Dolphin-Assisted Therapy, Antibiotics, Drug Reps – PediaCast 098
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Topics
- Dolphin-Assisted Therapy
- Hib Booster Deferment
- Are The Antibiotics Working?
- Coffee For Kids
- Drug Rep Rant
Links
- Dolphin Therapy Is A Dangerous Fad
- CDC Defers Hib Vaccine Booster Due To Supply Problems
- Hib Disease Information From CDC
- PediaScribe: Christmas Recap
Transcription
Announcer: Bandwidth for PediaCast is provided by Nationwide Children's Hospital, for every
child, for every reason.
[Music]
Announcer: Welcome to PediaCast, a pediatric podcast for parents. And now direct from
Birdhouse Studios, here's your host, Dr. Mike.
Dr. Mike Patrick: Hello everyone and welcome to PediaCast, a pediatric podcast for moms, and dads.
This is Dr. Mike coming to you from Birdhouse studio, and I'd like to welcome everyone to the
program.
01:00
Also welcome to 2008! It's our first show of the New Year, and I want to put a special welcome
out there for all of our new listeners, you know who you are, you're the ones who got iPods for
Christmas and you discovered the iTunes store. The podcast directory and you're wondering
what podcast were all about, and then you came across PediaCast, so welcome all of you, and a
special welcome back to our regular listeners as well.
Now since it is a New Year, it's time for a fresh start, so you'll notice we have some new intro
music, we also have some intro interlude music as well, and I'm tweaking the format a little bit, I'm
not going to talk too much. Exactly what I'm doing with that, because you kind of listen, and then
you kind of figure it out. In a nut shell, the news and the listener's segment have been the most
popular segments of the program.
Rather than doing a separate new show, the listener segment and the news segments have been
the most popular.
02:03
Our standard show is going to be here for a little while anyway till I decide to change it again. A
couple new stories, instead of a whole show, full of new stories, and then a listeners segment
where we'll try to answer about three listener questions, and we'll try to do all that in a half an hour,
so I know we're going to have to really boogie to do that to get it all in. But we're going to try, and
then we'll still throw on a research show here and there and an interview show here and there too,
but the standard one is going to be a little bit of news in the beginning, and then our listener's
questions.
Ok I do want to also thank everyone who did reviews in iTunes; I really, really appreciate that. I
guess where this started is around Thanks Giving time; I had mentioned that I wanted to try to
break the 200 mark in the number of iTunes reviews before the New Year. And I think at that time
we had around 160, 165, something like that.
03:02
And honestly, after I mentioned it, I thought, "Oh I shouldn't have done that", because I really did
not think it was possible to get 40 new reviews in iTunes in the course of a month. I mean, we're
talking ten a week, and to get people motivated to do it, you know I thought, "Oh great, I'm not
going to make it, we're going to fall flat," and then pretend that never happened and don't mention
it, is that what you do? But you guys surprised me.
People came out of the wood work and more of them broke the 200 mark with the review. So,
really, all of you who took the time to do a review on iTunes, seriously, from the bottom of my
heart, I really appreciate it. It means a lot to me, and I really thank you for taking the time to do
that. And in return, I will honor my pledge to not mention iTunes reviews again for a very, very
long time. OK, I'm going to zip my lips on the iTunes reviews and I got at least a month without
mentioning them, OK because you know enough is enough.
04:05
All right, before we get started, one other thing I have to mention, you probably noticed from my
voice, now the new listeners out there, you won't really notice, but my regulars, you're going to
know, my voice sounds a little scratchy, and I had actually wanted to get this show out the day
after New Year's. And I had that script all done, everything was ready, I had the new music set,
but then I had laryngitis, and my throat is still scratchy. In order to not cough, I've had to suck
down honey; it works great, by the way.
This is about my third take of the introduction, I was just coughing through it and Karen, it was her
ideas, because we've talked about this before in past episodes about the benefits of honey in
helping cough, and I have to tell you, it really does work. So I had a teaspoon of honey right
before I started this introduction.
05:00
And I haven't coughed at all; it's going well, during the interludes I've got the honey and the spoon
down here. So if you hear some funny noises in the background, it's just me sucking down some
honey to try to coat my throat, so I don't cough through all the different segments. All right, usually
the introductions not quite this long, but when we've been away from each other for couple of
weeks, there's a lot to say.
Tonight, the Buckeyes play LSU in the national championship game of college football, and of
course those of you who know me well know that I'm rooting for the Ohio State Buckeyes, so go
Bucks. Last year, they didn't show up to the national championship game, so it's an honor to be
able to be there again. This time we need to show the nation our stuff, so let's go Bucks! And
you'll know if you don't watch the game you'll know from my tone of voice on Wednesday whether
we won or not.
06:00
All right, so what are we going to talk about today? In the news segment, dolphin assisted
therapy, is it good? Is it bad? We're going to talk about that. Also, Hib boosters, doctors are
asked to defer those, and then in our listener segment this week, are the antibiotics working in
coffee for kids? And then we have a rant from a listener, we'll let it speak for itself when we get to
that in the listener segment little bit later on.
Don't forget if there's a topic that you would like us to discuss or if you have a question or a rant,
you can go to pediacast.org and click on the contact link. Pediacast@gmail.com is another way
to get a hold of us, make sure you'll let us know who you are and where you're from when you do
that, or you can call the voice line, 347-404-KIDS. And of course the information presented in
PediaCast is for general educational purposes only; we do not diagnose medical conditions or
formulate treatment plans for specific individuals.
07:04
If you have a concern about your child's health, call your doctor and arrange a face to face
interview, and hands on physical examination, also your use of this audio program is subject to
the PediaCast terms of use agreement, which you can find at pediacast.org. And with that in
mind, we'll be back with news parents can use, right after this short break.
[Music]
08:00
[Music]
Dr. Mike Patrick: Our News Parents Can Use edition is brought to you in conjunction with news partner,
Medical News Today, the largest independent health and medical news website. You can visit
them online at medicalnewstoday.com. And I do want to take a moment here just to say a
special thank you to the folks at Medical News Today. They do a wonderful job, bringing
excellent news story to the PediaCast audience week after week.
With the New Year, I just wanted to say special thank you and kudos to them. If you're interested,
we just cover couple stories here and there, and if you are interested in more medical news,
whether it be pediatric, adult medicine, anything with a medical bend to it, make sure that you do
check them out, again that's at medicalnewstoday.com.
09:07
All right, people suffering from chronic mental or physical disabilities should not resort to a
dolphin healing experience, warn to researchers from Emory University, Lori Marino, senior
lecturer in the neuroscience and behavioral biology program has teamed up with Scott
Lilienfeld, professor in the Department of Psychology, to launch an educational campaign
countering claims made by purveyors of what is known as dolphin assisted therapy.
Dolphin assisted therapy is not a valid treatment for any disorder, says Marino, a leading dolphin
and whale researcher. We want to get the word out, that it's a lose-lose situation for people and
for dolphins. Swimming with dolphins maybe a fun, novel experience, no scientific evidence exist
for any long term benefit from dolphin assisted therapy. Marino says that, "People who spend
thousands of dollars for the experience don't just lose out financially, they put themselves and the
dolphin at risk of injury or infection, and they're supporting an industry, at least outside of the
United States. Takes dolphins form the wild in a brutal process that often leaves several
dolphins dead for every surviving captive."
10:16
Marino and Lilienfeld reviewed five studies published during the past eight years, and found the
claims for efficacy of dolphin assisted therapy were invalid. Their conclusions were recently
published in Anthrozoos, the journal of the International Society for Anthrozoology. The paper
entitled "Dolphin Assisted Therapy, More Flawed Data and More Flawed Conclusions….
We found all five studies were methodologically flawed and plagued by several threats to both
internal and construct validity, wrote Marino and Lilienfeld who conducted similar review in 1998.
We conclude that nearly a decade following our initial review, there remains no compelling
evidence that dolphin assisted therapy is a legitimate therapy, or that it affords any more than
fleeting improvements in mood.
11:04
An upcoming issue of the newsletter of the American Psychological Associations Divisions of
Intellectual and Developmental Disabilities will feature another article by Marino and Lilienfeld,
entitled "Dolphin Assisted Therapy for Autism and Other Developmental Disorder's a Dangerous
Fad'. We want to reach psychologists with this message; because dolphin assisted therapy is
increasingly being applied to children with developmental disabilities.
Although there is no good evidence that it works, said Lilienfeld, who's also a clinical
psychologist. It's hard to imagine the rationale for a technique that at best, makes a child feel
good in the short run but could put the child at risk of harm. The Emory scientists have timed their
campaign to coincide with the recent call by two UK based none profits, The Whale and Dolphin
Conservation Society, and Research Autism, to ban the practice of this therapy.
12:00
Well, Marino is against taking dolphins from the wild and holding them a captive for any purpose,
she finds dolphin assisted therapy specially egregious, because the people who are being
exploited are the most vulnerable, including desperate parents who're willing to try anything to
help a child with a disability. Many people are under the impression that dolphins would never
harm a human. In reality, injury is a very real possibility when you place a child in a tank with a
400 pound wild animal that may be traumatized from being captured, Marino says.
Dolphins are breed in captivity in US Marine parks, but in other countries, they're often taken
from the wild. If people knew how these animals were captured, I don't think they would want to
swim in it, with them in a tank, or participate in this, Marino says, referring to the annual dolphin
drive in Japan. During the dolphin drive, hundreds of animals are killed in water that's red with
their blood, while trainers from facilities around the world picked out young animals for their
marine parks. They hoist them out of the water, sometimes by their tail flukes, and take them
away
13:01
Each live dolphin can bring a fisherman $50,000 or more, she says. The marine park makes
millions off dolphins, so that's a drop in the bucket. Marino goes on to say it's ironic that dolphins
are among the most beloved and the most exploited animals in the world. All right, for those of
you, new to the program, I'll admit that some of this information is kind of gross, about the dolphin
dives, and I did not check the validity of those facts.
It seems like there could be some animal activist propaganda at work here, but my point with this
article is not the animal right aspect to the story, not that I don't care about that, but it's a pediatric
podcast. So my point is if you contemplated spending thousands of dollars for dolphin assisted
therapy for your developmentally disabled child or you know someone else who has
contemplated that, maybe you should think again.
14:05
All right, the CDC which is the US Centers for Disease Control and Prevention in Atlanta,
Georgia has asked doctors to defer the final booster dose of the childhood haemophilus
influenza type B, known simply as HIB, because of a possible problem with supplies, however,
children at high risk of HIB, which cause serious bacterial infections including meningitis and
pneumonia should continue to receive the booster shot which is given at age 12 to 15 months.
High risk children include those with cancer, sickle cell disease, or HIV as well as American
Indian, and native Alaskan children. There is likely to be a short term shortage of HIB vaccine in
the US this year. The drug company Merck announced it was recalling over 1 million doses of
HIB vaccine, following a potential bridge of sterilization procedures at its Pennsylvania factory.
15:00
The recall is simply a precaution, its company officials found no contaminated vaccines during
quality sampling of factory shipment. Merck filled about half of the annual US demand for HIB
vaccine, the other half being filled by Sanofi Aventis. However, according to the CDC, Sanofi
Aventis cannot immediately fill the gap left by the Merck recall; hence the need to prioritize this
year's vaccination program until the full demand can be met again.
According to CDC, when supplies are restored doctors should go ahead and give the booster
shot to the children who were deferred. The CDC recommends all American children under five
receive the vaccine; the first dose is given at two months, the second at four months, the third at
six months, and the final one, the booster at 12-15 months. According to the CDC, HIB is the
leading cause type B of bacterial meningitis in children under five years old, and it's still a leading
cause of bacterial pneumonia that's in children as well.
16:02
During the 1980's the incidence of this disease was between 40 and 100 for 100,00 children
under age five in the US, but since routine administration of the vaccine, that incident has
dropped under 2 per 100,000 children. In developing countries where the vaccine is not routinely
given, haemophilus remains a major cause of lower respiratory tract infection in babies and
young children.
The CDC advice doctors to defer the booster dose for those children not at a high risk for taking,
when they made this decision, it was taken in consultation with the American Academy of
Pediatrics, and the American Academy of Family Physicians, and the Advisory Committee on
Immunization Practices. That way they can spread the blame if a child who it was deferred to get
HIB disease in my opinion, but you got to do that. These days with all the litigation that's out
there.
17:00
So what does this mean for you as a parent, this story may sound familiar, we did cover it before
the New Year, and I'm covering it again because the situation has changed when we covered it
before, we were just saying that there have been a recall, but now we do have official
recommendation to defer the booster dose except for high risk individuals, and we already
mentioned who those are.
Your kids should get the HIB vaccines at two months, four months, and six months, but the 12 -15
month dose were asked to defer those to make the supply more readily available for the two,
four, and six month old. If your doctor says that your 12-15 month old is not getting their HIB
vaccine now but the six month old across the street who sees the same doctor did get his, well
now, you can understand why.
Check out the show notes, we do have a link to the CDC website with some more information
about haemophilus influenza type B disease and the vaccine that prevents it.
18:00
All right, we're going to take a quick break and we will be back with the listener segment of the
program right after this.
[Music]
19:04
Dr. Mike Patrick: All right folk, my throat is loving the honey, although at the end of that last segment, I did
have to do a little coughs, so I apologize for that. My pancreas on the other hand is not liking the
honey so much; it's having an insulin spasm of the pancreas with all the honey that I've been
sucking down. The honey works it just didn't last very long, that's the problem. Let's move on to
our listener segment.
First up we have Jennifer from Garden City, Michigan, and Jennifer says, "Hi Dr. Mike, my son is
20 months old and has his first ear infection, his pediatrician prescribed antibiotics. We are on
day three and his behavior is off, he wouldn't play like he normally does at day care. He's very
inactive; the day care provider suggested his antibiotics aren't working.
My question, how do you tell if antibiotic is working? I will of course follow up with my
pediatrician, but I thought it was a great question for you and the show. Thank you for the
informative podcast."
20:06
Well thank you for your question, Jennifer. The answer to this question is not as easy as it might
first appear. First, some points to consider. The pain that's associated with ear infections is not
caused directly by the bacteria that you're killing when you treat with antibiotic. The pain is
caused by the body's response to the infection, so the body recognizes that the middle ear
space is overrun with bacteria, you got increased blood flow to the area which equals to
inflammation, that equals ear drums swelling and pain, and then plasma leaks in, and white blood
cells invade to mop up the bacteria until you get puss, you get fluid, you get pressure, you get
pain.
It's not the bacteria itself causing the pain; it's your body creating the inflammation and the puss
that results from your body killing the bacteria, and that pressure that causes the pain that's
associated with ear infections.
21:02
So, pain is really not a good indicator of how well the antibiotic is working, the antibiotic may be
killing the bacteria fine, but if inflammation, and puss, and fluid, and pressure, those things are
going to persist and pain goes along with them for a while. What do you do? Well, you want to
do pain control along with the antibiotic, and you can use acetaminophen, which is Tylenol versus
ibuprofen, which is the Motrin and Advil products.
For the kids who are older than six months, I prefer ibuprofen myself, because it's a non-steroidal
anti-inflammatory drug, where Tylenol is not. Technically you're going to get some reduction in
inflammation, since inflammation is one of the things causing the pain with the ear infection that
helps a little bit more. Now on the other hand you could argue that the inflammation is important
for getting rid of the infection because it's just doing its job and pain is a by-product of that
inflammation.
22:00
So if you suppress the inflammation with your non-steroidal anti-inflammatory drug, then it does
again take longer for the body to take care of the infection. Pain control's important and
ibuprofen products, I think, are going to help with pain a little bit more that the Tylenol products.
The other thing you can use, a topical analgesic, there's one called Auralgan for instance, it's a
drops that topically numb the ear drum. They have a substance kind of like you get what before
you have stitches, you put the medicine and it numbs the skin.
These are just ear numbing drops that help with pain, and I'll be honest, your mileage may vary on
those, you find some kids who they really make a big difference, and then others are just so
irritated that you'd put something in their ear, they seem to be worst that better, it's one of those
things where you just have to tell if your kid tolerate it or not and use the kind of sparingly or if it
really seems to work, use them as often as every two to four hours.
23:00
But these things can only do so much, in terms of helping the pain it's just a good old fashion
comfort kind of things, let them cuddle up on the couch, the kind of stuff your mom did for you
when you were sick that just made you feel better. What if fever persist a couple of days after the
antibiotic is started? This is a better indicator than pain. Fever is a by-product of the immune
systems recruiting process.
Cells release chemicals to make this increase blood flow and inflammation, and the white blood
cell migration to the area of infection and along with the release of those chemicals, you get
fever. So if the antibiotic is working, the battle should be shifting over in favor of the body, so
you get less chemical release, less fever production, and if the antibiotic is not working, then the
immune system recruitment and fever are going to persist.
24:00
However, often an upper respiratory virus accompanies a bacterial ear infection, and ear
infections themselves may be caused by a virus rather than bacteria, which case the antibiotics
aren't going to do anything anyway. And these viral infections also results in fever production, but
of course the antibiotic's not killing the virus, they're design to kill bacteria, not viruses. So in
these cases the fever may not represent an antibiotic failure, it may just represent the viral upper
respiratory infection or cold virus, or the ear infection itself, if it's a viral ear infection and really
treating the symptoms is all you can do.
And the fever, it may not be that it's the problem with the antibiotic even with the fever persisting.
Here's another however, the fever may represent a new infection, possible complications of
bacterial ear infections include mastoiditis, which is a bone infection behind the ear, meningitis,
sinusitis, periorbital cellulitis, tonsillitis, peritonsillar abscess, pneumonia.
25:07
So you know, you can get complications from ear infections and so the fever persisting could be
one of this complications starting to set in, and addition to the fever you may see decreased
activity, behavioral changes, grumpiness, lethargy. We sort of come full circle here, decreased
activity and increase pain from inflammation fluid and pressure may be there even if the
antibiotics are working, or they could be a sign of a developing complications, so what is a
parent to do?
Well there's no easy answer, you got to just stay in touch with your doctor, schedule a recheck
appointment if the fever persist beyond the couple of days of starting the antibiotic. Schedule a
recheck appointment if the pain is not responding to pain medication, and schedule a recheck
appointment if decreased activity, irritability or fuzziness is worsening.
26:01
There'll be a tendency for some doctors to want to just call in a different antibiotic over the phone,
if this occurs. I've been tempted and guilty of this myself from time to time, especially when the
office is already over booked and parents are inconvenience, but every time we do this, both us
doctors and you as parents, we and you risk missing a potentially life threatening complication,
it's unlikely but it's not impossible, so, something to keep in mind for doctors and parents alike.
The bottom line Jennifer, I'd say, follow up with your doctor, which was what Jennifer said she
was going to do and of course I agree with that plan whole heartedly. All right, moving on,
Brenda in North Central, Indiana, first she says, "My husband wonders if you feel bad because
the Ohio State win preceded the resignation of Michigan's football coach?"
27:00
No, I don't feel bad at all. I hate to see Lloyd Carr go though, because new coaches mean new
beginnings and I'd rather not mess with the direction that series between Ohio State of Michigan
is gone in recent years. All right, so Brenda goes on to say, "McDonalds has iced coffee, and
Burger King has a mocha Joe, I have on occasion let my 10 year old daughter have an iced
coffee type drink, but I'm wondering, partially because my daughter asked, is coffee an
acceptable occasional beverage.
I know milk, juice, and water are the preferred, but let's be real, children do drink pop in
moderation, so what about coffee?" All right Brenda, well thank you for your question.
28:00
You're asking the wrong person about coffee because I live on coffee and for me coffee is my
stimulant of choice to control my ADHD symptoms. And I have a 13 year old daughter who
adores Frappuccino from Starbucks. Now that said, the party line answer would be that kids
shouldn't drink coffee or soda pop, and juice, well fine in small quantities should not be
consumed in excess. Milk is an important source of calcium and vitamin D, and the majority of
adults, and children both do not get adequate amounts of daily water intake.
Kids in a habit of drinking soda, and coffee, and juices are not drinking enough milk and water,
and milk, and water will greatly benefit their future health. But then let me take off my pediatrician
hat and put on my dad cap and my human cap too. Indulgences do come with living, and life
would be pretty boring without them, and really, I'd rather see a kid indulging in the occasional
iced coffee than dope.
29:01
Caffeine is not all that bad. In some, it can contribute to high blood pressure in a small number of
individuals. It can also alter appetite and sleep cycles, but it also improves attention and
concentration, that's why people get addicted to it. I don't really call that an addiction because it's
not a physical addiction. But caffeine is related to the stimulants that we use to treat ADHD, so
Ritalin, Concerta, Adderall, Focalin
, Metadate, all of these are related to caffeine.
OK, so why don't we send kids to school a thermos of coffee instead of taking a daily pill? It's a
good question. Unfortunately my answer's not as good as the question. Well first, coffee has a
short life span, so you need to drink it all day long, and unless you drink your coffee black, then
you're getting extra calories all day, that's not necessarily good if you're putting cream and sugar
in your coffee.
30:07
And then you could also argue with other beverages or the kid's going to sneak into their
thermos, I'll leave that to your imagination. The Janitorial staff may have issues with the coffee
policy at school. And it's also difficult to adjust dose based on a measured response, difficult
standardized the dose of coffee, and of course, different coffees have different t caffeine content.
Also there's no studies that I know of giving us guidelines on how much coffee to use and
probably never will be, because you think the drug companies are going to give up the ADHD
market to Juan Valdez? No, of course not, I'll keep treating the kids I see their ADHD with the
approved medications, but for my own ADHD, I'll continue to use coffee, and I'll continue to allow
my daughter to indulge in the occasional Frappuccino, but again that's my choice.
31:00
Now, what about your kids? Well, as a parent that's going to be your choice. I think it gives you
the right guidelines, keep it occasional, keep it in moderation and I'll add a few more guidelines.
Insist on a balanced diet with a reasonable number of daily calories, insist your kids get daily
physical activity that results at least 30 minutes of them sweating, and insist on safe indulgencies,
like occasional Frappuccino, that's part of living.
Again, it's better to have your teen to an iced coffee in front of your face than sneaking dope
behind your back. Understand folks, that's not the party line, but I'm not really a party line kind of
guy, you probably figured that out by now. All right, we have one more, you guys are going to love
this one. This comes from Elaine in Rocky Mount, North Carolina. Elaine says, "Dr. Mike, I'm
writing in regard to your gripe about the pharmaceutical view finder you received via mail." Let
me stop here, those of you who don't remember this.
32:00
I got a box in the mail at home, opened it up and there's a view master inside with a drug
wrapped presentation on the slides that you click around, and on the show I griped about it and
said that, "It's inappropriate, it's just a waste of money to send me a view finder presentation."
OK, so what does Elaine say? Elaine says, "First I respected that it's your show, and you can
discuss any topic you like, but I usually really like and appreciate all the medical knowledge you
impart, even on topics I don't have immediate application for….
"However the recent pharmaceutical gripe was inappropriate, I'm a pharmaceutical Rep. I work
all day, five days a week waiting patiently, bringing in modest meal, to meet the crazy
requirements many offices have just to allow me a signature for samples, and often not allowing
the medical discussion for which I was hired. When I started this job ten years ago, I could see
many physicians between patients for quick reminder or update on new information."
33:00
"Now I have to be Rep. Number one on Wednesday from 12:30 to 1:30 for a signature only.
Doctors have made it almost impossible for us to do our jobs, so our headquarters are trying to
be creative and find ways of getting the basic information to you. I'm sorry you are offended, I
agree it's not the best use of resources, but you and your peers have driven us to these tactics,
inventing about our marketing on air, just allows misplaced anger from your patients that I already
deflect daily.
I pay the same cost of medication you do, and pharmaceutical companies are not the evil witch,
many make us out to be, please don't help perpetuate this image with your listeners." OK,
Elaine, I don't think I'm perpetuating any sort of image about pharmaceutical companies.
Obviously, they're important, I rely on them every day, you rely on them, I personally rely on them
because I have glaucoma, and pharmaceutical companies allow me to keep my eyesight.
34:00
Now at the same time, I think it is all together appropriate to make mom and dad's aware of the
tactics drug companies used to reach doctors. I mean, the actions speak for themselves and if
you're worried about the reaction parents and patients will have with the marketing tactics, then
that reinforce my claim that they are flawed. With regard to signing for samples and finding time
to talk to us, you must realize, doctors are under increasing pressure to see more and more
patients than ever before because of decrease reimbursements and increased over head, and
you couple that with an ever increasing number of drug Reps to request our time, and something
has to give.
There's just isn't enough time during the day, but as doctors we do have a responsibility to stay
current with the latest information on the drugs we use, there's no question about that. But, let's
face it; the best source of information is not always the person trying to sell you the product.
There's a fine line between drug Reps and used car sales man, now, yes, I just said that.
35:00
That's not to say that all drug Reps are shysters, and that's not to say that all used car salesman
are shysters for that matter, because they aren't. But many in both groups are. It's the rare drug
Rep that will tell you the entire story, their product is always the best one, the data they show
supports their position every time, never mind that their company designed and conducted the
clinical trial, or that their competition we use the different study that conveniently proves their
product is in fact better.
So, do we take their claims with a grain of salt? Yes! Do we look at their studies with the critical
eye? Yes! Do we trust everything they tell us is absolute truth about the drug? No! Are we
frustrated by the number of Reps and the time they demand? Yes! And do I enjoy opening the
tenth brochure of the afternoon, or the box with the view master presentation in it? No! So let me
give you just a bit of advice Elaine, and not just you but any other pharmaceutical Rep that's out
there.
36:00
The best way to get to me, and I'm sure many of my colleagues will agree with this, is to schedule
a meeting, perhaps over lunch, so as not to encroach on patient time, or my personal family time,
which is also important, with a pediatric medical expert who can talk about their experience with
your drug, and pick one who'd be candid, who will tell us about alternative therapies they have
tried, and will give us an honest assessment of the pro's and con's all around.
For example, if you represented ADHD medicine, bring in a pediatric psychiatrist who can talk to
us about their experience with your drug and other drugs. If you represent an asthma medicine,
bring in a pediatric pulmonologist, if you represent an antibiotic; bring in an infectious disease
expert. Sure it's going to take more planning and time, it cost money, the expert may say that
they don't always use your product, but that's life, let's be honest about it, and I'm going to be a lot
more receptive and will learn a lot more from this kind of a presentation.
And it's going to beat the flashy brochures and the view master presentations that go into the
trash can five minutes after it crosses my desk.
37:02
You speak about the good old days Elaine, when you have open access to your doctors. Well I'm
proud to deny open access to drug reps. My patients come first, and I don't have time to listen to
the rosy can spill, while kids are waiting for me in the exam room, that's what's not appropriate.
But on the other hand, if you'll take the time to educate me at the time that's convenient to me,
with a respected source, that isn't objective third party, then I will listen and I will learn.
And if we can't have this sort of debate in full view of the moms and dads and young patients that
we're supposed to be serving, and then we should probably find different lines of work. We were
running over and we need to wrap things up, so let's take it to one last break and we'll wrap up
the show right after this.
[Music]
38:00
[Music]
Dr. Mike Patrick: All right, we're back one last time here. I want to thank Nationwide Children's Hospital
for providing the bandwidth for this program today, also Medical News Today which you can find
at medicalnewstoday.com for contributing the news stories, Vlad at vladstudio.com for providing
the artwork for both the website and also the feed.
39:12
And of course, thank you to all of you, the listeners, for joining us and for participating in the
program with your questions, and your comments, and your rants, and Elaine, no offence
personally, just on your position, I appreciate you, being a listener, really I do, and it's not
personal attacks, it's just a difference of opinion, which is always healthy. And we're fortunate to
live in a country where we can do that, and broadcast it in the world.
OK, Pediascribe, for those of you who are new listeners, my wife handles the blogging arm of
PediaCast, we call it Pediascribe. And it's not really a medical blog as much as it is a parenting
and mom type blog. So what we try to feature a post with each of our episodes, and the featured
post this week, or today I should say our Christmas recaps. So since we haven't really talked
since Christmas, Karen gives a nice recap of our family's holiday and you can find a link to that in
the show notes at pediacast.org.
All right, more pediatric news and might take on your questions are coming up on Wednesday
and we'll do another show on Friday, and until then, this is Dr. Mike saying, "Stay safe, stay
healthy, and stay involved with your kids," so long everybody.
[Music]
