Editor's note: In this article, we are pleased to unpack the key elements of our latest Acute Care Concerns issue, Pediatrics released in March 2025.
Pediatricians play an integral role in child health and development, delivering specialized care to children from infancy to adolescence. Whether they’re resuscitating newborns, seeing patients in an emergency department or providing mental health support, these specialists are united by a passion for caring for Alberta’s youngest patients.
“We do the job because we like taking care of kids,” says Dr. Wong, President of AMA’s Section of Pediatrics. “We enjoy the satisfaction of taking care of patients who, most of the time, get better.”
Pediatricians help keep kids healthy to prevent illnesses in adulthood, ensure they have the support they need to succeed in school and help families manage health conditions. But these specialists are being squeezed by compounding pressures that impact their ability to care for children, and Alberta is at risk of losing more pediatricians to retirement or other provinces.
Alberta Doctors' Digest Editor in Chief Marvin Polis talks about acute care concerns with Dr. Sam Wong, President of the AMA's Section of Pediatrics (Producer credit: Marvin Polis)
Burnout and ballooning patient rosters
The root of many of these challenges, Dr. Wong says, is the patient-to pediatrician ratio that has been steadily climbing along with Alberta’s population boom.“The number of pediatricians has not kept pace with the number of patients who need us,” Dr. Wong observes. “And we’re seeing more children with complex health needs such as kids who were born prematurely, and these kids tend to need more care and more time with us. Many pediatricians face burnout as we try to keep up with demand.”
There are also not enough new pediatricians to replace the ones who are close to retiring – a situation Dr. Wong says will lead to a crisis in the next five to ten years. The situation is particularly dire in rural areas, where pediatricians often face heavy patient demands along with limited resources and support staff.
“Pediatricians who work in smaller centres do a lot of neonatal care and a lot of emergency care, so they could go from resuscitating a newborn to treating a patient in the emergency department in the same day,” Dr. Wong notes.
Along with burnout from the fraught realities of rural health care, Dr. Wong cites low stipends and changes to on-call payments as some of the reasons fewer rural pediatricians are willing to do on-call shifts and after-hours hospital work. This translates to longer waits for children, who may need to travel long distances for care at an urban centre.
“We do the job because we like taking care of kids.” - Dr. Sam Wong, President of AMA’s Section of Pediatrics
Wait times and diagnosis delays
Along with rising patient volumes and complex needs, the demand for mental health and developmental care is ticking up. Pediatricians often work closely with professionals such as speech language pathologists, occupational therapists, mental health counsellors and dieticians to provide fulsome children’s care – but there is a shortage of these essential staff.“Patients used to be able to see one of these professionals within a month of being referred,” Dr. Wong says. “It now takes three to four months, and these long wait times lead to worse outcomes for kids and families. We see complex kids suffer academically, socially and often physically.
“Children are waiting a year to 18 months for an autism diagnosis – even with a referral – because of high demand. It’s also common for a child to wait more than a year to be diagnosed with a learning disability, behavioural issue or other conditions.”
These long wait times put tremendous strain on children, whose diagnoses are often key to receiving the supports they need to succeed in school and beyond – and pediatricians often experience moral distress as they see their patients go without the care they need.
“We try our best as pediatricians to help while they wait, but we don’t have the bandwidth to do this as well as we would like,” Dr. Wong says.
Pediatric hospital care at risk
The effects of recruitment challenges, diagnosis delays and limited resources are all impacting hospitals and departments across the province. A group of pediatric emergency department physicians penned a letter to the public last month outlining the dire challenges they encounter every day.“The ED has become the default option for families when a family doctor isn’t available, when specialists are backed up for months or when mental health care is out of reach,” the letter states. “It takes a lot to surprise or frighten us. But right now, we are very scared.”
And a group of hospital medicine pediatricians who care for children admitted to Alberta Children’s Hospital recently cited a lack of pediatric mental health care in hospitals and community settings among their top challenges (download document).
“We see it every day – in youth battling severe eating disorders, in teenagers who have self-harmed and in children with acute mental health issues,” the group says. “We often act as psychiatrists, psychologists, developmental pediatricians, behavioural specialists and social workers even though these are not our specialties.”They also reference the additional strain on pediatric hospitals during the winter surge of viruses such as RSV, influenza and COVID.
“The number of patients admitted to hospital almost doubles,” the hospital medicine pediatricians write. “Sicker patients need more time with our care teams, and this means patients in the emergency room wait much longer than they should.”
Dr. Amber Reichert, an Edmonton-based neonatologist, says neonatal intensive care units (NICUs) are also bursting at the seams. While the province added a handful of additional NICU beds last year, Dr. Reichert says more are needed to ensure safe care for the province’s tiniest patients.
“We’ve been above 90% capacity for most of 2025 thus far, which is an increase from 2023-2024,” she notes. “This puts patients at a huge safety risk. There is strong evidence and a wealth of data showing that NICU occupancy should be at 80-85% to maintain ‘crash beds’ for newborns needing intensive care. We can’t have a waitlist for neonatal intensive care.”
At the same time, and like their pediatrics colleagues in other departments, NICUs are always contending with insufficient clinical staff and physicians.
Solutions
- Alberta’s pediatricians have solutions to the issues threatening children’s care, and they’re calling on the province to partner with them. Support pediatricians to provide care that cultivates better health outcomes throughout childhood and beyond, for example, by promoting vaccines. “We really appreciate the minister of health endorsing two doses of the measles vaccine for everyone, and the ministry’s continued support for immunization programs,” Dr. Wong says. “But we miss the days when leaders would get photos taken of themselves receiving their shots and take every opportunity to actively promote vaccines.”
- Develop a comprehensive plan to combat the viral surge that happens each winter – a situation that Dr. Wong says can be mitigated with proper planning, vaccine promotion and universal coverage of the RSV vaccine in infants.
- Create fellowship opportunities for physicians to deep and expand their skillsets and gain confidence in subspecialties. “This would also help pediatricians feel more comfortable working in rural areas, which is a unique skillset on its own,” Dr. Wong says.
- Increase funding for children’s mental health, addictions care and support staff to ensure children can access these critical services when and where they need them.
- Incentivize pediatric work to retain and attract pediatricians.
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