Healthcare Policy

More Cooperation/Healthier Kids (Pedcast)


I know, you are wondering if it will be worth your time to listen to a pedcast that has such a strange name, More Cooperation/Healthier Kids. Let me assure you that it will be. While the topic today is not disease specific, it is vital that you be made aware of when your child’s healthcare system is falling short. And let me tell you, it’s falling short. Having spent my entire adult life working in healthcare, I know some of the system’s deficiencies which is exactly what we are going to talk about today. My topic today is every bit as important as parents learning about how to manage fever or teaching their infants how to get good nights sleep. Your child’s well being depends on their healthcare system working seamlessly with one purpose… to improve their health. Continue reading

Computers Taking the Care Out of Healthcare? (Pedcast)

Opinions expressed in this pedcast are solely my own!


Ever wonder why so many doctors today have such negative attitudes about their jobs, why so many are retiring early, and why so many wouldn’t want their children becoming doctors. I thought becoming a doctor was synonymous with success? So why are these highly successful people, today’s doctors, not smiling? One word, computers.   Specifically, I am talking about the introduction of the electronic medical record, also called EMR, into their daily lives.  Say the letters EMR to most doctors today in the US, and stand back– you will get a very strong emotional response.  Today, a pediatrician’s day is spent almost entirely with a computer screen and keyboard. Because of this sad fact, I am going to do something that I have never done before in my six years of blogging, I am going to weigh in on some of the choices our governmental leaders, our computer scientists, our insurance executives, and our pharmaceutical executives have made in shaping today’s healthcare system. I want to pull back the curtain a little and let my listeners get a feel for what today’s pediatricians are up against as they go about their day to day jobs and maybe start a conversation about improving things. Continue reading

Parent’s Guide to Childhood Immunization (Book Review Pedcast)

Parent’s Guide to Childhood Immunization

Written and Published by the US Department of Health and Human Services/ Center for Disease Control

August 2015


Interest in vaccine safety has been, and continues to be, a hot topic with parents and the media. Unfortunately, from where I sit, the AAP and others professional organizations have been missing in action when it comes to mounting an effective media campaign to educate parents and counter much of the misinformation parents are exposed to. I have been to professional meetings where my pediatrician colleagues have stood up and railed at our professional organization for not being very visible in this important debate. Given that as background, it was of great interest when I came across a new handbook, written and published by the US Department of Health and Human Services and the CDC, laying out the facts including vaccine safety.  Maybe as the number of outbreaks of measles, whooping cough, and mumps continue to climb, organizations like these will put more effort toward countering the messaging from people and organizations that are opposed to vaccines.  I actually think this beginning to happen since many state legislatures, public health groups, and even the AAP have been becoming more public about their support for vaccines. My guess is that it will take at least five positive vaccine messages to counter the unrealistic fear that one negative message about vaccines can create. Multiple positive messages from multiple reliable sources, on an ongoing basis, are what are needed. That’s why is this handbook is significant in my opinion so let’s get into the details of my review. Continue reading

Marijuana and Children w/ Dr. Andy Farah (Pedcast)



w/ Dr. Andy Farah



Welcome to the next edition of Portable Practical Pediatrics. I am your host, Dr. Paul Smolen, a practicing board certified general pediatrician in Charlotte, NC. I am thrilled to have a returning guest and expert psychiatrist, Dr. Andy Farah. Dr. Farah is on the faculty at High point University, Chief of Psychiatry at High Point Division of UNC Healthcare, Distinguished Fellow of the American Psychiatric Association and an expert in many things, one of which is the effects of marijuana on children. Information about this subject is literally exploding so Dr. Farah is here to bring us the latest. Welcome Dr. Farah!   Continue reading

2015 Lessons Learned about Measles (Pedcast)


Topic Introduction

Today I thought it would be useful and informative to review what we have learned in 2015 about a very old but still important disease, measles. I think that the resurgence of measles in 2015, reminds us about why it is important for us, as a society, to stay the course with respect to requiring and giving vaccines.  I hope after listening to today’s pedcast, you will agree.  As I like to say, “We don’t have to touch the hot stove, to find out that it still hurts” so to speak!  So sit back and crank up your mp3 player for an important edition of Portable Practical Pediatrics.

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New Era of Minimal Treatment (Pedcast)

Topic Introduction

The other day I was thinking about how recommended therapies, also known as the “standard of care”, have changed during my pediatric career for routine illness. It struck me that we have entered an era of minimalism with regards to treatment. It seems to me that medicine has aged into middle age, no longer eager to “treat” every condition with a therapy, assuming that medical science was smarter than mother nature. I think that concept is passe. No, we have entered an era where interventionism is out and natural healing is in. Hence the rise of integrated medicine, homeopathic medicines, nutritional and aroma therapies.  Let me give you a few examples of how previously recommended treatments have changed during my pediatric career and I think you will see what I am talking about. Let’s start with a short list of health problems pediatricians are frequently consulted about and I think you will see what I am talking about.

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Doctor, “Do No Harm” (Pedcast)

When our kids are sick and we take them to the doctor, we expect a nice, concrete and presumably treatable diagnosis. It usually takes the form of a group of medical jargon that leads to a medication, surgery, or some intervention meant to provide relief. While this may seem logical, giving a label to a set of symptoms or an abnormal test may not only be useless and not improve the child’s quality of life– but also actually be harmful at times. This phenomenon, known as over diagnosis and seems to becoming more common in the era of expert panel recommended healthcare and mass health screenings. Screening is designed to identify children with a condition that needs treatment that will result in benefit to their health and well being, not just to identify those with a certain condition. It is that benefit that is often absent. Continue reading