It’s a cold fact: caring doesn’t always pay. From a reimbursement perspective, there is little to gain from spending that extra hour talking to patients and their families, particularly in medical specialties that are not well supported. The Packard Distinguished Fellows program is an innovative plan to help fund research that doesn’t always get the resources it deserves.

"The objective is to recognize individuals who are in medical subspecialties, such as those focused on caring for kids with chronic diseases, for which compensation has always been an issue," said Packard Children’s Hospital chief of staff Harvey Cohen, MD, PhD.

Packard Distinguished Fellows will be supported by an endowment of a $500,000 gift and a $500,000 matching grant offered as part of the Campaign for Lucile Packard Children’s Hospital. Fellows, who are endowed for five years, will receive a $5,000 award to assist them in their academic pursuits. Other income from the endowment will be distributed to support the medical subspecialties as recommended by the chief of staff and the chair of pediatrics.

"This will allow the money to be used to support either clinical care that isn’t adequately reimbursed, important teaching activities or research by faculty members who primarily do clinical work," said Cohen, the Arline and Pete Harman Professor for the Chair of the Department of Pediatrics at the School of Medicine.

Pediatric rheumatologist Christy Sandborg, MD, the Kirkwood Family Distinguished Packard Fellow, was the first of an anticipated 10 to 12 recipients over the next three years. Charles Prober, MD, professor of pediatrics and of microbiology and immunology, and H. Eugene Hoyme, MD, professor of pediatrics, have also recently been named Distinguished Packard Fellows.

"Dr. Sandborg is one of the country’s best clinical rheumatologists," said Cohen. "She cares for kids with a chronic disease that is difficult to treat, and she’s involved in translational research to discover what determines the severity of the disease in different children. She’s a superb clinician-researcher and teacher in a discipline that will never be able to adequately support itself.

"Dr. Prober, one of the nation’s most respected infectious disease experts, has helped develop one of the finest educational programs in pediatrics and has organized a multi-institutional clinical trials network. Dr. Hoyme, a leader in clinical genetics, has recruited superb colleagues to offer the finest care for children with complex medical and biochemical genetic diseases," said Cohen.

"One of the global problems in pediatric rheumatology is that it’s a very small subspecialty; it’s only been around for about the last 20 years," said Sandborg, chief of pediatric rheumatology.

"There are fewer than 200 board-certified pediatric rheumatologists in the United States. But this family of diseases is one of the more common that affects kids," Sandborg said. If left untreated, rheumatic disorders would be the most common cause of acquired disability in childhood.

Genetic services, including diagnosis and counseling, are also poorly reimbursed, according to Hoyme, the Mosbacher Family Distinguished Packard Fellow. "Clinical genetic programs are necessary for the comprehensive care of patients," said Hoyme. "Statistics show that at least half of the children admitted to children’s hospitals across the country have some type of genetic or birth defect. Yet, because we don’t perform medical procedures, billing pays very little for our services."

Infectious disease specialist Prober, the Berger-Raynolds Distinguished Packard Fellow, concurs. "Our division, like many, balances clinical activities with research programs and teaching," said Prober.

"And yet all of these activities would not support themselves because we have a limited clinical base of revenue. The fellowship allows this gap to be filled and frees me to concentrate on the increasingly complex patients that are appearing in children’s hospitals around the country," said Prober, who is also the scientific director of the Glaser Pediatric Research Network.

"We are very fortunate to have a faculty with distinguished reputations nationally and internationally," siad Cohen. "This is a way we can reward their accomplishments and support their future activities on behalf of children."