why don't we practice cost-effective care?

An editorial published in this week's edition of the New England Journal of Medicine, asks the question: "Why does cost-effective care diffuse so slowly?" In other words, if we (the medical profession) have demonstrated ways in which we could provide the best care at the lowest price, why don't  more sectors of our society adopt such practices more rapidly?

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on childhood obesity

I asked a colleague of mine--a pediatrician, and a mother--to write a post about childhood obesity. This is a topic everyone is talking about; from Michelle Obama to your local YMCA. Is it just a trend, or do we really need to be concerned? Are you ready to meet the challenges she poses for parents as well as physicians at the end?

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Do we need "disaster champions"?

Today, some of my colleagues and I are bringing teams of physicians and nurses together from many of the surrounding community hospitals in our region, for the first installment in a year-long program designed to build confidence and competency for these hospitals in dealing with children in disasters.

Starting with the horrific events of the 9-11 terrorist attacks the nation has slowly come to the realization that we are not very good at predicting the needs of children in disasters.

This lack of expertise was demonstrated in response to the hurricanes Katrina and Rita. For many years, children were considered (AND NO, I AM NOT KIDDING) a "special population" similar to PETS, that needed a couple of additional sentences included in a manual.

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...and the world of pediatric emergency medicine

Over a week ago I let you know that I was headed out for a number of important medical society and continuing education meetings.

I was planning to write at least every other day or night to share what I was learning and doing; to give you a behind-the-scenes view of how some of these organizations work and what they do. I am sad to report that I have been so busy, and so tired I neglected this blog in favor of more meetings, sweet dinners with old friends, and sleep, when I could manage to get some. Now, as I sit in the airport lounge waiting to make my last connection before I arrive in Roanoke, I finally have a few minutes to catch my breath and catch you up on the week's activities.

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sudden infant death related to in utero smoke

My office is on the 13th floor of Roanoke Memorial Hospital.  I take the elevator that stops directly in front of the Labor and Delivery unit. Usually a happy place, this is where babies are born. It is also where mothers are admitted if they are in premature labor, placed on drugs to stop the contractions, and gain some time for the infant to mature before birth.

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alcohol energy drinks

Canned drinks that combine alcohol--usually a malt beverage --with caffiene have been in the news of late. You may have seen this article in the Roanoke Times: As adolescents and young adults ingest these drinks, they are turning up in Emergency Departments around the country. Some states have already banned the sale of one or more of the energy drinks, and others are considering doing so. Colleges are banning the drinks and/or warning their students about the dangers.

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caring for our youth means accepting them

Today's blog deviates a bit from my usual. I am sharing a video that makes me proud of my youngest daughter,  Rachel Fogel, a student at American University, fighting to prevent bullying of gay and lesbian teens. She appears toward the end of the video. This is from USA today.

As a community concerned with supporting all aspects of health for our children, adolescents and young adults, I urge us all to fight against the kind of bullying that has resulted in the recent increase in notable suicides among gay youth.

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pediatric asthma; a real challenge in management

Asthma is the most common chronic disease of childhood. Continuing on a theme we started yesterday, talking about children with chronic disease, I was very interested to read an  article by Kevin Dubrowski and colleagues from this month's edition of Pediatrics about one way to follow children with this disease, called spirometry.

I have asked my colleague, Dr. Andre Muelenaer, head of the Carilion Clinic Children's Hospital section of pediatric pulmonology and allergy, to comment on this article. Here is what he has to say:

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more complex children in our hospitals

Those of us who provide inpatient care for children have been saying this over and over for the last decade or so: "children in our hospital are more complex to care for than ever before." However, most of the time, we were saying this based solely on our feeling, and the nature of the children we were seeing in the institutions in which we worked. 

This month's issue of the journal Pediatrics, published by the American Academy of Pediatrics presents two articles and a  commentary that address the issue of what types of children are being admitted to our hospitals.

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