Social Media Makes Me A Better Pediatrician

Heidi Roman, MD, FAAP

About two years ago I started writing more regularly- reflections on being a new mom, thoughts on my changing perspective as a pediatrician. I kept a notebook that quickly filled with musings that occurred to me during clinic, questions parents asked, things that came up with my son. I realized that a lot of other parents had the same kinds of questions I did. They too were Googling questions and looking for credible sources of information. So, I started actively creating and curating child health information via social media. I'm still a neophyte compared to many online pediatricians that I respect and follow. Nonetheless, I'm a relative veteran compared to most of my colleagues. I’m often asked about how and why I do this. When I answer that I think being online is making me a better pediatrician, I get some curious and quizzical looks. I admit that I  didn’t expect it when I started all of this, but being involved in social media is shifting the way I think about medicine and ultimately making me a better doctor. Here’s how.

•          I write more. I write, on average, a post a week. Writing has made me a better doctor and mom, in many ways. When a parent asks a question on a topic I’ve recently researched and written about I can direct them to useful resources without a moment’s hesitation. And, writing makes me read more too. I now have a set of go-to sources for quality child health information that I am well acquainted with and that I can use quickly in clinic or to research a topic.

•          I think more. Writing makes me think. Insightful comments from readers make me think. Listening to the amazing online community of patients makes me think. My point of view is challenged. My mind is opened. I’m a better doctor.

•          I make more connections. After I started blogging, I joined Twitter. I thought it might be a good way to share my work. But, I’ve found that, for me, Twitter is so much more. For me, Twitter is about the thoughtful, generous, intelligent community of people that I follow. Every day, they bring me the latest information in medicine, child health, parenting, and general news. They enable me to say to my patients’ parents, yes I did read that study on sleep that just came out and here are some thoughts. Or, there are some new car seat regulations and here’s what you need to know.

•          I am a more effective child advocate. By being more connected, I am both more aware of the current policy issues affecting kids and more effective at spreading the word.

•          I’ve started to become more “digitally literate.” There is no debating that this is where healthcare is going. It’s good to be in the thick of it.

•          I have more hope for healthcare. Thanks to social media I have met,people both online and in real life who are working every day to make healthcare better. People with innovative ideas and incredible drive who I am excited to join. People who give me hope that, with the help of new technology and hard work, we will improve our broken healthcare system.

Sure, there are limitations to social media. Nothing replaces face-to-face communication. I’ve also learned to take breaks now and then. Regain perspective. I’ve learned to dip in and out of the social media stream and not worry too much about missing something. If it’s important or compelling, it’ll come around again. I’m certain that the ways we share information will continue to change and evolve. Perhaps, this will all sound quaint in five years. But, for now, I think all of this communication and knowledge sharing is a good thing for patients, their families and for me.

Editor’s Note:  For AAP Members, the Academy has a wonderful webpage entitled, “Making the Most of SocialMedia” This resource is full of helpful tips and advice so login and check it out.

National Immunization Awareness Month

WHAT EVERY PARENT NEEDS TO KNOW ABOUT VACCINES

JoANN C. ROHYANS, MD, FAAP

August is National Immunization Awareness Month.  As summer vacation winds to a close, parents should be aware that they need to check their child’s vaccination record.  Vaccines (or immunizations) are recommended for people of all ages (from newborns through adults) and are the best way to keep children and adults healthy.  Through social media and television, we are all bombarded with tons of “quasi” medical information.   Unfortunately, parents don’t always know to whom to listen.  Not only are there doctors on television talk shows, news programs, Twitter, Facebook and blogs, but there are also celebrities and broadcasters who feel compelled to offer their advice regarding the immunization program. 

The best advice should come from a trusted medical source, primarily your physician.  The Institute of Medicine (IOM) has released two very important reminders.  One is that the MMR vaccine is NOT associated with autism and the other is that the current vaccine schedule (2013) is SAFE and best to be given on the schedule as it is written. 

Parents often ask if we can change the vaccine schedule to give fewer shots at each visit.  This is not recommended. Very good research shows that the number of vaccines given at one time does not increase side effects.  Instead, by using “alternative schedules,” parents leave their children vulnerable to very dangerous diseases. 

It can be confusing to parents since both the media and some doctors often speak of alternative schedules as if they are actually approved alternatives.  However, parents should be aware that there is only one official vaccination schedule.  This vaccination schedule is recommended both by the American Academy of Pediatrics and the Center for Disease Control.

It is also understandable that many parents feel overwhelmed and confused by the increase in the number of vaccines children and adolescents receive these days.  By age 2, a child can receive up to 24 injections and 2-3 doses of an oral immunization.  Luckily, combination vaccines can significantly reduce the number of injections without decreasing their efficacy.  But even so, it certainly does sound like a lot until you realize that we are able to protect against 16 diseases, all of which can be serious -- often causing hospitalization or even death. Because the vaccine program has been so successful in decreasing the incidence of many of these diseases, vaccine discussions in the media today often loose sight of how serious these diseases or their sequela can be.

This can lead to parents feeling ambiguous as to whether or not they should vaccinate their children.  It is not uncommon in my practice for a parent to ask, “Why does my child need a vaccine if the disease is almost eliminated from the U.S.?”   Unfortunately, diseases can have resurgences and when that happens the disease can spread quickly between countries and infect unvaccinated individuals. For example, in England in the late 1990s, parents chose not to give their children the measles vaccine.  Over the next 7-10 years, the incidence of measles increased dramatically especially in those unvaccinated.

What the vaccine discussions in the media and on-line often lack is a sense of what the world would be like without these vaccines. I saw many of the diseases now considered vaccine preventable when I was a child and more recently during medical school, residency and in my pediatric practice.  I have seen infants and children die of varicella (chicken pox) and its complications, which can include severe skin infections, blood stream infections and even central nervous system infections.  Before the rubella (German measles) vaccine became available, infants born to mothers who had rubella during their first trimester of pregnancy had a 50% chance of being born deaf, blind or having heart disease. 

I remember vividly a call from a mother on a Sunday morning saying that her child had developed a fever during the night, woke up having a seizure and was admitted to the hospital with meningitis and subsequent severe brain damage due to the Haemophilus influenza bacteria (HIB). This was just a few months before the HIB vaccine became available.  I also remember a young nurse with a chronic cough.  Her ill five week old was later admitted to the hospital and placed on a breathing machine.  It turns out her chronic cough was pertussis (whooping cough) and she had passed it to her baby. 

The diseases that we vaccinate against are real and serious. So as we enter August and prepare to go back to school, check that everyone in your family -- children, adolescents and adults -- is up to date on all their immunizations and booster shots. Furthermore, if you have any questions about vaccines, your doctor is a far better resource for medical information than the media.