As all of us know, there is a long, long tradition in our culture of disciplining or punishing children using physical means. “Spare the rod and spoil the child,” as the old saying goes. That explicit wording, by the way, does not come from the Bible, as most people think. Rather, it comes from a seventeenth century satirical poem by Samuel Butler. Still, The belief that …
Does spanking control a child’s bad behavior?
My son had been having episodes of belly pain right around his belly button for several weeks. I watched and waited. Between these bouts of mild abdominal pain he was completely fine – healthy appetite, active, happy. But I had a feeling something was brewing. I was waiting for the other shoe to drop. The disease finally declared itself: several nights ago his belly pain was severe and unremitting. He …
Why I’m thankful for my son’s surgery team
I am a devoted fan of Zumba, specifically as it is taught by my wonderful teacher, who has a dedicated following. She has been out for the past month, home with a newborn and two year old. Last week, she came with her baby to try to take the class, now being taught by a substitute, also a regular member of her class.
“I need this for my mental heath, ” …
Being home with an infant: Take care of your mental health
There are about 27 million visits by children to America’s emergency departments each year. About a quarter of those are to rural EDs or ones at some distance from a dedicated children’s facility, such as a children’s hospital. Over the last decade or so it’s become clear that, for critically ill children, early transfer to an advanced pediatric facility improves outcomes. The children do better if they can be transferred …
Are emergency department pediatric transfers always necessary?
In early 1996, I sat down at my computer looking for help.
My third child, 2 months old, had just been diagnosed with a severe brain malformation called lissencephaly. He won’t be normal, the doctors said grimly. His life will be shorter, we were told. He will have seizures and other problems, they said, but it’s hard for us to say what or how bad those problems will be. We were …
We need a doctor-family partnership on the Internet
A recent case from Dayton, OH highlights the tangled mess of emergency department specialty coverage, federal law, and out-of-network insurance benefits. When these interact, patients, doctors, insurers and hospitals can be left frustrated and perplexed.
Here’s a brief summary.
A 6-year old boy suffered a fingertip injury and the emergency staff called the covering plastic surgeon, who repaired the injury. The surgeon, who does not participate with insurance, submitted a bill for …
Mandating care in the ER but not payment: Why that’s a problem
More than 80 percent of the United States supply of heparin, a commonly used blood thinner, originates from pigs reared in farm co-ops in China. Farmers scrape mucus from the intestines and send it to central processing facilities, where heparin is extracted and purified before being sold to U.S. pharmaceutical companies.
But in 2007, blue-ear pig disease, causing a respiratory syndrome, became endemic in Asia—leading to a shortage of pigs …
Why the drug shortage is leading to desperate measures in hospitals
I’ve written about this before, but some recent encounters with medical students have me thinking about it again. I went off to medical school thirty-eight years ago. For the era, I went to what folks regarded as a very progressive place. It had a curriculum that was quite revolutionary for the time. Among other things, we started having interactions with actual patients during our first year, rather than the third …
The need to watch medical students interact with patients
The last patient of the day rushed to the office before closing time. When I entered the room, the dad was texting as the nurse finished recording the child’s temperature. He shook his head in disbelief and confessed that he just sent his wife this message, “I feel stupid. No fever here.”
Parents apologize to me everyday because they feel like they wasted my time and/or their co-pay. Coordinating a doctor’s …
In pediatrics, no visit is a wasted one
If we want to fight childhood obesity, we need to get kids moving.
Sounds incredibly obvious. And that was my reaction when I first read the study just released in the journal Pediatrics—in it, the authors said that high school students were less likely to be overweight or obese if they played at least two sports during the school year, or if they walked or biked to school. Really? Next we …
When it comes to exercise, stating the obvious is really important
One evening during my first year of medical school, I was waiting by the entrance to The Salvation Army to let another student back into the free clinic. The weekly clinic was organized by MEDiC, an organization of student-run free clinics in the Madison area. A family with four small children was returning to spend the night at the shelter, and one of the kids saw the stethoscope around my …
Reinforcing my desire to become a pediatrician
In my behavioral pediatrics practice, it is not uncommon for parents to go to great lengths to put up a good front. They feel terrible shame about moments of out-of-control behavior, and also fear that I will blame them for their child’s troubles. They focus primarily on “what to do” about their child’s difficult behavior. However with time, and the realization that I am interested in understanding, not shaming or …
Eliminate the guilt in parenting
I had an unexpected gift this week: a not-so-sick sick day with my 5 year-old. And it really couldn’t have come at a better time.
We’ve never had a sick day like this before and he’s off to Kindergarten in September so the days were running out for preschool stolen-away sick leave.
In the past when he’s been ill he’s been well enough for me to head off to clinic or work …
Sick days: When our children show us the way
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The drama surrounding the Supreme Court decision upholding the ACA as constitutional has ended. As legions of reporters and bloggers have written, the law has far-reaching effects. In my corner of medicine it will greatly help (already has, really) a small but not insignificant number of children and families. These families are those who have a child with a severe chronic medical condition. Many of these children spend time in …
How ObamaCare affects critically ill children
One magical thing I see while working in health care is the love story. Each and every child who encounters a diagnosis or illness spawns a collection of love stories around them. The stories come spontaneously from parents, siblings, friends, nurses, doctors, community, and peers. It all happens organically and sometimes it happens without notice. Babies cling to their parents when they ache; parents cling to their children when they …
Behind every illness, there is a love story
In a pediatrician’s office, summertime is teen check-up time.
And, I love it.
Annual checkups are a time for me to catch up on the school year, brag about amazing extra-curricular accomplishments, and swoon over summer vacation plans. It is also a time for anticipatory guidance, private conversations, and facing the often sobering reality of teen life.
Throughout this past year, I have had the privilege of being involved in the lives of many …
10 topics to discuss with your teen this summer
My boys and I suffer from tree pollen allergies. More than birds chirping or flowers blooming, I have come to associate boogery sleeves and sneezing with the onset of spring. But these are the typical symptoms, which are easily recognizable as allergy-induced.
What I’d like to address in this post are some lesser known symptoms of seasonal allergies, which may also be rearing their ugly heads this spring. Red eyes and …
Lesser known symptoms of seasonal allergies
For years, I have been telling families in my practice, especially those with teens, to eat dinner together. Family dinners make a difference, I tell them. Studies show that they not only help prevent obesity, they help kids do better in school and help keep them out of trouble.
Now a study says that’s a bunch of hogwash.
Well, not exactly hogwash. The researchers from Cornell who wrote “Assessing Causality and …
Don’t give up on the family dinner
I know a surgeon who, when consulted about a child with appendicitis, will insist that a CT scan of the abdomen be performed before he will see the patient. It doesn’t matter that the history and physical exam fit the diagnosis perfectly. It doesn’t matter that the child has already undergone an ultrasound of the appendix that shows it is dilated and inflamed. It doesn’t matter that the radiologist has …
Parents need to ask: Is this CT scan necessary?
Does your doctor have something on the wall that starts with “American Board of … “?
The terms “board certified” and “board eligible” are confusing to people not in the medical profession. It doesn’t help that more than a few doctors blur the distinctions to their own benefit. This post gives you a brief rundown of the distinctions at stake.
The first thing to understand is that anybody who has graduated from …
Does it matter if your doctor is board certified or board eligible?
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