After Newtown: From Emotion to Action

It is clear that so many of us have been deeply impacted by the horrific school shooting in Newtown. My social media channels have been flooded by this event in a way I can’t remember happening before. Countless expressions of deep, deep sadness. Now, as the days pass many have started asking how to turn this deep emotion into positive change. How can we better protect our children? Continue reading

When Will We Choose Our Children?

An open letter to policymakers in the wake of another devastating shooting.

Today close to thirty people died in a horrific school shooting. In an elementary school. Twenty of the dead were young children. Countless other children were witness to this horrific crime.

Like so many times before the news comes to us as people talk about what happened. About the shooter. About the families.

Some people say that Americans are becoming numb to these shootings. That we have come to expect them. This is simply not true. Continue reading

A Prescription to Vote

As the November election draw near, some (especially those in swing states) may be starting to feel election fatigue. Tiring of the back and forth barbs, the never ending media coverage, and the ads as the candidates vie for your vote. Despite being a bit of a political junkie I rarely bring up politics via social media and never share my opinions in clinic. But, I do feel compelled to bring it up here now. Continue reading

On Justice and Medicine

During medical school, future physicians learn of the four pillars of medicine, the ethical foundation upon which we should strive to build our work in the field. The first three, beneficence (provide good care), nonmaleficence (do no harm), and respect for autonomy (of both patient and physician) are oft-cited in the medical literature and emphasized in our current healthcare system. The fourth pillar, justice, is sometimes forgotten. Webster‘s defines justice as “the quality of being just, impartial, or fair”. In simple terms, then, all physicians have been given the ethical obligation to treat all patients in a fair and impartial way. On a societal level, the fourth pillar of medicine provides the foundation for us to say that all persons have the right to quality health care. We are not living up to to this obligation. Very real disparities still exist in our health care system. Continue reading

Do we really need fluoride in our water?

The epidemic of poor oral health in young children, and the problems it can cause has been in the news. I recently wrote about how hard it is to keep young children’s teeth clean. (Thanks to some amazing reader suggestions, I’m happy to say that we’ve now got a great routine going that might actually approach two minutes of brushing.)  But, today I want to highlight an important public health measure that is helping many of us keep our kids teeth (and our own) healthier, and we might not even know it. Continue reading

You say Phys Ed, I say Phy Ed, let’s not call the whole thing off

In middle and high school I kind of hated phy ed. It all seemed so awkward. I mean, you come from class and change into awkward looking uniforms like this.

by Duke Yearlook, Duke University Archives

Okay, they weren’t quite that bad.  And then you stand around staring at your feet for awhile. Then you (if you are me) drag your 5 foot (on a good day with shoes) self out to the basketball court and kind of hope that no one throws you the ball or really expects you to make a basket. Twenty minutes or so later you head back to the locker room and face another awkward decision. Do you shower, or do you spend the rest of the day sweaty in order to preserve what’s left of the bangs that you had meticulously teased and sprayed that morning?  Now, to be fair, there were some great days in PE.  Archery was cool, badminton was fun, and the bowling unit was like getting a short field trip each day.  But, still, it was hard not to feel like PE was somehow a waste of time.  This, despite the fact that I was a kid that actually really liked being active and was part of various sports teams growing up.

Fast forward 20 years or so. That high school kid who wished she could get out of phy ed, is now a pediatrician who is a vigorous supporter of physical education for all children at all levels of education. Why the change? Well, the reasons are part anecdotal, and part data driven. Continue reading

The Changing Face of Hunger

As the fall-out of the recession lingers on, I am seeing more and more families in my clinic who are facing food insecurity and hunger. Many of these are families who used to be solidly middle class, but have been out of work for a year. They’ve already sold their car, their home, some of their belongings. They are running short each month. They are not sure where to turn, and they are often ashamed to talk about it. Continue reading

School-less in California

I recently became a fan of Rob Reiner.  No, it is not for his work on The Princess Bride (although I must say, “wuv tru wuv”).  I became a fan when I learned that he is a major advocate for early childhood development and helped to create First 5 California, a program that now provides critical services to young children.  And, then, I learned, he turned his energies toward making preschool available for all California children.  He backed Proposition 82 in 2006, a ballot initiative that would have provided access to free, voluntary, half-day preschool for all 4 year olds in California.    Some say the bill was well designed, some say flawedReiner took an incredible amount of heat for backing the bill, was forced to resign his position on the First 5 board, and the bill failed miserably at the polls.  What?  Well, it turns out that preschool is surprisingly controversial. Continue reading

Pediatrician as turnip, or feeling the squeeze

Are we keeping up with the times?

Recently Dr. Maggie Kozel wrote an excellent post for Huffington Post regarding the need for evolution in the way that we deliver health care in pediatrics.  This is a very timely article in an area that needs attention.  She responds to a recent study out of UCLA that found that well child visits are shorter than we would hope- one-third last less than 10 minutes.  There’s been a lot of talk about this study, but to be honest, I’m not at all surprised.  And, Dr. Kozel is the first I’ve heard truly address the reasons behind this problem.  The current structure of medicine forces primary care physicians to see more and more patients per day.  She points out that the study showed that this problem is especially notable in private practice. Continue reading