Sometimes an interesting thing happens on patient rounds. Rounds are a traditional exercise in hospitals going back at least a century. In the old days, this meant the physician going from patient to patient. He (it was nearly always he back then) went over the patient’s progress with the bedside nurse, examined the patient, reviewed pertinent test results, made an assessment, decided on a plan for the day, and gave ...

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Asthma is a complex, chronic lung problem that now affects nearly 10 percent of all children. Both the incidence of new cases and the prevalence of ongoing cases in the pediatric population have been rising steadily for years, although there are hints these increases may have leveled off. A wealth of research suggests a huge part of asthma causation comes from the environment the child lives in, things like air quality and exposure to various ...

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A manifesto has been making the rounds on Twitter (and other places) over the past year. It has been attributed to Dr. Mike Ginsberg, a California pediatrician. It reportedly was originally a Facebook post that has since been taken down, perhaps because of the controversy it generated. I can understand why; vaccines are a hot button topic, and anyone who writes about them attracts attention, some of it unpleasant. I know ...

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I found this study to be absolutely fascinating. The link is to the abstract; the complete article is behind a paywall, but I can get it for anybody who’s interested in reading the whole study in detail. Its title is “Fundamental frequency variation in crying of Mandarin and German neonates.” I have always assumed, like most people I suspect, that babies cry the same the world over. When they’re uncomfortable or ...

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The USA trains its physicians differently from every other Western country I know. Everyone (with rare exceptions) who goes to medical school first must get a four-year undergraduate college degree in something. There are no such degrees in medicine, although the overwhelming majority of students going on to medical school major in one of the sciences, such as chemistry, biochemistry, and biology. If they don’t major in a science, they generally ...

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There are over 400 pediatric intensive care units (PICUs) in the USA, as most recently estimated by the Society of Critical Care Medicine. These units vary widely in size, from 4 or 5 beds to fifty or more. The smaller units are generally found in community hospitals; the larger ones are usually in academic medical centers, often in designated children’s hospitals, of which there are 220. Given this size range, it ...

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The debate over the safety of giving birth at home, both for the mother and for the infant, has been debated for years. I’ve written about the issue myself. From time immemorial until about 75 years ago or so most babies were born at home. Now it’s around 1 percent in the U.S., although it’s much higher than that in many Western European countries. The shift to hospital births ...

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shutterstock_94423981 A recent series of articles in the Washington Post and a segment on NPR have caused quite a stir. The articles are about what we have called for decades shaken baby syndrome. It can be fatal. We now use the term non-accidental head trauma. This term replaced the older one because it is more specific; children ...

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shutterstock_134719667 Some months back I read an interesting interview with Jonathan Skinner, a researcher who works with the group at the renowned Dartmouth Atlas of Health Care. More than anyone else I can think of, the people at the Dartmouth Atlas have studied and tried both to understand and to explain the amazing variations we see in how ...

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One of the goals of the Affordable Care Act (a.k.a. Obamacare) was to increase access to primary care physicians. The notion is that if people have insurance it would be easier for them to get appointments with primary care physicians. This is because many physicians are unwilling to accept new patients who are uninsured. Further, a key component of the ACA was to increase physician reimbursement for Medicaid because this program ...

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