PEDIATRICIAN Spring 2003 - AAP-CA

More documents

Recommendations

Info

EDITOR-IN-CHIEF Jeffrey S. Penso, M.D. 9696 Culver Blvd., #108 Culver City, CA 90232 (310) 204-6897 jpenso@ucla.edu ASSISTANT EDITOR Marianne Hockenberry aapmarianne@aol.com ADVERTISING Stuart A. Cohen, M.D. 6699 Alvarado Rd., #2200 San Diego, CA 92120 (619) 265-3400 scohen98@ipninet.com DESIGN AND PRODUCTION Rosalie Blazej 50 Laidley St. San Francisco, CA 94131 (415) 695-0264 FAX (415) 641-5409 rblazej@pacbell.net DISTRICT EXECUTIVE DIRECTOR Kris Calvin, MA 853 Ramona Ave. Albany, CA 94706 (510) 559-8383 FAX (510) 559-8464 aapcalifornia@aol.com Marianne Hockenberry Associate Director EDITORIAL BOARD Chapter 1 Lewis Nerenberg, M.D. Chapter 2 Joan E. Hodgman, M.D. Chapter 3 Howard Taras, M.D. Chapter 4 Stanley Galant, M.D. CHAPTER OFFICES Chapter 1 Executive Director Beverly Busher 900 Fifth Ave. #204 San Rafael, CA 94901 (415) 459-4775 aapbev@aol.com www.aapca1.org Chapter 2 Executive Director Kathleen Shematek, MPH 6233 East Allison Circle Orange, CA 92869 (714) 744-8245 aapca2kshematek@socal.rr.com www.aapca2.org Chapter 2 Chapter Administrator Eve Black P.O. Box 2134 Inglewood, CA 90305 (323) 757-1198 aapcach2@aol.com Chapter 3 Executive Director Erika Kalter 3020 Children’s Way MC 5073 San Diego, CA 92123 (858) 569-8816 sdpeds@chsd.org www.aapca3.org Chapter 4 Executive Director Debbie Monfea 12377 Lewis Street, #103 Garden Grove, CA 92840 (714) 971-0695 ca4aap@sbcglobal.net www.aapca4.org Address comments and questions to Jeffrey S. Penso, M.D. jpenso@ucla.edu 2 District Report Burton Willis, M.D. and Kris Calvin, M.A. 3 Childhood Cancer Survivors Report Life Changes Brad J. Zebrack, Ph.D., M.S.W., and Mark A. Chesler, Ph.D. Today 75% of children diagnosed with various forms of cancer in the United States are expected to survive their disease and treatment. But what of their quality of life expected, enjoyed, or endured? 4 Tandem Mass Spectrometry in Newborn Screening George C. Cunningham, M.D., M.P.H. The Department of Health Services keeps us current on neonatal screening. 5 Culturally Appropriate Communication Is Good Medical Practice Allan Lieberthal, M.D., FAAP Poor communication results in inferior medical care, and is not in compliance with federal government standards. Can we improve compliance? 6 CMA House of Delegates Report Paul Y. Qaqundah, M.D. State budget concerns were key but access to the care and employer mandate proposals were issues we wrestled with in San Francisco. 7 Weighing the Radiation Risks of CT Scans Nikta Forghani, M.D., Ronald A. Cohen, M.D., Myles B. Abbott, M.D. CT scans expose children to high doses of ionizing radiation. What are the best ways to use CT scans? 8 Adolescent Idiopathic Scoliosis Robert M. Bernstein, M.D. What is the natural history of scoliosis, which cases need to be referred? What are the treatment options? 9 Preventing Ear Infections in Children Harry Pellman, M.D. AOM is the most common bacterial infection diagnosed in children. What is known to reduce the frequency of middle ear problems? 10 A Low-Glycemic Index Diet in the Treatment of Pediatric Obesity David S. Ludwig, MD, PhD, et. al. Obesity is arguably the most prevalent medical problem in the United States today. Weight loss on current reduced-fat diets is characteristically modest and transient. Can a novel treatment, the low-glycemic index diet, be the breakthrough we need? 12 Why California’s MICRA Is Good for the Nation Ron Bangasser, M.D. We face a national medical liability crisis. The solution is California’s MICRA. 13 Ten-Year Experience with Pediatric Bilateral Living Donor Lobar Lung Transplantation Marlyn S. Woo, M.D. and Vaughn A. Starnes, M.D. The medical team had exhausted all conventional medical and surgical options. What about lung transplantation for this dying patient? 14 The Tao of Pediatrics and Chinese Medicine Wendy Yu, M.S., L.Ac., Jeffrey I. Gold, Ph.D., Michael H. Joseph, M.D. Health is not just about a disease factor, it’s about the whole environment. 17 In Memoriam — Joseph H. Davis A beloved pediatrician is recalled by his son. 18 Chronic Pain in Children: A Multidisciplinary Biopsychosocial Treatment Approach (Part III) Michael H. Joseph, M.D. and Jeffrey I. Gold, Ph.D. we must decrease all ongoing nociceptive pain and support, encourage, and reinforce the child in working through chronic pain symptomatology. 21 Twenty-Five-Years of Home Mechanical Ventilation in Children: The Program at Childrens Hospital Los Angeles Manisha Witmans, M.D., Sheila S. Kun, R.N., M.S., and Thomas G. Keens, M.D. The last 25 years has witnessed enormous improvement in home mechanical ventilation. Since the inception of the home ventilator program in 1977, the program at Childrens Hospital Los Angeles CHLA has grown to include over 375 children. CONTENTS CALIFORNIA PEDIATRICIAN — SPRING 2003/ 1
TABLE OF CONTENTS continued District Report AAP-CA Advocacy in Hard Times: Multiple Strategies to Success Burton Willis, M.D. and Kris Calvin, M.A. Despite the flowering trees around the majestic Capitol dome, Sacramento offers few pretty pictures this year. Take a shot of the full landscape: an unprecedented $30 billion dollar-plus state deficit looms. Zoom in for a family portrait? Democrats, Republicans and the Governor’s office seem trapped on their own limited platforms, with no real solution in sight. Worse yet for pediatrics, snapshot photos of the health budget show only shrinking dollar signs. This is because health dollars are largely unprotected in an era of budget “lock-ins” in other areas due to initiatives or other mandates. The California District of the American Academy of Pediatrics (AAP-CA), representing all four California AAP Chapters, has developed a pragmatic, yet hopeful approach to this state crisis. Strategies include: • Increased AAP-CA leadership and participation in coalitions to ensure that children’s health advocates are heard above the din in the budget debates in Sacramento. This includes intense advocacy with 70 other groups to oppose proposed cuts to Medi-Cal physician reimbursment. • Build on successes. Last year AAP-CA and our allies were successful in saving and expanding the Child Health and Disability Prevention (CHDP) state-only program. If state-only CHDP had been eliminated these children would have fallen into the ranks of the uninsured and an important source of pediatric revenue to sustain their care would have been eliminated. This year AAP-CA has worked closely with the state to protect the program and improve it. Starting July 1, 2003 CHDP providers will be able to pre-enroll children into the Medi- Cal program through the Internet or new Point of Service devices. For more information go to www.medi-cal.ca.gov/new_chdp.asp. • “Back-end” involvement in implementation of children’s programs. Programs are best protected in the budget if they are fully implemented and working well for both physicians and children. For example, AAP-CA “Chapter Champions” are working with the state to ensure that the already enacted Newborn Hearing Screening Program is fully implemented with appropriate reimbursement. • Prevent budget problems before they start. This includes careful legislative monitoring and intervention to ensure that only those bills whose benefits outweigh their costs are enacted. This requires AAP-CA to be available to legislators and their staff as an expert resource on a wide range of issues, including vision screening, early brain development anticipatory guidance and HMO contracting issues. We have already had great success this year in this regard. • Engage legislators and policymakers by utilizing credible pediatrician advocates. Legislators and other policymakers prefer to hear from you, practicing pediatricians with first-hand experience with children and families, rather than from lobbyists and staff. Something as simple as a “form” letter from you to your legislator on a priority AAP-CA issue matters. Those of you with a flair for public comment can make a tremendous difference by testifying for AAP-CA on a bill or budget item in Sacramento. Building an ongoing trust relationship with your local legislator in his or her home office is invaluable. If you have not already completed the brief AAP-CA Grass Roots Advocacy Survey please request one from aapcalifornia@aol.com. Improving the state child health picture in California this year will take more than just a pretty new frame. AAP-CA will continue to work towards real change for pediatricians and the children and families that you serve. 22 Childcare Health Linkages Program: How Pediatricians Can Collaborate with Local Childcare Health Consultants Robin Calo, R.N., M.S., P.N.P. and Karen Sokal-Gutierrez, M.D., M.P.H. When you think about the young children in your practice, who besides their parents takes care of them? Is a childcare consultant coming to your neighborhood? 23 Eve Black Honored 24 Annual Las Vegas Seminars — 25 Years of District Education and Support Rosalie Blazej and Milton Arnold, M.D. For 25 years, pediatricians have flocked to Las Vegas to learn and relax. 25 Selling Tobacco Products as a Public Health Issue Trisha Roth, M.D. At the urging of the California Medical Association and with the help of the Preventing Tobacco Addiction Foundation, a proposal is on the table to increase the minimum age for purchasing tobacco to 21. 26 Early Hearing Detection and Intervention Sudeep Kukreja, M.D. To be successful, California needs to address several issues in the Newborn Hearing Screening Program. 29 SED — California Region Leonard Kutnik, M.D. One in 10 children suffer from a mental health illness but only one in five children receive specialty services. Unfortunately, even this rate of treatment is not achieved in the Healthy Families Program. 29 California Surgeon General Needed to Protect Californians 31 Retirement Options for Pediatricians Joan E. Hodgman, M.D. Retirement should not be dull or boring. With the increase in the average life expectancy, more and more of us can look forward to years of active life after retirement. 32 Last Word: After the Iraq War Jeffrey S. Penso, M.D. Even with victory an implacable worldwide enemy will remain. While physicians are aware of the continued threat of bioterrorism, we have yet to recognize that bioterror will change relationships between physicians and the community. 33 President-Elect Candidates 33 Contributors 35 Officers and Committees California Pedatrician does not assume responsibility for authors’ statements or opinions. Opinions expressed are not necessarily those of California Pediatrician or the California District, American Academy of Pediatrics. Vol. 19 No. 1 Spring 2003 California Pediatrician [ISSN 0882-3421] is the official publication of the American Academy of Pediatrics, California District IX. Copyright © 2003 American Academy of Pediatrics, California District IX 2 / CALIFORNIA PEDIATRICIAN — SPRING 2003
Page 1: california PEDIATRICIAN Spring 2003
Page 5 and 6: in and of itself, but I think you t
Page 7 and 8: CMA House of Delegates Report Paul
Page 9 and 10: Adolescent Idiopathic Scoliosis Whi
Page 11 and 12: A Low-Glycemic Index Diet in the Tr
Page 13 and 14: Why California’s MICRA Is Good fo
Page 15 and 16: The Tao of Pediatrics and Chinese M
Page 17 and 18: Chronic Pain in Children: A Multidi
Page 19 and 20: LUNG TRANSPLANTATION CONTINUED FROM
Page 21 and 22: Childcare Health Linkages Program:
Page 23 and 24: Annual Las Vegas Seminars — 25 Ye
Page 25 and 26: Early Hearing Detection and Interve
Page 27 and 28: THE TAO OF PEDIATRICS AND CHINESE M
Page 29 and 30: A LOW-GLYCEMIC INDEX DIET IN THE TR
Page 31 and 32: I write in late March, as American
Page 33 and 34: Nikta Forghani, M.D. Weighing the R
Page 35 and 36: COUNCIL ON CHILD HEALTH CHAPTER 1 B
Page 37: CALENDAR May 14, 2003 Los Angeles P

PEDIATRICIAN Spring 2003 - AAP-CA

Create successful ePaper yourself

Delete template?

Save as template?