Child advocates are urging local hospitals to step up efforts to hire a pediatrician who can help detect child abuse and neglect. But with a national shortage of pediatricians specializing in child abuse, Cleveland’s healthcare institutions have struggled to fill the gap. For about two years, Cleveland hospitals have tried to hire an experienced full-time pediatrician with credentials and experience in child abuse cases. The position was pitched as a key part of a Cuyahoga County team that responds to child abuse and neglect reports made by teachers, doctors, child care providers and family members. The Child Protection Team launched in 2023 on the heels of high-profile child deaths and amid reports that more children were dying in Cuyahoga County than the rest of the State of Ohio. The goal was to catch the signs of abuse earlier. For more than a year, the team has been forced to do its best without an experienced pediatrician on staff to help evaluate cases. Without that medical expertise, advocates say the county is failing children who are at risk of further harm.Advocate says lack of investment is ’embarrassing’Last week, the county’s Division of Child and Family Services (DCFS) Community Advisory Board wrote a letter to head pediatricians at University Hospitals, Cleveland Clinic and MetroHealth Medical Center telling them to do more to fill the child abuse pediatrician role. “We’re a healthcare town,” said Gabriella Celeste, a member of the advisory board and policy director for the Schubert Center for Child Studies at Case Western University. “It’s embarrassing that we don’t have the level of investment around this.” In a joint statement, the three hospitals said they’re conducting a nationwide search “for a pediatrician with the right background and expertise.” Celeste told Signal Cleveland that board members felt they had to put something in writing about the importance of having child abuse pediatricians. Child advocates said they would like to see children’s hospitals raise more awareness about the national shortage and push to change the nature of how people are recruited for the role. “The fact that Cuyahoga County is without a single board-certified child abuse pediatrician is alarming given our county’s high prevalence of child abuse and neglect,” the letter said. It undermines the work of the countywide Child Protection Team by not having the right medical expertise to oversee examinations of children who are at risk of abuse. “Cleveland really needs to get in the game and take care of our kids,” Celeste told Signal Cleveland. Northeast Ohio has no credentialed child abuse pediatricians The Child Protection Team provides physical and sexual abuse examinations. The team, led by the Canopy Child Advocacy Center, started reviewing cases in July 2023.The goal is to provide comprehensive care to children experiencing abuse, said Canopy Executive Director Jennifer Johnson. The pediatrician would work alongside social workers and other healthcare professionals. Previously, pediatrician Dr. Lolita McDavid filled the role. McDavid still works at University Hospital Rainbow Babies and Children’s and provides part-time support to the advocacy center as a stop gap until the position can be filled.There are no experienced pediatricians in Northeast Ohio who can do this work full-time, Johnson told Signal Cleveland. There are some in Ohio, but there are not enough in the state or the entire United States to do the work that’s needed to meet the needs of abused children, she said.While it would be ideal to have a certified child abuse pediatrician in each of the three hospital systems, at least one should be available, said Angela Newman-White, Community Advisory Board member and Executive Director of First Year Cleveland, an advocacy organization that works to reduce infant mortality rates in Cuyahoga County. Hospitals should support a local pediatrician to become child abuse-certified or work with a consultant to find someone to fill the role, Newman-White said. “We are asking for a shared commitment to recruit someone, not just for the CPT [Child Protection Team] but to ensure children at risk of abuse are protected,” she said. Detecting child abuse is ‘very rarely’ clean cutWithout a pediatrician who specializes in child abuse, it’s possible to miss specific evidence of physical abuse, Johnson said. Canopy Children’s Advocacy Center is more child friendly than other medical settings. Credit: Canopy CAC“It’s really important to properly identify child abuse. It’s not easy to determine with young kids whether bruises or broken bones are a result of them being children – falling or running – or if it’s a direct result of child abuse,” Johnson said. “Very rarely is it clean cut.”In 2023, roughly 9,500 cases were screened for abuse and neglect, according to a county report. Children often end up going to the emergency room instead of the advocacy center, Johnson said. Canopy Children’s Advocacy Center provides a more child-friendly one-stop shop for children who may have been abused.Some nurses in the county are trained to do sexual abuse and assault examinations, but when a child has experienced physical abuse, or there are concerns about physical abuse and a mandated reporter – such as a teacher, doctor or child care provider – is unsure, that child has to be seen in an emergency room. “I’m not saying that what the physicians in the emergency rooms are doing now is wrong,” Johnson said. “They’re doing the best they can with what they have.” County officials and local hospitals weigh inOfficials from the county agree that children need a pediatrician in partnership with the Child Protection Team. “It is an uncommon specialty that requires a unique set of skills and fortitude that can be difficult to find,” wrote Deonna Kirkpatrick, county spokesperson, in an email to Signal Cleveland.Yet, Kirkpatrick said the county remains “confident that our local medical institutions will prioritize filling this critical gap.” The three hospitals – Cleveland Clinic, MetroHealth and UH — said in a joint statement: “There is a shortage of pediatricians in this specialty, but we are hopeful to have a candidate in place by the end of the year.”Credit: Jessie Deeds for Signal ClevelandAlthough UH has a pediatric fellowship program, it does not have a specific “child abuse” pediatric fellowship, wrote a UH spokesperson.Two pediatricians at Cleveland Clinic Children’s hospital “have received extra education and training to evaluate children with suspected abuse,” said a Cleveland Clinic spokesperson. “We remain committed to actively recruiting for this position to serve pediatric patients across Northeast Ohio.”MetroHealth did not return a request for comment. There’s a national shortage of child abuse pediatriciansAlthough the number of pediatricians trained to handle child abuse cases is expected to increase in the next 20 years, it will be a smaller increase than other pediatric subspecialties, according to a report published this year in by the American Academy of Pediatrics.“Despite the high rates of child maltreatment across the United States, CAP [child abuse pediatrics] remains the smallest pediatric subspecialty,” the report said.Few doctors are joining the field of child abuse pediatrics, and those who are in the field are paid lower wages compared to those in other medical specialties, the report said. “We need to pull out all the stops,” Johnson told Signal Cleveland. “Double the salary, find a way, because it’s that important.” The post Why Cuyahoga County desperately needs a child abuse pediatrician appeared first on Signal Cleveland.