I am a pediatrician. I don't know how much more I can take The American healthcare system and the political landscape are making me regret dedicating my entire adult life to medicine. I guess the point of this post is to vent, and to ask if anyone has advice on how to keep going. Every single day has some new hurdle or attack. For every kid and family who are grateful for something I have done, there are 3 other things happening that burn me out a little more. The head of HHS is fighting against vaccines and more and more parents are believing in this nonsense. They are voluntarily putting their children at risk because of a horrifically effective combination of misinformation, grifters, and scientific illiteracy. I have had to send infants to the ER in respiratory failure from whooping cough. Their parents could have prevented it, but they never see it that way. Parents are telling me "the less vaccines the better." The head of Medicare and Medicaid said pediatricians are "groomers" for wanting to talk to adolescents without their parents in the room. Tell that to the teenage boy who was comfortable telling me (but not his mom) that he tried to hang himself the night before. That teenager is alive and well because I was able to get him help. Tell that to the teenage girl who came in for her well check and was on the verge of tears but could not tell me why. After bypassing the physical exam so she would not have to get undressed, and spending time talking to her and letting her get comfortable, she talked to me in private and revealed that her stepdad was molesting her. She is safe now. I could not have done those things without getting the parents out of the room. Nearly half of all children in the US are on Medicaid or a related program. More than half of my patients are. Medicaid reimbursement rates are not adequate, and efforts to increase rates always fail. Many offices are flat out refusing to see patients with Medicaid because it costs too much. Insurance companies are getting bolder with their denials and prior authorization requests. Child with clearly diagnosed autism? I have to write a letter of medical necessity to get them covered for ABA. Patient with a seizure disorder and motor delay who needs leg braces? Sorry, the detailed note you wrote about their condition is not good enough. You need to go to their well check 6 months ago and amend it using this very specific phrasing to get insurance to pay (it is riddled with typos). Patient with concern for a brain mass and the CT is not enough for a clear diagnosis, and the radiologist and nearest neurosurgery service both recommend an MRI? Sorry, cannot approve that without a peer-to-peer, but the "peer" is a podiatrist who has never treated children. My state is run by conservatives who are clueless about medical care of any kind, but especially related to children. They spout that they want to protect children. But they don't want to fund good schools, a functional CPS service...