OBJECTIVE: To assess whether underrepresented minority (URM) pediatricians serve minority and/or publicly insured or uninsured children to a greater degree than non-URM pediatricians, and to evaluate trends in these relationships. PARTICIPANTS AND METHODS: Respondents to American Academy of Pediatrics surveys in 1993, 2000, and 2007, provided their race/ethnicity, practice locations, and estimated race/ethnicity and insurance sources of their patient panels. We classified pediatricians by race/ethnicity as either URM (black, Hispanic, Hawaiian/Pacific Islander, or American Indian/Alaskan Native) or non-URM (white, non-Hispanic/Latino, Asian, or other). We compared the average percentages of minority individuals (excluding Asians) in the patient panels of URM and non-URM pediatricians, and compared the average percentages of publicly insured (includes TRICARE) or uninsured patients. RESULTS: Response rates were >50% for all surveys. There were 1003 (10.2% URM) postresidency respondents in 1993, 707 (11.8% URM) in 2000, and 900 (11.1% URM) in 2007. In all 3 surveys, the average percentage of minority children in URM pediatricians' patient panels was higher than for non-URM pediatricians by approximately 20 percentage points (all P