Nice post, Paul. I am a recently retired pediatric pulmonologist and could not agree with you more. In my area of expertise, my biggest pet peeves are the following"
- among pediatricians, the liberal prescription of antihistamines and nasal corticosteroid sprays for children with mild recurrent viral respiratory infections. Instead o…
Nice post, Paul. I am a recently retired pediatric pulmonologist and could not agree with you more. In my area of expertise, my biggest pet peeves are the following"
- among pediatricians, the liberal prescription of antihistamines and nasal corticosteroid sprays for children with mild recurrent viral respiratory infections. Instead of educating the worried parents about the normalcy of these illnesses, the prescription pad is whipped out.
- among pediatricians and adult physicians, the over-diagnosis of sinusitis as an excuse for antibiotics.
- among my fellow pulmonologists, the over-use of systemic corticosteroids in acute illnesses.
Education and reassurance are the pillars of managing viral illnesses with welcoming return calls or return visits if the natural history of the illness is violated.
Thanks George. I totally agree with you. Unfortunately, it's easier to give a quick script rather than a longer spiel. Warm tea with honey still beats most pharmaceuticals for mild viral illnesses. With urgent cares in particular, I see oral steroids get used like they're candy. I suspect this is partly a problem of the one-off relationships: Short term gains are favored over long term risks.
As a pediatrician, I remembered when the FDA and AAP in a strong move of ELITE PANIC made recommendations that pediatricians should stop prescribing Sudafed and most forms of robitussin, which were mostly placebo drugs although higher dose Sudafed was NOT good. What did pediatricians do when they could not hand out little sample bottles of Robitussin, they prescribed antihistamines and nasal steroids, which cost ten times as much and have far more side effects. Perhaps, more importantly, they missed the chance to educate the child's parent about homeopathic harmless remedies like tea and honey and that no treatment was really necessary, just love and limited interruption in normal activities.
Nice post, Paul. I am a recently retired pediatric pulmonologist and could not agree with you more. In my area of expertise, my biggest pet peeves are the following"
- among pediatricians, the liberal prescription of antihistamines and nasal corticosteroid sprays for children with mild recurrent viral respiratory infections. Instead of educating the worried parents about the normalcy of these illnesses, the prescription pad is whipped out.
- among pediatricians and adult physicians, the over-diagnosis of sinusitis as an excuse for antibiotics.
- among my fellow pulmonologists, the over-use of systemic corticosteroids in acute illnesses.
Education and reassurance are the pillars of managing viral illnesses with welcoming return calls or return visits if the natural history of the illness is violated.
Thanks George. I totally agree with you. Unfortunately, it's easier to give a quick script rather than a longer spiel. Warm tea with honey still beats most pharmaceuticals for mild viral illnesses. With urgent cares in particular, I see oral steroids get used like they're candy. I suspect this is partly a problem of the one-off relationships: Short term gains are favored over long term risks.
As a pediatrician, I remembered when the FDA and AAP in a strong move of ELITE PANIC made recommendations that pediatricians should stop prescribing Sudafed and most forms of robitussin, which were mostly placebo drugs although higher dose Sudafed was NOT good. What did pediatricians do when they could not hand out little sample bottles of Robitussin, they prescribed antihistamines and nasal steroids, which cost ten times as much and have far more side effects. Perhaps, more importantly, they missed the chance to educate the child's parent about homeopathic harmless remedies like tea and honey and that no treatment was really necessary, just love and limited interruption in normal activities.
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