Sunday, December 26, 2010

Physicians must ride the third great wave

Physicians Must Ride the Third Great Wave...

 

Here we are ready to say goodbye to 2010 and usher in 2011.  This year has been a massive year for the tech world. The Consumer Internet reigns.   Start-ups are providing incredible services for both consumers and businesses to gain feedback on their application and use of their sites.  Lean start-ups which start first with customers and then create products out of nothing are the norm.  Cost of business creation is at an all time low.   Free and freemium models abound.   Our social graphs have deepened and have new-found importance.  As of November 2010 Apple is activating 275,000 ios devices a DAY.  Consumers have chosen the mobile as their device of choice.  E commerce reins as the consumer’s choice and has decimated almost every brick and mortar industry.  

 

Now let’s reflect on the year of 2010 in health care.   There is a lot going on.  Hospitals and physician practices are hard at work.  The focus is on reform and meaningful use implementation, as well as the acquisition of government funding to keep floating our ailing hospitals and broken fee for service business models.   Primary Care continues to lose ground, as hoards of physicians flock to retirement, better opportunities in health care consulting and health IT sales, as predicted in this Physician’s Foundation Study from 2008.  Physicians in private practice are leaving contracts with medicare in a variety of states, notably, Texas. Innovative products and services do help our hospitals and physician practices improve, with improved billing platforms, portals, and the like. These are all forms of incremental innovation. Yet, the focus for both  hospitals and physician practices remains the third party payer, with most of our products in Health IT laser focused on revenue cycle management.  They focus on the  improvements in the work-flow of the physician office that must implement the excruciating and time consuming details of third party payer practice.  There are certainly opportunities for improved contracting, process, revenue cycle and acquisition of HHS funding for Medical Home projects.  These are the domain of consultants in the industry.  Christensen notes that industries in decline always have the most robust consulting opportunities.

 

I want to take a minute to warn all of us entrenched in the above considerations, that we  have missed the boat, my friends.   Meaningful use and specifically the Patient Health Record has a far more significant importance.  Clay Christensen writes in Innovator’s Prescription that the only chance of saving healthcare is through disruption.  Disruptive Innovation that is.  Disruption is all around us in 2010. Both hospital and physician practice models are being massively disrupted already, by companies harnessing the third great wave of innovation that John Doerr of Seqoiua Capital predicts.  We have been disrupted by a long list of emerging business models that have taken marketshare, accentuating the financial woes of the typical physician practice.  Clay C. and Jason Hwang discusses a long list of these in his book.   Coming from the experience of building a health service organization and cloud platform that helps doc’s go mobile, I have spoken at conferences and Health IT panels with the founders of these emerging businesses that focus on consumers, self tracking, social contagion, and croudsourcing.  There are even new professional organizations that have grown out of this refreshing consumer interest in creation of health WITH their physician. that are growing as a result.  They focus on consumer’s interest to improve the physician patient relationship utilizing high tech tools in some instances, specifically the PHR.  Yes, the group of us doctors who use social media to improve health all agree that 2010 is the “ Year of the Patient”, with epatient dave leading the charge.  

 

The growing success in these emerging business can be attributed to new business model creation which validates pricing directly with customers.  They utilize a host of high tech tools to rapidly gather feedback and iterate their product offerings.  They are creating something out of nothing, what Eric Ries from Lean Startup calls, a “ Miminum Viable Product” and then selling it.  They then build the business around customers with an ongoing process of customer development.  They build out process and corporate culture that revolves around customers. This is disruptive innovation.  As the existing business models in healthcare continue to struggle with distractions like meaningful use, government, reform and revenue cycle management, the new value network in health care is DISRUPTING you.  The disruption will continue, Clay says, until within 5 years we will have a new value network, the center of which is the Patient Health Record.  (Not hospitals and physician offices as in 2010)  In order to stay in the game, primary care physicians MUST implement the principles of disruptive innovation alongside the continued incremental changes that you are implementing in practice.  

 

See, disruption starts and ends with consumers.  If you listen to your patients carefully, they will tell you exactly what they want.  Consumers and businesses are willing to pay for services.  I want physicians in primary care to remember they need us now more than ever.   We are focused at Personal Medicine on service line strategy of disruption and new business model creation for physicians.  Our legacy and vision is a global mobile primary care workforce who rides the third great wave of innovation, the mobile, social, e-commerce revolution.  

 

Feedback?

 

Natalie Hodge MD FAAP

Chief Health Officer Personal Medicine

www.personalmedicine.com

Posted via email from Personal Medicine

Physician's Ride the Third Great Wave

Click to open:

Physicians Must Ride the Third Great Wave...

 

Here we are ready to say goodbye to 2010 and usher in 2011.  This year has been a massive year for the tech world. The Consumer Internet reigns.   Start-ups are providing incredible services for both consumers and businesses to gain feedback on their application and use of their sites.  Lean start-ups which start first with customers and then create products out of nothing are the norm.  Cost of business creation is at an all time low.   Free and freemium models abound.   Our social graphs have deepened and have new-found importance.  As of November 2010 Apple is activating 275,000 ios devices a DAY.  Consumers have chosen the mobile as their device of choice.  E commerce reins as the consumer’s choice and has decimated almost every brick and mortar industry.  

 

Now let’s reflect on the year of 2010 in health care.   There is a lot going on.  Hospitals and physician practices are hard at work.  The focus is on reform and meaningful use implementation, as well as the acquisition of government funding to keep floating our ailing hospitals and broken fee for service business models.   Primary Care continues to lose ground, as hoards of physicians flock to retirement, better opportunities in health care consulting and health IT sales, as predicted in this Physician’s Foundation Study from 2008.  Physicians in private practice are leaving contracts with medicare in a variety of states, notably, Texas. Innovative products and services do help our hospitals and physician practices improve, with improved billing platforms, portals, and the like. These are all forms of incremental innovation. Yet, the focus for both  hospitals and physician practices remains the third party payer, with most of our products in Health IT laser focused on revenue cycle management.  They focus on the  improvements in the work-flow of the physician office that must implement the excruciating and time consuming details of third party payer practice.  There are certainly opportunities for improved contracting, process, revenue cycle and acquisition of HHS funding for Medical Home projects.  These are the domain of consultants in the industry.  Christensen notes that industries in decline always have the most robust consulting opportunities.

 

I want to take a minute to warn all of us entrenched in the above considerations, that we  have missed the boat, my friends.   Meaningful use and specifically the Patient Health Record has a far more significant importance.  Clay Christensen writes in Innovator’s Prescription that the only chance of saving healthcare is through disruption.  Disruptive Innovation that is.  Disruption is all around us in 2010. Both hospital and physician practice models are being massively disrupted already, by companies harnessing the third great wave of innovation that John Doerr of Seqoiua Capital predicts.  We have been disrupted by a long list of emerging business models that have taken marketshare, accentuating the financial woes of the typical physician practice.  Clay C. and Jason Hwang discusses a long list of these in his book.   Coming from the experience of building a health service organization and cloud platform that helps doc’s go mobile, I have spoken at conferences and Health IT panels with the founders of these emerging businesses that focus on consumers, self tracking, social contagion, and croudsourcing.  There are even new professional organizations that have grown out of this refreshing consumer interest in creation of health WITH their physician. that are growing as a result.  They focus on consumer’s interest to improve the physician patient relationship utilizing high tech tools in some instances, specifically the PHR.  Yes, the group of us doctors who use social media to improve health all agree that 2010 is the “ Year of the Patient”, with epatient dave leading the charge.  

 

The growing success in these emerging business can be attributed to new business model creation which validates pricing directly with customers.  They utilize a host of high tech tools to rapidly gather feedback and iterate their product offerings.  They are creating something out of nothing, what Eric Ries from Lean Startup calls, a “ Miminum Viable Product” and then selling it.  They then build the business around customers with an ongoing process of customer development.  They build out process and corporate culture that revolves around customers. This is disruptive innovation.  As the existing business models in healthcare continue to struggle with distractions like meaningful use, government, reform and revenue cycle management, the new value network in health care is DISRUPTING you.  The disruption will continue, Clay says, until within 5 years we will have a new value network, the center of which is the Patient Health Record.  (Not hospitals and physician offices as in 2010)  In order to stay in the game, primary care physicians MUST implement the principles of disruptive innovation alongside the continued incremental changes that you are implementing in practice.  

 

See, disruption starts and ends with consumers.  If you listen to your patients carefully, they will tell you exactly what they want.  Consumers and businesses are willing to pay for services.  I want physicians in primary care to remember they need us now more than ever.   We are focused at Personal Medicine on service line strategy of disruption and new business model creation for physicians.  Our legacy and vision is a global mobile primary care workforce who rides the third great wave of innovation, the mobile, social, e-commerce revolution.  

 

Feedback?

 

Natalie Hodge MD FAAP

Chief Health Officer Personal Medicine

www.personalmedicine.com

 

 


Google Docs makes it easy to create, store and share online documents, spreadsheets and presentations.
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Posted via email from Personal Medicine

Sunday, December 19, 2010

Knowledge Centers for Your Child's Health

Check out this website I found at paducahpediatrics.snappages.com

Here is a list we put together of great knowledge centers on the web for Pediatric health! The better information you have the more prepared you are to parent!

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Sunday, December 12, 2010

Regulation of genetic tests unnecessary, government says -- Webster 182 (16): 1715 -- Canadian Medical Association Journal

From the standpoint of a mother, having had the experience myself of holding down my children in a chair for a venous stick, consumers will be demanding this...

Posted via email from Personal Medicine

Friday, December 10, 2010

Computing in the Age of the $1,000 Genome: Xconomy to Convene Leaders of New Era in Personalized Medicine | Xconomy

We are looking down the barrel of having the answers to our patients personal genomes. These are companies primarily going direct to consumers. I have had the experience of parents requesting genetic testing OVER our current lab technologies and have been recommending 23and me and or Bayor screen here. So we are primed for a MASSIVE shift in the way that consumers view our current blood chemistry industry and how we as physicians use that information. We are entering a new era of " prediagnosis" and consumers are on board with it. Payors as usual will not be, but it is understood by consumers that this testing will be out of pocket. Furthermore, consumers are NOT willing to share this private genetic data with payors. Get on board doc's the future is coming, well, no, it is here.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Thursday, December 09, 2010

SIDS may be related to deficits in Seratonin

Serotonin May Be the Key to SIDS

Lack of biochemical causes baby's alarm system to fail if breathing problems develop, experts say

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, Dec. 8 (HealthDay News) -- Sudden infant death syndrome, or SIDS, has for years had a reputation as a mysterious and terrifying killer of newborns.

But medical researchers now think they have cracked the secret of what causes babies to die of SIDS, an advance that could save hundreds of lives each year.

Doctors have found that babies who die of SIDS tend to have significantly lower amounts of serotonin than babies who die of other causes. Serotonin is a hormonal neurotransmitter closely linked to many of the body's vital functions, including the sleeping cycle.

A lack of serotonin is suspected to hamper a sleeping baby's ability to wake up when its safety is threatened by a lack of oxygen or some other health hazard, said Dr. Rachel Y. Moon, a pediatrician, SIDS researcher and associate chief of the division of general pediatrics and community health at the Goldberg Center for Community Pediatric Health at Children's National Medical Center in Washington, D.C.

"We think a lot of it has to do with arousal, and how babies can wake up when they are asleep," Moon said. "If you have a baby who gets into a compromised situation and they are becoming hypoxic, there are some babies who are sleeping so deeply or have an arousal defect that they can't wake up."

SIDS is the leading cause of death for babies between 1 month and 1 year of age, according to the U.S. National Institutes of Health. Most SIDS deaths occur between the ages of 2 months and 4 months, and more than 2,200 U.S. infants die of SIDS every year.

These deaths are sudden and unexplained, even after doctors perform an autopsy and review the infants' health. Since most of these deaths happen when the babies are sleeping, SIDS is known to many as "crib death."

Researchers believe that some sort of birth defect leads to the serotonin deficit in some babies, said Laura Reno, vice president of public affairs for First Candle, a nonprofit organization dedicated to the study and prevention of SIDS.

Some of the most recent research came from work headed by Dr. Hannah C. Kinney, a neuropathologist at Children's Hospital Boston and a professor of pathology at Harvard Medical School. Kinney, a leading SIDS researcher, and her colleagues found that serotonin levels of 35 babies who died of SIDS were 26 percent lower than those of babies who died of known causes. The SIDS infants also had 22 percent lower levels of tryptophan hydroxylase, an enzyme that helps make serotonin.

Serotonin is suspected to be crucial to a baby's arousal system, which Reno likened to an "alarm" that wakes a baby up when the infant's health is compromised.

"In these babies, the alarm doesn't sound," Reno said. "They continue to sleep even if there is a challenge in their environment, which then causes them to die."

Environmental hazards that could lead to a SIDS death, Reno said, include:

  • Belly sleeping. Infants allowed to sleep on their stomachs end up rebreathing their own exhaled air rather than fresh air. "They are taking in carbon dioxide instead of oxygen," which creates an oxygen deficiency that can result in death, Reno said.
  • Overheating. Babies dressed too warmly or swaddled in thick blankets can become too warm for their own health. "These babies get too heated and, again, the alarm doesn't sound," she said.
  • Too much soft and fluffy bedding and pillows in a crib also can cause a baby to smother. Babies who sleep in the same bed as their parents also are more likely to die of SIDS, Reno said.
  • Smoking. Cigarette smoke robs sleeping babies of needed oxygen. Secondhand smoke, she said, is "really dangerous for these babies."

The next step in research would be to find a way to identify babies who suffer from a natural lack of serotonin. "That would be the goal, because then we would be better able to target messaging," Moon said.

In the meantime, parents are urged to follow the recommendations that doctors have been issuing for years to limit SIDS deaths:

  • Always place babies on their backs to sleep. Since the American Academy of Pediatrics issued this recommendation in 1992, SIDS deaths have dropped by more than half, according to the Nemours Foundation.
  • Place babies on a firm sleeping surface with a tightly fitted sheet. Don't allow a baby to sleep on a pillow, quilt or other soft surface.
  • Dress babies in light clothing for sleep, and keep the room at a temperature that adults would find comfortable.
  • Give babies a pacifier when putting them down to sleep. Studies have found that babies who use pacifiers are less likely to die of SIDS. "We think it may change the baby's arousal threshold, or the way the baby breathes," Moon said.

These are guidelines that parents should follow regardless of whether they believe their child may suffer from a serotonin deficiency, Moon added.

"Babies do suffocate," she said. "Babies do get trapped between mattresses and other things. So these safe-sleep recommendations will help protect against those things as well."

More information

The U.S. National Institute of Child Health and Human Development has more on SIDS.

For more on SIDS, read about one mother's experience.

SOURCES: Rachel Y. Moon, M.D., associate chief, division of general pediatrics and community health, Goldberg Center for Community Pediatric Health, Children's National Medical Center, Washington, D.C.; Laura Reno, vice president, public affairs, First Candle, Baltimore

Last Updated: Dec. 08, 2010

Copyright © 2010 HealthDay. All rights reserved.

Hmmm this is interesting, from the team at Boston Children's regarding SIDS causes... Bottom line is put your baby on their back to sleep to minimize risk.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Wednesday, December 08, 2010

The Superfoods Rx

Here is an excellent book I suggest for everyone who wants to keep their family healthy... Tonight I'm making the Turkey Pumpkin chili on page 291

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Saturday, December 04, 2010

Your Diet: Eat More, Weigh Less, Pt. 2 | The Dr. Oz Show

Here is a great video from Dr Oz on how to eat MORE!

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Friday, December 03, 2010

Home

Wow just got asked to speak at this cool conference in Singapore, Asian wireless Summit about Personal Medicine care delivery model and Panel with other wireless leaders... Asia... big market, huh?

Posted via email from Personal Medicine

Thursday, December 02, 2010

Obesity Bill Shot Down...

Republicans block child nutrition bill

So sad... if everyone will just read this post on superfoods and go out and buy them and EAT them... we won't have to worry about this anymore...

http://paducahpediatrics.snappages.com/blog.htm

WASHINGTON (AP) — House Republicans have temporarily blocked legislation to feed school meals to thousands more hungry children.

Republicans used a procedural maneuver Wednesday to try to amend the $4.5 billion bill, which would give more needy children the opportunity to eat free lunches at school and make those lunches healthier. First lady Michelle Obama has lobbied for the bill as part of her "Let's Move" campaign to combat childhood obesity.

House Democrats said the GOP amendment, which would have required background checks for child care workers, was an effort to kill the bill and delayed a final vote on the legislation rather than vote on the amendment.

Because the nutrition bill is identical to legislation passed by the Senate in August, passage would send it to the White House for President Barack Obama's signature. If the bill were amended, it would be sent back to the Senate with little time left in the legislative session.

House Majority Leader Steny Hoyer, D-Md. said the House would hold separate votes on Thursday on the amendment and the bill.

Republicans say the nutrition bill is too costly and an example of government overreach.

"It's not about making our children healthy and active," said Rep. John Kline, R-Minn., the top Republican on the House Education and Labor Committee. "We all want to see our children healthy and active. This is about spending and the role of government and the size of government — a debate about whether we're listening to our constituents or not."

Former Alaska Gov. Sarah Palin has also taken a swipe at the first lady's campaign, bringing cookies to a speech at a Pennsylvania school last month and calling the campaign a "school cookie ban debate" and "nanny state run amok" on her Twitter feed.

The legislation would give the government the power to decide what kinds of foods could be sold and what ingredients may be limited in school lunch lines and vending machines.

The Agriculture Department would create the standards, which would likely keep popular foods like hamburgers and pizza in school cafeterias but make them healthier, using leaner meat or whole wheat crust, for example. Vending machines could be stocked with less candy and fewer high-calorie drinks.

The bill would provide money to serve more than 20 million additional after-school meals annually to children in all 50 states. Many of those children now only receive after-school snacks. It would also increase the number of children eligible for school meals programs by at least 115,000, using Medicaid and census data to identify them.

The legislation would increase the amount of money schools are reimbursed by 6 cents a meal, a priority for schools that say they don't have the dollars to feed needy kids.

(This version CORRECTS that Palin is a former, not current, Alaska governor.)

Copyright © 2010 The Associated Press. All rights reserved.

Related articles

The Associated Press

Posted via email from Personal Medicine

Wednesday, December 01, 2010

Disruptive Innovation in Primary Care

Here is a 35 minute clip from Medfusion on the emerging technologies that enable physicians to go mobile and connect online and in the homes of patients.

To Your Best health,
The Personal Medicine Team

Posted via email from Personal Medicine

Tuesday, November 30, 2010

How to Manage Food Allergies in Children

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How to Manage Food Allergies in Children

New Guidelines to Help Parents, Pediatricians, and School Officials Cope With Kids’ Food Allergies
By Katrina Woznicki
WebMD Health News
Reviewed by Laura J. Martin, MD

Kids in school cafeteria

Nov. 29, 2010 -- Pediatricians play a key role in preventing and treating food-related allergic reactions among school-aged children, and can help implement plans concerning the way food allergies are managed in the school setting, according to a clinical report published by the American Academy of Pediatrics.

Food allergies are estimated to affect about one in 25 school-aged children. Research suggests that as many as 18% of children with food allergies experience a reaction while in school, indicating that the school environment is an important place to help prevent and treat allergic responses. Food allergy is also a common trigger of anaphylaxis, a possibly life-threatening reaction to a particular food.

Published in the December issue of Pediatrics, the journal of the American Academy of Pediatrics, the report includes:

  • Advice for pediatricians on diagnosing and documenting any potential life-threatening food allergies, including identifying any food that might truly be life-threatening.
  • Developing and writing down age-appropriate management and emergency response plans and including children, parents, and school officials in the planning process.
  •  Determining whether a health care professional, such as a nurse, is available to help the child in the event of a reaction at school.
  • Prescribing self-injectable epinephrine and, if schools permit and if age-appropriate, allowing children to carry their own epinephrine in the event of an emergency, such as outside of the school cafeteria, because delays in treatments have been linked to fatalities.
  • Teaching children and their families how to use and store medication properly.
  • Informing children, families, and schools how to identify signs of anaphylaxis and how to best respond to expedite treatment.
  • Understanding the school’s anaphylaxis response protocols. The report notes that 25% of anaphylaxis cases that occur in schools are among children without a previous diagnosis of food allergy.

Building Partnerships

“Partnerships with students, families, school nurses, school physicians, and school staff are important for individualizing effective and practical care plans,” the authors write.

The report did not include infants, toddlers, and preschool age children, since these children are cared for in a variety of settings and would require their own set of prevention and treatment guidelines.

According to the Food Allergy and Anaphylaxis Network, an advocacy group, an estimated 3 million children have food allergies. Eight foods account for 90% of all food allergies in the U.S.: milk, eggs, peanuts, tree nuts (such as almonds and walnuts), wheat, soy, fish, and shellfish. Food allergies account for more than 300,000 ambulatory care visits per year among children.

Great article from Web MD on management of Food Allergies. Here is an integral part of the pediatrician's role in your child's health.

To Your Best Health,
The Personal Medicine Team

Posted via email from Personal Medicine

Friday, November 26, 2010

Uwe Reinhardt: Medicare and Hospital Payments

Essential reading for everyone who still wonders why healthcare is so expensive...Princeton Economics Prof...

Posted via email from Personal Medicine

Wednesday, November 24, 2010

HealthDay Articles

Children Born 'Late Pre-Term' More Prone to Low IQ

Risk of attention problems at age 6 also rises for those born between 34 and 36 weeks, study finds

By Serena Gordon
HealthDay Reporter

TUESDAY, Nov. 23 (HealthDay News) -- Being born just a few weeks early might have a long-term impact on a child's IQ and ability to pay attention, new research suggests.

In a study that compared babies born at term (40 weeks) to those born between 34 to 36 weeks (called "late pre-term"), researchers found that the children born early had more than twice the risk of having an IQ score below 85 and about double the risk of having socioemotional difficulties, such as attention problems, at age 6.

"There's a subgroup of children born late pre-term that have an increased risk of developing problems by age 6," concluded study author Nicole Talge, a postdoctoral research associate in the department of epidemiology at Michigan State University in East Lansing, Mich.

"What this study tells us is that late prematurity is not a benign situation. Not every kid will have a problem, but there's a higher chance for some to have interaction problems, attention problems and lower IQ," added one expert, neonatal psychologist Cheryl Milford of Magee-Women's Hospital at the University of Pittsburgh Medical Center.

Milford said the reason for the risk is that the brain simply isn't developed enough at 34 to 36 weeks. "A lot of the development of higher-order functioning in the brain is occurring in the 34-to-36-week range," she explained, adding that "there's a reason that humans gestate for 40 weeks."

The current study included 168 pairs of babies -- one born at term and one born between 34 and 36 weeks. The babies were born during 1983 and 1985. At age 6, they had their IQ scores measured and their teachers reported on classroom behaviors.

The Michigan team found that late pre-term birth more than doubled the risk of having an IQ score of less than 85. Furthermore, the odds of having emotional difficulties, such as attention problems, were about twice as high for those born a little bit early compared to the children born at full-term.

Results of the study appear in the December issue of Pediatrics.

Talge said it's important to note that not every child born at 34 to 36 weeks had problems. In fact, most didn't. "Only about 20 percent fell below that IQ threshold, and that means 80 percent were above that. And, about 20 to 30 percent had internalizing or attention problems," she said.

"We now have a greater understanding that each week matters," said Dr. Michael Msall, chief of developmental and behavioral pediatrics at the University of Chicago Medical Center. However, he sad that "the good news from this study is that at age 6, even in a different era of neonatology [the 1980s], these kids did quite well. Yes, on a population basis, there may have been some problems, but I think that it may be like being five pounds overweight on a population basis, and most of these differences may be subtle."

However, he said that if parents see that their child is struggling with schoolwork, or is having a hard time paying attention in school, they shouldn't hesitate to ask for help. "Talk to your child's pediatrician or their teacher; let them know you want to make sure your child stays on track. Recognize the problems and develop a strategy to manage them," said Msall.

Milford agreed. "Babies who are born late pre-term look like small, full-term babies, and for a long time the perception was that they were just a little early, but that they were mostly developed," she said. "The reality is, if you had a late pre-term infant, you should be looking to see if they're on track. Do they have any behavioral issues? If so, you need to find out what resources are available to you in the community and at school."

More information

Learn more about premature birth and what you can do to help prevent it from the March of Dimes.

SOURCES: Nicole Talge, Ph.D., post-doctoral research associate, department of epidemiology, Michigan State University, East Lansing, Mich.; Cheryl Milford, Ed.S., neonatal psychologist, Magee-Women's Hospital, University of Pittsburgh Medical Center, Penn.; Michael Msall, M.D., chief, developmental and behavioral pediatrics, University of Chicago Medical Center; Dec. 2010 Pediatrics

Last Updated: Nov. 23, 2010

Copyright © 2010 HealthDay. All rights reserved.

As if we need ANOTHER reason to warn against late preterm births. Moms these are those last days of pregnancy when you're thinking to yourself, " I want this OVER WITH" from 34 to 36 weeks. There are a multitude of complications that occur in this group. The baby is NOT finished yet. This study suggests a variety of mental health concerns and even LOWER IQ! Unless your OB has a concern, sit tight.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

White Out Now

Parents here is a great video from Dr Alan Greene, which compels us to stop feeding babies white rice cereal as their first food, and replace it with fruit/veggies/whole grains... please send this out to your friends. It's time to put a stop to the obesity epidemic now. It starts with breastfeeding and training babies palates in the first year.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Tuesday, November 23, 2010

CDC - Influenza (Flu) | Weekly Report: Influenza Activity Interactive Map

Trying to share this week's influenza map from the CDC... if the link doesn't work, try clicking on this link below... still time to get your flu shot folks...

http://www.cdc.gov/flu/weekly/WeeklyFluActivityMap.htm#

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Monday, November 22, 2010

The Promise of Cloud Computing -- cloud computing -- software as a service -- SaaS -- Web applications

Physicians, get your practice in the cloud... save yourself 80%... we can show you how...

The Personal Medicine Team

Posted via email from Personal Medicine

Green Beans with Toasted Walnuts and Dried-Cherry Vinaigrette Recipe at Epicurious.com

Still looking for that perfect green bean recipe for Thanksgiving? Here is one I like from Epicurious. I learned from John la Puma that walnut's eaten before a meal vasodilate your arteries... a good thing for your heart, right John?

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Sunday, November 21, 2010

Martha Rose Shulman Cooks With Lentils

Here is a great Lentil Recipe by New York Times, high in fiber and protein, lentils are a great addition to your wellness routine!

To Your Best Health,
The Personal Medicine Team

Posted via email from Personal Medicine

Epilepsy’s Big, Fat Miracle

Cool Article on Ketogenic Diet use in pediatric Epilepsy...

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

CDC Health-e-Cards - The Flu Ends with U - New Moms Please RT

Look at these cool ecards that providers can send out to there patients electronically, courtesey of CDC, Way to go you down in Atlanta. Please Forward to your friends!

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Thursday, November 18, 2010

Pediatricians group offers tips on antibiotic use

Pediatricians group offers tips on antibiotic use

Associated Press

5:37 a.m. CST, November 17, 2010

chi-ap-il-antibioticsadvice

CHICAGO —
The American Academy of Pediatrics says it's Get Smart About Antibiotics week and it's offering advice on how to avoid overusing these important medicines.

With the arrival of cold and flu season, the academy has partnered with the federal Centers for Disease Control and Prevention in raising awareness about appropriate antibiotic use.

The drugs work against bacteria but not illnesses caused by viruses. That includes colds and the flu, and also most coughs and sore throats. Using antibiotics for those illnesses can be dangerous because it can help make germs more resistant to the drugs.

Illnesses that antibiotics can treat include bacterial pneumonia, some sinus infections and sore throats caused by strep bacteria.


The academy says be sure to use all doses of antibiotics; otherwise the infections could return.

Copyright 2010 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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Here is a nice article on the smart use of antibiotics by AAP and CDC

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Monday, November 15, 2010

At the End of their Rope, Some Parents sedate their kids...

What do you think parents?

Posted via email from Personal Medicine

amednews: Cyberbullying a high-tech health risk for young patients :: Nov. 15, 2010 ... American Medical News

A few years ago, patients of child and adolescent psychiatrist Niranjan Karnik, MD, PhD, began talking to him about online harassment. Some of the youths were teased on social networking sites. Others received threatening text messages.

Since then, such complaints have been on the rise at the University of Chicago clinic where Dr. Karnik works. To address the growing problem, he continues to ask about traditional bullying but has added a new topic to office visits -- cyberbullying, in which technology is used to repeatedly harass an individual. The incidents can occur through e-mails, text messages, Twitter and social networking sites.

"We do see more of this happening, [partly because] it's so simple to do," said Dr. Karnik, assistant professor of psychiatry at the University of Chicago. "It doesn't require you to stand in front of a person to bully them."

Mental health professionals are urging primary care physicians to address this mounting problem with their young patients by educating them on the topic and screening for possible victims and perpetrators. They say leaving the issue unchecked can result in anxiety, depression and, in some instances, suicide among those involved.

Suicide rates for cyberbullying victims and perpetrators were above those of students not involved in the activity, just as the rates for victims and perpetrators of traditional bullying also were elevated, according to a July 2010 Archives of Suicide Research study based on 1,963 sixth- through eighth-graders in one of the largest school districts in the U.S. Cyberbullying has gained more public attention recently due to several high-profile suicides in 2010 that followed such harassment.

Cyberbullies and their victims have higher suicide rates than their peers.

Although research indicates that cyberbullying seems to occur most frequently among teenagers, anyone who spends time online can be harassed, according to child and adolescent psychiatrists.

To help identify youths who are affected by such incidents, pediatricians and family physicians should ask all of their patients if they use the Internet and have a cell phone, said Boston psychiatrist Tristan Gorrindo, MD. Patients who answer "yes" to either question are vulnerable to being a cyberbully victim or perpetrator, he said.

Despite the growing prevalence and publicity of cyberbullying, many physicians are not yet seeing patients with complaints of such harassment, said Gwenn Schurgin O'Keeffe, MD, an executive committee member of the American Academy of Pediatrics' Council on Communications and Media. She said the topic won't be brought up in a doctor's office until primary care physicians ask patients about it.

"I recognize that doctors have a lot on their plate. This is all new for everybody. But everyone has to have a heightened sense of awareness that children are being bullied [with technology], and it's happening more than people want to admit," said Dr. O'Keeffe, a Hudson, Mass., pediatrician.

Technology spreads, cyberbullying follows

About 43% of teenagers age 13 to 17 reported being cyberbullied during the previous year, according to 2006 data from a National Crime Prevention Council survey. The council is a Virginia-based nonprofit that addresses the cause of crime and violence and aims to reduce it.

That study is among the most recent and widely cited on the prevalence of cyberbullying. But mental health experts estimate that these numbers have increased with the growth of mobile access to the Internet and the involvement of youths in technology at younger ages. In fact, many psychiatrists said the cyberbully victims they see in their practices are getting younger.

About 43% of teenagers age 13 to 17 reported being cyberbullied in 2005.

In 2009, 58% of 12-year-olds owned a cell phone, up from 18% in 2004, according to a survey of 800 adolescents by the Pew Research Center's Internet and American Life Project. Overall, 75% of teens age 12 to 17 had a cell phone in 2009.

Experts say the rise of social media is making cyberbullying more common. In 2009, 73% of teenagers who spent time online used a social networking site. The figure was 55% in 2006.

But even as younger children become more active online, cyberbullying probably will remain most problematic for teenagers, said Dr. Gorrindo, a child and adolescent psychiatrist at Massachusetts General Hospital in Boston.

He noted that the developmental task of teenagers is to figure out who they are. This group already has an unstable image of themselves, which can be further weakened by moving to a new school or uncertainty about their sexuality, he said.

Dr. Gorrindo stressed that for many individuals, cyberbullying is largely a nuisance and will not lead to suicide or other serious mental health issues. A 2006 Pediatrics study of 1,500 Internet users found 38% of 10- to 17-year-olds who were the target of Internet harassment reported "emotional distress."

But for adolescents who have a less stable sense of their identity, including individuals with mental health issues and those who are perceived as outsiders by their peers, cyberbullying can drive them deeper into depression.

"In children with these [types of] vulnerabilities, cyberbullying is probably worse" than traditional, face-to-face harassment, he said.

Dr. Gorrindo noted that taunts on social networking sites can be viewed by hundreds of Internet friends, compared with traditional bullying, which often is witnessed by a small group of people. Cyberbullying is difficult for victims to escape because the attacks can occur in private moments over a computer and through cell phones.

Identifying victims and perpetrators

To identify potential victims and perpetrators of such harassment, Dr. Gorrindo suggests that physicians ask all their patients who use the Internet what they do online. He recommends that physicians specifically inquire about whether they use social networking sites and ever felt as if they were harassed. Additionally, he said doctors should ask patients if they bully other people. Dr. Gorrindo, in his experience, said children will be honest and forthcoming with their answers.

Adolescent medicine specialist Elizabeth Alderman, MD, said that children bully others for a reason, which could include depression or abuse by a parent. If a patient admits to cyberbullying, physicians should help the individual identify his or her actions as a problem and then involve the parent or guardian in the situation, said Dr. Alderman, a professor of clinical pediatrics at Montefiore Medical Center and Albert Einstein College of Medicine in New York.

58% of 12-year-olds owned a cell phone in 2009, up from only 18% in 2004.

When patients acknowledge that they have been victims, doctors first should assure the individuals that it's not their fault and then determine their level of danger for self-harm or acts inflicted by others, said Dr. O'Keeffe, of the AAP.

She said patients who need counseling should be referred to a mental health professional. Physicians should urge families to contact police if threats made against a patient seem credible, she added.

"Like almost any disease, the earlier we recognize [cyberbullying] and treat it, almost without exception, the better the outcome will be," said Henry J. Gault, MD, a child and adolescent psychiatrist in Deerfield, Ill.

"If you can intervene, you can protect a child from a great deal of harm," he said.

This content was published online only.

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 ADDITIONAL INFORMATION: 

Identifying cyberbullies and victims

All adolescents are at risk of cyberbullying, according to mental health professionals. But there are characteristics that make certain individuals more vulnerable to such harassment than others -- and more likely to commit cyberbullying.

Most susceptible patients:

  • Individuals with mental health issues
  • Those with a developmental disability
  • Adolescents who are gay or lesbian, or those who are struggling with their sexuality or gender identity
  • Youths who recently moved to a new school
  • Children who are perceived as outsiders by their peers
  • Adolescents who spend a lot of time online

Signs that a patient could be a cyberbully victim or perpetrator:

  • Problems sleeping
  • Anxiety
  • A sudden disinterest in school
  • Increase in somatic complaints, such as stomachache and headache
  • Bed-wetting in younger children
  • A decrease in social activity

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Weblink

"Bullying, cyberbullying, and suicide," Archives of Suicide Research, July (www.ncbi.nlm.nih.gov/pubmed/20658375)

"Social Media & Mobile Internet Use Among Teens and Young Adults," Pew Research Center, Feb. 3 (www.pewinternet.org/reports/2010/social-media-and-young-adults.aspx)

National Crime Prevention Council on teens and cyberbullying (www.ncpc.org/resources/files/pdf/bullying)

"Examining characteristics and associated distress related to Internet harassment: Findings from the Second Youth Internet Safety Survey," Pediatrics, October 2006 (www.ncbi.nlm.nih.gov/pubmed/17015505)

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Copyright 2010 American Medical Association. All rights reserved.

Good article for parents. Cyberbullying is real and has contributed to the suicide deaths of several teens over the past year. Social Media platforms can accelerate the problem. Parents can stay connected to your preteen and teen children's social media presence. We'll be reading more and more about this.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Healthcare sector among top adopters of iPad | Healthcare IT News

This is what we have been talking about. Game Changer.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Saturday, November 13, 2010

Use of World Health Organization and CDC Growth Charts for Children Aged 0--59 Months in the United States

Here is a hot off the press recommendation for changing to utilizing WHO growth charts for babies, with the gold standard for growth being breastfeeding. Now time to change everything... Again. This is refreshing, as it grows tiring having breastfed mom's concerned about their baby's growth when they are compared to our current bottle fed curves. Progress...

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Mom, Dad, You’re Stressing Me Out! - The Juggle - WSJ

Parents there is a nice article noting the effects that parental stress has on kids. An important reminder to put the kids second. ( I always say second, because you have to put your marriage first) So where does that put your career? Third...

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Friday, November 12, 2010

Adults may not be spreading whooping cough: study | Reuters

Adults may not be spreading whooping cough: study

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    By Julie Steenhuysen

    CHICAGO | Thu Nov 11, 2010 4:25pm EST

    CHICAGO

    (Reuters) - Children largely spread whooping cough among themselves, so blanket vaccination campaigns targeting teens and adults may be a waste of time, according to a study that looks at how social patterns affect disease transmission.

    The findings, published on Thursday in the journal Science, contradict the notion that infected adults are behind outbreaks in California and elsewhere of whooping cough, a contagious disease caused by the bacterium Bordetella pertussis.

    A U.S. advisory panel last month recommended that adults over 65 be given a booster of the "Tdap" vaccine for tetanus, diphtheria and pertussis, or whooping cough, to protect infants under a year old, who are too young to be vaccinated.

    But older people may not be the main culprit, Pejman Rohani of the University of Michigan and colleagues say.

    Whooping cough, which causes uncontrollable, violent coughing, infects 30-50 million people a year globally and kills about 300,000, mostly children in developing countries.

    There are regular outbreaks in developed countries, including one in California that has affected more than 6,400 people and killed at least 10 infants, the U.S. Centers for Disease Control and Prevention said.

    To study the effects of social interactions on spreading whooping cough, the research team used a situation in Sweden.

    That country halted its whooping cough vaccination program in 1979 because of vaccine safety concerns, and did not resume routine vaccination for 17 years. But health authorities continued to track cases of whooping cough by age group.

    "We took advantage of an unplanned natural experiment," Rohani said in a telephone interview.

    The team compared this to a 2008 study of more than 7,000 people from eight European countries that tracked social contacts by age. They plugged this into a computer model to see how social contacts affected the spread of whooping cough.

    The team found that when Sweden resumed vaccinating young children, there was a big drop in the number of cases of whooping cough in all age categories except in teenagers.

    With the patterns of social mixing, children mostly interact with other children, and are unlikely to be infected by adults, they found.

    "Infant immunization produces a protective effect for other children, who are likely to be mixing with other infants," the team wrote. Infected adults did not play a major role in spreading whooping cough to children.

    Rohani said other studies would be needed to explain how social networks affect regional disease outbreaks.

    But he said looking at social networks is another way to better understanding how infectious diseases are spread -- and may save health officials the time and expense of mass vaccination campaigns that may not work.

    (Editing by Vicki Allen)

     

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    Interesting study on the spread of pertussis.

    To Your best Health,

    The Personal Medicine Team

    Posted via email from Personal Medicine