Author's posts
Why developing new antibiotics is a losing battle
“We believe that the current entrepreneurial development model for antibiotics is broken and needs to be fundamentally transformed.” This provocative opinion is from a recent editorial in the New England Journal of Medicine. The introductio…
Don’t let patient care interfere with documentation
I’m being sarcastic, of course, but that’s often how it seems some days. Those are days when I’ve been busy at patients’ bedsides all day and then struggle to get my documentation done later, typically many hours later. I jot notes to myself as I go al…
The randomness of cancer: bad luck or something else?
Randomness in life is inevitable because the universe is a pretty random place, although the extent to which you believe that depends upon your own value system. This notion comes into play almost every day of my practice in the PICU because many of th…
The problem of overdiagnosis: What can patients do?
An interesting article in the journal Pediatrics is both intriguing and sobering. It is intriguing because it lays bare something we don’t talk much about or teach our students about; it is sobering because it describes the potential harm that can come…
When physicians inappropriately judge
All physicians naturally make judgments regarding the parents they are interviewing. For example, we assess how accurate and plausible their history is. We try to decide if they are telling us the whole story and, if not, if they are inadvertently or d…
The government’s role in compelling individual actions for public health
I wrote about this topic a few years back, but the recent outbreak of measles has once again ignited the debate of just what the government has the right to do or not do in compelling individual actions in support of public health. This is an old quest…
Why an asthma action plan is so important for children
Asthma is a common childhood condition. Estimates are that around 8 percent of all children have it. The incidence had been steadily increasing for many years, but some recent data suggest the burden of the disease in children may have leveled off over…
Do after-hours call centers send too many children to the ER?
A large number of pediatric practices these days use after-hours call centers for parents who have questions about a sick child. I’ve been looking around to find some data about how common this is, but my sense is that the majority of pediatricians use…
What to do with disparaging doctors
Doctors who disparage, or even ridicule, what parents tell them are, fortunately, rare. Nevertheless, sometimes parents may infer from what the doctor says or how he acts that he does not value what they are telling him, even though he did not mean to …
What to do with physicians who don’t explain
How doctors treat patients’ need for information has changed significantly over the past decades. Sixty years ago medical practice was much more paternalistic than it is now, although some would say it continues to be so in important ways. Still, not t…
