I have a colleague who has lost his capacity to continue practicing pediatric critical care medicine. It didn’t happen suddenly; it came on gradually over a year or so. It also didn’t follow from a single event or bad experience. It was just a creeping uneasiness that culminated in his unwillingness, after two decades, to go on doing this. Even though I’ve been practicing pediatric critical care for thirty years, ...
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I was changing my daughter’s diaper the other night when I noticed some spots. There was a cluster of six or so around her belly button and a line of them tracing her bottom rib on the right. They were reddish-brownish-purple pinpoints and when I pressed on them, they did not blanch. She did not seem bothered by them at all. I, on the other hand, began to quietly freak ...
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1. Pediatricians: Watchful Waiting Best for Ear Infections. Stricter diagnostic criteria and broader use of observation to further rein in antibiotic prescribing for acute otitis media emerged in a revision of American Academy of Pediatrics (AAP) guidelines.
2. Is Evidence-Based Medicine Only an Illusion? In a system where half of all clinical trials never ...
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I recently read an article on the RAND Corporation’s analysis of electronic health records (EHRs). As a practicing pediatrician currently using EHRs, and given the reality that EHRs are still a relatively new addition to the U.S. medical profession and have created a fundamental shift to the care delivery process, I am compelled to respond to assertions made in this article.
The first RAND study, sponsored by a ...
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Sam burst into the office, a two-year-old wild bundle of energy. Squealing with delight -- or was it distress; it was hard to tell -- he ran from toy to toy not looking at me or his mother, Jane. He was unable to engage with anything. Jane had brought him to see me in my pediatric practice because, “he hits me, has explosive tantrums, and I can’t take him anywhere.” ...
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During a routine office visit, I was discussing activities and extracurriculars with a bright 10-year old girl. She loved talking about her dance team, gymnastics, and her new hobby of horseback riding.
Towards the end of our conversation, however, she said something that surprised me: “And, I am addicted to Pinterest.”
I turned to her mother, who was also in the exam room, and asked, “Did you know she is on Pinterest? ...
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Young children are naturally petulant, noisy, and self-centered. We’re all born with ourselves in the center of the universe, an impression reinforced by parents who must cater constantly to their young babies. But babies become toddlers, and toddlers become children. Sometime during this transition, parents have to teach their children that they are part of a family. For a family to function ...
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If only it was as simple as looking into our old Magic 8 Balls® to find out if it is “Very doubtful” or “Decidedly so” that refusing to stop at the Good Humor® truck on the way home from school will be the right thing to do for our children. It is worries like this, along with the challenge of raising children ...
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As a pediatrician at a busy county clinic with close proximity to pediatric specialists, I care for a significant number of children with special health care needs. Instead of colds and ear infections (though there are those too), my days are often filled thinking about gastrostomy tubes, tracheostomies, and ventriculo-peritoneal shunts. I sign orders for specialty formulas and nebulizer machines. Many of my patients have thick charts and diagnoses like ...
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Those who forget history are doomed to repeat it. Most of us have not had personal experience with illnesses like measles, mumps, German measles, or polio. Thank goodness for that. It is because a generation ago individuals, families, and doctors choose a different path. They witnessed loved ones stricken with these diseases. When the opportunity arose to protect themselves from these ...
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