Demolition is underway and so is summer fun May 31, 2008

Demolition is really on the move now.  Mark, the demo guy, is working his crew into the wee hours of the morning to get the job done.  The ceiling is down and by Monday night the carpet and remaining walls will be gone too.  It is underway!  Check out the ‘Build out photos #2′ page and see the progress.

I saw a few patients today in the morning and then spent the rest of the afternoon with my sons, Declan and Conall.  We played and swam and read and when Kevin joined us at the swim club, we all had pizza for dinner.  Yummy.  Mairen is away in Chicago this weekend with the Derby Band for a festival and will return very late tonight….this is the first time she has been away for more than a night and I have missed her!  I will be glad to have her home even if it means going to pick her up at 1:30 in the morning! 

Enjoy the wonderful weekend weather with your kids….get outside and play on the playground or go to the Village Fair in Birmingham or swim together.  Tomorrow the Farmer’s Market opens in Birmingham so consider taking a walk into town and see the wares and then play at Booth Park on the way home.  Let me know what you enjoy doing as a family to be active and together.

Eat, love and play and each day will be your best!

Molly O’Shea, MD  Birmingham Pediatrics and Wellness Center

www.birminghampediatrics.com 

Techno-geek May 30, 2008

I admit it…I am a techno-geek, an early adopter, a nerd in slightly better clothing….I always have been.  In the summer between my junior and senior years of high school, I learned computer programming at Lawrence Tech and that was in 1982!  We used punch cards and the mainframe took up a room the size of Rhode Island.  This morning I got some of my geek fix met by spending an hour with my EMR folks setting up my training and discussing my hardware needs.  I am really excited about the e-MDs software.  It has a place called the patient portal where all of my patients’ families can log in and see their child’s chart and vaccine info and growth curves, request referrals or prescription refills or appointments, and even send me an email that will integrate into the child’s chart.  Here’s a link to the info about the portal on the e-MDs site: http://www.e-mds.com/solutions/Portal/Portal.html.  I will be going to Austin, Tx for a week of training on both the charting and billing components of the program just after the fourth of July and I am really looking forward to it!  I am setting up the server in my house until the office is open so I can fool around with the software and make my templates and get used to every bit of it before the office opens.  Nice!

I got my next techno-geek fix when I met Diana Brown for lunch and we talked about website stuff.  She is going to help develop and manage the ‘community’ portions of my website.  We talked about polls and recipes and activities sections that parents can add stuff to as well as a community bulletin board of a type where parents in the practice can connect and ask each other questions and share experiences.  We also talked about the look and feel of the site.  She is terrific.  She works for e-prize (sp?), a company that does web-based rewards and marketing for really big companies so I am fortunate that she is interested in doing this little job for me.  We enjoyed a great lunch and will work well together.  Let me know more of what you are interested in having as part of the site!  I would love to integrate as many ideas as possible! 

After a couple of home visits, I met with my architect and builder and we hammered out some details about the ceiling and the lighting and the electrical.  He is ordering all the stuff for the framing which will start early next week.  He called me at the end of the day to say that the demo is well underway!  I am going to head over there tomorrow and take some more photos for the buildout page.  Exciting! 

I also saw a wonderful friend near the end of the day who keeps me smiling and happy even when things aren’t so good….thank you b!

Thanks to everyone who is reading this blog regularly (nearly 200 people a day now!) and for all the support!  I love caring for your children and am lucky to have such a great group of folks behind me!

Eat, love, and play and each day will be your best!

Molly O’Shea, MD   Birmingham Pediatrics and Wellness Center

www.birminghampediatrics.com

Apparently Neatness Counts! May 29, 2008

I am by nature a messy person.  Not a grimy person but a messy person.  If you were to open up the passenger door to my car, you would find a baby scale, assorted pieces of paper and old receipts, a blue bag full of medical equipment, a striped laptop bag frayed at the edges, an old pair of running shoes, two empty bags from rite aid (or cvs I forget) and a purse that is for show only.  If you were to enter my dressing room at home, assuming you didn’t crack your head open tripping on the assorted shoes strewn about, you would find a collection of lotions and creams and make up and jewelry all little used but still there, jumbled in baskets and cases, along with a hairdryer, brush, an old deoderant stick and its replacement.  When I walk in to everyone else’s homes for the home visits I am amazed at the degree of neatness in each!  I don’t think I have ever in my life been in such consistently neat homes.  I am glad that the home visits aren’t generally at mine!  Here’s a message to all of you potential home visit recipients…DON’T CLEAN UP ON MY ACCOUNT!  I saw seven kids today for home visits and nary a book was out of place!  Toys were neatly placed in bins or were out of sight completely.  Are you people for hire???!!!!

Anyhoo, I am loving the home visits.  It is providing me with some structure to my day and a sense of productivity.  The families I am seeing seem genuinely happy to have me there and I am happy to do it.  If only I could make a living just doing these….hmmmm maybe……and perhaps I would even pick up some neatness tricks!

Eat, love and play and every day will be your best!

Molly O’Shea, MD

www.birminghampediatrics.com

Motivation May 28, 2008

Geralyn Lucas.  Does the name ring a bell?  I had never heard of her before but she is a breast cancer survivor and wrote a book entitled, “Why I Wore Lipstick To My Mastectomy.”  My mom invited me to a luncheon at Oakland Hills today sponsored by Congressman Knollenberg and she was the featured speaker.  She was AMAZING.  She was diagnosed at age 27 with breast cancer and is now a 13 year survivor.  She spoke today with humor and tenderness and pain about that chapter of her life.  Geralyn described herself as a woman who was always a little afraid to show the world who she was; she was intimidated by the women who seemed confident of themselves and could walk around wearing red lipstick as if to say to the world, “Look at me!  I am fabulous!”  When she was diagnosed with breast cancer she made a choice….she decided that she was going to show the world who she was come hell or high water and from that moment on she has embraced the world.  She was lucky (in the way someone is lucky if they are hit by a train and live) that she survived and went on to have two children and share her humor and joy and suffering with all of us.  She was a terrifically natural, conversational, not scripted speaker…completely genuine.  All 360 of us at one time or other during her talk cried and laughed out loud and I suspect we all walked away with a greater sense of contendedness in our own skin.  Wonderful.

The other joys of my day included seeing my cousin’s baby at Troy Beaumont (a gorgeous baby girl) and attending field day at Quarton with my boys.  The weather was fantastic and the kids all loved it.  Mary Ellen Turner, the phys ed teacher there, is great.  She has the ability to make every kid, no matter what their physical strengths are, enjoy being physically active.  One of my kids has some special needs and will never be an athlete in the traditional sense but under her guidance (and others too) he has found a joy in being active that I am thrilled about.  She was able to find out how to reach him and motivate him and that is a true gift. 

My last comment on this theme of motivation is that I have been so lucky to have gotten to know my brothers better over the last year or so.  I know it sounds odd, but we always loved and looked out for each other as kids and young adults but were never really close.  Over the last year, we made a decision to meet weekly for breakfast and I have loved it.  I have grown so close to them that Chuck will be occupying space in my suite and the thought of having him with me every day is wonderful.  He is a man who is unable to see the glass as half empty.  He has faced much adversity in adult life and only finds joy in it.  He sees every roadblock as a challenge and every challenge as an opportunity.  He is so in touch with his feelings that it makes it easy for my other brother Tom and me to admit our own.  Nice!  He met me today at the office and I snapped a photo of him I wanted to share.

here’s a photo of chuck.

Eat, love and play and every day will be your best day!

Molly O’Shea, MD

www.birminghampediatrics.com

busy day May 27, 2008

The day following a long holiday weekend was always a little hectic at the office and so I think I was still in that mode when I scheduled my day.  I had an EMR conference call scheduled at 9 am, a meeting in Farmington Hills at 10, a home visit at 11:15 in Huntington Woods, another for newborn twins in Sterling Heights at 12, a baby in the special care nursery at Troy Beaumont to see and then I was supposed to have three more home visits to round out the afternoon and a final one in the evening.  Lucky for over-achieving me, two of the three afternoon visits were rescheduled when the parents emailed this morning and needed a last minute change.  The third visit was on my books but I hadn’t gotten the confirmation email with the family’s address so I couldn’t go.  As it turns out, the mom sent her address info to someone else by accident which we discovered when she called wondering where I was!  I did see the little girl I was scheduled to see in the evening and then visited a close friend for an hour or so.  On my way to the evening home visit, I stopped by my new office and took a picture of the chute where debris will be falling as the demolition progresses.  I will post it tomorrow….

I am really enjoying the home visits.  Not only do I love seeing the kids in a natural setting but I also am getting to work a bit which I am finding to be a wonderful benefit….I miss the contact with the kids and their parents….

Eat, love and play and each day will be your best day!

Molly O’Shea, MD

www.birminghampediatrics.com

 

time article about vaccines May 27, 2008

Time magazine will publish an article in their June 2nd edition about the vaccine controversy that is well written and balanced.  http://www.time.com/time/health/article/0,8599,1808438-1,00.html

The article was made available on the web today….maybe the author read my previous blog on vaccines and autism :-)

in-house pharmacy? May 26, 2008

Kevin and I have another business www.camprx.com where we provide prepackaged medications to kids at sleep away camps.  Through this business, we have gotten to know Jalal Zaweidah and his sister Amanda who run a local mail order pharmacy, DirectRx.  They run the pharmacy that fulfills the prescriptions for the campers we serve and do an amazing job.  When Jalal heard that I was going out on my own, he reminded Kevin that his wife is a family practitioner and he set up an in-house pharmacy for her solo practice.  Hmmmm interesting.  I have explored this possibility in the past and there are two or three national companies that provide this service but the problem has always been that the medications were paid for in cash by the families at the office and the families then had to submit the receipts for reimbursement.  The other barrier is that one of the ways that insurance companies ‘grade’ doctors is by assessing our generic use rate for medications.  Since the prescriptions aren’t run through insurance in the traditional way, these office-filled prescriptions don’t count toward my generic use rate and I would get ‘dinged’ from the insurance companies.  Jalal, since he is a local pharmacist and entrepreneur, is interested in finding a way to make an in-house pharmacy happen without these barriers.  Assuming that I could get a set up in a way in which your insurance can be used up front and I would give you the medications before you leave the office I am sure that it would be a big hit.  My question for you is this:  if you paid up front for the prescription but Jalal or I submitted the paper work for you for reimbursement, would you still want the service?  Please leave comments and let me know!

Eat, love and play and each day will be your best day!

Molly O’Shea, MD

www.birminghampediatrics.com

 

Vaccines and Autism article in the Detroit News May 25, 2008

Kevin told me about an article about the vaccine debate in the Detroit News which appeared while I was traveling, (http://www.detnews.com/apps/pbcs.dll/article?AID=2008805230376).  I have always been a big supporter of vaccines based on their proven safety and efficacy and felt that this article tried to present a balance between the parental concerns and the science but didn’t come across strongly enough regarding the LACK of association between vaccines, thimerisol, and autism.  No doubt there have been many more kids recognized as having conditions on the autism spectrum and no doubt there are more vaccines given to children now than were given in the past but this does not equal a causal relationship.  Thimerisol was removed from vaccines in 2002 and there has been NO DECREASE in the rate of autism so clearly thimerisol is not the culprit.  The MMR vaccine has been given (and in much higher doses than given today) for well over thirty five years and yet the rate of autism has been rising only for the last two decades.  Seventeen studies have been published that refute the association between the MMR and autism as well so I feel the data to make a connection is very weak.  That leaves only one possible connection between vaccines and autism: that the sheer number of vaccines children receive and the antigen load they confer somehow damages some children in this unexpected way.  The problem with that theory is that back in the 70s and early 80s even though there were many fewer vaccines given, each was so much stronger that the antigen load given during the first two years of life is actually LESS NOW even though a larger number of shots is given today. 

Having said all of this, I have some families in my practice who prefer to vaccinate on an alternate schedule.  Some choose to do one vaccine a month and still get all of the required vaccines in by age 2; others choose to delay the start of vaccination until a child is somewhat older or choose to delay certain vaccines because the risk of contracting the diseases is small.  In the article in the Detroit News, I felt that the quote from Dr. Dorsey was likely edited by the reporter and as such came across as if to say that delaying vaccines is no big deal.  Of course the decision if and when to vaccinate lies with the parents but I would be remiss not to mention that delaying or foregoing vaccines is risky.  If many families decide not to vaccinate it puts not only their own children at risk but all of ours because the diseases become more prevalent again.  In 2005 (the last year that we have data), there were more cases of whooping cough (more than 24,000) in the US than have been in decades and infants under one year of age are at the greatest risk for death if they contract it.  Whooping cough is the ‘P’ in DTP and over 25% of infants who contract it end up hospitalized and nearly 5% die if under a year of age.  We have also seen outbreaks of mumps and measles which are both serious diseases and in Great Britain where the vaccination rate is low, this year there was a child who contracted diphtheria (a life threatening throat infection) and nearly died.  I work with families to feel comfortable about vaccination and am happy to support an alternate schedule of vaccines and support families who opt not to have their child receive them at all but as the evidence mounts, the benefits of vaccines are more and more apparent and the risk of vaccines as a cause or even exacerbator of autism is shrinking.  Food for thought…..

Molly O’Shea, MD

www.birminghampediatrics.com

travel and sun and widgets May 25, 2008

Wow.  That’s the operative word for today.  I got back from Hilton Head at 2 am and spent the day with my family.  The swim club opened this weekend and today we all enjoyed the sun and the pool and the friends we see each summer.  It was gorgeous and relaxing and terrific to reconnect with my family after my trip.  I know a lot of parents have jobs that involve travel and even though we all get accustomed to it, I still miss my kids a lot while I am away.  This is not unique to me, I know a lot of moms and dads who feel exactly the same way and when they come home try to make the most of the time they have with their families.  It still amazes me to see the physical changes in my kids in just a few days.  Conall had lost a tooth just before I left and the new one is peeking through his gumline now, Declan seems to have grown another inch while I was away for four days and Mairen’s freckles are emerging in the summer sun.  Wonderful. 

Now that summer seems officially here, I have a confession to make…..even though I am very fair-skinned and a doctor for goodness sake, I can’t seem to stay out of the sun.  There is little I enjoy more than sitting on a lounge chair in my bathing suit (liberally doused with sunscreen of course) while the sun beats down on my skin.  When I finally get so hot I can’t stand it anymore, I slip into the pool and play catch or tag with the kids or do handstands in the water.  I am actually a 12 year old trapped in a 40-something body.  I love going off the diving board, swimming laps, and drinking diet coke poolside. 

If you noticed on my widget sidebar I have added more links to others’ sites including the American Academy of Pediatrics which has terrific resources for parents.  I was trying (without success) to add a survey to the sidebar…..aarrgghhh.  I made the ONE QUESTION poll on several sites several times and tried to import the html text and it NEVER worked.  UUUUGGGHHH.  I will keep trying….ANY ADVICE WOULD BE WELCOME…..

Eat, love and play and every day will be your best.

Molly O’Shea, MD

www.birminghampediatrics.com

drive by the new office May 23, 2008

I got a call from Frank, my architect and the scaffolding is being built and the windows are out that need to be removed to accommodate the chute for the demolition debris.  Woo Hoo!  I will be returning home late tomorrow night from Hilton Head and will try to get into the building over the weekend and take some photos of the ‘before’ office.  Exciting!

I got exciting news that a good friend just found out he has been admitted to nursing school starting this fall!  He’s a terrific guy and will make an awesome nurse and this is something he has been working toward for some time.  I love getting good news!

With all of the suggestions for the website from all of you, I have a much better idea of the content and design.  It will be interactive, changing frequently and relevant.  Again, thanks to the mom of three kids I see, I am getting wonderful advice about setting up the site and it reinforces what a wonderful community of people I have within my work life.  I appreciate all of your ideas and suggestions and criticisms and advice.  If there is something in particular you DISLIKE about your experiences as patients in my office (or any other for that matter) tell me so I can design not only my website to meet everyone’s needs but the flow through the office, the way we answer the phones or talk with you, the way the office looks or feels….tell me your beefs so I can avoid as many of them as possible!  Keep the ideas comin’!

Eat, love and play and every day will be your best.

Molly O’Shea, MD

www.birminghampediatrics.com