Reader Reaction and Timely Answers From Experts

We received this online comment in response to our February 25 Online Exclusive article, “AAP Again Blasts Pediatric Care at Retail Clinics,” in which we reported on the academy’s updated policy statement opposing retail clinics as appropriate sites for pediatric care:

This policy does not take into account the reality of the vast number of pediatric patients in rural America. As the physician shortage gets worse, wait times for acute appointments will continue to rise. Less than 1% of pediatric residents choose rural medicine as a specialty, leaving a dramatic primary care shortage for greater than 20% of our pediatric population. Family medicine will not be able to take up the slack with the flood of baby boomers and expansion of Medicaid. So where will these patients be seen? Retail medical clinics. It’s the reality for the vast number of pediatric patients, because they have no other access to care. This policy statement is a little inflammatory to our colleagues (who) offer a service that academic and large group pediatric practices have no conceptual knowledge about. As pediatricians we need to focus on how to improve our relationship with them, not limiting access or “blasting” other providers of care. 

—Matthew Downs, MD

This comment came in response to December’s Top Papers of the Month column, “Obesity and Disordered Eating in Children,” in which Chalanda Jones, MD, wrote that even though adolescents with obesity are at significant risk of developing an eating disorder, clinicians often fail to identify symptoms and intervene early:

I’ve noticed through the years that obese children often have a very limited number of foods they will eat. Seems that restrictive eating can present in quality versus quantity of foods but possibly is already an issue. Unfortunately, I’ve never found an eating disorders program that really circumvents the long-term diagnosis and sequelae but is more compensatory. 

—Donni Fleischaker, MD

We received this note from a health communications specialist at the Centers for Disease Control and Prevention (CDC) Office on Smoking Prevention and Health. He wrote in response to the August 2013 “Parent Coach” column, in which Meredith C. Broberg, MD, and Linda S. Nield, MD, offer advice about helping a parent who is concerned about a daughter’s smoking:

Thank you for the excellent article, “Helping Adolescents Kick the Habit.” The article had a wealth of important information and useful advices. You may know about the “Talk With Your Doctor” initiative that was part of the CDC’s “Tips From Former Smokers” national education campaign last year. One small criticism: We discourage use of the phrase “kick the habit” in order to focus awareness on just how powerful an addiction cigarette smoking can become.

The advice is well taken: tobacco addiction is much more than simply a “habit” that can be “kicked.” We at Consultant for Pediatricians will avoid using the term “kicking the habit,” and we recommend that pediatricians and other health care providers do the same.

—Michael Gerchufsky, ELS, CMPP, Managing Editor