Posts Tagged ‘
American Academy of Pediatrics ’
Thursday, February 16th, 2012
A growing number of pediatricians are refusing to treat families who choose not to vaccinate their children, according to a report in the Wall Street Journal.
Medical associations such as the American Academy of Pediatrics don’t recommend that doctors “fire” families who opt out of vaccines. Instead they encourage pediatricians to bring the topic up at multiple visits but continue to work with families. Yet research shows that it’s increasingly common for practices to push these patients out.
From the Wall Street Journal:
In a study of Connecticut pediatricians published last year, some 30% of 133 doctors said they had asked a family to leave their practice for vaccine refusal, and a recent survey of 909 Midwestern pediatricians found that 21% reported discharging families for the same reason.
By comparison, in 2001 and 2006 about 6% of physicians said they “routinely” stopped working with families due to parents’ continued vaccine refusal and 16% “sometimes” dismissed them, according to surveys conducted then by the American Academy of Pediatrics.
Many pediatricians see administering vaccines as one of their main duties in keeping children healthy, and say it’s difficult to work with families when parents and doctors don’t see eye-to-eye on this key issue.
Pediatrician Allan LaReaux of Kalamazoo, Mich., stopped treating non-vaccinating families in 2010, in part because he worries that children who have not been immunized could make others in the waiting room sick. From the Journal:
“You feel badly about losing a nice family from the practice,” [said] Dr. LaReau, but families who refused to vaccinate their kids were told that “this is going to be a difficult relationship without this core part of pediatrics.” Some families chose to go elsewhere while others agreed to have their kids inoculated.
Pamela Felice, an Atlanta mom whose family was dismissed by their pediatrician for refusing vaccines says it’s been difficult to find another doctor. One of her children has gastrointestinal problems and regressed development that she believes is related to immunizations. At least four practices have denied them a first appointment when Felice explains her opposition to vaccines.
What do you think? Do doctors have a responsibility to treat patients even if they refuse vaccines?
Image: Doctor, baby and mom via Shutterstock.
Thursday, January 5th, 2012
The American Academy of Pediatrics issued a policy statement this week urging pediatricians to ask questions–and listen carefully–to identify warning signs that children are suffering under “toxic stress,” a chronic stress condition that can have serious health implications later in life.
Toxic stress is different from everyday stress, as it is the result of prolonged exposure to intensely difficult situations, such as abusive or neglectful family relationships, poverty, or parental substance abuse or mental illness. Health conditions including mental illness, obesity, diabetes and heart disease are linked to toxic stress.
The Boston Globe’s child development blogger, Dr. Claudia M. Gold, argues that the new statement should be seen as a call to respect–both with time and wages–the work of primary care physicians, particularly pediatricians, as they can be the first line of defense in identifying and easing toxic stress:
As a culture we need to value the primary care clinician, not only in the form of payment equal to the more lucrative subspecialties, but in the form of recognizing the role of relationships in healing. It makes sense that if we are recognizing the importance of family relationships in preventing poor health outcomes, that we should recognize the importance of doctor-patient relationships in supporting these families.
When primary care clinicians take time to carefully listen to stressed parents, parents feel supported in their efforts to carefully listen to their children, thus promoting healthy development. In turn, our culture needs to support and value primary care clinicians ( and its not only pediatricians, the subject of this policy statement, but all those entrusted with primary care of children.)
Image: Upset child, via Shutterstock.
Monday, October 31st, 2011
The American Academy of Pediatrics, which has long recommended HIV screening for teenagers who admit to being sexually active, is now recommending that all teenagers between ages 16 and 18 receive regular HIV testing if they live in an area where the HIV infection rate is higher than 0.1 percent of the population.
“We’re finding that when targeted testing is offered to sexually active youth… we’re not getting those youth to actually test and we have not decreased the number of new infections in [that] population,” says Dr. Jaime Martinez, an adolescent medicine specialist with Stroger Hospital of Cook County in Chicago. He deals with HIV-infected youth daily and is one of the authors of the AAP paper.
In 2006, there were more than 1.1 million HIV-positive people living in the United States. Of that population, the CDC says 5% were adolescents and young adults, ages 13 to 24 years old. That may seem like a small overall percentage but consider this: Upwards of 70% of new HIV infections are caused by people of all ages who are unaware of their HIV-positive status. Roughly one of every two HIV-infected adolescents don’t know they’re positive.
“I can’t think of a downside [to testing],” says Martinez. “We find that youth who test and become aware of whether they’re affected… become more conscious about engaging in safer sex practices.”
Tuesday, October 25th, 2011
A new study by a San Francisco non-profit organization has found that kids are spending more time than ever in front of television, tablet, computer, and smartphone screens. This is despite longstanding advice from the American Academy of Pediatrics (AAP) that screen time be severely limited, if not avoided, before age 2.
Common Sense Media, the organization that conducted the survey of more than 1,300 parents, found that half of all children under age 8 had access to a smartphone, tablet, or other mobile media device. About half of kids under age 2 watch some television or DVDs every day, and those who do spend an average of 2 hours in front of the screen. And almost one-third of kids under 2 have televisions in their bedrooms, which is something the AAP specifically recommends against.
“It’s the beginning of an important shift, as parents increasingly are handing their iPhones to their 1 ½-year-old kid as a shut-up toy. And parents who check their e-mail three times on the way to the bus stop are constantly modeling that behavior, so it’s only natural the kids want to use mobile devices too,” James Steyer, chief executive of Common Sense Media, told The New York Times.
The study found significant differences across socioeconomic lines, with more children (64 percent) under 8 having televisions in their rooms if their family income is under $30,000. Twenty percent of kids that age have televisions in their rooms in families with incomes above $75,000.
The study also noted that only 14 percent of respondents said their pediatricians had discussed media use with them.
(image via: http://blog.smarthide.com)
Wednesday, October 19th, 2011
Sudden Infant Death Syndrome (SIDS), where infants die of unexplained cause before age 1, has declined dramatically since 1992, when the American Academy of Pediatrics started recommending that babies be placed on their backs to sleep. But at its annual meeting in Boston this week, the AAP said that sleep-related deaths for other reasons, including entrapment or suffocation, have been on the rise, prompting the group to issue new guidelines for safe sleep.
The group made the following recommendations:
- Always place your baby on his or her back for every sleep time.
- Always use a firm sleep surface. Car seats and other sitting devices are not recommended for routine sleep.
- The baby should sleep in the same room as the parents, but not in the same bed (room-sharing without bed-sharing).
- Keep soft objects or loose bedding out of the crib. This includes pillows, blankets, and bumper pads.
- Wedges and positioners should not be used.
- Pregnant woman should receive regular prenatal care.
- Don’t smoke during pregnancy or after birth.
- Breastfeeding is recommended.
- Offer a pacifier at nap time and bedtime.
- Avoid covering the infant’s head or overheating.
- Do not use home monitors or commercial devices marketed to reduce the risk of SIDS.
- Infants should receive all recommended vaccinations.
- Supervised, awake tummy time is recommended daily to facilitate development and minimize the occurrence of positional plagiocephaly (flat heads).
For more, visit the AAP website http://www.healthychildren.org/.