Scribit Veritas

Protecting the Child, Preserving the Family, and Honoring Life

Welcome to the Blog page of the American College of Pediatricians.  Each issue of the Blog is intended to assist parents, encourage children, and enrich the family.  Read our most recent issue below, and scroll to the bottom of this page to read earlier issues.

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How to modify a child’s behavior

behaviorIn a classic experiment, rats were placed in identical cages. Each cage had a bar that could be pressed down. In cage 1, pressing the bar resulted in food being dispensed, every time. In cage 2, pressing the bar resulted in nothing happening. In cage 3, pressing the bar resulted in food sometimes being dispensed and sometimes not being dispensed in a random fashion.

You have probably guessed which bar was pushed the most – the bar that randomly dispensed food. We humans are not rats and we humans respond to rewards differently than rats – or do we? If you want your child to continue a behavior, praise them randomly. If you want your child to stop doing something, try ignoring the behavior. If you praise them every time they may simply come to expect it.

 

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Media and Sexual Exploitation

sexy 6 y.o.Parents feel sad and horrified when they hear of the sexual abuse or exploitation of a child or young teen. We are concerned that we do everything possible to protect our children from such abuse – but what specific actions can we take?  How can we help our children and adolescents recognize individuals who might seek sexual favors or who might coerce them into unwanted sexual activities?

One of the greatest risk factors for adolescents is to date an older individual, and the risk for coercive sexual relationships is even greater when the adolescent is younger (12 – 14 years of age).  Young adolescents who watch more television are more likely to participate in early sexual activity. (Manlove J, Moore K, et al.  “Sex Between Young Teens and Older Individuals:  A Demographic Portrait”   Child Trends Research Brief. September 2005 at www.childtrends.org.)

A protective factor is a strong and stable family.  Children and teens that experience secure, loving relationship at home are less likely to be coerced or exploited by others.  Don’t be afraid of tough topics – be willing to talk and listen and admit when you don’t know the answers.  Convey your values and teach your child to respect herself and others for character traits rather than physical appearance.

Children and teen are often at risk during unsupervised time after school.  Please think of ways to assure your child’s safety during this time.

For additional information, see the book So Sexy So Soon:  the new sexualized childhood and what parents can do to protect their kids by Diane E. Levin, Ph.D. and Jean Kilbourne Ed.D.

Jane Anderson, MD
Excerpted from the Prescriptions for Parents Newsletter found at this link: Media and Sexual Exploitation
 

 

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Obamacare

Healthcare.gov

Do you  find it hard to understand Obamacare?  If so, you are not alone.  My son, a healthy medical student in his twenties, still has medical insurance through my job.  However, like many people in the country, I got a letter saying that the affordable care act makes his health insurance product illegal.  If no actions were taken, his insurance would automatically change to another product at over three times the cost.  What happened to “If you like your insurance, you can keep it.”?  Furthermore, if anyone tries to sign up for Obamacare, they face an impossible obstacle in trying to use the non-functional web site.  Confused, I did some research into the website woes.  The best explanation that I could find was  this two minute video:    http://unclejayexplains.com/2013/10/30/uncle-jay-explains-healthcare-gov/.
Enjoy.
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pixel people

Pixels or Patients?

Pixels or patients?  That is a choice that government mandated EMR (electronic medical records) has foisted upon me.  Not so long ago, I could actually look folks in the face as I listened to what was going on with their children.  Now, I spend much of the time, looking for the right boxes to click.  After all, parents and patients often don’t give the history in the same sequence that my EMR program wants it. (“How dare they!”).  I miss the face time.  I fear that my medical records have changed from a thoughtful history, physical, assessment and plan.  Now, I find that it reads like awkward boilerplate.  With the increased cost and decreased productivity,  it seems like I am forced to spend time documenting to justify the highest billing codes.  I know that there are some benefits to EMR (legible records, easy to transfer information), but  unfortunately, they were forced upon us before they were user friendly enough to be worthwhile.
–a physician
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Harvey Milk day

Harvey Milk a hero – really?

The state of California recently came up with a new state holiday:  Harvey Milk Day.  The US postal service even came up with a Harvey Milk commemorative postage stamp.  So….Who was Harvey Milk?  The short answer is that he was a San Francisco city commissioner.  He became famous for being one of the first openly homosexual candidates to achieve public office.  Therefore, he has become a hero to the homosexual movement.  However, if you look deeper, things become very worrisome.  Mr. Milk was also a rapist with a preference for underage boys that had substance abuse problems.  He apparently considered himself a mentor to these young boys.  He would encourage them to (among other things) run away from home.  One of his victims, Jack McKinley, unwisely listened to and followed  the” wit and wisdom” of Mr. Milk.  Years later, McKinley committed suicide presumably because of his angst  about his experiences with this  pederast.
What does it say about a movement, when it pulls its heroes from the ranks of people like Harvey Milk?
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little cowboy

Priorities

Today, my nurse’s son goes in for surgery.  Eleven year old Slayton has alveolar sarcoma (a rare type of soft tissue cancer) in his leg.  Slayton’s  mom has been out from work for over a week now due to this scary event.  Understandably, she is too upset to be able to function and  she needs to be present for her family.
We have so many battles to face these days:  Obamacare, Maintenance of Certification, political correctness to  the point of harming children, overly stringent CLIA (Clinical Laboratory Improvement Amendments) regulations etc.  Sometimes in the heat of the battle and in our frustration, it is easy to forget why we actually practice pediatrics.  An event like this, at least for me, causes me to refocus on why we do what we do.  For those of you that have children that are home and healthy, I urge you to give thanks and give them a little extra hug.  Try to look at the kids that you see everyday through the eyes of a worried parent.  And…..if you think of it, Slayton and  his family could use your  prayers.
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listen

Listen, listen, listen!

When I was a resident, a woman brought her child to me and told me “there is something wrong with my child.” I asked her what was wrong and she could not explain what was wrong; she just knew that something was wrong. I examined the child and finding nothing wrong, told her so.

She knew in her heart that something was wrong and so she brought him back over and over. She saw other residents (pediatricians just learning for the first time how to be a pediatrician) and more experienced pediatricians. Each time, the examining physician was not able to identify anything wrong. Until one day, when he did have identifiable symptoms. Then we all knew that something was wrong and it was terribly wrong; he had a brain tumor.

I and the other doctors listened to that mother; we conscientiously looked for what the problem might be. We didn’t find the problem for a while.

As a parent, if you know that something is wrong, say so! And keep saying so until you are satisfied that really nothing is wrong or the thing that is wrong has been found. And if you are in the medical field, listen, listen, listen.

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Health Care Delivery

My good friend Jim retired from the State Department after serving for many years. One of his chief responsibilities was making sure that animals destined for human consumption did not transmit any infectious diseases to humans.  He has worked in many countries and also worked for a spell at the Centers for Disease Control in Atlanta.

In the course of his career he has had an opportunity to study many health care delivery systems. He observes that no matter what health care delivery system, the system delivers care on two tiers. The upper tier is reserved for those who are favored. In the United States, that tier is comprised of those who have private health insurance. In Britain and other countries that provide universal healthcare, the upper tier is comprised of those who have connections.  How can that be? It is human nature. Generally those who are politically connected or have a personal relationship with an influential physician or healthcare administrator get top tier care.

Given the veracity of the observation that no system of healthcare delivery exists that does not have two (or more) tiers of delivery, I think the system of private health insurance is superior to a universal healthcare system provided by the government. What do you think?

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Jury Duty

I have been called for jury duty on more than one occasion. The last time I was called, I arrived at the court house at the designated time and was directed into a courtroom filled with other potential jurors. Twenty of us at a time were called to the jury stand and screened for participation as jurors in a specific case. Finally my turn came.

The lawyers for the case in question explained to us that the case would involve testimony by a convicted felon. We were asked if we would have any difficulty believing the testimony presented by this felon. I was the seventh person to answer this question. Those who answered before me averred that they would believe this felon’s testimony without question. I answered that it would be difficult for me to believe the testimony of a felon. The remaining 12 potential jurors then stated, one after the other, that they too would have difficulty believing the testimony.

This experience reinforced that one should be true to one’s beliefs and positions. It also demonstrated that once stated, others likely will embrace our belief and position on a given matter.

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Make more bricks with less straw

My self-imposed goal is to get 200 hours of CME each year.  My state only requires fifty credits every 2 years.  I have my goal because I think it takes that much for me to keep up adequately and help me provide the best care for children.  However the MOC (Maintenance of Certification) requirements provide a huge barrier.  I have always participated in quality control programs.  Part 4 of the MOC now requires hours of my time in order for me to document what I am already doing.  Wasting time like that makes it harder than ever for me to continue to reach my personal goal of CME.  Likewise the government-imposed EHR (Electronic Health Records) makes visits take almost twice as long as when I used a more efficient paper system.  In this time of shrinking reimbursements, adding these extra time drains and expecting us to continue to provide quality care is unreasonable.  I feel like the children of Israel when they were told to make more bricks with less straw.

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