40-plus years as a pediatrician

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In more than 40 years as a pediatrician, I've worked in the military, in a small private practice and in a large multi-specialty group. And I've seen huge changes, both in administrative practices and in treatment protocols.

Many of the changes have been just short of miraculous. When I was training to be a pediatrician in the late 1960s and early '70s, I visited wards filled with cases of childhood meningitis — a very serious condition that can lead to death or lifelong neurological complications.

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In another area, I'm hoping we have finally learned that less treatment is sometimes better than more. When I was being trained, pediatricians were taught to use antibiotics only when necessary, but that lesson wasn't fully embraced and many doctors prescribed the medications when they weren't called for. This was due to a number of factors: patient pressure, fear of having missed a diagnosis that would call for antibiotics, and time constraints. (Sometimes, it's faster to write a prescription than it is to explain why antibiotics are unnecessary.)

But this widespread use of antibiotics has led to bacterial resistance, and we are now paying the price. Fortunately, the pendulum has finally swung back to a more judicious use of these agents.

http://www.latimes.com/opinion/commentary/la-oe-buchta-labor-pains-pediatrician-20131124,0,2551251.story

[xchrom]

1. du rec.