New Year's Resolutions/Wishes

Happy New Year to everyone!! Now that the holidays are over and school is back in session, my life is returning to it's usual busy wintertime schedule. It's also the time of year when people discuss their resolutions for the new year, and I see a lot more people walking on the track after work! I've often been tempted to ask if they are there to lose weight in the new year, but instead I just see how many days they last...it seems that two weeks is about the maximum. All this aside, it's also a special January this year, as we will be inaugurating a new president in a few short weeks. I hope things will start to change quickly.

In light of the potential for change, I have come up with a list of my top 10 wishes for our health care system which I am hoping will be targeted for change early in this new administration. I know that some of these wishes are not free, and I don't know where the money will necessarily come from, but a wish is just that, a wish! I could also go on with many more wishes, but I think ten is a good start.

1. Renew and increase funding for SCHIP. Perhaps with more Democrats and more progressive Republicans in Congress, this will happen.

2. Increase reimbursement for pediatricians giving vaccines.

3. When considering universal health care, examine what other countries have done and perhaps create a system which combines the best from the different approaches being used world-wide. Having waited this long to do what most other first-world countries have already done, we might as well turn this to our advantage and learn from the mistakes of others.

4. We, as physicians, need to practice medicine responsibly. We need to accept that we are contributing to the skyrocketing costs of medical care in the US, and we need to do something about it.

5. Continue to encourage medical students to go into primary care with increased emphasis on programs that already exist, such as the National Health Service Corps. As costs for higher education continue to escalate and funding for student loans is cut, informing pre-med college students about the availability of scholarship programs may be more effective than in the past.

6. Continue to study pharmaceuticals specifically in the pediatric population.

7. Continue to promote the safety of vaccines. The American Academy of Pediatrics is working diligently on this effort.

8. Strive to continue research efforts with stem cells.

9. Provide adequate reimbursement for obesity counseling, nutrition education.

10. Let's get daily physical education back in schools!!

obesity weighs heavily on my mind

I was reading the NY Times online today, catching up on news of the world around me. In the past 10 days or so, there has been a series of articles about doctors counseling patients about weight loss (http://tinyurl.com/63d9zh). I was definitely intrigued by the headlines, as I was recently told that I was mean to my overweight patients; I am honest with my patients. What was more interesting to me than the articles themselves were the comments. The basic idea is that overweight and obese people know they are overweight and don't need another lecture. I can see that, although in my office it tends to be the parents who already know their children are overweight, and are often overweight themselves. But I still feel that it is important to show the child (depending on the child) and the parent(s) the growth chart with the BMI plotted. Maybe in doing so, I am being too harsh. Yet, I feel that if my concern is health, I need to address the topic in a frank way. I do ask families how I can help, and I try to refer them to a nutritionist, if available; when necessary, I check a lipid profile. I can think of other things I would like to do, like change school lunch menus, get kids in daily physical education classes from kindergarten through 12th grade, and teach parents how to cook in a healthful way, but we don't have the resources. I do as much as I can to offer solutions, like cutting out the ramen noodles and flaming hot cheetos! But I also ask parents not to keep unhealthy snacks in the house. Just the other day, I had a parent tell me that it makes her 107 pound five year old son sad when she goes to the grocery store and doesn't come home with ramen noodles, and I suggested that that was OK that he was sad, that she could perhaps just make them as a treat once in a while. My patients know though that I am their loudest cheerleader when they start exercising and watching what they eat, even if they don't lose weight right away.