I've always wanted to be a pediatrician because I love kids; if you ask most people who work in pediatrics whether nurses or physicians they may say that. It's a very common response to the question "Why pediatrics?” Or how can you do pediatrics?" when students and physicians are asked. Yes, we love working with children for many reasons. Some love the unexpected unrehearsed things kids say; they will shock ...

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To be clear, this is about one person.  It warms my heart to know that people want to come and start new lives as Americans.  Some of the best doctors got their education and training overseas.  Not only have I worked with many of them, I’m related to three by marriage.  Most people have heard of Mr. Andrew Wakefield.   He used to be a British doctor before being stripped of ...

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As physicians ready themselves for the future of medicine under onerous MACRA regulations, it seems appropriate to glance into the future and visualize the medical utopia anticipated by so many.  Value-based care, determined by statistical analysis, is going to replace fee for service. Six months ago, I received my first set of statistics from a state Medicaid plan and was told my ER utilization numbers were on the higher end compared ...

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During the first year of medical school, one of the most nerve-wracking, but exciting, experiences was learning how to interview and examine patients. At that time, we mostly worked with “standardized patients” -- people who are trained specifically to play the role of a scripted medical case. Although working with them seemed incredibly challenging at the time, the rules of engagement were in fact very favorable to us. Asking a question ...

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Early in our careers, few of us imagined a vaccine could one day prevent cancer. Now there is a vaccine that keeps the risk of developing six Human Papillomavirus (HPV)-related cancers at bay, but adoption of it has been slow and surprising low. Although it’s been available for more than a decade, as of 2014 only 40 percent of girls had received the full three doses of the vaccine, ...

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I am a new mom to a beautiful 8-month-old girl, and I am breastfeeding. I am also a doctor at a large, well-known academic institution. The hospital where I work delivers several thousand babies a year, and highly encourages their new moms to breastfeed. They offer a postpartum consultation with a lactation consultant, keep the baby in the mom's room 24/7 while in the hospital, and provide several other pro-breastfeeding ...

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A fairly recent article in the Journal of Pediatrics is both intriguing and sobering. It is intriguing because it lays bare something we don’t talk much about or teach our students. It is sobering because it describes the potential harm that can come from it — harm I have personally witnessed. The issue is overdiagnosis, and it’s related to our relentless quest to explain everything. "Overdiagnosis" is the term the authors ...

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We do many things in medicine to patients that are either not helpful or have the potential to harm. If you take the long view of medical history, this should not be surprising. After all less than a century ago, physicians were still giving toxic mercury compounds to people in the form of calomel. And a century before that, physicians were bleeding people because they thought that was a good ...

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A concussion is a brain injury. A mild one, yes, but one that can lead to longstanding symptoms. What you do after a concussion, immediately and in the weeks that follow, can make a big difference in how your child recovers. Though it’s a mild injury -- there’s nothing to see on a CT, X-ray, or MRI -- the effects of a concussion can be significant and uncomfortable for a child ...

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William Osler once said, “Listen to your patient; he is telling you the diagnosis.”  Anybody who practices medicine knows that is easier said than done. The ability to take a skillful history takes years to develop. There are many nuances in a medical history and physicians must know the right questions to ask. The next step is to avoid asking the wrong questions and the wrong wording of the right ...

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