David Hill, MD

What’s your idea of adventure travel? Scuba-diving with sharks? Scaling glaciers? Child’s play. I am about to spend 2 weeks driving around the western United States with five kids. Are you not yet afraid? Three of them are teenagers. Still not afraid? We’re taking away their iPhones. Now tell me you don’t feel the cold sweat.

Jupiterimages

We’re not broaching any whining, either. After all, we’re renting an SUV large enough to be seen from the International Space Station. And there will be old-school entertainment: travel BINGO, Mad Libs, and I-swear-if-you-don’t-stop-fighting-I’m-leaving-you-both-here-in-the-desert-to-walk-home. Then, when we reach our destination, my wife and I will play who-can-finish-their-wine-first. Depending on how this trip goes, we may make it a tradition, but just in case, save me a spot in the shark cage.

Make it work

Okay, y’all, I’m calling a moratorium on Jenny McCarthy jokes. I know what you’re thinking: “But she’s comedy gold! What else are you going to make fun of?” There’s always gross stuff guaranteed to get a laugh like baby poop, spit-up, and drug reps, but that’s not the point. The point is that no one would listen to vapid celebrities spouting antivaccine rhetoric if they didn’t have the support of a couple of actual pediatricians (let’s call them “Dr. Rob” and “Dr. Kay”) who’ve made lucrative careers selling pseudoscientific, legitimate-sounding arguments with all the integrity of, well, baby poop.

I know these guys  are tempted to rest on their laurels, having done their fair share to ensure that the next generation of doctors gets firsthand experience of measles and whooping cough, but thanks to a new study, they’re going to have to step up their game.  In order to argue against vaccines, you need to convince people of two things that are patently false: that vaccines are somehow dangerous, and that vaccine-preventable diseases are somehow safe. Oh, and one more: that you are somehow credible.

In order to better define what we mean when we say that vaccines are “safe,” Margaret A. Maglione, MPP of the Rand Corporation evaluated 20,478 studies of vaccine side effects. I can only assume that Ms. Maglione has no hobbies. The results would surprise only those people who have shelled out good money for books full of bad science.

Let me sum up: Measles/mumps/rubella vaccine does not cause autism, but it can cause febrile seizures which, unlike measles, mumps, and rubella, are harmless. (“Dr. Kay” doesn’t think measles is so bad because, you know, since no one he knows has died of it yet.) Varicella vaccine can cause problems for immunocompromised patients, which is why we don’t give it to immunocompromised patients. Rotavirus vaccine may cause very rare cases of intussusception, which must be weighed against its ability to prevent nearly 70,000 hospitalizations and 60 deaths a year in the U.S. alone.

Of course, I don’t think for a minute that solid science will cut into anyone’s book sales or the growing rates of preventable life-threatening diseases. If we’ve learned one thing from recent history, it’s that facts are never a barrier when people have a vested emotional or financial interest in ignoring them. After all, have you ever seen a baby run out of poop?

Kids' size

There are some experiences that really should wait for adulthood to be fully enjoyed: drinking champagne, gambling in Las Vegas, standing in line at the DMV. To this list I propose we add looking critically at your body. Kids should still just be amazed to have a belly button, not looking in the mirror and wondering how they can lose some of that applesauce weight. A new study out of Australia, however, suggests that body dissatisfaction starts at an alarmingly young age: 8-9 years old. And that’s only because that’s the age group the authors studied. For all we know, there are infants out there comparing themselves to Cabbage Patch Kids and thinking, “I wish my cheeks weren’t so chubby...”

The study, headed by Dr. Ben Edwards of the Australian Institute of Family Studies, tracked more than 4,000 children from age 8 to age 11 years, comparing their perceptions of their bodies to their actual sizes. More than half the children said they desired a body size that was slightly thinner than average, making me wonder what sort of scrawny superheroes they show on Australian television. By age 11, 61% of boys and 56% of girls had tried to do something to manage their weight, with the most effective intervention being “not moving to America.”

Just like adults, kids who were unhappy with their bodies also had more problems being social and enjoying exercise. I think it’s tragic that children this young are already developing body issues, and in a country with distractions as amazing as actual kangaroos! And of course it won’t be long before the hucksters exploit this market: Who wants a Garcinia gummy?!

Framed

In school, kids used to call me “four-eyes.” Then I’d  explain calmly that I didn’t actually have four eyes, it was just that due to the high refractive index of my glasses, light traveling at certain angles would produce duplicate images, which I’d then go on to demonstrate with a simple diagram and a protractor, which did nothing to stop the name-calling. Now a group of ophthalmologists from Germany have used science and technology to prove that the stereotype of the squinting intellectual is based in truth. I hate stereotypes, and anyway, could anything be more German?

The study found a strong correlation between years spent in school and myopia, bolstering theories that staying indoors and staring at books actually contribute to the changes in eye structure that cause nearsightedness. The authors suggest that if kids spend more time outdoors, fewer of them will need glasses. It’s already too late to save two of our children from my fate, but I think taking away the iPhones is a good start, and if that doesn’t work, there’s always that walk in the desert.

David L. Hill, M.D., FAAP, is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and  adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.

What’s your idea of adventure travel? Scuba-diving with sharks? Scaling glaciers? Child’s play. I am about to spend 2 weeks driving around the western United States with five kids. Are you not yet afraid? Three of them are teenagers. Still not afraid? We’re taking away their iPhones. Now tell me you don’t feel the cold sweat.

Jupiterimages

We’re not broaching any whining, either. After all, we’re renting an SUV large enough to be seen from the International Space Station. And there will be old-school entertainment: travel BINGO, Mad Libs, and I-swear-if-you-don’t-stop-fighting-I’m-leaving-you-both-here-in-the-desert-to-walk-home. Then, when we reach our destination, my wife and I will play who-can-finish-their-wine-first. Depending on how this trip goes, we may make it a tradition, but just in case, save me a spot in the shark cage.

Make it work

Okay, y’all, I’m calling a moratorium on Jenny McCarthy jokes. I know what you’re thinking: “But she’s comedy gold! What else are you going to make fun of?” There’s always gross stuff guaranteed to get a laugh like baby poop, spit-up, and drug reps, but that’s not the point. The point is that no one would listen to vapid celebrities spouting antivaccine rhetoric if they didn’t have the support of a couple of actual pediatricians (let’s call them “Dr. Rob” and “Dr. Kay”) who’ve made lucrative careers selling pseudoscientific, legitimate-sounding arguments with all the integrity of, well, baby poop.

I know these guys  are tempted to rest on their laurels, having done their fair share to ensure that the next generation of doctors gets firsthand experience of measles and whooping cough, but thanks to a new study, they’re going to have to step up their game.  In order to argue against vaccines, you need to convince people of two things that are patently false: that vaccines are somehow dangerous, and that vaccine-preventable diseases are somehow safe. Oh, and one more: that you are somehow credible.

In order to better define what we mean when we say that vaccines are “safe,” Margaret A. Maglione, MPP of the Rand Corporation evaluated 20,478 studies of vaccine side effects. I can only assume that Ms. Maglione has no hobbies. The results would surprise only those people who have shelled out good money for books full of bad science.

Let me sum up: Measles/mumps/rubella vaccine does not cause autism, but it can cause febrile seizures which, unlike measles, mumps, and rubella, are harmless. (“Dr. Kay” doesn’t think measles is so bad because, you know, since no one he knows has died of it yet.) Varicella vaccine can cause problems for immunocompromised patients, which is why we don’t give it to immunocompromised patients. Rotavirus vaccine may cause very rare cases of intussusception, which must be weighed against its ability to prevent nearly 70,000 hospitalizations and 60 deaths a year in the U.S. alone.

Of course, I don’t think for a minute that solid science will cut into anyone’s book sales or the growing rates of preventable life-threatening diseases. If we’ve learned one thing from recent history, it’s that facts are never a barrier when people have a vested emotional or financial interest in ignoring them. After all, have you ever seen a baby run out of poop?

Kids' size

There are some experiences that really should wait for adulthood to be fully enjoyed: drinking champagne, gambling in Las Vegas, standing in line at the DMV. To this list I propose we add looking critically at your body. Kids should still just be amazed to have a belly button, not looking in the mirror and wondering how they can lose some of that applesauce weight. A new study out of Australia, however, suggests that body dissatisfaction starts at an alarmingly young age: 8-9 years old. And that’s only because that’s the age group the authors studied. For all we know, there are infants out there comparing themselves to Cabbage Patch Kids and thinking, “I wish my cheeks weren’t so chubby...”

The study, headed by Dr. Ben Edwards of the Australian Institute of Family Studies, tracked more than 4,000 children from age 8 to age 11 years, comparing their perceptions of their bodies to their actual sizes. More than half the children said they desired a body size that was slightly thinner than average, making me wonder what sort of scrawny superheroes they show on Australian television. By age 11, 61% of boys and 56% of girls had tried to do something to manage their weight, with the most effective intervention being “not moving to America.”

Just like adults, kids who were unhappy with their bodies also had more problems being social and enjoying exercise. I think it’s tragic that children this young are already developing body issues, and in a country with distractions as amazing as actual kangaroos! And of course it won’t be long before the hucksters exploit this market: Who wants a Garcinia gummy?!

Framed

In school, kids used to call me “four-eyes.” Then I’d  explain calmly that I didn’t actually have four eyes, it was just that due to the high refractive index of my glasses, light traveling at certain angles would produce duplicate images, which I’d then go on to demonstrate with a simple diagram and a protractor, which did nothing to stop the name-calling. Now a group of ophthalmologists from Germany have used science and technology to prove that the stereotype of the squinting intellectual is based in truth. I hate stereotypes, and anyway, could anything be more German?

The study found a strong correlation between years spent in school and myopia, bolstering theories that staying indoors and staring at books actually contribute to the changes in eye structure that cause nearsightedness. The authors suggest that if kids spend more time outdoors, fewer of them will need glasses. It’s already too late to save two of our children from my fate, but I think taking away the iPhones is a good start, and if that doesn’t work, there’s always that walk in the desert.

David L. Hill, M.D., FAAP, is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and  adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.

What’s your idea of adventure travel? Scuba-diving with sharks? Scaling glaciers? Child’s play. I am about to spend 2 weeks driving around the western United States with five kids. Are you not yet afraid? Three of them are teenagers. Still not afraid? We’re taking away their iPhones. Now tell me you don’t feel the cold sweat.

Jupiterimages

We’re not broaching any whining, either. After all, we’re renting an SUV large enough to be seen from the International Space Station. And there will be old-school entertainment: travel BINGO, Mad Libs, and I-swear-if-you-don’t-stop-fighting-I’m-leaving-you-both-here-in-the-desert-to-walk-home. Then, when we reach our destination, my wife and I will play who-can-finish-their-wine-first. Depending on how this trip goes, we may make it a tradition, but just in case, save me a spot in the shark cage.

Make it work

Okay, y’all, I’m calling a moratorium on Jenny McCarthy jokes. I know what you’re thinking: “But she’s comedy gold! What else are you going to make fun of?” There’s always gross stuff guaranteed to get a laugh like baby poop, spit-up, and drug reps, but that’s not the point. The point is that no one would listen to vapid celebrities spouting antivaccine rhetoric if they didn’t have the support of a couple of actual pediatricians (let’s call them “Dr. Rob” and “Dr. Kay”) who’ve made lucrative careers selling pseudoscientific, legitimate-sounding arguments with all the integrity of, well, baby poop.

I know these guys  are tempted to rest on their laurels, having done their fair share to ensure that the next generation of doctors gets firsthand experience of measles and whooping cough, but thanks to a new study, they’re going to have to step up their game.  In order to argue against vaccines, you need to convince people of two things that are patently false: that vaccines are somehow dangerous, and that vaccine-preventable diseases are somehow safe. Oh, and one more: that you are somehow credible.

In order to better define what we mean when we say that vaccines are “safe,” Margaret A. Maglione, MPP of the Rand Corporation evaluated 20,478 studies of vaccine side effects. I can only assume that Ms. Maglione has no hobbies. The results would surprise only those people who have shelled out good money for books full of bad science.

Let me sum up: Measles/mumps/rubella vaccine does not cause autism, but it can cause febrile seizures which, unlike measles, mumps, and rubella, are harmless. (“Dr. Kay” doesn’t think measles is so bad because, you know, since no one he knows has died of it yet.) Varicella vaccine can cause problems for immunocompromised patients, which is why we don’t give it to immunocompromised patients. Rotavirus vaccine may cause very rare cases of intussusception, which must be weighed against its ability to prevent nearly 70,000 hospitalizations and 60 deaths a year in the U.S. alone.

Of course, I don’t think for a minute that solid science will cut into anyone’s book sales or the growing rates of preventable life-threatening diseases. If we’ve learned one thing from recent history, it’s that facts are never a barrier when people have a vested emotional or financial interest in ignoring them. After all, have you ever seen a baby run out of poop?

Kids' size

There are some experiences that really should wait for adulthood to be fully enjoyed: drinking champagne, gambling in Las Vegas, standing in line at the DMV. To this list I propose we add looking critically at your body. Kids should still just be amazed to have a belly button, not looking in the mirror and wondering how they can lose some of that applesauce weight. A new study out of Australia, however, suggests that body dissatisfaction starts at an alarmingly young age: 8-9 years old. And that’s only because that’s the age group the authors studied. For all we know, there are infants out there comparing themselves to Cabbage Patch Kids and thinking, “I wish my cheeks weren’t so chubby...”

The study, headed by Dr. Ben Edwards of the Australian Institute of Family Studies, tracked more than 4,000 children from age 8 to age 11 years, comparing their perceptions of their bodies to their actual sizes. More than half the children said they desired a body size that was slightly thinner than average, making me wonder what sort of scrawny superheroes they show on Australian television. By age 11, 61% of boys and 56% of girls had tried to do something to manage their weight, with the most effective intervention being “not moving to America.”

Just like adults, kids who were unhappy with their bodies also had more problems being social and enjoying exercise. I think it’s tragic that children this young are already developing body issues, and in a country with distractions as amazing as actual kangaroos! And of course it won’t be long before the hucksters exploit this market: Who wants a Garcinia gummy?!

Framed

In school, kids used to call me “four-eyes.” Then I’d  explain calmly that I didn’t actually have four eyes, it was just that due to the high refractive index of my glasses, light traveling at certain angles would produce duplicate images, which I’d then go on to demonstrate with a simple diagram and a protractor, which did nothing to stop the name-calling. Now a group of ophthalmologists from Germany have used science and technology to prove that the stereotype of the squinting intellectual is based in truth. I hate stereotypes, and anyway, could anything be more German?

The study found a strong correlation between years spent in school and myopia, bolstering theories that staying indoors and staring at books actually contribute to the changes in eye structure that cause nearsightedness. The authors suggest that if kids spend more time outdoors, fewer of them will need glasses. It’s already too late to save two of our children from my fate, but I think taking away the iPhones is a good start, and if that doesn’t work, there’s always that walk in the desert.

David L. Hill, M.D., FAAP, is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and  adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.

As pediatricians, our first response to the announcement today by CVS/Caremark that they would stop selling tobacco products in all their stores should be to applaud. As soon as we’re done, however, we should ask ourselves: Why would the nation’s second-biggest drugstore chain relinquish $2 billion a year in sales? The answer to that question should be a wake-up call to us all.

First, the good news: While pharmacy sales of tobacco reportedly account for only 5% of U.S. purchases, any time kids and parents in our practices can avoid the temptation presented by a wall of tobacco products is a good day. We can only hope that other pharmacies follow suit for fear that doctors everywhere will steer patients toward CVS. Unfortunately, I suspect the tobacco industry has little to fear from this development.

Next, the concerning news: Doctors’ offices don’t sell cigarettes, and comments from CVS president and CEO Larry J. Merlo make it clear that’s where they’re heading with this.

"As the delivery of health care evolves with an emphasis on better health outcomes, reducing chronic disease and controlling costs, CVS/Caremark is playing an expanded role in providing care through our pharmacists and nurse practitioners.

"Put simply, the sale of tobacco products is inconsistent with our purpose," Mr. Merlo said.

CVS already runs more than 800 MinuteClinics in 28 states and the District of Columbia, staffed by nurse practitioners. Additionally, they are the only pharmacy chain equipped with a huge pharmacy benefits management company, Caremark. CVS knows where the growth is, and it’s not in a tobacco field.

Why do executives and shareholders seem so sanguine about getting out of the tobacco business? Because they are doubling down on their investment in our business. If that doesn’t scare you just a little, you’re either not involved in patient care, or you’re not paying attention.

How are you going to compete with CVS/Caremark? Do you have walk-in hours? Late hours? Short wait times? Do your patients understand the value of a patient-centered medical home with a board-certified fellow of the American Academy of Pediatrics at its helm? Are you joining an accountable care organization?

It will take CVS months to empty its stores of tobacco products. If you walk into one of those stores in the meantime, take a good look at the cigarette display and ask yourself, "What are they going to replace those with?" Unless you’re prepared to compete, the answer may well be "your patients."

Dr. Hill is vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as chair-elect of the American Academy of Pediatrics Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. Dr. Hill said he had no relevant conflicts of interest.

As pediatricians, our first response to the announcement today by CVS/Caremark that they would stop selling tobacco products in all their stores should be to applaud. As soon as we’re done, however, we should ask ourselves: Why would the nation’s second-biggest drugstore chain relinquish $2 billion a year in sales? The answer to that question should be a wake-up call to us all.

First, the good news: While pharmacy sales of tobacco reportedly account for only 5% of U.S. purchases, any time kids and parents in our practices can avoid the temptation presented by a wall of tobacco products is a good day. We can only hope that other pharmacies follow suit for fear that doctors everywhere will steer patients toward CVS. Unfortunately, I suspect the tobacco industry has little to fear from this development.

Next, the concerning news: Doctors’ offices don’t sell cigarettes, and comments from CVS president and CEO Larry J. Merlo make it clear that’s where they’re heading with this.

"As the delivery of health care evolves with an emphasis on better health outcomes, reducing chronic disease and controlling costs, CVS/Caremark is playing an expanded role in providing care through our pharmacists and nurse practitioners.

"Put simply, the sale of tobacco products is inconsistent with our purpose," Mr. Merlo said.

CVS already runs more than 800 MinuteClinics in 28 states and the District of Columbia, staffed by nurse practitioners. Additionally, they are the only pharmacy chain equipped with a huge pharmacy benefits management company, Caremark. CVS knows where the growth is, and it’s not in a tobacco field.

Why do executives and shareholders seem so sanguine about getting out of the tobacco business? Because they are doubling down on their investment in our business. If that doesn’t scare you just a little, you’re either not involved in patient care, or you’re not paying attention.

How are you going to compete with CVS/Caremark? Do you have walk-in hours? Late hours? Short wait times? Do your patients understand the value of a patient-centered medical home with a board-certified fellow of the American Academy of Pediatrics at its helm? Are you joining an accountable care organization?

It will take CVS months to empty its stores of tobacco products. If you walk into one of those stores in the meantime, take a good look at the cigarette display and ask yourself, "What are they going to replace those with?" Unless you’re prepared to compete, the answer may well be "your patients."

Dr. Hill is vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as chair-elect of the American Academy of Pediatrics Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. Dr. Hill said he had no relevant conflicts of interest.

As pediatricians, our first response to the announcement today by CVS/Caremark that they would stop selling tobacco products in all their stores should be to applaud. As soon as we’re done, however, we should ask ourselves: Why would the nation’s second-biggest drugstore chain relinquish $2 billion a year in sales? The answer to that question should be a wake-up call to us all.

First, the good news: While pharmacy sales of tobacco reportedly account for only 5% of U.S. purchases, any time kids and parents in our practices can avoid the temptation presented by a wall of tobacco products is a good day. We can only hope that other pharmacies follow suit for fear that doctors everywhere will steer patients toward CVS. Unfortunately, I suspect the tobacco industry has little to fear from this development.

Next, the concerning news: Doctors’ offices don’t sell cigarettes, and comments from CVS president and CEO Larry J. Merlo make it clear that’s where they’re heading with this.

"As the delivery of health care evolves with an emphasis on better health outcomes, reducing chronic disease and controlling costs, CVS/Caremark is playing an expanded role in providing care through our pharmacists and nurse practitioners.

"Put simply, the sale of tobacco products is inconsistent with our purpose," Mr. Merlo said.

CVS already runs more than 800 MinuteClinics in 28 states and the District of Columbia, staffed by nurse practitioners. Additionally, they are the only pharmacy chain equipped with a huge pharmacy benefits management company, Caremark. CVS knows where the growth is, and it’s not in a tobacco field.

Why do executives and shareholders seem so sanguine about getting out of the tobacco business? Because they are doubling down on their investment in our business. If that doesn’t scare you just a little, you’re either not involved in patient care, or you’re not paying attention.

How are you going to compete with CVS/Caremark? Do you have walk-in hours? Late hours? Short wait times? Do your patients understand the value of a patient-centered medical home with a board-certified fellow of the American Academy of Pediatrics at its helm? Are you joining an accountable care organization?

It will take CVS months to empty its stores of tobacco products. If you walk into one of those stores in the meantime, take a good look at the cigarette display and ask yourself, "What are they going to replace those with?" Unless you’re prepared to compete, the answer may well be "your patients."

Dr. Hill is vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as chair-elect of the American Academy of Pediatrics Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. Dr. Hill said he had no relevant conflicts of interest.

Motivational speaker Tony Robbins endured potentially embarrassing publicity this week when 21 attendees of his workshop “Unleash The Power Within” sustained second- and third-degree burns while walking on hot embers.  The firewalking ritual was apparently designed to help participants learn that Robbins can get people to pay to walk on burning coals.

In a press release, Robbins Research International explained that over 6,000 people walked on the coals, and the vast majority of them did not require emergency medical services. I wonder if the ones who were burned failed to internalize the speaker’s message, "understand that there is absolutely nothing you can't overcome," or maybe they just never learned that thermal effusivity is determined by the square root of the product of thermal conductivity, density, and specific heat capacity. In response, I’m planning my own motivational workshop entitled, “Unleash The Power Of Shoes.”

Photo CuchulainMacLugh/iStockphoto.com

A survey of parents who belong to online support networks for trisomy 13 and trisomy 18 suggests that some pediatricians could be more sensitive when talking about genetic conditions. By “more sensitive,” I mean we should refrain from referring to someone’s child as “the T-13,” or, as some parents reported, “it." Parents who chose medical intervention rather than comfort care for these typically-severe conditions also recall pediatricians telling them their children would be “vegetables,” would lead “meaningless lives,” and would “ruin their marriages.” Some parents felt such statements were “judgmental.” Around half the the parents surveyed acknowledged that caring for their disabled children was harder than they had expected. An overwhelming 97% of parents, however, described their children as “happy,” and a large majority felt their children had enriched their lives. I suspect this study will have a profound effect on how pediatric residency programs teach trainees to talk with parents about severe medical conditions. As for me, I’ve pledged never to refer to any child in my practice as “it.”

Officials from the Centers For Disease Control (CDC) held a press conference last week to discuss this year’s explosion in cases of whooping cough (Bordatella pertussis), currently projected to hit a 50-year high. While unvaccinated children are 8 times more likely to contract pertussis than vaccinated children, the CDC’s Dr. Anne Schuchat explains that vaccine hesitancy has not yet been a major factor in the spread of the disease, even in severely affected Washington State, where adequate vaccine protection threatens to go the way of professional basketball. Since the most severely affected infants are too young to have been completely immunized, it still appears the best response to the outbreak is to encourage adults to get their Tdap boosters if they plan to have a baby, be around a baby, or walk within 100 yards of a Toys R Us store.

A new study on sexual content in movies and teen sexual behavior is making me want to cancel our family’s cable service. Researchers writing in Psychological Science interviewed kids between the ages of 12 and 14 about what movies they had watched, then they interviewed those same kids 6 years later about their sexual activity. Not only did they prove both that watching movies with more sexual content correlates strongly with unsafe sexual behaviors, but they won a bar bet about whose research team could wait the longest to collect results. The authors explained that watching movies with sexual content could permanently alter kids’ appetites for novel sensations as well as providing “sexual scripts” for their behavior, since the majority of US 15-year-olds rely on the media as their #1 source of sexual information.

Personally, I was shocked enough just to read that 68% of G-rated films contain some sexual content. I’m tempted to go back and re-watch the entire Land Before Time series, but I think I’d rather walk on hot coals.

Motivational speaker Tony Robbins endured potentially embarrassing publicity this week when 21 attendees of his workshop “Unleash The Power Within” sustained second- and third-degree burns while walking on hot embers.  The firewalking ritual was apparently designed to help participants learn that Robbins can get people to pay to walk on burning coals.

In a press release, Robbins Research International explained that over 6,000 people walked on the coals, and the vast majority of them did not require emergency medical services. I wonder if the ones who were burned failed to internalize the speaker’s message, "understand that there is absolutely nothing you can't overcome," or maybe they just never learned that thermal effusivity is determined by the square root of the product of thermal conductivity, density, and specific heat capacity. In response, I’m planning my own motivational workshop entitled, “Unleash The Power Of Shoes.”

Photo CuchulainMacLugh/iStockphoto.com

A survey of parents who belong to online support networks for trisomy 13 and trisomy 18 suggests that some pediatricians could be more sensitive when talking about genetic conditions. By “more sensitive,” I mean we should refrain from referring to someone’s child as “the T-13,” or, as some parents reported, “it." Parents who chose medical intervention rather than comfort care for these typically-severe conditions also recall pediatricians telling them their children would be “vegetables,” would lead “meaningless lives,” and would “ruin their marriages.” Some parents felt such statements were “judgmental.” Around half the the parents surveyed acknowledged that caring for their disabled children was harder than they had expected. An overwhelming 97% of parents, however, described their children as “happy,” and a large majority felt their children had enriched their lives. I suspect this study will have a profound effect on how pediatric residency programs teach trainees to talk with parents about severe medical conditions. As for me, I’ve pledged never to refer to any child in my practice as “it.”

Officials from the Centers For Disease Control (CDC) held a press conference last week to discuss this year’s explosion in cases of whooping cough (Bordatella pertussis), currently projected to hit a 50-year high. While unvaccinated children are 8 times more likely to contract pertussis than vaccinated children, the CDC’s Dr. Anne Schuchat explains that vaccine hesitancy has not yet been a major factor in the spread of the disease, even in severely affected Washington State, where adequate vaccine protection threatens to go the way of professional basketball. Since the most severely affected infants are too young to have been completely immunized, it still appears the best response to the outbreak is to encourage adults to get their Tdap boosters if they plan to have a baby, be around a baby, or walk within 100 yards of a Toys R Us store.

A new study on sexual content in movies and teen sexual behavior is making me want to cancel our family’s cable service. Researchers writing in Psychological Science interviewed kids between the ages of 12 and 14 about what movies they had watched, then they interviewed those same kids 6 years later about their sexual activity. Not only did they prove both that watching movies with more sexual content correlates strongly with unsafe sexual behaviors, but they won a bar bet about whose research team could wait the longest to collect results. The authors explained that watching movies with sexual content could permanently alter kids’ appetites for novel sensations as well as providing “sexual scripts” for their behavior, since the majority of US 15-year-olds rely on the media as their #1 source of sexual information.

Personally, I was shocked enough just to read that 68% of G-rated films contain some sexual content. I’m tempted to go back and re-watch the entire Land Before Time series, but I think I’d rather walk on hot coals.

Motivational speaker Tony Robbins endured potentially embarrassing publicity this week when 21 attendees of his workshop “Unleash The Power Within” sustained second- and third-degree burns while walking on hot embers.  The firewalking ritual was apparently designed to help participants learn that Robbins can get people to pay to walk on burning coals.

In a press release, Robbins Research International explained that over 6,000 people walked on the coals, and the vast majority of them did not require emergency medical services. I wonder if the ones who were burned failed to internalize the speaker’s message, "understand that there is absolutely nothing you can't overcome," or maybe they just never learned that thermal effusivity is determined by the square root of the product of thermal conductivity, density, and specific heat capacity. In response, I’m planning my own motivational workshop entitled, “Unleash The Power Of Shoes.”

Photo CuchulainMacLugh/iStockphoto.com

A survey of parents who belong to online support networks for trisomy 13 and trisomy 18 suggests that some pediatricians could be more sensitive when talking about genetic conditions. By “more sensitive,” I mean we should refrain from referring to someone’s child as “the T-13,” or, as some parents reported, “it." Parents who chose medical intervention rather than comfort care for these typically-severe conditions also recall pediatricians telling them their children would be “vegetables,” would lead “meaningless lives,” and would “ruin their marriages.” Some parents felt such statements were “judgmental.” Around half the the parents surveyed acknowledged that caring for their disabled children was harder than they had expected. An overwhelming 97% of parents, however, described their children as “happy,” and a large majority felt their children had enriched their lives. I suspect this study will have a profound effect on how pediatric residency programs teach trainees to talk with parents about severe medical conditions. As for me, I’ve pledged never to refer to any child in my practice as “it.”

Officials from the Centers For Disease Control (CDC) held a press conference last week to discuss this year’s explosion in cases of whooping cough (Bordatella pertussis), currently projected to hit a 50-year high. While unvaccinated children are 8 times more likely to contract pertussis than vaccinated children, the CDC’s Dr. Anne Schuchat explains that vaccine hesitancy has not yet been a major factor in the spread of the disease, even in severely affected Washington State, where adequate vaccine protection threatens to go the way of professional basketball. Since the most severely affected infants are too young to have been completely immunized, it still appears the best response to the outbreak is to encourage adults to get their Tdap boosters if they plan to have a baby, be around a baby, or walk within 100 yards of a Toys R Us store.

A new study on sexual content in movies and teen sexual behavior is making me want to cancel our family’s cable service. Researchers writing in Psychological Science interviewed kids between the ages of 12 and 14 about what movies they had watched, then they interviewed those same kids 6 years later about their sexual activity. Not only did they prove both that watching movies with more sexual content correlates strongly with unsafe sexual behaviors, but they won a bar bet about whose research team could wait the longest to collect results. The authors explained that watching movies with sexual content could permanently alter kids’ appetites for novel sensations as well as providing “sexual scripts” for their behavior, since the majority of US 15-year-olds rely on the media as their #1 source of sexual information.

Personally, I was shocked enough just to read that 68% of G-rated films contain some sexual content. I’m tempted to go back and re-watch the entire Land Before Time series, but I think I’d rather walk on hot coals.

The whole country is still abuzz about last week's huge legal news, the landmark case that is likely to play out through November and whose repercussions will eventually touch every American. To the relief of so many of us, Katie Holmes is finally filing for divorce from Tom Cruise. Admit it, the suspense was killing you.

Pediatricians have many judges to thank this week, and not only the five Supreme Court Justices who voted to uphold the Affordable Care Act. We can also thank the Federal District Court that just issued a permanent injunction in the unpronounceable-yet-critical case of Wollschlaeger vs. Farmer, better known to pediatricians as the "Florida Gun Gag Law." Not only does the decision protect Florida pediatricians' right to counsel patients about a hazard that accounts for 1 out of every 25 pediatric trauma center admissions, but it should earn the judge a place in the Guinness Book Of World Records for overturning what has to be The World’s Stupidest Law.

New research adds fuel to the debate over whether parents who spank their kids should be put in time out. A group of Canadian researchers studied whether adults who recall their parents pushing, grabbing, shoving, slapping, or hitting them in childhood were more likely to suffer from mood disorders, anxiety disorders, alcohol and drug abuse/dependence, and personality disorders. After all the math, such punishments seemed to account for between 2% and 7% of the studied mental health diagnoses.

In my opinion, proponents of corporal punishment would probably quickly point out that 93% to 98% of kids whose parents push, grab, shove, slap, or hit them do just great, and they may be even more likely to become successful talk radio personalities. Critics also attacked the methodology, pointing out that the study relied purely on adult subjects’ recollection of their childhoods.

Clearly the only way to settle this debate is to embark on a 20-year prospective trial in which half of parents are randomized to push, grab, shove, slap, or hit their children and the other half are assigned to move to one of the 24 countries that have outlawed spanking. Of course the parents who move would have to contend with really boring talk radio.

©koya79/Fotolia.com

Finally, in yet another blow to the egos of mid-career doctors (ahem), it turns out medical residents in training can do our jobs just as well as we can, provided they're adequately supervised. A meta-analysis of 97 studies of resident training and patient outcomes did find that residents’ performance tended to improve with time, becoming equal to that of fully trained physicians around the day they're fully trained. Future studies will examine whether experienced clinicians' jobs can be performed equally well by adequately supervised robots, rhesus monkeys, and GI Joe dolls with the Kung Fu grip. Fortunately by the time these studies are completed I will have moved on from medicine to a lucrative career training monkeys in the practice of divorce law. I have a tip there’s a famous client who might be interested.

David L. Hill, M.D., FAAP, is vice president of Cape Fear Pediatrics in Wilmington, N.C. and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. 

The whole country is still abuzz about last week's huge legal news, the landmark case that is likely to play out through November and whose repercussions will eventually touch every American. To the relief of so many of us, Katie Holmes is finally filing for divorce from Tom Cruise. Admit it, the suspense was killing you.

Pediatricians have many judges to thank this week, and not only the five Supreme Court Justices who voted to uphold the Affordable Care Act. We can also thank the Federal District Court that just issued a permanent injunction in the unpronounceable-yet-critical case of Wollschlaeger vs. Farmer, better known to pediatricians as the "Florida Gun Gag Law." Not only does the decision protect Florida pediatricians' right to counsel patients about a hazard that accounts for 1 out of every 25 pediatric trauma center admissions, but it should earn the judge a place in the Guinness Book Of World Records for overturning what has to be The World’s Stupidest Law.

New research adds fuel to the debate over whether parents who spank their kids should be put in time out. A group of Canadian researchers studied whether adults who recall their parents pushing, grabbing, shoving, slapping, or hitting them in childhood were more likely to suffer from mood disorders, anxiety disorders, alcohol and drug abuse/dependence, and personality disorders. After all the math, such punishments seemed to account for between 2% and 7% of the studied mental health diagnoses.

In my opinion, proponents of corporal punishment would probably quickly point out that 93% to 98% of kids whose parents push, grab, shove, slap, or hit them do just great, and they may be even more likely to become successful talk radio personalities. Critics also attacked the methodology, pointing out that the study relied purely on adult subjects’ recollection of their childhoods.

Clearly the only way to settle this debate is to embark on a 20-year prospective trial in which half of parents are randomized to push, grab, shove, slap, or hit their children and the other half are assigned to move to one of the 24 countries that have outlawed spanking. Of course the parents who move would have to contend with really boring talk radio.

©koya79/Fotolia.com

Finally, in yet another blow to the egos of mid-career doctors (ahem), it turns out medical residents in training can do our jobs just as well as we can, provided they're adequately supervised. A meta-analysis of 97 studies of resident training and patient outcomes did find that residents’ performance tended to improve with time, becoming equal to that of fully trained physicians around the day they're fully trained. Future studies will examine whether experienced clinicians' jobs can be performed equally well by adequately supervised robots, rhesus monkeys, and GI Joe dolls with the Kung Fu grip. Fortunately by the time these studies are completed I will have moved on from medicine to a lucrative career training monkeys in the practice of divorce law. I have a tip there’s a famous client who might be interested.

David L. Hill, M.D., FAAP, is vice president of Cape Fear Pediatrics in Wilmington, N.C. and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. 

The whole country is still abuzz about last week's huge legal news, the landmark case that is likely to play out through November and whose repercussions will eventually touch every American. To the relief of so many of us, Katie Holmes is finally filing for divorce from Tom Cruise. Admit it, the suspense was killing you.

Pediatricians have many judges to thank this week, and not only the five Supreme Court Justices who voted to uphold the Affordable Care Act. We can also thank the Federal District Court that just issued a permanent injunction in the unpronounceable-yet-critical case of Wollschlaeger vs. Farmer, better known to pediatricians as the "Florida Gun Gag Law." Not only does the decision protect Florida pediatricians' right to counsel patients about a hazard that accounts for 1 out of every 25 pediatric trauma center admissions, but it should earn the judge a place in the Guinness Book Of World Records for overturning what has to be The World’s Stupidest Law.

New research adds fuel to the debate over whether parents who spank their kids should be put in time out. A group of Canadian researchers studied whether adults who recall their parents pushing, grabbing, shoving, slapping, or hitting them in childhood were more likely to suffer from mood disorders, anxiety disorders, alcohol and drug abuse/dependence, and personality disorders. After all the math, such punishments seemed to account for between 2% and 7% of the studied mental health diagnoses.

In my opinion, proponents of corporal punishment would probably quickly point out that 93% to 98% of kids whose parents push, grab, shove, slap, or hit them do just great, and they may be even more likely to become successful talk radio personalities. Critics also attacked the methodology, pointing out that the study relied purely on adult subjects’ recollection of their childhoods.

Clearly the only way to settle this debate is to embark on a 20-year prospective trial in which half of parents are randomized to push, grab, shove, slap, or hit their children and the other half are assigned to move to one of the 24 countries that have outlawed spanking. Of course the parents who move would have to contend with really boring talk radio.

©koya79/Fotolia.com

Finally, in yet another blow to the egos of mid-career doctors (ahem), it turns out medical residents in training can do our jobs just as well as we can, provided they're adequately supervised. A meta-analysis of 97 studies of resident training and patient outcomes did find that residents’ performance tended to improve with time, becoming equal to that of fully trained physicians around the day they're fully trained. Future studies will examine whether experienced clinicians' jobs can be performed equally well by adequately supervised robots, rhesus monkeys, and GI Joe dolls with the Kung Fu grip. Fortunately by the time these studies are completed I will have moved on from medicine to a lucrative career training monkeys in the practice of divorce law. I have a tip there’s a famous client who might be interested.

David L. Hill, M.D., FAAP, is vice president of Cape Fear Pediatrics in Wilmington, N.C. and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society.