Christopher Johnson, MD

Christopher Johnson is a pediatric intensive care physician and author of Keeping Your Kids Out of the Emergency Room: A Guide to Childhood Injuries and Illnesses, Your Critically Ill Child: Life and Death Choices Parents Must Face, How to Talk to Your Child’s Doctor: A Handbook for Parents, and How Your Child Heals: An Inside Look At Common Childhood Ailments. He blogs at his self-titled site, Christopher Johnson, MD.

Do call centers send too many children to the emergency department?

Physician

April 2, 2014

A large number of pediatric practices these days use after-hours call centers for parents who have questions about a sick child. I’ve been looking around to find some data about how common this is, but my sense is that the majority of pediatricians use them. There is no question these call centers make live easier for the doctor; having somebody screen the calls, answer easy questions, and only call you …

A case where a meta-analysis can help

Christopher Johnson, MD

Conditions

March 26, 2014

Clinical medical research — finding out which treatments help and which ones don’t (or even make the situation worse) — is tough research to do. In the laboratory a scientist can control conditions so that only one thing is different between the control and the experimental groups. This isolates the effect of the particular thing and one can see if there is any difference in outcomes depending upon what is …

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A case where a meta-analysis can help

Vaccines: An unprecedented use of state power?

Christopher Johnson, MD

Physician

March 5, 2014

One aspect of the endless vaccine debate is the aspect of coercion some parents feel about requiring children to be vaccinated before they can go to school. The government mandates vaccination. But this isn’t really an absolute requirement. Although all 50 states ostensibly require vaccination, all but 2 (Mississippi and West Virginia) allow parents to opt out for religious reasons, and 19 states allow this for philosophical reasons. (See Read more…

Vaccines: An unprecedented use of state power?

Framing an ethical dilemma: 4 basic concepts of medical ethics

Christopher Johnson, MD

Conditions

February 26, 2014

It seems lately that questions of medical ethics are coming up more and more in the news, things like the rights of patients to make decisions, definitions of futile care, and end of life care. The way to look at these things is not in a vacuum. All of us may have our own opinions about right and wrong, but the field of medical ethics is actually one that has …

Analyzing the Jahi McMath case

Christopher Johnson, MD

Conditions

February 11, 2014

The recent tragedy of Jahi McMath, the 13-year-old girl who died following complications of tonsillectomy and adenoidectomy, has focused many people on the question of brain death. Although I have no more details about this case than anyone else reading the news, I am quite familiar with the sort of things that happened to this unfortunate child. As many of you know, her family does not believe she is …

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Analyzing the Jahi McMath case

Bronchiolitis and RSV: What you need to know

Christopher Johnson, MD

Conditions

January 30, 2014

It’s time again for bronchiolitis, which usually comes in winter through spring. In some ways this problem is similar to asthma, but in other important ways it is very different. With winter upon us it’s time to reacquaint ourselves with this common entity. There is a reliable seasonal arrival of the virus we call RSV, the chief cause of bronchiolitis. The letters stand for respiratory syncytial virus, a description of what …

A new respect for norovirus

Christopher Johnson, MD

Conditions

January 23, 2014

Gastroenteritis, often called “stomach flu,” is common in children. It has nothing to do with influenza, the “true flu,” which is caused by a respiratory virus. Gastroenteritis is caused by a different set of viruses. These viruses are generally transmitted by what physicians call the fecal-oral route, which sounds kind of gross.

What we mean by that term is that the bug is in our intestinal tract and gets on our …

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A new respect for norovirus

The economic cost of measles vaccine refusal

Christopher Johnson, MD

Conditions

January 6, 2014

The measles virus is among the most infectious of all know viruses, with an attack rate of well over 90%. That means that over 90% of susceptible people — those who have not been vaccinated or who have not had the disease — will get it if exposed. I’ve seen one case, and that was thirty years ago, although my parents showed me a picture of what I looked like …

Cough medicines shouldn’t be used in small children

Christopher Johnson, MD

Meds

December 17, 2013

It’s once more cold season, bringing up the question parents commonly face. Should they buy one of those rows and rows of cough, sneeze, and runny nose medicines one finds in every drug store and supermarket?

In a nushell, no — none of the preparations sold over-the-counter to treat upper respiratory infections in children work, and all could be dangerous. That’s the conclusion of a report some years ago by the Food and Drug Administration, …

Are we making progress in the fight against childhood obesity?

Christopher Johnson, MD

Conditions

December 9, 2013

It is well known that more people today are overweight or obese than in the past. This has been a steady trend for decades, but there is some recent evidence this increase has stabilized. This is promising. Since many obese adults began as obese children, during the last decade physicians who care for children have devoted considerable effort to reversing the trend. This is important because obesity sets up the individual …

Asthma in children: A complete primer

Christopher Johnson, MD

Conditions

November 15, 2013

Asthma is a common problem in children — nearly 10% now have it — and the number is increasing. Researchers are not sure of the reasons for this steady increase, but decreased air quality, lower activity levels among children, and an increase childhood obesity have all been implicated. Whatever the cause, it means that millions of American children take medicine for asthma. A significant number of these children end up in …

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Asthma in children: A complete primer

A strategy to approach patients who don’t believe in vaccines

Christopher Johnson, MD

Physician

October 24, 2013

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Childhood vaccination remains controversial among some non-physicians, in spite of being nearly universally recommended by physicians. If you spend some time on Google you will discover a whole world of websites where the issue, long settled in the medical community, is vigorously debated among non-experts. Of course a large component of this controversy is fallout from the now thoroughly debunked claims by Andrew …

Should medical school be shortened by a year?

Christopher Johnson, MD

Education

October 15, 2013

We have been training physicians the same way for a century, ever since the famous Flexner Report of 1910. That report was commissioned by the Carnegie Foundation in an attempt to improve medical education. Up until then many medical schools were simply terrible. Many were proprietary schools, owned by doctors and run for profit rather than education. Many doctors met their first actual patient after they graduated.

During the decade following Flexner report these proprietary …

What is the ideal number of CT scans for headaches in children?

Christopher Johnson, MD

Conditions

August 27, 2013

Many, myself included, have written about the overuse of head computed tomography (CT) scanning in children. This concern has become more focused now that we have some data on the radiation risk of those scans. The bottom line is not that we should stop doing head CTs in children, but that we should always balance the risk against the benefit, just as we should do with all medical testing. In …

C difficile in children: Do probiotics help?

Christopher Johnson, MD

Conditions

August 13, 2013

The intestines, particularly the large intestine, are teeming with bacteria. They are piled on each other as dense as the above photomicrograph shows. The huge majority of them are what we call friendly bacteria: they live inside us, feeding off the rich stew of food we eat, but cause no disease. In fact, their presence is important to our health because they crowd out bacteria that cause disease — the …

News on cancer breakthroughs: Curb your enthusiasm

Christopher Johnson, MD

Meds

July 20, 2013

Hardly a day goes by when some news outlet does not report, often breathlessly, some new breakthrough in cancer research. We need to turn a skeptical eye on most of these reports, particularly those that contain information about very preliminary research findings. The always astute Gary Schweitzer gives a good perspective on this in his HealthNewsReview.org; it’s a good site to bookmark if you follow the medical news.

Respect diagnostic radiation, but don’t have an irrational fear of it

Christopher Johnson, MD

Physician

July 6, 2013

shutterstock_94210177

I’ve written before about the increased risk for future cancer, if any, of diagnostic radiation. These posts have generated a large number of comments and questions from parents. Most take the form of fear they have needlessly increased their child’s future cancer risk by agreeing to a CT scan. A new research study give us some important new information about …

A pediatrician’s approach to dehydration in children

Christopher Johnson, MD

Conditions

June 24, 2013

Our bodies are mostly water — about 60% water, in fact. This varies a little with age and sex, but it is a good rough estimate. Of that 60% water, about a third of it is outside the body’s cells, so-called extracellular fluid, and two thirds of it is inside the body’s cells, so-called intracellular fluid. The easiest way to remember this is the “60/40/20″ rule: total body water is …

Let’s change the way we select medical students

Christopher Johnson, MD

Education

June 2, 2013

Students wishing to go to medical school — premedical students — have gone through pretty much the same process for nearly a century. The requirements have some variability according to the whims of particular medical schools, but in general a person wishing to go to medical school needs a four year collage degree, during which he or she has completed two years of chemistry (including organic chemistry), a year of …

Should families be allowed to witness CPR?

Christopher Johnson, MD

Physician

May 15, 2013

This is a topic that comes up from time to time for often spirited discussion. The most recent example comes in a a couple of articles in the New England Journal of Medicine. One was a research paper; the other was a pro and con discussion.

The research paper studied cardiac arrests that happened outside the hospital. The authors tested the premise that allowing families to watch the efforts of …

Christopher Johnson, MD

Christopher Johnson, MD

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