Fashionably Late
It’s amazing any pediatric research is getting done at all right now, what with New York Fashion Week in full swing. Pediatricians, famous among physicians for our sartorial panache, can barely pick up our stethoscopes, waiting to see which designer will dazzle the runway with just the right ensemble to accessorize best with green snot! My bet is on Haus Alkire, but I know some of my colleagues won’t be satisfied until they see the presentation from Rochambeau. And yet, as fashion-obsessed as pediatricians are known to be, we must remember, we’re doing it for the kids.
Sometimes you go to do one thing, and you end up doing something else, like when I make such a mess trying to eat a sandwich that I can also check the box for "Feed the dog." According to an article in Pediatrics, this is just the sort of thing that happened with a couple of parenting programs for high-risk families. Two early childhood interventions designed to help parents learn basic child care skills wound up reducing childhood obesity, an outcome missing from most programs designed to, you know, reduce childhood obesity.
The programs, ParentCorps and The Incredible Years (which is not, as I had hoped, a mash up of The Incredibles and The Wonder Years) focused not on diet and exercise but on helping parents and children maximize two key aspects of the parenting relationship: sensitivity to children’s needs and expectations of children’s behavior. Follow-up analysis of program participants happened to uncover marked long-term improvements in BMI and blood pressure compared to controls. Both programs will shortly be retitled Honey, I Shrunk The Kids. Of course these results open up whole new fronts in the war on obesity. Don’t steal this idea, but I’m writing a grant to print parenting tips on french fry cartons.
Or am I? You see, doctors responding to a survey in Health Affairs admitted a level of comfort with lying to patients that some people might find a little unsettling (those people would be, oh I don’t know, patients). While the majority of the 1,891 docs surveyed agreed with the Charter On Medical Professionalism that telling patients the truth is a good idea, around a third of respondents thought Medical Professionalism didn’t necessarily apply to disclosing serious medical errors, but more to topics like the weather or how poorly State played in last night’s game. Two fifths of doctors thought relationships with pharmaceutical or device makers that might present a conflict of interest were secrets best kept between a doc and his industry handler. These survey results generate some serious questions, most importantly: if we docs are so comfortable with dishonesty, why aren’t more of us in Congress?
When it comes to truth-telling, pediatricians generally favor sex education programs that do more of it. After all, states with more comprehensive sex education programs also have lower teen birth rates. But what if we’re confusing correlation and causality, like when my being late for work makes all the stoplights turn red? That’s what researchers publishing in the Archives Of Pediatrics And Adolescent Medicine assert in their new study comparing teen birth rates, sex education and social and economic factors in 24 states over an 8-year period. States with more complete sex ed programs indeed boasted lower teen pregnancy rates, but once the authors corrected for crime rates, poverty, and religious attitudes limiting the availability of birth control and abortion, the differences in sex ed quality didn’t seem to matter. So what should we do? Don’t steal this idea, but I plan to propose that instead of wasting a bunch of money on high quality sex ed, the other 49 states just ship all their teens to the state with the best stats: New Hampshire.
I have other great ideas as well, including shirts, designed especially for pediatricians, made entirely of facial tissues. Sadly, I couldn’t get a venue in New York this week, but there’s always the fall shows. One thing is for sure: pediatricians never miss a moment of Fashion Week.