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Background Pediatric outpatient care in Germany is significantly affected by the COVID-19 pandemic. The study aims at exploring the subjective views of pediatricians on changes in their routine healthcare work during the COVID-19 pandemic. Methods 19 qualitative semi-standardized telephone interviews were conducted with pediatricians in Germany. The interviews were audio-recorded, transcribed verbatim and analyzed based on qualitative content analysis (Kuckartz 2012) using QDA software (Atlas.ti, V8). Results COVID-19 infection protection measures induce substantial changes in the pediatricians' work, e.g. separating infectious and non-infectious patients, re-structuring appointments and practice setting and wearing PPE. Some interviewees emphasize that re-structuring measures have set positive impulses for the future. Wearing face masks is difficult when communicating with infants and children with psychosocial issues. Pediatricians feel well-informed on COVID-19-related health information but find it challenging to constantly re-adjust their professional position based on the rapidly changing official recommendations. This also makes it difficult to communicate COVID-19-related information to their often insecure patients. The pediatricians are concerned about a changed (degree of capacity) utilization: Preventive appointments are utilized almost as before, however, parental fear of visiting the practice and infection protection measures in the children's living environments have led to a significant decline in utilization for mild infections. While some pediatricians appreciate this as a relief of workload, others experience severe financial distress. Conclusions The decline in healthcare utilization for mild infections and the resulting financial distress call for health policy measures in order to ensure comprehensive pediatric care in the future. Positive experiences regarding the pediatric practice should be spread as “best practices”. Key messages Pediatricians in outpatient care in Germany experience substantial changes in their routine work due to the COVID-19 pandemic, e.g. practice organization and infection protection measures. They are especially affected by rapidly changing official recommendations and a changed (degree of capacity) utilization.