Category: Uncategorized

October 19, 2020

by drplasticpicker

Did I really get into a vaccine debate on Facebook with the COVID-19 Pediatric Group? Yes I did. I couldn’t keep my big mouth shut. I left my comments there because they are actually really important. Someone was complaining about pharmacies giving out flu shots to kids, and I disagreed. I think kids should get their flu shot wherever they are available, and I think they should get other vaccines as well. Sometimes when I shoot my mouth off, I’ll go back and delete comments. But I left these up despite the controversy. And those that feel the same way as I do and are looking at the “big picture” in terms of vaccine rates need to see the comment. But I MUTED a bunch of the repliers. Wow, gotta love Facebook that you can MUTE people. The crux of the issue is that some pediatricians want vaccines only given in their office. I get it. They are actually reimbursed quite a bit for vaccines and well child visits and vaccines are 60% of pediatric outpatient volume. I work in an integrated healthcare system and I don’t need to think about my reimbursements and patient volume. I’m always busy. I do procedures. If pharmacies and dental offices and others give out vaccines, what are pediatricians going to do? It threatens their livelihood and is an existential threat to some of their identity. They believe they are dispensing wonderful advice and care during well child visits. Kids should 100% come in for well child visits. But the truth is they are not coming in for vaccines right now, and they need their vaccines. My take on things is that it’s about the patient. We need to admit when we are supposedly painting things as “for the patient” when it’s really “for us.” I don’t believe it. Then see sick kids! You can start siphoning off work from the urgent cars and EDs. We can start seeing up to 21 years of age. Or stop referring to dermatology or all the specialist, and learn to work up patients more thoroughly for bread and butter stuff. Oh, open up a Headache Clinic! Start training to do bread and butter mental health issues, as we don’t have enough pediatric psychiatrist. Put in implantable birth control. Or go pick up some trash. Trust me, there is enough work for everyone. Their business and livelihood is not my problem. I’m looking at the big picture which is increasing plummeting vaccine rates in the country. It felt so good to MUTE the said person. Flu Vaccines absolutely should be given at pharmacies and I believe HPV should as well, and maybe even dental offices. Why not? If pediatrics can’t survive without vaccines, than what are we? I’m pretty sure we are smart enough and versatile enough to pivot.

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October 13, 2020

by drplasticpicker

One of my favorite bloggers is LenPenzo. He’s one of the original personal finance bloggers and sometimes writes nonsense and talks a lot about the gold standard. He’s from Southern California as well, and represents a conservative financial and political outlook that I’m very comfortable. I grew up in that kind of culture, although I am more politically left now. It’s hard not to be when you take care of children as a pediatrician in an underserved area. But LenPenzo has been blogging forever and he’s still my internet hero. I stop by his blog now and again, and leave comments. Len’s dad passed away recently and he left a short post on his blog https://lenpenzo.com/blog/id63332-black-coffee-10-oct-2020.html.

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October 9, 2020

by drplasticpicker

Our tween daughter and I finished watching the documentary “RBG” yestserday in preparation for our Cadette Girl Scout Meeting. It was a special night to have the time to watch it with her and answer her questions, and watch her expressions. It was meaningful for so many reasons. As someone who considers myself of a historical bent, I did earn my undergraduate degree in History of Science, I am always curious as the origins of quotes. The original quote that RBG credited but is often forgotten by our modern society comes from Sarah Grimke https://en.wikipedia.org/wiki/Sarah_Moore_Grimk%C3%A9.

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August 23, 2020

by drplasticpicker

We are settled in our first night of a short likely two night stay in Palm Springs. Like most of the world, travel plans the last six months due to the 2020 COVID-19 pandemic had to be changed. It was the first time in six months we have left the confines of our Southern California county. I felt slightly embarassed about needing to leave, but mentally I felt the entire family spiralling into irritability. Pre COVID-19, we had planned on visiting my sister in Northern Virginia. Our traveling compared to our same-income cohorts in the US is very limited and we spend considerably less just hearing what my friends tell me anecdotally. We usually visit family in New York and Virginia and then stay with them a few nights and drive a few nights somewhere else. We usually take one western US domestic trip as well and maybe every other year one big international trip. But even that amount of traveling is not sustainable for the world. I’ve always bought carbon offsets the last five years, but even that – does it even make a difference?

But we are here now in Palm Springs, an easy 2.5 hour drive from our hom We drove our trusty Prius that gets 50 MPG. I never truly appreciated this area growing up. Being from Coastal Southern California, I wanted trees and history. I preferred Yosemite, San Francisco, and the East Coast. This is probably why I lived in Boston for 15 years. But with age comes wisdom. And I’ve come to love Palm Springs.

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July 18, 2020

by drplasticpicker

Yesterday morning began with a plogging session and a bag of trash. I was feeling hopeful as I had eyed a large clear plastic single-use cup from 7-eleven sitting on the curb and circled back after my run to pick it up. Someone else had picked it up. It was a neighbor a bit older than me with a mask, an orange bucket and a grabber. I waved to him across the street with my own two plastic bags and said, “Are you part of the Street Stewards? We have a Facebook group.” He replied, “No. I just started picking it up recently.” I said thank you.

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July 11, 2020

by drplasticpicker

There are times when you know you have made the right decision and that you are in the right place. I remember being six months into categorical pediatric residency and working an evening shift in the Pediatric ED at Mans Greatest Hospital (MGH). It was a normal shift. I knew what to do. Who to consult. What orders to write. I was walking down the narrow hallway that separates the two bays of exam rooms when a toddler peaked her head out and saw another toddler. This toddler said in her high-pitched very friendly voice, “Hey baby.” I think she was looking for a playmate. I stopped what I was doing. I paused and I thought “They ARE both babies and that is so incredibly cute.” I was in the right place.

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July 3, 2020

by drplasticpicker

The medical training process can be brutal. Even in pediatrics after the 80-hour-work-week restrictions and in a more “benign” supportive program, it was hard. I think all of us tend to forget as we get older and are professionally and financially and psychologically in safer places. I wrote this post about the culture of bullying in medicine and physician burnout, which I thought was decent https://drplasticpicker.com/stop-physician-burn-out-there-is-no-house-of-god/. The other byproduct of being a doctor is that I’ve fallen asleep in odd places.

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