While we can't predict the future, we may find clues to possible future developments in pediatric medicine based on changes that have occurred over the past two decades or so.
Some of the most notable improvements in child health have come through vaccines and pharmacologic innovation. Twenty years ago, pediatricians emerged from training having cared for many children with invasive bacterial diseases that are now largely prevented in the developed world by vaccines. Varicella and rotavirus have more recently been added to the list of vaccine preventable diseases, with complications that lead to hospitalization for thousands of children annually. Antiretroviral therapy for HIV-infected women during pregnancy and for newborns in the United States has nearly eliminated mother-to-child transmission of an infection that, in the 1980s, killed most congenitally infected patients by the time they were 5 years old.
Medications available for treating asthma, diabetes, and many other chronic diseases have increased and been improved during the past 20 years. Many of the available drugs have not been studied in children, but there is hope in the growth of multicenter collaborations that pool the resources of multiple investigators studying possible treatments for rare conditions.
So, what about the future? Will the new pediatricians, along with the newly graduated scientists and behavioral therapists and public relations and public health experts bring as much positive change to the medical and mental health of children as has been achieved during the past 20 years?
Acknowledging that I've surely left out some important hopes, here's my wish list for 20 years hence:
What do you wish for?