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On 'Sound Medicine': Concussion clinics, childhood vaccinations, and doctors doing with less

  • Sept. 12, 2013

INDIANAPOLIS -- The award-winning “Sound Medicine” announces its program for Sept.15, with segments covering the dangers of childhood concussions, the importance of childhood vaccinations, and doing less in the health care profession.

Why are concussions so hard to detect?:  According to the Centers for Disease Control and Prevention more than 200,000 young children go to the emergency room for traumatic brain injuries and concussions each year.  Concussions are caused when a jolt to the body causes the brain to move. Julie Gilchrist, M.D., compares the brain to the yolk of an egg and the rest of the body to the shell, “you can break the yolk without ever damaging the shell.” Concussions can occur without any physical symptoms and do not show up on any type of scan or X-ray. The only proven treatment for a concussion is rest. Symptoms of a concussion include dizziness, blurred vision, nausea and sleep related disturbances. Joseph O’Neill, M.D., a pediatrician at Riley Hospital for Children in Indianapolis, recommends that physicians and parents develop an individualized recovery approach for children with concussions. Dr. Gilchrist is a pediatrician and medical epidemiologist for the CDC injuries center.

What are concussion clinics?:  After the suicide of former NFL star, Junior Seau, revealed a traumatic brain condition caused by violent hits throughout his football career, parents of young athletes have been taking concussions seriously. The Vanderbilt University School of Medicine recently opened a concussion clinic to provide coordinated concussion care for youth athletes. Concussion clinics now exist in 35 states and are expanding rapidly. According to Andrew Gregory, M.D., an assistant professor of orthopedics and rehabilitation at Vanderbilt, the treatment for head injuries varies from patient to patient, but all concussion patients should abstain from activity until their concussion is completely healed and all symptoms have been alleviated.   

Why are childhood vaccinations so important?:  A recent outbreak of measles in Texas has affected two dozen people, including a 4-month-old infant. All cases have been linked to a mega-church that believes in faith healing and discourages vaccinations. According the Rachel Vreeman, M.D., many parents are refusing to vaccinate their children due to the myth that vaccinations cause autism, even though evidence has shown this to be false. Dr. Vreeman encourages physicians to explain the science behind vaccinations to parents, since evidence shows that once parents understand the science and evidence debunking the autism-vaccination correlation, they are more likely to have their children vaccinated. Dr. Vreeman is an assistant professor of pediatrics at the Indiana University School of Medicine.

 Why are blood use guidelines being re-evaluated?:  A recent trend encouraging surgeons to order less blood during surgeries has emerged across the nation. A study on blood use conducted at John Hopkins Hospital, showed that hospitals could save up to $200,000 per year by reducing the amount of blood ordered for surgery. Steven Frank, M.D., the director of blood management services at Johns Hopkins Hospital, headed the study and found that it was useful and cost-effective to decrease the amount of blood ordered for surgeries. The study used two years of electronic medical records and found that blood was being ordered for surgeries that rarely called for transfusions. The last published blood order guidelines were published in 1978, before the advent of laparoscopic surgery.

Should doctors do less?: Michael LeFevre, M.D., visits “Sound Medicine” to discuss his article in the Journal of the American Medical Association about doctors ordering fewer unnecessary screening tests. According to Dr. LeFevre, doctors have a hard time reducing the amount of unnecessary tests and procedures they order because they have been trained to cover all of their bases. The current reimbursement system encourages doctors to order more tests and the threat of malpractice is always looming. Dr. Lefevre encourages patients to question their physicians and ask about the benefits and risks of the tests they order. Dr. LeFevre is a professor and the director of clinical services at the University of Missouri School of Medicine.

Should hospitals do less?: Chris Moriates, M.D., just finished his residency and is a member of the "High Value Care Committee" at the University of California at San Francisco Medical Center. The committee is dedicated to reducing the number of unnecessary procedures at UCSF. They have recently targeted the $20 iCal test, an ionized calcium test that was given to every patient, whether or not they needed it. According to Dr. Moriates, the committee plans to target other unnecessary procedures in order to reduce cost to the patients and make the hospital more efficient.  Dr. Moriates is an assistant clinical professor at UCSF.

“Sound Medicine” covers controversial ethics topics, breakthrough research studies and the day-to-day application of recent advancements in medicine. It’s also available via podcast and Stitcher Radio for mobile phones and iPads and posts updates on Facebook and Twitter.

Co-produced by the IU School of Medicine and WFYI Public Radio (90.1 FM) and underwritten in part by Indiana University-Purdue University Indianapolis, Sound Medicine  airs on the following Indiana public radio stations: WBSB (Anderson, 89.5 FM), WFIU (Bloomington, 103.7 FM; Columbus, 100.7 FM; Kokomo, 106.1 FM; Terre Haute, 95.1 FM), WNDY (Crawfordsville, 91.3 FM), WVPE (Elkhart/South Bend, 88.1 FM), WNIN (Evansville, 88.3 FM), WBOI (Fort Wayne, 89.1 FM), WFCI (Franklin, 89.5 FM), WBSH (Hagerstown/New Castle, 91.1 FM), WFYI (Indianapolis), WBSW (Marion, 90.9 FM), WBST (Muncie, 92.1 FM), WBSJ (Portland, 91.7 FM), WLPR (Lake County, 89.1 FM) and WBAA (West Lafayette, 101.3 FM).

“Sound Medicine” is also broadcast on these public radio stations across the country: KSKA (Anchorage, Alaska), KTNA (Talkeetna, Alaska), KUHB (Pribilof Islands, Alaska), KUAF (Fayetteville and Fort Smith, Ark.), KIDE (Hoopa Valley, Calif.), KRCC (Colorado Springs, Colo.), KEDM (Monroe, La.), WCMU (Mount Pleasant, Mich.), WCNY and WRVO-1 (Syracuse, N.Y.), KMHA (Four Bears, N.D.), WYSU (Youngstown, Ohio), KPOV (Bend, Ore.) and KEOS (College Station, Texas).

Please check local listings for broadcast dates and times.

Mary Hardin
Sydney Willmann