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The Changing Landscape of Pediatrics
By Ellen Passloff, MD, FAAP.
Trustee, King County Medical Society
When I started out in primary care pediatrics in 1994, we used paper charts, we had more time with each patient, and we diagnosed at most one patient with anxiety or depression each year.
Currently, I stare at computers all day, and I don't have enough time to spend with my patients. My days are filled with an overwhelming In Basket of MyChart messages, phone calls, prior authorization requests, medication refills, and too many patients with mental health concerns.
My daily well-child counseling has also changed. Now I spend a good deal of time stressing the importance of screen time limits, getting outside, exercising, and getting enough sleep at night (with phones outside bedrooms and NOT used as their alarm clock). I also discuss gun storage safety, car safety, drug avoidance, and the importance of learning how to swim and ride a bicycle (it shocks me when I discover that some middle schoolers and high schoolers still don't have these important life skills). However, the conversation about screens is always the longest, and the one most fraught with arguments from my patients.
Some of my patients report between 4 and 6 hours of non-academic screen time each day, on school days. These same patients report poor sleep, limited exercise, and anxiety and depression. Some of my patients have smartphones before they even reach middle school. Currently, I am grateful if I have fewer than three patients in a day with a diagnosis of anxiety and/or depression. I know many articles have been written about the ills of social media and how much it affects the lives of children and teens. I fully agree that technology has truly had a negative effect on the mental health of children today. I feel we need to do more to educate parents about the detrimental effects of technology on their children.
I am thrilled that schools are now restricting phone use during the school day. I'd also love to see more emphasis on outdoor exercise and healthy activities. Some of my patients don't have PE because it rotates with music or art. All kids should have regular exercise built into the curriculum. I wish schools still used pencils and paper to teach children. And good old blackboards. Children need to write things down, work math problems out on paper, and take handwritten notes. Studies have shown that taking notes by hand helps with information recall. When schools rely on the use of screens so heavily, students have no qualms about spending so much of their non-academic time on video games, video watching, and social media.
When children and teens do end up suffering from anxiety and/or depression, therapy and medication are essential. However, it would be great to prevent the development of these mental health conditions in the first place. I would love to see a return to the days when computers and phones had no place in schools. Let's bring back composition notebooks and pencils. I would love for cell phones to be reserved for older teens and adults only. There are simpler devices for parents who need to be able to communicate with their children who may be coming back from school on their own. I would also like to see regular exercise return to schools during all semesters, not just when they are rotating from music or art. Limited screen time, regular exercise, healthy eating, and adequate amounts of sleep are the best way to prevent mental health disorders.
We have all had to adapt to the use of technology in our professions, but it should not be the norm in schools or for entertainment during non-school hours. This is one area where I believe we will make more progress by reverting to the "good old days."
See more KCMS 'Physician Perspectives' here.
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What KCMS Is Doing About It
KCMS physicians are acting on exactly what Dr. Passloff describes. At the 2026 WSMA House of Delegates, Drs. Kevin Johnson and Danny Low wrote two resolutions, now state medical association policy, on restricting cell phones during instructional hours and on the health impacts of excessive EdTech in Washington schools. KCMS physicians also won three resolutions on prior authorization and on insurers’ use of AI in coverage decisions.
Our lobbyist is working to turn these into legislation in the 2027 session. Every one started with a physician tired of a problem. Any member can write a resolution, and we’ll help. The next cycle opens in the spring.
Not a member yet? Join us using the links below.
Have an idea? info@kcmsociety.org
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| KCMS Community Foundation Grant Winners
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Each year, the KCMS Community Foundation awards grants to Washington medical students who show leadership and a commitment to community health. This year, the Foundation chose one student from each of the state's three medical schools. Please join us in congratulating Alice, Hector, and Nashrah!
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Alice Sohn University of Washington School of Medicine
Alice brings a strong research record to her training, with seven peer-reviewed publications and a clear sense of how barriers to care shape patients' lives. Her faculty mentor described her as an outstanding student.
"I am incredibly honored and grateful to receive this grant. It reminds me that it truly takes a village to support someone in getting to where they are today. This grant will help alleviateis verdana 15 the financial burden of attending medical school and allow me to focus on my education and becoming a compassionate physician. I am grateful for this opportunity, and hope to one day do the same for future students who are following a similar path."
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Hector Andres-Gaspar
Pacific Northwest University of Health Sciences
Hector has spent years bringing care directly to people who need it most. He helped launch the UW Mobile Health Clinic, coordinates a local shelter, and created a scholarship to support other students following a path like his own.
"In middle school, I wrote a letter to my future self saying that I wanted to become a doctor. Coming from an underserved and underrepresented background, I now realize how much the odds were stacked against me, but that never stopped me from dreaming. I owe it to that younger version of myself, and to every child who dares to dream, to keep pushing forward and become a familiar face in medicine for those who may not have always seen themselves represented. Receiving this grant brings me one step closer to fulfilling that childhood dream."
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Nashrah Junejo
Washington State University Elson S. Floyd College of Medicine
Nashrah began her path to medicine after immigrating to the United States at 17, while also helping her parents learn English. Since then, she has co-founded two organizations, completed an NIH research internship, and published five papers.
"This grant is more than funding; it is an affirmation that the work I care about, expanding access to care and mentorship in underserved communities, matters. I am honored and excited to carry that mission with me as a future physician."
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The Hardest Part Was Saying "No"
Our judges knew this year's decision would be hard, but they weren't prepared for how difficult it would be.
Forty-nine medical students applied. One interpreted for his sister’s cancer treatment at age seven. Another went without care after being hit by a truck as a child because the family couldn’t afford it, and now runs a state Medicaid program while training to be a doctor. And one lost a brother to cancer mid-training and drove for delivery apps to stay in school.
The need was profound. We could fund only three.
Alice Sohn, one of this year’s recipients, put it best: “It takes a village.” You are that village. These grants exist because KCMS physicians gave. Every gift grows the endowment, so more students can benefit. Gifts to the KCMS Community Foundation are tax-deductible.
Give today and help us say yes to more students.
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American Red Cross: Healing Communities Together
The Red Cross is hosting a virtual information night for healthcare professionals on flexible volunteer opportunities supporting people affected by disasters and emergencies. Thursday, November 12, 6 p.m. JOIN US
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Charity Care Rule Could Extend to Physician Fees
The Department of Health has proposed extending hospital charity care requirements to physician professional fees for care delivered in hospital settings, starting July 31, 2028. Physicians, especially independent groups that bill separately for hospital-based work, would be required to discount or write off those bills for qualifying patients. Legislation on the same issue may come up in the 2027 session.
If this affects your practice, the Department needs to hear it from physicians directly. A public hearing will be held via Zoom on Tuesday, December 1, at 11 a.m., and written comments are due the same day.
REGISTER HERE. Read the proposed rule.
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In 2024, KCMS wrote a resolution calling for a Washington State Commission on Boys and Men: a dedicated body to address the health disparities affecting boys and men, including mental health, school dropout rates, mentorship, and support for boys and men who are victims of violence. In the 2026 session, KCMS supported HB 2401 to create the commission.
Washington Initiative for Boys and Men, Big Brothers Big Sisters of Puget Sound, and Seattle Theatre Group are hosting a free screening of Gone Guys, a 45-minute documentary drawing on Richard Reeves’ Of Boys and Men, followed by a panel discussion.
Wednesday, November 4, 6:30 to 8:30 p.m., Kerry Hall, 710 E. Roy St., Seattle REGISTER HERE
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WMC Finalizing New Opioid Prescribing Rules for MDs and PAs
The Washington Medical Commission is rewriting the opioid prescribing rules for physicians and PAs. The 2024 petition behind the rulemaking asked the WMC to protect stable chronic pain patients from unnecessary tapering, remove fixed MME thresholds, and exempt patients with rare diseases.
The WMC plans to move to the formal proposed rule stage in early 2027, and after that the text is largely set. If you prescribe opioids, these last two virtual workshops are your chance to weigh in.
Workshop: Monday, December 7, 1 to 4 p.m., with written comments due November 30 by 5 p.m.
Workshop: Monday, January 18, 2027, 1:30 to 4:30 p.m. (final workshop), with written comments due January 11 by 5 p.m.
Register for workshops and submit comments through WMC’s Rules in Progress page. You can read the original notice (CR-101, WSR 25-10-039) or join the interested parties list for updates.
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