fewer pediatricians, and a system that forces families into fragmented, patchwork solutions.

But it’s not just policymakers and investors who bear responsibility. Pediatric innovators themselves must rethink their role. While many new models promise greater access, too many focus on quick-fix solutions rather than strengthening the core of primary care. The rush to create the latest telehealth platform, concierge service, or on-demand care model may provide temporary convenience, but if these models do not prioritize continuity and comprehensive care, they ultimately add to the problem rather than solve it.

The challenge for pediatric innovators is clear: Are we building solutions that truly improve outcomes, or are we simply creating more silos?

Who Will Lead the Shift Back to Strong Primary Care?

If primary care is to be revitalized, we need champions who will invest in, protect, and expand its role in pediatrics. Here are the key players who must step up:

1. Healthcare Investors: Backing Sustainable Primary Care Models

Venture capital and private investment have largely fueled the expansion of telemedicine, concierge, and DTC models, but few have prioritized value-based, relationship-driven pediatric care. Investors must recognize that a strong primary care foundation leads to better long-term health outcomes—which, in turn, reduces overall healthcare costs.

Emerging advanced primary care models, such as those blending in-home care, enhanced digital access, and stronger longitudinal relationships, need financial backing to scale. Investors should shift their focus from quick-revenue solutions to models that support comprehensive, team-based pediatric care.

2. Health Systems & Payers: Aligning Incentives for Primary Care

Health systems and insurers need to reimburse primary care at higher, sustainable rates. Instead of favoring hospital-based services and specialty care, payers must recognize the value of continuity-based pediatrics.

3. Policymakers: Making Primary Care a National Priority

Government policies can dramatically shift how pediatric primary care is funded and sustained by increasing Medicaid reimbursement rates, supporting medical education for pediatricians, and ensuring telehealth and retail clinics complement rather than replace comprehensive care.

4. Pediatricians: Advocating for Change & Adopting Innovation Wisely

Pediatricians themselves must push for systemic change while also embracing new models that enhance—not replace—continuity of care. Hybrid models, team-based care, and strategic use of technology can help balance access and quality.

5. Parents & Families: Choosing Sustainable Care Over Quick Fixes

Finally, parents play a critical role. While convenience is tempting, families must recognize the long-term benefits of continuity with a trusted pediatrician. Health literacy efforts should focus on educating parents about the risks of fragmented care and the importance of consistent, preventive care over time.

Conclusion: The Path Forward for Pediatrics

Pediatrics is at a crossroads. The current trajectory favors convenience over continuity, leading to a system where children receive fragmented care that may not support their long-term health. But the good news is that this trend can be reversed—if the right players step up to reinvest in primary care.

Healthcare investors, payers, policymakers, pediatricians, and parents must collectively commit to restoring the value of strong, relationship-driven pediatric care. With thoughtful innovation, aligned incentives, and a renewed focus on comprehensive care, we can build a system that prioritizes what truly works: better primary care for healthier children and families.