Pediatrics

Important new information in the tragic cases of child abuse

Conditions

April 9, 2019

Like many pediatric intensivists, I care from time to time for victims of child abuse in the form of what is often called “shaken baby syndrome.” This syndrome is a characteristic constellation of finds that happen when a strong person grasps a child around the chest and aggressively shakes the infant. It was first described by Caffey, a pediatric radiologist, fifty years ago. The baby may have …

It’s time to acknowledge the developmental behavioral pediatric workforce

Nerissa Bauer, MD, MPH

Conditions

March 26, 2019

There are roughly 15 percent of the nation’s children who suffer from a developmental-behavioral condition or about 1 in 6 children. Unfortunately, many of those children often do not get the help they need.

Children with developmental and behavioral challenges can easily be missed, especially when the behaviors are more subtle or impacts on function are not evident daily, such as with a …

Adverse childhood experiences: How changing a child’s environment can help

Heather Finlay-Morreale, MD

Conditions

March 21, 2019

Some children present to me with complex problems or multiple problems that fail to resolve after the typical interventions.

I recall a child with severe abdominal pain. He had tried numerous medicines and had had scopes and studies galore. It had reached the point where he was being scheduled for exploratory surgery to try and see the cause of his pain. I lost track of his case when I rotated elsewhere …

A pediatrician’s tips for your kids’ snacking habits

Jennifer Trachtenberg, MD

Conditions

March 15, 2019

Parents often ask me about snacks for their children once they are eating table food. Should they even give them snacks? If so, what kinds are good for them, and how often? In general, after age one I recommend three kid-size meals and 1 to 2 snacks to help them get their daily nutritional requirements. Try not to stress or obsess at each feeding about them eating all that you …

The consequences of celebrity endorsements in health care

Sheindel Ifrah

Meds

March 14, 2019

“Try this,” whispers Kate Winslet as I wander past the Lancôme counter. “Your glowing skin will thank you.”

The consequences of a celebrity endorsement are seemingly harmless when it comes to revamping a makeup routine, but what happens when this type of advertisement seeps into the world of health care? It has been proven many times that celebrity endorsements influence decisions about specific political candidates, issues or parties, and the positive …

Does work-life balance really exist for young mothers pursuing medical careers?

Sheindel Ifrah

Education

March 14, 2019

As our society’s awareness of mental-health issues increases, the idea of balancing personal and professional life has become a central topic of conversation. It cannot be disputed that finding a healthy equilibrium is especially important for mothers who enter the professional world, medical or otherwise. As a student in an accelerated post-baccalaureate pre-health program and a mother of a 3-year-old girl and a 10-month-old boy, I have made many strides …

Motrin vs. Tylenol for children: A pediatrician explains

Jennifer Trachtenberg, MD

Meds

March 12, 2019

As a pediatrician, I am asked by worried parents about what they should give their child with a fever, Motrin (ibuprofen), or Tylenol (acetaminophen) to bring down the temperature daily.

This question always requires more than a one-word response to the choice between anti-fever medications. An explanation of medication even being necessary for the fever and to clarify many long-standing fever phobia misconceptions.

Mainly, it is not necessary to treat the number …

To parents who have lost children: We never forget your children

Quinn Bensi, MD

Physician

March 7, 2019

Her name was Callie (identifying information changed). She was four years old. She loved glitter and princesses and anything sparkly. She was affectionate and silly, and I fell hard for her. She was a patient, my patient, on the pediatric oncology unit during my very first ward rotation intern year.

On my first day, I was as scared as any person can be, palms sweating, heart pounding, faced with these tiny, …

The clinical and financial life of a pediatrician

Smart Money, MD

Physician

February 14, 2019

Most doctors well into their tenure of medical already have a general idea about how other specialists spend their days (except for radiation oncologists, where no one else knows what they do). However, as a medical student, I had incredibly limited insight into the variety of means to practice medicine. Even as an attending physician, I am still discovering how creative some medical specialties allow one to be. For instance, …

How to say “no” to kids

Jennifer Trachtenberg, MD

Physician

February 6, 2019

Do you feel like you’re always saying “no” to your child and not getting the response from them that you are looking for? Do you end up repeating yourself over and over, so frustrated you begin to yell or just given in to your toddler’s demands? Unfortunately, I hear this way too often from moms, so I wanted to give some tips on the art of saying “no” that will …

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How to say “no” to kids

How an insurance company auditor tried to destroy a physician’s career

Niran S. Al-Agba, MD

Physician

February 6, 2019

It’s no secret that in today’s health care market, insurance companies are calling the shots. As a pediatrician in private practice for almost two decades, I’ve seen insurance companies transform into perhaps the single most powerful player in today’s health care landscape — final arbiters whose decisions about which procedures or medications to authorize effectively end up determining the course of patient care.

Decisions made by insurers, such as MassHealth, have …

A reflection on the last day of residency

Lucy Uber, MD

Physician

January 20, 2019

I entered residency self-assured, if not in my scholarly achievements, at least in who I am as a person.

I left slightly broken.

Something happens to you in residency, and you don’t realize the transformation as it occurs. It may be the loss of a patient who died on your watch, or the realization that you have not changed the world. It could be the constant fear of failure or punishment by …

Peanut allergies: What is the best policy for schools?

Roy Benaroch, MD

Conditions

January 14, 2019

Peanut allergies can be a serious problem, and many exposures happen when our kids are at school. On average, there are probably about 5 peanut-allergic children in each of our nation’s 100,000 school buildings. What’s the best policy for schools to use to help protect these kids from potentially fatal reactions?

Different schools have taken different approaches, and as far as I can tell there is no authoritative national guideline …

Non-therapeutic relationship or human kindness?

Anonymous

Physician

January 4, 2019

About two months ago, a 15-year-old Native American male was riding around in a stolen car on the reservation. “M” and the driver were drinking. And somehow, after he exited the vehicle at 4 a.m., the car struck him. Hours later, it became clear that something was wrong. M was transferred to our pediatric hospital as a trauma and was found to have an unstable vertebral fracture. Conservative treatment with …

The myths and truths about med-peds physicians

Andrea Lauffer, MD

Physician

January 2, 2019

Yes, med-peds is a real residency! It is a real specialty! And it is a practicing profession by many physicians today! It can open doors for so many wonderful professional opportunities. It is a discipline that can provide patients and communities extremely comprehensive medical care. People need to know more about this unique and sometimes under-recognized field. And here is why:

Like many people today, I didn’t even know what med-peds …

The Wild West approach to PICU practice

Christopher Johnson, MD

Policy

December 10, 2018

I spent my early and mid-career years working in a pediatric intensive care unit (PICU) at a large academic center. We did almost everything except for a few things esoteric at the time — small bowel transplants, a few kinds of experimental surgery. I’m now in my late career (but have no plans to quit anytime soon!) and work in a smaller PICU. I am frequently confronted with the issue …

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The Wild West approach to PICU practice

Medicine is just a job

Kpeds, MD

Physician

November 28, 2018

A couple of years ago, I read an article by Dr. Profeta at LinkedIn called “These four words that may offend you … may also just save you.” He was invited to talk about burnout in medicine and did not get a warm reception.

“It’s just a job.”

The “it” in this case is medicine. Medicine, just like any other, is just a job. Let that sink in. Everything …

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Medicine is just a job

Everything you ever wanted to know about croup

Christopher Johnson, MD

Conditions

November 20, 2018

Imagine this scenario. Your two-year-old son has had a runny nose for a day or two and an occasional cough, but seemed no worse to you that everyone else in his preschool class. Two hours after you put him to bed you hear him coughing, only this cough is like none you have ever heard from him before. It sounds like a barking seal at the circus — a brassy, …

Why demanding a randomized controlled trial for vaccines is disingenuous

Christopher Johnson, MD

Physician

November 1, 2018

I swiped this editorial cartoon by Steve Sack from the redoubtable Dr. David Gorski’s blog, who goes by the nom-de-web of Orac. Recent epidemiology shows reducing the fraction of vaccinated children in the population rather promptly leads to a resurgence of the diseases vaccines protect against. This is the concept of community or herd immunity. …

A physician loves the adrenaline surge

Alexandra Novitsky, MD

Physician

October 25, 2018

Have you ever felt so cold? I mean bone-chilling cold. I don’t mean the same kind of cold that northern winters can leave you feeling. I am talking about working in a hospital that is climate-controlled, and you are undoubtedly shivering.

I still remember my first day on the job as a neonatology fellow. I was anxiously walking to the operating room to attend the delivery of a 25-week infant. As …

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A physician loves the adrenaline surge