Highlight HEALTH

At midnight just over a week ago, the seventh and final edition of the children’s wildly popular Harry Potter series, “Harry Potter and the Deathly Hallows”, was officially released.

To commemorate the occasion, each section of this week’s PGR begins with a quotation or some dialogue from the story. A total of 25 blog articles are included in this edition, each one just as magical as the next, and I hope you enjoy reading them all as much as I did. I intentionally kept my comments short so that you can focus on the content of each article.

So, without further delay, I present to you Pediatric Grand Rounds 2.8.

Health and Science

Breath Spa for Kids

Shinga leads this edition of PGR with two articles on the MMR vaccine. As the parent of a 2 year-old, I can appreciate the confusion and anxiety surrounding this controversial topic. Shinga responds to a number of common vaccination rumors in Fitzpatrick and Halvorsen Speak About Vaccines: Whom Do You Trust?. She follows that up by addressing the question Why Can’t We Have Single Jabs While There Is Uncertainty?

Junkfood Science

Always intelligent and articulate, Sandy Szwarc injects a dose of reality to refute the media’s alarming reports on “high” mercury levels that really aren’t high. Booster shots with mercury looks at the latest ‘mercury is hurting kids’ fears.

Angry Toxicologist

Before we leave the subject of vaccines, we visit the Angry Toxicologist who’s responding to a recent comment regarding the lack of an extreme view one way or the other towards vaccination in the Stupidity of Lying.

Tales from the Womb

Necrotizing enterocolitis (NEC), meaning tissue death of sections of the bowel, is typically seen in premature infants. Neonatologist Phillip V. Gordon reviews a cohort study investigating NEC and its association with formula products. Drawing upon the results of two additional studies evaluating the effects of formula or breast milk on the development of NEC, From the Journal of Perinatology advocates the use of breast milk not only for mothers of term infants with known preconditions for NEC, but for every neonatal intensive care unit patient.

Med Journal Watch

Christian Bachmann writes that parents Better Let Kids Play in the Sun, suggesting that protecting children from the sun may do as much as seven times more harm than good.

Genetics and DNA

Eye on DNA

Which Came First? The Genes or the Divorce? That’s the question Hsien-Hsien Lei poses after reviewing two studies examining divorce and depression in children and their parents.

ScienceRoll

Bertalan Meskó had the opportunity recently to see how geneticists work in a pediatric deparment and has some suggestions to combine Web 2.0 and Clinical Genetics: In Practice.

Gene Sherpas: Personalized Medicine and You

Steve Murphy reviews a survey of pediatric Ear, Nose and Throat (ENT) doctors and the use of genetic testing when evaluating childhood hearing loss in Pediatric Ear Nose and Throat but Not Gene Specialists. The Gene Sherpa asserts that the results demonstrate why genetic counselors and geneticists are needed.

Working with Patients

Musings of a Distractible Mind

Seriously amusing … or is it amusingly serious? … Dr. Rob offers some tips that may help future office visits go better in his letter To My Patients.

Tiggers don’t Jump

Judy discusses how difficult it is to teach heel stick draws in Preceptor — Learning to Teach Heel Stick Blood Draws.

Random Acts of Reality

Tom Reynolds, an E.M.T. working for the London Ambulance Service, writes about two calls and Two Children.

Recollection and Emotion

Chrysalis Angel

Chrysalis Angel, always one to write with inspiration and hope, recalls delivering a baby boy some years ago and wonders at the ability of creatures’ big and small to have offspring as Life’s Circle Goes On.

Unintelligent Design

Clark Bartram, the keeper of PGR, ruminates about doctors showing emotion in Delivering Bad News: When Good Doctors Go Sad. The story continues with some engaging discussion and comments at the end of the post.

Healthy Children

Dr. Steven Parker writes about euphemisms and developmental disabilities in “Developmental Delay” or “Mentally Retarded?” Getting Off the Euphemism Treadmill.

Universal Health

The ever eloquent N=1 recalls Some Enchanted Evening, a pediatric nursing rotation in a unit that housed cystic fibrosis (CF) patients and an evening of sandwiches and excitement.

Unique But Not Alone

In a heartfelt post, Jen acknowledges the daily struggles her daughter Meghan, born prematurely with Alpha-1 (a genetic disorder of the liver), faces and recalls when she was Discharged from NICU.

Neonatal Doc

Neonatal Doc writes about pregnancy and newborn Loss and how there aren’t any good words of comfort at such a time.

Nutrition and Health

Junkfood Science

Sandy Szwarc reports on The Real Tragedy, how heavy focus and media attention on the childhood obesity epidemic is having a dangerous counter effect on young people.

Dr. Gwenn Is In

While we’re on the subject of childhood obesity, Dr. Gwenn gives us a News Flash - Dancing Veggies Don’t Work! and suggests that replacing the dancing veggies with dancing kids eating veggies may be more effective. I think she might be right.

FoodSpark

Oliver’s Story starts with love and concern for a son. Cindy discusses treating Ollie’s physical and developmental issues through diet with some amazing results.

Being a Parent

Belvidere, Nebraska Pop. 98

Looking for tips on child care? The mayor of Belvidere, Nebraska presents an amusing manual on Child Care Maintenance that includes many excellent suggestions picked up over the years. A must read!

Family Connection

In a blogging community of central Ohio parents, Marcia describes Mothering, New York Times Style. She’s convinced something is being lost in the fast-paced mechanical pretense of life.

The Diet Dish

Tara Gidus discusses Nursing No No’s; food and non-food related dangers for nursing mothers to avoid.

The Preemie Experiment

Stacy asks if she’s been giving her daughter Too Much Praise?. In a society that’s overdoing more and more, I think it’s something that every parent should examine.

Conclusion

That concludes Pediatric Grand Rounds 2.8 - I hope the presentation left you spellbound. It’s been a pleasure to host this edition and I’d like to thank everyone that contributed articles. Be sure to take a moment and let your fellow bloggers know this issue of PGR is available so that everyone’s hard work can be appreciated and enjoyed by all.

Clark Bartram is looking for future Pediatric Grand Rounds hosts. You can find both the PGR hosting schedule and past editions at the Pediatric Grand Rounds Archive.

The next issue of Pediatric Grand Rounds is being hosted by Spooner Jenkins of Belvidere, Nebraska Pop. 98 on Sunday, August 12th.

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The Washington Post published an interesting article today on physician profiling.

In the fight to control healthcare costs, employers and insurance companies are now monitoring physican performance. Using sophisticated computer software to analyze millions of health claims and billing data, doctors are being profiled. Physician profiles are rated and used to direct patients to effective and reasonably priced healthcare.

According to the article:

The trend is in its infancy, but such programs are already in more than 100 insurance industry markets or regions across the country, from entire states such as Massachusetts to metropolitan areas such as Los Angeles. Supporters say the programs have slowed the rate of growth of insurance premiums by 3 to 6 percent in their first year.

However, such data-driven scrutiny is raising questions regarding the line separating oversite and interference in patient-caregiver relationships.

The effort is more about cutting costs than raising quality, some say, adding that doctors could begin to “cherry pick” healthier patients whose problems are less costly to treat. Such systems fail to capture the intangibles of quality, such as a doctor who visits a dying patient at home, critics say.

More importantly, the data, which often contains errors, is difficult for physicians to correct. These inaccuracies can not only damage a doctors reputation but have a significant financial impact.

Regardless of these problems and the controversy surrounding physician profiling, it’s likely that doctor ratings are going to become more widely used. The Wall Street Journal Health Blog citied a doctor at a benefits-consulting firm who believes the future of such physician scrutiny is unavoidable:

“In every industry, consumers have a thirst for performance information,” he tells the Post. “People don’t want to go to a movie or buy a book or buy a car or go to a restaurant without some ability to assess value for dollar. What’s taking place here is inevitable.”

Similar Health 2.0 resources are available online. RateMDs.com offers patients the ability to rate their doctor by scoring three areas: punctuality, helpfulness and knowledge. Along with ratings, users can leave comments. A more in-depth survey is used at DrScore.com, which evaluates patient issues including coordination of care, access to services and appointments, the quality of medical care and the efficiency of the practice.

Both of these websites as well as a number of other resources can be found in the Healthcare Reviews category of the Highlight HEALTH Web Directory.

How do you feel about physician ratings? Do you use any of the resources listed above or something similar?

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I’ve written previously about the Highlight HEALTH Web Directory and my effort to catalog and make available health-related websites I find to be informative and useful.

I’m very pleased to announce that, similar to Highlight HEALTH, the Highlight HEALTH Web Directory is now an HONcode accredited website.

The Health On the Net (HON) Foundation is a non-profit organization that is attempting to guide the growing community of healthcare providers and consumers on the World Wide Web to sound, reliable medical information and expertise through quality assessment and systematic and stringent peer review. HON is the largest voluntary accreditation network on the Web with over 4,700 HONcode accredited websites that honor the standards for disclosure and responsibility in online medical publishing [1].

There are 8 principles of the HON Code of Conduct (HONcode):

1. Authority - Indicate the qualifications of the author(s).
2. Complementarity - Information should support, not replace, the doctor-patient relationship, which is the desired means of contact.
3. Privacy - Respect the privacy and confidentiality of personal data submitted to the site by the visitor.
4. Attribution - Cite the source(s) of published information, date and medical and health pages.
5. Justifiability - The website must back up claims relating to benefits and performance.
6. Transparency - Accessible presentation, accurate email contact of authors.
7. Financial disclosure - Sponsorship should be transparent and funding sources identified.
8. Advertising policy - Clearly distinguish advertising from editorial content.

Below is a list of HONcode accredited websites in a number of categories from the Highlight HEALTH Web Directory that I recommend. Hint: click on the category title to see all the websites currently listed.

Is your site listed in the Highlight HEALTH Web Directory?
Send me an email if you would like to be included!

References

1. Boyer and Geissbuhler. A decade devoted to improving online health information quality. Stud Health Technol Inform. 2005;116:891-6.
   View abstract

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