Dear anti-vax parents,
In the wake of the Disneyland measles outbreak, there’s been a lot of heated talk about parents who choose not to vaccinate their children. It seems like the medical community is now protesting even louder than the anti-vax groups were a couple years ago. But I want to take a moment and apologize for the harsh tone some of …
Dear anti-vax parents: It’s not your fault
Although the Affordable Care Act’s second enrollment period is nearly over, politicians, medical professionals, and the public still debate its implications. According to David Houle and Jonathan Fleece, one-third of all hospitals in the United States will close or be reorganized into another kind of health care provider by 2020. What will differentiate the winners from the losers? Simply put, it will be high patient satisfaction.
In consumer terms what …
Improve patient satisfaction from the eyes of the consumer
Recently, at a holiday meal with my extended family, it came to light that neither of my typically developing teenage children really knows how to tie his or her shoes. It seems that for the past decade or so, both have been using the “bunny ears” technique introduced to preschoolers for tying their shoes. My children appear never to have moved on from there to the mature “around the tree” …
Children with developmental disabilities and the guilt parents feel
Last August, the American Academy of Pediatrics (AAP) issued a statement regarding school start times, really a plea to all middle and high schools to start the school day no earlier than 8:30 a.m.
The statement emerged as a result of accumulating evidence showing that earlier school start times effectively restrict an adolescent’s ability to get regular healthful sleep.
The timing of the AAP’s …
Kids need more sleep and later school start times
When babies are born prematurely, they often lack surfactant: a soapy substance produced in the lungs that helps to keep the air sacs open. Without surfactant, these tiny babies fight to breathe, a condition known as infant respiratory distress syndrome. Within the past 50 years, the delivery of artificial surfactant therapy has revolutionized neonatal care, saving many lives that previously would have had no chance at survival. As a neonatal intensive …
Let’s be judicious in our use of surfactant
There have been countless instances in which the traditional practice of medicine has been disproved when someone actually took the time to perform a study. But who cares if a treatment doesn’t work — why does it really matter? Let me walk you through why it’s important, starting with the Hippocratic oath.
As physicians, our top priority is to “do no harm.”
But this priority often clashes with the patient’s reason for …
Here’s why we need evidence-based pediatrics
Everyone yells at their kids. Oh, I’m sure there are some truly perfect parents out there who don’t (and some who don’t because they are physically unable to yell), but the rest of us do. Parents are human; we all get frustrated, angry, exhausted and scared and, well, yell.
But yelling rarely helps. It usually makes things worse. And it makes us …
Stop yelling at your kids. Here’s how to do it.
I am a doctor today because of Dr. J.W. Epstein, my pediatrician in Cleveland in the 1950s. An immigrant from the Nazi terror in Europe (it was family lore that he had escaped the Holocaust), he had trained in Vienna and spoke English with a Germanic accent. His house calls are etched permanently in my memory. His visits were heralded by a fury of activity, led by my mother. “The …
Professionalism: A commitment to lifelong learning aimed at the care of the patient
NPR recently reported, “Measles makes an unwelcome visit to Disneyland.” Nine people who visited Disneyland theme parks in California over winter break had caught measles, almost all of them unvaccinated children. The next day, ABC reported that the number of cases has grown to 19. Of these, only two had been fully vaccinated. Some of the cases were too young to receive vaccines, others apparently chose not to get vaccinated. …
Measles in Disneyland is entirely preventable
Ear infections (or, what we like to call “acute otitis media”) are one of the staple diagnoses of pediatrics. Most kids have at least one before their third birthday. And most pediatricians see at least one every day by 11. You would think we would always get it right. But I have a confession — we don’t. In fact, children are misdiagnosed and over-treated at an alarming rate.
There are several reasons for …
Why is diagnosing ear infections so hard?
Our children will never be the sole judge of our job as parents of course. We are likely our own closest and most fastidious critic. And really it’s just us (and our partners) that can truthfully reflect and evaluate how it goes as we raise our children — what our hopes were when we started on the journey of raising another and where we find ourselves.
And so, however radiant the …
Reflecting on how we raise our children
For years, my husband and I have argued about how to dress the kids for cold weather (given that we have five kids ranging in age from 23 to 9, this argument truly has been going on for a while). He says I don’t dress them warmly enough. I say he overdoes it.
After all these years, I still think I’m right. But that doesn’t mean I don’t appreciate the way …
How you dress your kids can say something about you as a parent
The action steps, in any health emergency, are: ABC. Airway, breathing, circulation. The airway has to be open, the patient has to be making an effort to breathe, and the heart has to pump blood. In any emergency, health care people are trained to address these, one by one, in order. Fix what you can before moving on, and concentrate on what’s going to kill the child first. Then, arrange …
Airway, breathing, call your insurance company?
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The day before I began my second year of medical school, I spent the day at the beach with my daughter, who had just celebrated her third birthday. Most of my classmates had spent their “last summer ever” traveling or doing research, but I had chosen to take the time off to make up for some of the family time I …
A 3-year-old taught me to chase my dreams
Our current health care system will fail; it’s simply a matter of time. Yet the delivery of efficient, quality, and progressive health care is quite possible once we shift our thinking. A true paradigm shift in medicine begins with first establishing that each pillar in health care has an equal responsibility in making a new system work: patients, providers, and places (facilities).
This article pertains to only the provider portion.
As …
Improve the inequalities among physicians
A woman delivered a baby boy at 30 weeks’ gestation at a Boston hospital. After birth, the infant required a ventilator for 3 days. The family visited every day, traveling over 45 miles each way, for the first 2 weeks of their baby’s life. After her husband went back to work, the mother visited infrequently because she relied on friends and family members to transport her to the hospital as …
Relieve the bottleneck at NICUs: Insurers aren’t helping
Look here: I am a breastfeeding supporter. I regularly help new moms breastfeed successfully, and I even took a special class to learn how to do a brief procedure to help babies overcome breastfeeding problems caused by tongue-tie. I’ve got a happy breast support sticker, right on my AAP card.
But I think honesty is (or should be) the breast policy. Some …
Stop the hyperbole when it comes to breastfeeding
I see it all the time at our practice. Parents come with kids who really don’t need to go to the doctor; they are only mildly ill, or already getting better. When I ask them why they came, the answer is simple: daycare.
They need a note saying the child is better in order for the child to go back. They need …
Should sick kids be allowed at daycare?
Being sick isn’t easy, but neither is being the sibling of someone who’s sick.
We’ve shared many stories about children who are living with a serious illness. We’ve talked about their disease, what life is like for them, how they cope in such dire circumstances. But in all of these conversations, one thing we’ve overlooked is telling the stories of the brothers and sisters who sometimes feel that they live in …
Having a sibling with special needs: A challenge for the whole family
Every new parent has heard the dire warning: Never sleep with your baby.
State and local health departments in Massachusetts and around the U.S. have prioritized this message. Millions of dollars have been invested in promoting it, and millions more spent on giving away cribs to poor families. It all comes from the official recommendations of the influential American Academy of Pediatrics published …
Never sleep with your baby: Has that advice backfired?
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