Stories about: Health legislation & reform

The medical home: what health care needs now

Claire McCarthy MD

You may have heard the term “medical home”—it’s been bandied about recently as something we all should have. No, it’s not a nursing home. Nor is it a house well-stocked with Band Aids and Tylenol, or one where doctors live.

The American Academy of Pediatrics defines medical home as “a model of care that is accessible, family-centered, continuous, comprehensive, coordinated, compassionate, and culturally effective.”

Well, that sounds exceedingly lovely. Of course we’d all want that. But still, what does it really mean?

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Education: My best weapon in injury prevention

By Eric Fleegler, MD, MPH, attending in Pediatric Emergency Medicine; co-author, “Attempts to Silence Firearm Injury Prevention.”

I remember the first time I fired a shotgun: the noise was extreme, the kickback stronger than I anticipated. It was exhilarating. I was 17 years old.

At the time I was struck by the raw power of the gun, the enjoyment of the moment. Twenty-two years later I am struck by the potential on that day for a devastating accident. I was in the backwoods of a classmate’s house. We were by ourselves, shooting an old microwave in the middle of the day.

As a pediatric emergency medicine doctor I see the results of bad decisions every single shift: bike accidents that occur without helmets which lead to permanent brain injury. Intoxicated teenagers who aspirate their own vomit and end up in the intensive care unit. Sexually active adolescents who don’t use protection and get infections—or get pregnant. A 10-year-old child accidentally shot in the thigh by his friend while playing with his dad’s gun.

Discussions about risky behaviors are too late for these kids. They needed guidance, at regular intervals, prior to these incidents—the kind of guidance that is the mainstay of what we do as health care providers. Asking patients about tobacco, drug and alcohol use, sexual activity, and finding out if they are depressed, have suicidal thoughts and have access to weapons that can readily kill them is vital to my work as an emergency medicine physician. 

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The lessons health care can learn from Steve Jobs

By Clement Bottino, MD, Fellow in General Pediatrics at Children’s Hospital Boston’s Primary Care Center

Steve Jobs Memorial outside an Apple store. Image flickr/Ron Cogswell

Like many people across the country, I was sad to hear about the passing of Steve Jobs.

I grew up with the technology Mr. Jobs created. My 5th grade final science project entitled “The Moray Eel” was typed on an Apple II computer. My college soundtrack was powered by a first generation iPod and nowadays I keep in touch with my sister who lives in Spain using face-time on my iPad.

The technology Steve Jobs created radically changed how we interact with computers, the way we listen to music, even the way we communicate with each other. Mr. Jobs was an innovator on a grand scale; some say a Thomas Edison or Henry Ford for our time.

Before Mr. Jobs, computers were big, clunky machines. There was no mouse, no desktop, just a solitary green cursor on the lower corner of an empty black screen. You needed to be an expert in the field to use one.

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How learning about the FDA drug shortage could help your child’s care

Having a sick child is hard enough, but a current drug shortage is threatening to complicate matters even more for many families with chronically ill children.

“There is a supply problem with many drugs in this country right now, and it’s getting worse,” says Kathleen Gura, PharmD, BCNSP of Children’s Hospital Boston’s Department of Pharmacy. “Last year we had about 200 drugs in short supply, we’re already up to 211 this year, and that number may grow.”

Drug shortages are nothing new; in the past few decades several medications have dipped to very low supply levels, complicating care for many patients. But the problem with the current shortage is the fact that many different medications are becoming scarce at the same time, creating several shortages simultaneously.

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