April 30, 2009

Sexting: dangerous but is it a crime?

“Come gather round people wherever you roam
And admit that the waters
Around you have grown
And accept it that soon
You’ll be drenched to the bone
Then you better start swimming
Or you’ll sink like a stone
For the times they are a changing”

Bob Dylan’s song of protest (voted #59 of the top 500 songs ever written by Rolling Stone) seems as prescient today as in 1964, especially as COCM members recognize the latest teen-technology on-line behavior:sexting. Research studies reflecting usage reveal that between 20-25% of all teens have sent or posted semi-naked or naked pictures. A higher percentage says that exchanging sexy content makes dating or hooking up more likely.

Teens have been recently charged with disseminating child pornography in 9 states, many have to then register as sex offenders. Meanwhile,the media (as usual) has sensationalized the issue by the way it has covered the topic, often confusing parents, teens and even pediatricians.

But the real question here is this: should laws made to protect children be used to prosecute them? I believe that misses the point. Pediatricians and parents should look beyond the headlines to the convergence of adolescence and these electronic devices that allow instant communication decisions from immature teen brains.

These kids are not threats to society.They’re reckless hormonal narcissists who are tasked with growing up in a sexualized society. Their previously private thoughts are now revealed all too publically. They often are the real victims here: assaulted by a desire and opportunity to get older-younger.

Parents need to become aware that the media has ensured that adolescence occurs well before Tanner stage II. The media has framed the issue, but not focused on real solutions. That's where we can help enormously with our pediatric knowledge and media skills!

So what is the Pediatrician’s role when it seems that teens are more connected to their devices, and each other, but disconnected from their parents? It doesn’t have to be complicated.

1) Don’t wait until a health maintenance appointment to frame the issue of texting/sexting. Rarely does a teen or tween appear in the office without a cell phone. (Or receive a call during the appointment).

2) Remind them that a text or sext, once sent, is out of their control permanently. Examples abound from the pictures of Vanessa Hudgins (HSM 1,2,3-oh google her) or Michael Phelps and his famous bong picture.

3) Ask about whether parent is concerned about texting as nauseum. Most will agree
about the numbers, but will be clueless as to potential solutions.

4) Advise visiting ThatsNotCool.com (go there yourself). A great site with tools and guidance, prime parenting directives actually, to buffer cyber-stalking and cyber-pressures. The site also has great posts that could be taken from the site to stimulate a discussion in your examination rooms, newsletters, websites.

Note that as the January archives article revealed, uncovering the problem does not imply you have to solve it. Expressing awareness and concern, could, hopefully, motivate parents to seek opportunities to learn and engage in collaborative conversations that would lead to constructive solutions.

“Come Mothers and fathers throughout the land
And don’t criticize what you don’t understand
Your sons and your daughters are beyond your command
Your old record is rapidly aging
Please get a new one
If you can’t lend a hand
For the times they are a changing”

By Don Shifrin, MD, FAAP

April 28, 2009

What if every pediatrician was on twitter?

Is the absence of pediatricians on social media platforms a public health issue for children? It might be. Misinformation predisposes children to risk. We all can identify instances where poor decisions for a child were made on corrupt information obtained online.

And as doctors we complain. We see ourselves as victims. Our patients are reading someone else’s information and opinion. And most of us handle matters by taking precious time to get the facts straight. Time that could be better spent on anticipatory guidance or counseling in other areas.

But to some extent the issue of bad information is our responsibility.

As pediatricians our response to online misinformation tends to be reactive. For some reason we never think that we should be the ones generating the information and dialogue. As the group charged with the well-being of the next generation we need to be proactive. We have a commitment to see to it that we are visible and vocal online.

So what can you as a fellow of the AAP do?

Contribute to a blog. It doesn’t have to be your own blog. There are many that would be happy to host you as a guest author. Offer practical input on the issues that you see creating confusion in your parent base. If every fellow of the AAP posted one blog post annually on the absent association between vaccines and autism, for example, there would be 60,000 online entries which would likely dominate search engines.

Comment regularly on news sites, blogs or anywhere there’s dialog on children’s health. With no input from those of us with the facts, discussion will be dominated by a vocal minority, many of whom have an agenda not representing the interests of the parental reader.

Begin a Twitter account. Just a few minutes a day cultivating relationships with peers, patients and ‘followers’, AAP fellows have the potential to change minds and influence thinking. Twitter is a platform for the dissemination of ideas, thoughts and information in ‘tweets’ of 140 characters. Assuming just 250 followers (I have 1,000), the news of a measles outbreak associated with undervaccination, for example, could instantly reach 15 million individuals with a single tweet from AAP members.

The battle for the health of our children and the sanity of our parents is now fought online. A commitment to online literacy through active involvement by AAP Fellows in social media should be seen as a critical advocacy role.

By Bryan Vartbedian, MD, FAAP

April 21, 2009

Being A TV Medical Expert: Tips to get asked back

Being asked to appear as a guest medical expert for the first time is an exciting experience. How do you ensure you will be asked to come back on the show again? The following are a few tips I have picked up along the way:

1) Arrive early. The last thing the producer wants to do is worry about whether you are going to make it to a live appearance. It's better for you stroll around the neighborhood and collect your thoughts on the topic for a few minutes, rather than run the risk of receiving panicked phone calls from a producer.

2) Be courteous from the moment you enter the building. Smile at the security guard, be friendly to the intern or page who escorts you in the building, and make small talk with the people in the green room. Not only will it make good impressions, but you will appear relaxed and confident. Often times, the make-up artist or others in the green room will ask what you are about to talk about…it's great practice to speak your thoughts aloud, so be sure to use the opportunity. Just remember that what's spoken in the green room may be repeated in public.

3) Ask ahead of time if you need to arrive camera-ready. Some shows will have a stylist on set to do hair and make-up, others will expect you to arrive camera-ready, and some will have someone ready to touch up what you have applied ahead of time. It pays to ask before you arrive. Additionally, I recommend that the ladies always carry some make-up and hairspray, in case you get stuck in traffic and don't have time for the full stylist treatment. Gentlemen, I encourage you to accept the offer of face powder. Distracting shine can take attention away from your good messages.

4) Discuss the segment with the producer ahead of time. Some producers will want to pre-interview you on the telephone, while others will want you to email 'talking points' in advance of the show. Either way, make sure you have some contact with the producer ahead of time, so you know what to expect and aren’t faced with any surprises on camera.

The producer will ask you about the topic you will be discussing so before you speak with the producer take a few minutes to do a quick internet search, even if you are well-versed on the topic. One great resource is the AAP "children's health topics" page on your topic at www.aap.org. A small bit of mental organization goes a long way in making you sound like an expert who can convey a lot of valuable information in a short period of time.

While on the phone, ask the producer if he or she would like you to email formal ‘talking points’ for the show. If so, send these in Q&A form. Even if the producer does not desire ‘talking points’ from you, creating some for your own personal use is a fantastic way to prepare for the segment.

Issues to ask the producer about include duration of the segment, who will be interviewing you, what to expect when you arrive at the studio, and whether hair and make up touch up are provided.

5) Be flexible. Things frequently change in the broadcast world, and they can change last minute. I have had a topic change upon arrival at the studio, leaving me only 10 minutes to review the topic on my i-phone. Though this would fluster almost anyone, try not to let the producers know you are uncomfortable about a last minute switch. The more easygoing you are, the more likely they are to have you back. And, unfortunately, we all get cancelled. Sometimes it's the day before, sometimes it's the morning of, and sometimes it's even after sitting on the set. I personally have been sitting next to the interviewer with my microphone on, only to have my medical segment bumped by someone talking about vegetarian turkeys for Thanksgiving! But don't give away your annoyance, even if you (ahem) changed around your whole schedule, only to have the segment be canceled at the last second.

6) Be reachable. Immediate access to email is a must. Often you will receive an appearance request in the form of an email. If your response time isn't quick enough, you risk losing the opportunity. A blackberry or i-phone really comes in handy if you plan to appear on air often.

7) Send a quick thank you email. It's always nice to send a brief "thank you for having me" email, and it gives you an opportunity to say that you would love to come on again if the need should arise. Many times this has opened the door for me to send pitches back to the producer.

By: Alanna Levine, MD, FAAP