They're Your Medical Records-Why Can't You Have Them?
This past week, I got a reminder that I am always a consumer of healthcare, and only sometimes a physician. I needed a copy of my immunization records. That sounds easy enough. As a provider, I know that this is the simplest part of the record to copy and forward. I also knew that I would have to jump through the same hoops as anyone else.
I called and was directed to the website to download the correct form. I did that. Fifteen minutes later, I was calling back, because I couldn't find the number to fax back the signed form. During that call, I pointed out that some of my immunization information might be in my employee file in Occupational Health, rather than my patient file. They assured me that they would check both. In less than 30 minutes, I was receiving my records back by fax.
I will admit that this is where it differs from most people. I only got my records by fax, because I was in a physician's office. A clinic or hospital will not fax records to an individual. Some will not fax them to a school. Some will fax them to an employer, others will only do so under special circumstances. Everyone else has to wait for snail mail. Okay, you say. That should only take 7-10 business days. Right. It should. Usually, though, it takes 2 months. It doesn't matter if you are having records sent across the country or 2 blocks down the street. It still takes 2 months. If you are asking for your complete medical record, it can take much longer.
What if I didn't have a fax machine, or a personal computer? Then, I would have to find the time to drive in to the office and fill out the release form. If you have moved out of the area, they can mail you the form. That is a 7-10 day delay each direction. This is very frustrating, especially if you are dealing with a deadline. People have asked me if this is an intentional stall technique designed to keep people from asking for their medical records. I don't think so. If it is, it isn't very effective.
As a pediatrician, most of my dealings with forwarding records are quite simple. Parents want immunization records, school physical forms and camp forms. Most of the time these are handed to the family at the child's well visit. Sometimes, however, forms get lost after that. Some parents have to have 3 physical forms completed for each child, each year. Yes, they lose them. Other times, I have seen schools or daycares lose forms for an entire class. It happens. We deal with it. However, there is no denying that such things put stress on the physicians and office staff involved.
I asked a few other people about difficulties getting medical records. I was overwhelmed with the horror stories that were forwarded to me. Stories of people whose records were delayed because of concerns about litigation. Stories of prolonged waits to get records transferred after a move. Stories of physicians not knowing where to look in the charts for outside records(http://chilmarkresearch.com/2011/03/04/a-tale-of-two-medical-records/). Stories of charts being "wrecked," or someone tampering with them, to hide information (http://www.usatoday.com/news/health/2008-04-29-medical-records_N.htm#). Exhorbitant fees charged by the page for copying and forwarding of records.
You have a right to your medical records. Hospitals and clinics have the right to charge a fee to offset the costs of copying and forwarding these records, but there is currently no industry standard for those fees. Hospitals can delay giving you the records under a few select circumstances. However, they should make every effort to get the records to you as quickly as possible. Especially, if it involves the transfer of care of a patient.
Shouldn't electronic medical records (EMRs) be making this easier? I've been using EMRs for almost 10 years. They have done some wonderful things. If a clinic has multiple locations, the same chart is available in all of those locations on the same day. Providers can now type (or use voice-to-text) a note into the chart and have it available the same day the patient is seen. Allergy information is available from the moment a client checks in until they fill their prescription at the pharmacy. Prescriptions are sent digitally, with no misinterpretation due to handwriting.
So, why can't you get your records? Well, a lot of people are working on this. The first part is to make sure the chart is up to date. You may have heard of a government initiative called Meaningful Use. One part of Meaningful Use wants to see providers complete patient notes within 72 hours of a visit. (I work with physicians who complete most of their notes the same day). The second part is accessibility. Some places allow the client (read patient) to access their EMR through a secure portal and view their information. However, most of these are "read only." At Personal Medicine, the patient owns the record and can access it at any time and print or download whatever they need, through their secure portal. Other places are looking at CCRs, Continuity of Care Records or CCDs, Continuity of Care Documents. These can be used to download your entire record to a SIM card or a MicroSD drive.
Talk to your healthcare provider. Let him or her know that you want more. You want accessibility and portability. You want a portal where you can view your records at any time. Better yet, you want to be able to print your records through that portal. Talk loud and talk often. Your voice can and will make a difference.
Oh, yeah. My immunization records are missing several pieces of information that should be there. Like my last 2 doses of influenza, and proof that I had measles, mumps, rubeola and varicella as a child.
I have emailed my Primary Care Physician and asked for a CCD. I'm still waiting to hear back. Next, I'll try visiting him in person.
Dr Nan N
House Call Pediatrician, Overland Park, KS
State of the art care for your child in your home
http://FiresidePediatrics.com
http://PersonalMedicine.com
Tuesday, April 26, 2011
Tuesday, April 19, 2011
Getting More Fruits and Vegetables in Your Diet
For years, I have been telling people to get 5-9 servings of fruits and vegetables in their diet every day. This past week, I saw someone post a new recommendation that stated we should get 10 servings of fruits and veggies a day. I haven't been able to confirm that. It doesn't make much difference, if most of us are only getting 3-4 servings a day. Many studies have shown that most Americans get only 3-4 servings of fruits and vegetables a day, with most of those being fruits. The recommendation I can find is that we should be getting 5-9 servings a day, with at least 3 servings being vegetables.
I'm not writing today to argue about the details of the recommendation. So, why am I writing? Because most of us aren't getting enough of the healthy cancer-fighting, heart disease-preventing vitamins and antioxidants that are found in fruits and vegetables. If you have family members in this situation, I would like to help. I am going to suggest several things that have worked for a number of people I know. Choose a couple and work them into your daily routine. Once you have done them for several weeks and they become habits, add a couple more.
First, let us talk about what constitutes a serving. A serving of fruit is either a piece, or 1/2 cup for fresh fruit, or 1/4 cup for dried fruit. Let me explain that. An orange is a serving. A medium apple is a serving. A watermelon is not a serving, but 1/2 cup of watermelon is. A grape is not a serving, but 1/2 cup of grapes is. For some reason, a banana is 2 servings. For vegetables, 1/2 cup is a serving for most vegetables with the exception of leafy green ones. It takes 1 cup of leafy greens to make a serving. They should be measured before any cooking, and do not press them down into the measuring cup.
I can already hear someone asking, "Do I really have to measure all this?" Um, yeah. I really don't know any way around that. Until you can accurately eyeball 1 cup and 1/2 cup as well as my great-grandmother, then yes. I suggest you buy several sets of measuring cups. Use them as serving spoons. Keep them handy when preparing food. For my little family of 2, we have 3 sets. It's not quite enough.
Now that you're prepared and have all the right tools, let's get started. It starts with breakfast. Try to get 2 servings of fruits and veggies worked into breakfast. Vegetables are easily added to omelets. Onions, tomatoes and mushrooms can also be put on breakfast sandwiches, English muffins and bagels. I can see getting 1-2 servings of vegetables in an omelet, but getting an entire serving of vegetables on a single breakfast sandwich may be more difficult. You may have to put half the serving on the sandwich and serve the other half as a side dish.
For many people, fruit is easier to eat at breakfast than vegetables. I recommend you use juice for only one serving of fruit (or vegetable) a day, as it is low in fiber. The exception to this is if you are using a juicer, as this retains much more of the fiber. Of course, whole, fresh fruit has all of the fiber and never any added sugar. Use whole, fresh fruit liberally throughout the day. Fruit smoothies are simple and quick and can be a complete breakfast. I suggest you use fresh or frozen fruit whenever possible. Smoothies need a little bit of liquid. Add milk or yogurt, rather than ice cream. For those who cannot have dairy, you can use soy milk, rice milk or almond milk. Smoothies are low in protein. You can add protein powder, or have 1/4 cup dry roasted nuts along with the smoothie (not in it) for a complete meal. Smoothies can be prepared in advance and kept in a thermos for an afternoon snack. Fruit can also be added to hot or cold cereals. For me, a typical breakfast is steel cut oatmeal with 1-2 cups of fresh berries and a little artificial sweetener.
Then there is snack time. For those of you who are home schooling, you have a bit more control over your children's snacks than children in the public or private school systems. However, parents can group together and put pressure on schools to change what is available at snack times. It is already working across the nation to get carbonated beverages out of schools. Snacks should be a fruit or vegetable paired with a source of protein. Simple things are a 1/4 cup of dried fruit mixed with 1/4 cup of nuts. My favorite is 1/4 cup of craisins with 1/4 cup of lightly salted, dry roasted peanuts. (I make several in advance and put them in sandwich-sized baggies). Another example would be an apple or pear and an ounce of cheese in cubes or slices. For those with dairy allergies, try substituting peanut or almond butter. For children allergic to both, apple with deli slices of ham is delicious. Pairing a protein source with your carbohydrate will keep hunger away longer and limits swings in blood sugar.
Lunchtime comes around and we haven't had much in the way of vegetables. This is an opportunity to change that. Swing the balance back with vegetable sticks. Carrots, celery, bell peppers, jicama, sugar peas, even raw sweet potatoes are good choices. Use your imagination. Try to avoid dipping vegetables in cheese or salad dressing, as these are high-fat choices. Choose instead hummus, nut butters, or go without dip. However, if ranch dressing is the only way you can keep your child from trading away his veggies at lunchtime, then measure out one serving. Serving sizes are on the bottle.
After school is another snack time and another opportunity to get a fruit or vegetable into everyone. Don't miss out on this. You can look at what they have already eaten during the day, as well as looking ahead to dinner plans and choose accordingly. Okay. Face it. Most of us aren't that organized. Make sure you have choices available for afterschool that include fruits and vegetables. Build on what we've already discussed.
Dinner comes along and most of us have not yet had 3 servings of vegetables for the day. We might have had 3-4 fruits and 1 vegetable, if we have been working at it. This means that most of the time, dinner plans need to include 2 servings of vegetables. If you opt for a large dinner salad, you can easily get 2-3 servings of vegetables into a single meal. If you only fix one vegetable at dinner, place 1 cup on everyone's plate. It's an easy fix. Of course, if you do that with 2 vegetables and they only eat one, you still win.
Have you reached your totals? Are we at 5-9 fruits and vegetables for the day? We should have had our 3 servings of vegetables. If you aren't sure about the total count, then go ahead and add a fruit to dessert. This takes the focus off of sugar in your dessert.
I hear it. Someone is grumbling about the cost. "All these fruits and vegetables are more expensive." More expensive than what? I could go on for hours about how you will be saving on healthcare costs in the long run, but I won't. I will say that it helps to buy what is in season. More importantly, studies have been done that show diets rich in fruits and vegetables are less expensive than diets rich in junk food. Those studies show that if you Change your buying power from junk food to fresh produce, you actually save money. The problem is that you cannot buy both. You have to decide what is important. I can't do it for you.
One word of caution: this is a lot of fiber. If this is a big change in someone's diet, it can cause some gastrointestinal discomfort. It needs to be paired with an appropriate intake of water! You need to be getting 64-80 ounces of water a day. If not, the fiber can sit in the gastrointestinal tract and cause pain. In rare cases, it can cause obstruction. Please, do not use this as an excuse to avoid fruits and vegetables, just drink the water. You can do it.
Dr Nan N
House Call Pediatrician, Overland Park, KS
State of the art care for your child in your home.
http://FiresidePediatrics.com
http://PersonalMedicine.com
I'm not writing today to argue about the details of the recommendation. So, why am I writing? Because most of us aren't getting enough of the healthy cancer-fighting, heart disease-preventing vitamins and antioxidants that are found in fruits and vegetables. If you have family members in this situation, I would like to help. I am going to suggest several things that have worked for a number of people I know. Choose a couple and work them into your daily routine. Once you have done them for several weeks and they become habits, add a couple more.
First, let us talk about what constitutes a serving. A serving of fruit is either a piece, or 1/2 cup for fresh fruit, or 1/4 cup for dried fruit. Let me explain that. An orange is a serving. A medium apple is a serving. A watermelon is not a serving, but 1/2 cup of watermelon is. A grape is not a serving, but 1/2 cup of grapes is. For some reason, a banana is 2 servings. For vegetables, 1/2 cup is a serving for most vegetables with the exception of leafy green ones. It takes 1 cup of leafy greens to make a serving. They should be measured before any cooking, and do not press them down into the measuring cup.
I can already hear someone asking, "Do I really have to measure all this?" Um, yeah. I really don't know any way around that. Until you can accurately eyeball 1 cup and 1/2 cup as well as my great-grandmother, then yes. I suggest you buy several sets of measuring cups. Use them as serving spoons. Keep them handy when preparing food. For my little family of 2, we have 3 sets. It's not quite enough.
Now that you're prepared and have all the right tools, let's get started. It starts with breakfast. Try to get 2 servings of fruits and veggies worked into breakfast. Vegetables are easily added to omelets. Onions, tomatoes and mushrooms can also be put on breakfast sandwiches, English muffins and bagels. I can see getting 1-2 servings of vegetables in an omelet, but getting an entire serving of vegetables on a single breakfast sandwich may be more difficult. You may have to put half the serving on the sandwich and serve the other half as a side dish.
For many people, fruit is easier to eat at breakfast than vegetables. I recommend you use juice for only one serving of fruit (or vegetable) a day, as it is low in fiber. The exception to this is if you are using a juicer, as this retains much more of the fiber. Of course, whole, fresh fruit has all of the fiber and never any added sugar. Use whole, fresh fruit liberally throughout the day. Fruit smoothies are simple and quick and can be a complete breakfast. I suggest you use fresh or frozen fruit whenever possible. Smoothies need a little bit of liquid. Add milk or yogurt, rather than ice cream. For those who cannot have dairy, you can use soy milk, rice milk or almond milk. Smoothies are low in protein. You can add protein powder, or have 1/4 cup dry roasted nuts along with the smoothie (not in it) for a complete meal. Smoothies can be prepared in advance and kept in a thermos for an afternoon snack. Fruit can also be added to hot or cold cereals. For me, a typical breakfast is steel cut oatmeal with 1-2 cups of fresh berries and a little artificial sweetener.
Then there is snack time. For those of you who are home schooling, you have a bit more control over your children's snacks than children in the public or private school systems. However, parents can group together and put pressure on schools to change what is available at snack times. It is already working across the nation to get carbonated beverages out of schools. Snacks should be a fruit or vegetable paired with a source of protein. Simple things are a 1/4 cup of dried fruit mixed with 1/4 cup of nuts. My favorite is 1/4 cup of craisins with 1/4 cup of lightly salted, dry roasted peanuts. (I make several in advance and put them in sandwich-sized baggies). Another example would be an apple or pear and an ounce of cheese in cubes or slices. For those with dairy allergies, try substituting peanut or almond butter. For children allergic to both, apple with deli slices of ham is delicious. Pairing a protein source with your carbohydrate will keep hunger away longer and limits swings in blood sugar.
Lunchtime comes around and we haven't had much in the way of vegetables. This is an opportunity to change that. Swing the balance back with vegetable sticks. Carrots, celery, bell peppers, jicama, sugar peas, even raw sweet potatoes are good choices. Use your imagination. Try to avoid dipping vegetables in cheese or salad dressing, as these are high-fat choices. Choose instead hummus, nut butters, or go without dip. However, if ranch dressing is the only way you can keep your child from trading away his veggies at lunchtime, then measure out one serving. Serving sizes are on the bottle.
After school is another snack time and another opportunity to get a fruit or vegetable into everyone. Don't miss out on this. You can look at what they have already eaten during the day, as well as looking ahead to dinner plans and choose accordingly. Okay. Face it. Most of us aren't that organized. Make sure you have choices available for afterschool that include fruits and vegetables. Build on what we've already discussed.
Dinner comes along and most of us have not yet had 3 servings of vegetables for the day. We might have had 3-4 fruits and 1 vegetable, if we have been working at it. This means that most of the time, dinner plans need to include 2 servings of vegetables. If you opt for a large dinner salad, you can easily get 2-3 servings of vegetables into a single meal. If you only fix one vegetable at dinner, place 1 cup on everyone's plate. It's an easy fix. Of course, if you do that with 2 vegetables and they only eat one, you still win.
Have you reached your totals? Are we at 5-9 fruits and vegetables for the day? We should have had our 3 servings of vegetables. If you aren't sure about the total count, then go ahead and add a fruit to dessert. This takes the focus off of sugar in your dessert.
I hear it. Someone is grumbling about the cost. "All these fruits and vegetables are more expensive." More expensive than what? I could go on for hours about how you will be saving on healthcare costs in the long run, but I won't. I will say that it helps to buy what is in season. More importantly, studies have been done that show diets rich in fruits and vegetables are less expensive than diets rich in junk food. Those studies show that if you Change your buying power from junk food to fresh produce, you actually save money. The problem is that you cannot buy both. You have to decide what is important. I can't do it for you.
One word of caution: this is a lot of fiber. If this is a big change in someone's diet, it can cause some gastrointestinal discomfort. It needs to be paired with an appropriate intake of water! You need to be getting 64-80 ounces of water a day. If not, the fiber can sit in the gastrointestinal tract and cause pain. In rare cases, it can cause obstruction. Please, do not use this as an excuse to avoid fruits and vegetables, just drink the water. You can do it.
Dr Nan N
House Call Pediatrician, Overland Park, KS
State of the art care for your child in your home.
http://FiresidePediatrics.com
http://PersonalMedicine.com
Tuesday, April 12, 2011
Ceruminosis
Ceruminosis is an interesting word. I like the way it rolls off my tongue. I don't like the way it blocks my ears. Ceruminosis is excessive wax blocking the ears. In some children it comes out of their ears in chunks. In others, it sets up in the ear canal like concrete. Parents sometimes feel it is an arch enemy that must be battled relentlessly until it is completely banished.
That might be a bit harsh.
Ear wax, or cerumen, is present for a purpose. It protects the inside of the ear canal from dryness, dust and other airborne particles. It is important that some ear wax be present at all times. Without wax our ears would itch all the time and even the tiniest dust particle would cause intense pain.
Small, young children seem to have more ear wax than older children. I don't know if that is really true, or if it is just that their ear canals are smaller. This would make the same amount of ear wax appear larger. Either way, parents of small children notice ear wax coming out of their children's ears more so than parents of older children. Please, resist the urge to remove this wax with paper clips, bobby pins or pen caps. These objects may damage the inside of the ear canal, and can even cause permanent hearing loss.
Cotton swabs, such as Q-tips, can actually push wax further back into the ear canal. Yes, a certain amount of wax will be visible on the head of the cotton swab. However, a larger amount tends to be pushed down into the ear canal, creating a firm, large "rock" of wax. These can be very difficult to remove.
So, what's a parent to do? First of all, don't panic. Remember that the wax is supposed to be present. Don't try to remove it. Don't consider it a problem, unless a healthcare provider comments that it is a large amount, or your child complains of pain or decreased hearing. If these things occur, there are several over the counter drops designed to dissolve the wax. These drops melt or dissolve the excess wax, allowing the hairs in the ear to move it out of the ear. Usually, you don't even see the wax leave, as it is moved out in a very thin film. This is a painless procedure, and does not require the ears to be rinsed afterward.
People who have very dry skin will also have dry ear wax. Their ear wax is flaky. These individuals can benefit from oil being placed in the ears on a regular basis, such as once a week. Good choices are Sweet oil or Baby oil. Some people like to warm the oil. If you choose to do this, then I recommend you drip the oil into the ear directly off your fingertip, so that you can be certain it isn't too warm. For small children with excessive amounts of wax, Sweet oil or Baby oil can be used nightly for a week (not warmed, for safety reasons). Have your healthcare provider check the amount of wax in the ears at the beginning and the end of this week. Sometimes, you will need to repeat for another week.
Of course before putting any oil, or anything else, in anyone's ears, it is best to have a healthcare provider check the ears to make sure there isn't some other problem, such as an infection.
Dr Nan N
House Call Pediatrician, Overland Park, KS
State of the art care for your child in your home
http://FiresidePediatrics.com
http://PersonalMedicine.com
That might be a bit harsh.
Ear wax, or cerumen, is present for a purpose. It protects the inside of the ear canal from dryness, dust and other airborne particles. It is important that some ear wax be present at all times. Without wax our ears would itch all the time and even the tiniest dust particle would cause intense pain.
Small, young children seem to have more ear wax than older children. I don't know if that is really true, or if it is just that their ear canals are smaller. This would make the same amount of ear wax appear larger. Either way, parents of small children notice ear wax coming out of their children's ears more so than parents of older children. Please, resist the urge to remove this wax with paper clips, bobby pins or pen caps. These objects may damage the inside of the ear canal, and can even cause permanent hearing loss.
Cotton swabs, such as Q-tips, can actually push wax further back into the ear canal. Yes, a certain amount of wax will be visible on the head of the cotton swab. However, a larger amount tends to be pushed down into the ear canal, creating a firm, large "rock" of wax. These can be very difficult to remove.
So, what's a parent to do? First of all, don't panic. Remember that the wax is supposed to be present. Don't try to remove it. Don't consider it a problem, unless a healthcare provider comments that it is a large amount, or your child complains of pain or decreased hearing. If these things occur, there are several over the counter drops designed to dissolve the wax. These drops melt or dissolve the excess wax, allowing the hairs in the ear to move it out of the ear. Usually, you don't even see the wax leave, as it is moved out in a very thin film. This is a painless procedure, and does not require the ears to be rinsed afterward.
People who have very dry skin will also have dry ear wax. Their ear wax is flaky. These individuals can benefit from oil being placed in the ears on a regular basis, such as once a week. Good choices are Sweet oil or Baby oil. Some people like to warm the oil. If you choose to do this, then I recommend you drip the oil into the ear directly off your fingertip, so that you can be certain it isn't too warm. For small children with excessive amounts of wax, Sweet oil or Baby oil can be used nightly for a week (not warmed, for safety reasons). Have your healthcare provider check the amount of wax in the ears at the beginning and the end of this week. Sometimes, you will need to repeat for another week.
Of course before putting any oil, or anything else, in anyone's ears, it is best to have a healthcare provider check the ears to make sure there isn't some other problem, such as an infection.
Dr Nan N
House Call Pediatrician, Overland Park, KS
State of the art care for your child in your home
http://FiresidePediatrics.com
http://PersonalMedicine.com
Monday, April 4, 2011
Social Media and Your Family
Recently, the American Academy of Pediatrics (AAP) published a report on social media and it's effects on children and teenagers. Since that time, there has been much talk in the media about "facebook depression." I would like to talk about the entire report, about social media and your children and teenagers, and how to digest this topic. It's a biggie.
The article is titled Clinical Report-The Impact of Social Media on Children, Adolescents and Families by GS O'Keefe and KC Pearson, Ped 2011; 127: 800-804. I will have to plagiarize from it liberally to give it justice. I will try to use quotation marks when I do so.
In the abstract (first paragraph), it states that "any web site that allows social interaction is considered a social media site, including social networking sites such as facebook, My Space, and Twitter; gaming sites and virtual worlds such as Club Penguins, Second Life and the Sims; video sites such as You Tube; and blogs." If it makes you feel any better, I had not heard of some of these sites until I read the article. Also, I immediately flashed back to when my son and his friends taught me how to use You Tube...the second and third time. I felt out of my league just reading that first paragraph.
The second paragraph went a little bit better. The authors reminded me that our children's online lives are an extension of their offline lives.
The article does a nice job of clarifying some of the dangers of social media: "bullying, clique-forming and sexual experimentation," which are also seen offline. It also mentions those dangers specific to the online world: "cyberbullying, privacy issues, sexting, internet addiction and sleep deprivation." It also points out the positives of social media for children and adolescents. It gives a lot of attention to privacy issues, including use of your child's information by ad agencies! There isn't a lot of time spent on facebook depression, considering the media attention it has received. Suffice to say, for children and teens who are prone to depression, spending many hours on facebook may make this worse.
They had some interesting statistics to share. Like, 22% of all kids go to their favorite site 10 times a day, and >50% go to a social media site at least once a day.
They had some nice caveats:
a) "Their online lives are an extension of their offline lives."
b) Know where they go. The site discusses the importance of checking your child's internet history, and if you don't know how to do this, learn.
c) "Don't falsify age to get around restrictions." This refers to age restrictions for signing up your child or teen. Those restrictions are there for a reason. If you falsify this information, you are sending a mixed message about lying. It is very hard to backpedal once you do this.
d) "What is happening online is an extension of underlying issues." This is pretty much a restatement of (a), but geared toward when you find a problem. If you find problem behavior, please bring it to the attention of your pediatrician, so that it can be addressed.
I was a little disappointed that the article didn't say anything about limiting screen time. Perhaps, they felt that the AAP has covered this elsewhere. The AAP Guidelines recommend no more than 2 hours of nonacademic screen time for anyone under 18 years of age. This includes television, all of those social media sites listed above, AND texting. (This news about texting makes my neices very unhappy).
When I was a kid (yes, I'm going to go there) I had a bicycle and a curfew. Now, we have to worry about Nature Deficit Disorder. If you don't know what that is, Google it. Kids don't have curfews anymore. They don't need them, because they are all on social media. We need to break that cycle and get them back outside. If your neighborhood is unsafe, then get them to the Boys and Girls Club or the YMCA. Find a church with an active Youth organization. If you can't find what you want, work with other parents and create something. Your kids are worth it!
Overall, it is a very good article. I would recommend you ask your physician about it.
It concluded with 2 statements of advice:
1. "Talk to them (your children and teens) about their online use."
2. "Become better educated about their online use."
To that, I would add:
3. Limit their nonacademic screen time to 2 hours a day.
4. Help them become more active.
DrNanN
House Call Pediatrician, Overland Park, KS
State of the art care for your child in your home
http://FiresidePediatrics.com
http://PersonalMedicine.com
The article is titled Clinical Report-The Impact of Social Media on Children, Adolescents and Families by GS O'Keefe and KC Pearson, Ped 2011; 127: 800-804. I will have to plagiarize from it liberally to give it justice. I will try to use quotation marks when I do so.
In the abstract (first paragraph), it states that "any web site that allows social interaction is considered a social media site, including social networking sites such as facebook, My Space, and Twitter; gaming sites and virtual worlds such as Club Penguins, Second Life and the Sims; video sites such as You Tube; and blogs." If it makes you feel any better, I had not heard of some of these sites until I read the article. Also, I immediately flashed back to when my son and his friends taught me how to use You Tube...the second and third time. I felt out of my league just reading that first paragraph.
The second paragraph went a little bit better. The authors reminded me that our children's online lives are an extension of their offline lives.
The article does a nice job of clarifying some of the dangers of social media: "bullying, clique-forming and sexual experimentation," which are also seen offline. It also mentions those dangers specific to the online world: "cyberbullying, privacy issues, sexting, internet addiction and sleep deprivation." It also points out the positives of social media for children and adolescents. It gives a lot of attention to privacy issues, including use of your child's information by ad agencies! There isn't a lot of time spent on facebook depression, considering the media attention it has received. Suffice to say, for children and teens who are prone to depression, spending many hours on facebook may make this worse.
They had some interesting statistics to share. Like, 22% of all kids go to their favorite site 10 times a day, and >50% go to a social media site at least once a day.
They had some nice caveats:
a) "Their online lives are an extension of their offline lives."
b) Know where they go. The site discusses the importance of checking your child's internet history, and if you don't know how to do this, learn.
c) "Don't falsify age to get around restrictions." This refers to age restrictions for signing up your child or teen. Those restrictions are there for a reason. If you falsify this information, you are sending a mixed message about lying. It is very hard to backpedal once you do this.
d) "What is happening online is an extension of underlying issues." This is pretty much a restatement of (a), but geared toward when you find a problem. If you find problem behavior, please bring it to the attention of your pediatrician, so that it can be addressed.
I was a little disappointed that the article didn't say anything about limiting screen time. Perhaps, they felt that the AAP has covered this elsewhere. The AAP Guidelines recommend no more than 2 hours of nonacademic screen time for anyone under 18 years of age. This includes television, all of those social media sites listed above, AND texting. (This news about texting makes my neices very unhappy).
When I was a kid (yes, I'm going to go there) I had a bicycle and a curfew. Now, we have to worry about Nature Deficit Disorder. If you don't know what that is, Google it. Kids don't have curfews anymore. They don't need them, because they are all on social media. We need to break that cycle and get them back outside. If your neighborhood is unsafe, then get them to the Boys and Girls Club or the YMCA. Find a church with an active Youth organization. If you can't find what you want, work with other parents and create something. Your kids are worth it!
Overall, it is a very good article. I would recommend you ask your physician about it.
It concluded with 2 statements of advice:
1. "Talk to them (your children and teens) about their online use."
2. "Become better educated about their online use."
To that, I would add:
3. Limit their nonacademic screen time to 2 hours a day.
4. Help them become more active.
DrNanN
House Call Pediatrician, Overland Park, KS
State of the art care for your child in your home
http://FiresidePediatrics.com
http://PersonalMedicine.com
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