Pediatrics

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

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

If you are ready to become a parent, don’t let residency stop you

Cassandra Fritz, MD

Physician

October 15, 2018

I had the fascinating experience of interviewing for residency at 20+ weeks’ pregnant. Although a number of people told me that I was doomed, I found the experience to be quite enlightening. Since I couldn’t hide the fact that life outside medicine was going to be important to me during residency, I felt empowered to ask the “don’t ask” questions during my interviews. What did I have to lose? The …

How to survive a medical liability lawsuit

Anonymous

Physician

October 7, 2018

I do not feel that I truly survived my lawsuit. Sure, I am alive, but the emotional toll it took on me during the four years that we co-existed was tremendous. That being said, I do feel that it taught me several things that may be helpful to others.

My lawsuit occurred very early in my career. The series of events that led up to it happened when I was a …

10 things a pediatric oncologist wants you to know

Wendy A. Rhoades, MD

Conditions

September 17, 2018

1. Cancer is not rare. Technically, childhood cancer is rare compared to adult cancer, but it’s not as rare as you think. Outside of my work, I can think of 3 people who I know personally that had a childhood cancer. A teammate on my high school basketball team, my sister-in-law, and a high school debate teammate. My guess is that you also know someone from church, a coworker’s …

We’re doctors, but we’re humans too

Elham Raker, MD

Physician

September 2, 2018

We are human, we are not indestructible. We have feelings and emotions that can get hurt, probably more than the average person based on the careers we have chosen. Yes, we will pass up on our well-being (such as sleep, hygiene, exercise, relationships with family and friends) to be there for our patients. To receive our critical training to be able to care for others. This is our sacrifice, and …

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We’re doctors, but we’re humans too

Why this physician quit her job

Uchenna Umeh, MD

Physician

August 31, 2018

So last week, I did the bravest thing I have done in a very long time — I quit my job. Yes, I put in my 60-day notice. This was my dream job post service in the U.S. Air Force. I had dreamed of working in this establishment for months before my service time was up. I could not have been happier when I joined their team, a group practice …

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Why this physician quit her job

A physician explains the afterlife to his child

Rogue Dad, MD

Physician

August 21, 2018

Death and dying — it is one of the first topics I was taught about in medical school. I was fortunate to attend a medical school that only made us spend half our time falling asleep in lectures. The other half we were in small group sessions, working our way through real patient scenarios, trying to learn to think like a physician.

As part of our first-year curriculum we had to spend time doing …

Urgent care centers prescribe more antibiotics. Why is that?

Roy Benaroch, MD

Conditions

July 30, 2018

Urgent care centers are way ahead in prescribing unnecessary, potentially harmful antibiotics that are doing no one any good – at least no patients any good. The owners of the urgent care centers are the ones who are benefitting. And you and your family are being bilked, misled, and harmed.

A recent study published in JAMA Internal Medicine looked at the proportion of antibiotic prescriptions that were made for viral respiratory …