Dr. Thompson's Blog

Eliminating Drug Ads on TV

I was delighted to see in an article in this morning's New York Times by Natasha Singer that Representative James Morgan is sponsoring a bill that would eliminate ads for prescription drugs such as Viagra and Levitra. Another Representative, Jerrold Nadler, has introduced a bill called "Say No To Drug Ads."  The bill unfortunately would not get rid of drug ads, but would eliminate deductions for advertising drugs as a business expense. At this point, drug companies spend about 4.8 billion dollars on drug advertising. This does not include all the advertising sent to doctors' offices.  Some of those that came to my office included special tubes for mailing and other expensive, creative marketing devices. These always ended up in the waste basket and were ignored.

Only New Zealand and the U.S. allow drug advertising. I am always appalled when I see an ad saying pediatricians chose this or that drug. I  called the F.D.A about one ad that was completely untrue and have just seen the ad a few times since then.

Many doctors are easily pressured by patients to write an Rx for drugs the patients have seen on TV. It does take time to research drugs and if money is more improtant than the patient's health, then an Rx may be easily produced. The side effects of a drug may not be evident until many patients have taken a drug and time may be important to show that there are problems. This has been true of drugs such as Vioxx that had to be taken off the market after bad side effects developed in patients. However, it took several years for this to happen.

Someday I hope all drug ads will be banned on TV or consumers will mute the ads and not pay attention to them.

Incorrect information about President Obama's Health Plan

It is amazing to me that there is so much incorrect information being put out about President Obama's courageous attempt to get health care for almost everyone in the U.S. With 47 million people without health care and 47,000 losing their health care each week, something has to be done.

I have heard the Republicans give all kinds of false information. On July 23rd there was an expensive full-page ad in the New York Times from the Cato Institute that said four our of five Americans were greatly concerned about the President's health care plan. The polls I have seen say that 75 to 80% of Americans are fed up with the present health care system and want changes.

I get almost daily e-mails and phone calls from people who are distraught about their medical care and their terrible health insurance. The government is not going to tell you which doctors you can use, only the HMOs do that. There will not be increased costs unless you are very wealthy and then there could be an increase in  taxes. I like the statement that says "To whom much is given, much is expected." I'm not sure of the origin of that statement but I think that those who are extremely wealthy have an obligation to help those who are less fortunate.

Health care quality should improve as certain standards for good care will be set by a panel of doctors. There is just too much bad medicine being practiced these days by greedy doctors who are more interested in their pocket books rather than their patients. Medicine should be about taking care of patients not about having a gorgeous house, an expensive car, a boat, and other luxuries.

Children and Drowning

Summer is always a worrisome time for pediatricians and family doctors. One of the worst fears we have as physicians who care for children is that a child will either have a near-drowing experience or die from drowning. Each year about 1500 children and teens drown. Little children can drown in a fish pond or a small amount of water. I was with a friend at a picnic in a lovely park one day and saw a two-year-old standing on a Japanese bridge over fairly deep water. The  only adults were at least 100 feet away. I hurried onto the bridge and called to the young couple, who I assumed were the parents. Yes, it was their child. I said I was not comfortable leaving the child there until one of them was nearby. They thought I was a meddling adult, but at least the cute little boy didn't go over the bridge and drown that afternoon.

A father was caring for a two-year-old  patient of mine and took his eyes off the little boy for a few minutes. The child disappeared and was found dead in a neighbor's pool. He had slipped through a fence when the father wasn't looking.  The tragedy changed the parents' life.

Another two-year-old slipped out a door when several people were in the house and was found dead in the family's fish pond. 

One four-year-old had a near drowning experience but was resuscitated. She was hospitalized for quite a while, but  became spastic and  markedly delayed intellectually.  Swimming is a wonderful exercise for all ages, but you cannot be too careful with kids. No child should ever, ever be allowed to swim without an adult close by with his or her eyes constantly on the child.

College Athletes and Inadequate Health Insurance

So many parents these days hope their high school graduates will qualify for college athletic scholarships and unfortunately often put great pressure on their kids to excel in sports. I must admit I was delighted when my son, who had been  on the varsity football team in high school,  chose not to play football  his senior year in order to take part in theater productions. This was despite several frantic phone calls from the football coach.

I have seen too many high school and college sports injuries, including quadriplegia. Even though I have always loved sports and been a good athlete, I don't like the emphasis that colleges put these days on sports. I thought you went to college to get a good education?

Now there is a major article in today's New York Times by Kristina Peterson noting that many young people who were injured playing varsity sports in college end up with extremely large medical bills. Many colleges do cover their athletes for injuries, but many do not. So any college athlete and his or her parents should be very sure to read  the fine print in the college health insurance policies or their own policies. Otherwise, they may be in for a very rude surprise. Asking lots of questions of the   college administrators would also be important. It is better to be safe than sorry and end up with major medical bills or a bad mark on your credit.

Skate Shoe Injuries in Kids

I have never quite understood why parents would buy their children skate shoes. if they are going to skate, why not have real skates or taking them ice skating, my favorite sport. My bias against these skate shoes was underscored by an article in the American Academy of Pediatrics. This was a summary of an aritcle by Ruth Shah and W. Fates from Michigan State University.

They studied skate injures in five to fourteen-year-olds between 2002 and 2006 and found that 3525 kids  had been injured. The injuries ranged from fractures (46.7%) to contusions (17.9%), sprains (17.2%), concusions (6.6%), dislocations, and some internal injuries. There were no deaths, but I wonder if the shoe makers should not reconsider having these shoes on the market. Just watching one of these kids try to skate with their skate shoes is always painful to me. it seems an abnormal way to skate. A family ice skating excurison can be a wonderful experience. There is a freedom of movement  that is almost unrivaled by  any other sport  I have tried. Yes, a child can be injured in any sport, but skate shoes cannot be considered as a true sport. Common sense would dictate that a child either walk with good shoes or skate with the skates designed for real skating.

Bicycle and Skate Board Helmets are a Must!

Having cared for many post-accident children, I am always greatly dismayed when I see children riding  bikes and not wearing helmets. I was waiting for the light to change at a corner one day and was standing next to a handsome ten-year-old. He was waiting with his bicycle and his helmet was strapped to the handlebars. When I commented that the helmet would be better on his head, I got no reply. I'm sure that the youth thought I was just a very meddlesome adult. I wished I could have shown him some of the kids I have cared for who didn't wear their helmets when skate boarding  or biking. I often see parents riding bikes with their children when none of the family members are wearing helmets. Sometimes the kids have them on, if they are little, and yet the parents don't. So if the parents are injured, what would happen to the little children?

in the New York times today, a small article by Eric Nagourney notes that one in four chidlren have been shown to bike without helmets. A survey was done by individuals at the University of Michigan showing that more kids wear helmets in the twenty-one states that require them. i am puzzled that more states don't require the use of helmets. No statistics were given on the number of head-injuries or deaths, but if you have seen even one serious injury or death that could have  been prevented with the wearing of a helmet, that is one too many. I hope parents will start insisting that helmets be worn.

Finding Medical Care for Unusual Disorders in a Child

When the diagnosis of an unusual disorder is made in a child, two questions usually arise. The first is: "When do I tell my child about the diagnosis?" and the second one is "Where can I get the best medical care?" My answer to the first question is dependent upon the age of the child and the child's ability to understand the problem. In general, it is better to simply answer a child's questions honestly and not go into a great deal of detail. Kids are very smart and often sense  something is wrong or they overhear a doctor, nurse, parent, family member, or neighbor dicussing the diagnosis. Honesty is the best policy.

In answer to the question about where to find the best medical care for a specific  disease or problem, a great deal of networking and research needs to be done. In the past, a child's pediatrician or family doctor would do the research, but now I don't think the usual doctor can be relied on to take the time to do much research. It is far too easy to refer the parents to the nearest medical school which may not have the necessary specialists. I get frequent e-mails from parents around the world asking about where to find the best medical care for specific problems. I do considerable research and over the years have developed a network of doctors who will be truthful with me about other doctors. An orthopedic surgeon who had been a classmate was always very helpful in telling me who were orthopedists that were right for a particular disorder. In one instance, I  had the parents cancel the surgery that was about to begin because I found out that the doctor had serious problems and had been dismissed from a hospital and medical society. So you cannot be too careful in choosing a physician or specialist.

Possible Closure of California Poison Control Centers

I cannot believe that any governor could be so near-sighted as to even consider closing his or her state's poison centers. However, according to an article by Sarah Arnquist in yesterday's New York Times that is exactly what Governor Schwarzenegger is considering. I have never understood how he came to be governor and this to me, as a pediatrician, is just very bad judgment. Having cared for multiple kids who ingested anything they could find, a poison control center is vital and invaluable.

The article states that 35,000 people died in 2005 from poisoning and if the California poison control centers are closed,  people will rush to the nearest ER. But where are the ER doctors supposed to get the most up-to-date information about the poison a child or adult has ingested? Yes, there is a National Poison Control Center at 1-800-222-1222, but a state still has to pay for the calls. The state's contribution to maintain the poison centers is just six million dollars. Perhaps the Governor could sell some of his many Hummers or other toys to make up the deficit? I cannot believe that any state official could care so little for the lives of children in his or her state; most of the calls are for kids under age five. We all should speak up and tell the Governor to find somewhere else to save the six million dollars.