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    Monday, May 01, 2006

    Pediatric Police: Pity the poor pediatricians. Already burdened by high office overhead thanks to the burgeoning number of recommended childhood immunizations, not to mention rising malpractice rates, now their national academy wants them to police their patients' exercise habits:

    The American Academy of Pediatrics wants to turn children's doctors into activity police, encouraging them to routinely monitor how active patients and even their parents are each day to help conquer obesity.

    The policy says pediatricians should ask patients and parents at regular office visits how active they are. They also should document how much time patients spend each day on sedentary activities and urge them to follow academy guidelines recommending no TV for children under age 2 and no more than two hours a day of TV, video games and other "screen time" for older children.

    It's all well and good, in an ideal world, to ask and educate about the importance of regular exercise, but in a practical world, where there are only so many minutes in an hour and so many hours in a day, shouldn't we concentrate our time and efforts on things that are likely to make a difference?

    These days, doctors are routinely told by their professional organizations that they should do something about drug use, teenage sexual activity, bad parenting, bad food choices, smoking, and a host of other lifestyle and personal choice issues. But does anyone really think a doctor's suggestion that people should do this or that - eat less, walk more, be nice to the kids and the spouse, not have promiscuous sex - makes any dent at all?

    posted by Sydney on 5/01/2006 08:16:00 AM 6 comments


    I actually I think it does make a dent but I do not see how you have the time and energy for all the things that should be monitored--and besides--a dent is just that, a dent. I imagine it will soon be forgotten and become part of the background noise we all live with Take Care

    By Anonymous Frank, at 10:02 AM  

    The national organizations should concentrate on the positive PR aspects of these issues. Sponsor public service announcements. Provide appropriate literature and posters for our offices. Produce other types of resource materials. However, don't establish more uncompensated mandates for practicing physicians who are barely keeping their heads above water. The shrinking pool of primary care physicians does not need any further sabotage.

    By Anonymous Anonymous, at 11:54 AM  

    I don't think it will really make a difference if there's no co-operation between the patient and family. It's futile task ahead. What I don't understand is why leave it all to the paediatricians?
    Don't the family have more responsibility on what the children do with their lives?

    By Blogger ipanema, at 3:15 AM  

    I don't think it will make a dent. Everyone knows that being fat is not healthy, and that kids need to exercise more and eat less. Does it help much now when a doctor says a fat kid's parents that he/she needs to loose weight?

    I think this type of education belongs with parents/schools more than with the doctor. Parents are supposed to be interested in their child's health, while it is school responsibility to educate kids on all matters including physical activity and food. If the school cafeteria serves junk food and has soda machines everywhere, how would a doctor who sees a child a couple of times in year make a difference? Also the school days here are pretty long, certainly much longer than where I grew up and yet we learned way more in all subjects. Why couldn't schools allow an hour a day for some physical activity outside - like jumping rope or whatever. Most games that we played outside when I was a kid involved some physical activity - jumping squares, jumping rope, hide/seek, whatever.... I don't see kids here doing anything like this. I do see parents driving kids to a school bus stop 2-minutes walk away.

    By Anonymous Anonymous, at 10:44 PM  

    I work for a federal clinic and most of my patients do not speak English. I know rudimentary Spanish and that's it. So beyond the basics, there's not a lot of conversation or bonding. Generally speaking, immigrant children are all slurping down sugary soft drinks and juice like there's no tomorrow (one of the wonders of America), and the parents become very concerned when their children are thin - and want vitamins to make them eat MORE. Being fat is seen as "healthy". The poor dentition I have seen in some of these kids would blow your mind.

    The sheer numbers of children that have to get through the clinic (many times we have no medical records, and the parents are poor historians) . . .and the things we have to do to meet all of the current standards (immunizations/labs/developmental screening/etc) . . . not to mention the language barrier . . . prohibit making any kind of substantive "dent" in eating habits.

    Yes, there is a problem. But it is a cultural one and it is about parenting, NOT doctoring. The people who make up these recommendations up do not live in the real world.

    By Anonymous Anonymous, at 11:40 PM  

    Make a dent? Well, yes --- but a small one. As the head of the clinic I go to explained, he knows I am quite aware of being overweight (heck, fat) and of the dangers of smoking, but he and his associates just automatically go through the spiel in case a patient is NOT aware.

    Oh, and it helps stave off "nobody ever told me smoking two packs a day could cause trouble" lawsuits...

    By Blogger John A, at 1:12 AM  

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