2009-05-25

The Obama Administration’s Plans for National Healthcare run headlong into a growing problem

The Obama Administration’s Plans for National Healthcare run headlong into a growing problem: There are not enough Primary Care Physicians in America (http://www.nytimes.com/2009/04/27/health/policy/27care.html )

The question this raises in NE Ohio is: Are there enough pediatricians for every family to
find a medical a medical home for their child? There is an epidemic in America. Not the Swine Flu Epidemic. This epidemic involves the rapid disappearance of individual Pediatricians and other Primary Care Physicians from the American culture.

Since 1997, the number of graduates from American medical schools who say they intend to be Primary Care Physicians has fallen from 40% to about 17%. This includes graduates who intend to become pediatricians. This trend can be traced directly to economics.

  1. Graduates from Medical Schools have huge expenses. They face the world owing, on average, $140,000 in tuition fees and other expenses.
  2. The income they would receive as Pediatricians and other PCP graduates is far less than they could earn if they were practicing medicine as a specialist.
  3. Federal insurance payment guidelines are much lower for pediatricians than for specialists.


Primary Care Physicians (Pediatricians, General Internists, and Family Practitioners) would be the heart of any sane medical system. PCPs see and handle 95% of a person’s medical needs, and at a fraction of the cost of specialists. In addition, they are the ones who recommend when specialists are necessary to maintain the continuity of care for a patient.

So what does all this mean for North East Ohio? Are there now, and will there be in the future, sufficient numbers of pediatricians for new families to find Primary Care Physicians who will help them take care of the medical lives of their children? And why do children and families need individual doctors rather than medical clinics and emergency rooms?

As one of Cleveland’s few remaining pediatricians in individual practice, Arthur Lavin, M.D., Advanced Pediatrics, Beachwood OH, is well versed in this topic. He is the author of Who’s The Boss? Moving Families from Conflict to Collaboration, Baby & Toddler Sleep Solutions for Dummies, and Finding a Medical Home for Your Child. Dr. Lavin’s entire career has been devoted to meeting the real needs of his
patients in regard to:


  1. Preventing and curing illness.
  2. Preventing and correcting obesity.
  3. Helping children and families deal with school failure.
  4. Helping families with parenting struggles.


He is available for comment and interview on this topic, as well as others.
For more information on Arthur Lavin, please visit: www.advancedped.com
Or call 216. 591-1515


*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Institute of Medicine Calls for Doctors to Stop Taking Gifts From Drug Makers

“In order to provide our patients the best uninfluenced information that science has to offer, we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.” from the website: www.advancedped.com

(Beachwood OH) – The Institute of Medicine (part of the National Academy of Sciences), yesterday issued a full report that scolded doctors for accepting money, samples, and food from drug companies.

Arthur Lavin, MD, a pediatrician at Advanced Pediatrics in Beachwood, has had a policy for 20 years of not taking money, samples, food, or gifts from any outside vendor. “It’s not something I think is beneficial to a patient,” Lavin said. “When we prescribe a drug, we want our patients to have the fullest confidence that the reason that particular drug is being ordered is because it is the best one for the job based on the evidence found by medical research, studies, and our previous experiences. We want no patient to even consider that the drug being prescribe might be a product from a company that provided us with free samples, money, gifts, or any other incentives designed to increase the sale of that and other products. We think the only honest way to be a doctor is to consider first what’s best for the child based on our own research and experience and follow that course of action free and clear of any possible suspicion of influence. Period.”

Dr. Lavin is the coauthor of “Who’s the Boss? Moving Families from Conflict to Collaboration” and “Baby & Toddlers Sleep Solutions for Dummies.”

He can be reached at Advanced Pediatrics, www.advancedped.com , 216-591-1515.
http://www.nytimes.com/2009/04/29/health/policy/29drug.html


*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

EKG Now Recommended if You Are Taking Stimulant Medications

Given recent findings, Advanced Pediatrics now recommends that all children taking stimulant medications have an EKG done prior to getting a refill. Stimulant medications are the most common drugs used to treat ADHD. They include amphetamine (Adderall, Vyvanse) and methylphenidate (Ritalin, Concerta, Methylin, Metadate, and Daytrana). All of these medications have been linked to rare instances of sudden cardiac death, and a simple screening EKG appears to offer the hope of preventing many of these tragic events. So if your child is taking one of these medications, please call your preferred hospital and schedule a simple EKG. Advanced Pediatrics would also be very pleased to help arrange for your child to get the EKG.  An EKG is simple to arrange, simple to do, and pain free.  So arrange for the EKG if your child is taking a stimulant medication.
Soon we will not be refilling these medications unless a normal EKG is on file.




*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Singulair

A recent notice from the FDA alerts us all to the fact that a person taking Singulair has committed suicide. This fact was actually brought to light by the manufacturer of Singulair, Merck.

Merck, like all drug companies, must monitor side effects after a drug is approved for use since now millions of people will be using it. During this monitoring process, Merck found a question of whether someone taking Singulair may have committed suicide as a side effect, or whether the Singulair just happened to be a medicine the person was taking at the time.

Merck's statement is at this web site:
www.merck.com/newsroom/press_releases/product/2008_0327.html

In response to this report, the FDA now has decided to help find out if Singulair could have a side effect of suicidal ideation. The FDA anticipates it will take 9 months to find the answer. http://www.fda.gov/cder/drug/early_comm/montelukast.htm

At Advanced Pediatrics, we are not aware of any biological reason that Singulair should cause depression or increase the risk of suicide. For those whose normal breathing relies on the use of Singulair, we agree with the FDA that it remains the safe choice to continue using Singulair. Of course, whether you take Singulair or not, if you find your child is thinking about hurting themselves, please contact us.


*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Statement on Autism

Advanced Pediatrics Statement on Autism

Spring, 2009

 

               What is Autism?

                The word autism derives from the root auto meaning self.  At its heart autism is a problem                  with a person’s ability to relate or connect to other people, rendering that person turned                      towards their self.  Of all human brain functions, namely walking, talking, using our hands,                  and socializing, the ability to socialize is by far the most complicated and challenging.                        To connect and relate to another person effectively, you must be able to read that other                       person’s mood and interests.  When does another person want to say hello, or be with                       you, or avoid you, or get angry with you, or be glad to see you?  To connect to others and                   relate effectively, a person must be able to answer all of these and many other such                             questions. 

Do Vaccines Cause Autism?

Before answering this question, we would like to repeat that our approach to investigating the facts is based on the best scientific methods possible.  We try to only review data that has not been sponsored by parties that have an interest in the answer, such as pharmaceutical manufacturers, or groups that advocate answers prior to the study.

Advanced Pediatrics is proud of its policy to allow no drug companies to offer our practice any items of any value.  We refuse all mailed goods such as pens and pads, and deny access to our office by any drug company representatives.  We have adopted this policy to make sure that any advice we offer families is based solely on the facts and not influenced by and gifts.

 

With that in mind, we now present our view of the facts as of early March, 2008.

 

The scientific literature is quite clear that vaccines do not cause autism.  Neither the vaccine or mercury in the vaccines appear to play any role in causing autism.

 

The most striking proof of this conclusion comes from Denmark.  Nearly 20% of families in Denmark do not immunize their children at all, and so in this country a massive study on this question could be conducted.  The study enrolled half a million children and studied them for seven years.  The study ended up looking at the chance of two groups of children developing autism:

1.      100,000 children who got no vaccines of any type

2.      400,000 children who got all their vaccines.  Some of these children had thimerosol in their vaccine, some did not.

 

The findings were dramatic.  The chance of a child developing autism was the same in both groups.  If a child got no vaccines at all, they had the same chance of developing autism as those who got vaccine, with or without thimerosol.

These chances of developing autism, of course, went up over the 7 years of the study, and the other striking finding was that the rise in the odds of developing autism went up at the same rate whether you got any vaccine at all or not.

 

This study proves that if we stopped immunizing children altogether, the chance of developing autism would continue to rise without any change.  If your newborn or child is not immunized, the chance of developing autism will not change!

 

What Does Cause Autism?

We are convinced that a most frightening and disturbing epidemic of autism is afflicting our children and community.  We are sad and angry that essentially no serious efforts have been launched by the United States or United Nations to find out why.  As a result of this failure to investigate, as of today we have no idea what causes autism, only that vaccines do not.

Our view is that two parties are primarily responsible for the failure to find the cause, and that it is the antagonism of these two parties that has created this paralysis.  One group are the advocacy groups that have already made up their mind about the cause: vaccines.  The other group are those scientists who respond to the false claim about vaccines causing autism by denying that an epidemic is upon us.  Together these groups have opposed serious investigation into the cause of the autism epidemic.  The vaccine advocacy groups oppose finding the cause because they think they know the cause already and fear investigation might undermine their position.  The scientists who counter these groups by denying an epidemic oppose investigation into the cause because they think it would be a waste of resource to investigate an epidemic that does not exist.

 

 

Our Conclusions

Our position at Advanced Pediatrics is:

1.      There is an autism epidemic, that it may be the most frightening risk parents of newborns face today.

2.      We are dismayed that our nation and world has not yet found the cause, but are convinced there is (are) a cause (or causes) to this tragedy.

3.      Immunizations clearly are not the cause.  Stopping the use of immunizations has been dramatically proven to have no effect on the rising risk of autism.

4.      We would like to see our community devote its time, energy, and resource to finding the cause(s) of autism and to stop being distracted by pretending we know the answer to this horrible malady.  Pretending that vaccines cause it or that there is no epidemic stops us from finding the real cause(s) and lets the epidemic rage on.

5.      We follow every newborn and infant carefully to make sure social development is normal and look for early signs of autism in every child born.

6.      We are happy to talk to families about the autism epidemic, about their worries and concerns, and about their infants and children.

7.      When autism strikes we are prepared and happy to work very closely with families to help their children develop as normally as possible.

Please feel free to meet with us, call us, and ask any questions about this deeply troubling problem.


At its heart, autism is a disorder of this ability to read other people’s moods and intents, leaving the affected person with autism isolated with limited or no social skills or experiences.

 

Is Autism on the Rise?

Our current reading of the medical literature strongly suggests that the answer is yes.

This is not yet a settled or fully proven fact, but the trends at this time appear quite striking.  Some experts cite incidence figures that state prior to 1990 the chance of a child developing autism was 1 in 2000 and now it is 1 in 160.   If these figures hold up under further scrutiny, then a true epidemic is indeed taking place.

Three striking features of this most disturbing rise in the incidence of autism should be noted:

  1. The rise in incidence appears to have begun rather sharply around 1990. 
  2. The rise is worldwide, being reported in Japan, Denmark, across the US, and England.
  3. The social and mental functioning of children affected varies widely from child to child.  All have some abnormality of social ability, but the severity of this difficulty varies quite a bit as do the chances of other cognitive troubles.


*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Announcing the Opening of the First Who's The Boss? Parenting Education Center in Greater Cleveland

Advanced Pediatrics is pleased to announce the opening of an exciting new resource for our community: The Who's the Boss? Parenting Education Center (For more information and appointments, call 216-647-1707).

The center will enable Advanced Pediatrics to be the first to make available to parents the highly successful philosophy and specific guidance featured in Who's the Boss? Moving Families from Conflict to Collaboration and Baby & Toddler Sleep Solutions for Dummies.

The center will provide support and guidance for parents who have questions about their child?s behavior or development. Through private sessions and group workshops, parents will learn specific techniques that will allow them to once again offer loving guidance while they teach their children the skills to find effective, peaceful solutions to their conflicts and allow them to become the boss of themselves. The center will feature some of our community's most trusted and effective parent educators, Susan Glaser MA and Courtney Evenchik MA.

Collectively, Susan, Courtney and I have counseled more than 10,000 families and have found that these techniques can be successfully applied to virtually any issue that families face, including:

  • Potty training
  • Sleeping through the night
  • Feeding issues**Sibling rivalry
  • Child care concerns
  • Tantrums **Discipline
  • Educational issues, and more

The cost for an hour-long individual appointment is currently available at an introductory rate of $80.

We are also very excited to offer a free introductory consultation for all parents of 12-month-olds. One year of age is at the threshold of emerging consciousness--a critical time to think ahead.

I am certain that families who take advantage of this opportunity will gain confidence and assurance on their exciting, challenging journey of parenting.


*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

A New Study for 6-17 Year Olds with ADHD at Advanced Pediatrics

People with attention deficit disorders typically have abnormal sleep function, too. Recent studies have linked exposure to strong white light after sunset to disruptions in normal sleeping. And so, we at Advanced Pediatrics are curious about whether limiting exposure to light before bedtime might help improve sleep and, in turn, improve attention during the day. In a study designed in collaboration with scientists at John Carrol we are now able to offer a study that limits the exposure to blue light before bedtime to see what impact this has on your child's attentional abilities. The interventions are:
  • Taking a 10 minute test of attentional skill with Dr. Weitman.
  • Wearing amber-tinted glasses for some time before bedtime every day, using an amber-tinted nightlight and/or light bulb for middle of the night lights.
  • Keeping a diary of sleep and attention functions
Do this for 10 weeks and then repeat the attention test with Dr. Weitman.  We have obtained formal certification from the University Hospitals Institutional Review Board for this study.

There is no cost to participate.

If interested, simply call our office, we will enroll the first 30 who meet the entry criteria of being 6-17 years old and having ADHD.

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Please Do Not Purchase Cold and Cough Medicine for Your Children

We are pleased to announce that the FDA and AAP have come to agreement with a position taken by this office in the early 1980's: cold and cough remedies do not work in children and can cause great harm.  The situation is severe enough that the FDA has actually induced manufacturers to take the following products OFF THE MARKET because they do not work and can cause harm, even death:

  • Dimetapp® Decongestant Plus Cough Infant Drops,
  • Dimetapp® Decongestant Infant Drops,
  • Little Colds® Decongestant Plus Cough,
  • Little Colds® Multi-Symptom Cold Formula,
  • PEDIACARE® Infant Drops Decongestant (containing pseudoephedrine),
  • PEDIACARE® Infant Drops Decongestant & Cough (containing pseudoephedrine),
  • PEDIACARE® Infant Dropper Decongestant (containing phenylephrine),
  • PEDIACARE® Infant Dropper Long-Acting Cough,
  • PEDIACARE® Infant Dropper Decongestant & Cough (containing phenylephrine),
  • Robitussin® Infant Cough DM Drops,
  • Triaminic® Infant & Toddler Thin Strips(R) Decongestant,
  • Triaminic®) Infant & Toddler Thin Strips(R) Decongestant Plus Cough,
  • TYLENOL® Concentrated Infants' Drops Plus Cold,
  • TYLENOL® Concentrated Infants' Drops Plus Cold & Cough.



*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

The IEP: Two Great Websites to Help You Prepare

The AMERICAN ACADEMY of PEDIATRICS
http://www.medicalhomeinfo.org/tools/school.html
This Web Page from the AAP is a treasure chest of resources to help you help your school deliver the help your child may need. It is also a great entry page for all sorts of help with children with special health care needs.

THE IEP POP-UP
http://www.handsandvoices.org/articles/education/popup/pop_index.html
The IEP Pop-Up is an extraordinary set of very common problems that parents have to contend with when seeking an EFFECTIVE IEP.

The Pop-Up is a 4 by 4 square of 16 questions. Click on the question and you will get a great answer with legal citations and other substantiation for a powerful response.


*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

New Lice Treatment

Curing Lice

 

In December, 2005, the journal Pediatrics published the finding that one could use the easily available skin cleanser Cetaphil® Gentle Skin Cleanser to cure lice.

 

The treatment is simple, and appears to be quite safe.  It relies on the property of this skin cleanser to create a film when it is blow-dried on hair.  If this film is left on your hair for 8 hours or more, it will kill the lice on your head with over 95% efficacy. 

 

Here is how to apply the treatment:

 

Place and massage in about 8 ounces of the Cetaphil® Gentle Skin Cleanser on the hair.

It is key to soak every hair in the Cleanser.  You can do this by applying the lotion in a zig-zag pattern from back to front, massage fully into every hair and the scalp, and then again from front to back, 3-4 times, using up all 8 ounces in the process.  The application can be with a squeeze bottle with a nozzle that should touch the scalp in every zig-zag.

 

Before blow-drying the lotion, let the lotion soak in the hair and scalp for 2-5 minutes.  Then be careful to comb as much lotion as you can, leaving only a film on the hairs and scalp.

 

A blow-dryer is then used to create a film on the hair and scalp.  You should blow dry these areas until they are all dry.  Then leave the film on overnight, at least 8 hours.  Showering or bathing in the morning ends the treatment.

 

Repeat the process exactly once a week for a total of three rounds.

 

In addition to treatment, the following steps are a complete description of how to remove lice from your home, please note, no other steps are necessary:

 

Remove lice from all the family's combs and brushes.  You can choose one of two methods.  You may soak the combs and brushes in isopropyl (rubbing) alcohol for 10 minutes or you may put them in the dishwasher on the full hot cleaning cycle.   

 

Treat all bedding at the time of each lotion application. Take all sheets, pillow cases, blankets, comforters, and bedspreads from the beds in your house and run them in the dryer for 10 minutes on high temperature. Then put the bedding back on beds. You do not have to wash it. 

 

Patients should change to new fresh clothes after each treatment. Put dirty clothes in the laundry hamper for later laundering.

 

Many schools require all eggs or nits to be removed, and the best tool to do this with is called the licemeister comb, only available on line at http://www.headlice.org/licemeister/

 

Remember, lice never cause physical harm, only fear, dread, and itch.  These steps will allow you to rid your children and home of them safely.



*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Folic Acid Alert

All women from their first to last period should take 400 micrograms of folic acid a day. If you do, you will prevent the development of spina bifida in many newborns.

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Vitamin D, The Second Vitamin to Have Proven Benefit as a Drug?

PRELIMINARY EVIDENCE IS NOW STRONG ENOUGH for Advanced Pediatrics to support the advice to give 400 units of Vitamin D every day to every child starting at birth (unless the child is mainly nourished by formula) through adolescence.

While much attention has been showered on the possible extraordinary power of vitamins to restore health, cure disease, and prevent illness, nearly all vitamin studies have failed to show any benefit beyond their very important role as nutrients. Vitamin C, for example, has been shown in study after study to have no ability to cure or prevent colds.

Folic acid is the only vitamin to date to have been proven to have benefits when taken beyond nutritional need. Women taking folic acid in the very first weeks of pregnancy can greatly reduce the chance of neural tube defects such as spina bifada.

There is now growing evidence that Vitamin D, taken in amounts beyond those needed to prevent rickets, might prevent some forms of cancer, auto-immune disease, and diabetes. While this is not yet proven, the chance it might be true is growing. The risk of taking as much as 400 Units a day appears slight. Therefore, Advanced Pediatrics supports the recommendation of the American Academy of Pediatrics statement published November, 2008. http://www.aap.org/presssroom/nce/nce08vitamind.htm

View pdf.

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

2009-05-24

Resources and Links



*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.