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Sunday, September 15, 2019

How quickly things can change. New advancements in the fields of science and technology seem to occur on a daily basis. These small miracles can easily be taken for granted.

Enterovirus D68 causing trouble? We’ll get the CDC to track it as it moves across the country and start working on better ways to test for it. Uncertain how to get to a friend’s house? Just type in an address on your smartphone and Waze can tell you the fastest way without traffic. It is when these two fields work together that an amazing synergy can be seen.

It wasn’t that long ago when hospital residents would walk around with their large beepers attached to the waist of their scrubs. Each red digit would flash one at a time telling them where to go or whom to call. I still remember the excitement of getting my first alphanumeric pager.

I had made it to the big time! Now I could be reached by anyone, anytime, anywhere. How naive I was then. Was such accessibility really an improvement to my quality of life?

The pager was soon joined by my trusty Palm Pilot. The flat silver design and cool stylus connected medicine and technology on a whole new level. I could create patient files and track labs. A quick docking in the cradle would update my contacts and I could beam information to other users.

These amazing advancements pale in comparison to the amount of information we can rapidly receive and transmit with today’s “smart” phones. Can we even really call them phones anymore when there is so much more that they do?

Doctors have always been on the forefront of embracing technology to advance their field. It probably comes from a basic tenet of medicine. While treatments and managements may change with time (gone are the days when asthmatics were treated with caffeine injections), it is the ability to blend experience with new knowledge that allows one to think critically analyze the new information, and apply it practically. When technology changes, we find ways to use what is offered. If there is a need for improvement, we utilize technology to find solutions.

How we handle this influx of information and constant state of connectivity is a considerable challenge and responsibility. Do we allow new technology to shape us and define who we are or do we use this array of access as a resource like a painter mixing paint on his palette in order to create his next masterpiece? How many times a day do we check Facebook to see how many ‘likes’ we have received on our most recent status update? Is this how we now build self-esteem through such instant gratification? Has the desire to be in contact with others at all times driven us to try to create apps so that we can text on Shabbos? How easy it is now to type in a few symptoms on a Google search and come up with a list of possible diagnoses?

There is no perspective or analysis given to such a search. Yes, a child with abdominal pain could have something serious like a tumor, but it is more likely related to a virus, or poor eating habits, or stress at home that nobody has been willing to admit to. Anyone with a little time can pose as an expert on the Internet. Post anonymously on a topic and cyberbully others, create a website with “facts,” or offer advice based on hearsay on a mommy chat group and these statements take immediate validity with little accountability–whether they are actually true or not. Is there any consideration of the Hippocratic Oath of “Do No Harm” in such situations?

One must become an informed consumer of the Internet. When was the found information first posted? Who is the author and what is his or her background? Vaccines continue to be a controversial topic in some social circles. Fortunately, the unwarranted backlash against them has quieted considerably. Gut feelings or unnecessary caution can be dispelled with an honest

conversation with a pediatrician. It definitely beats weeding one’s way through the minefield of misinformation available on the web. I frequently refer families to the Children’s Hospital of Philadelphia (CHOP) Vaccine Education Center website and app as an excellent resource.

The American Academy of Pediatrics doesn’t recommend introducing screen time to children until after the age of 2. After that, they don’t recommend more than two hours a day for children.

Whether that is realistic or not in an era where local yeshiva middle schoolers are given ipads to complete assignments and take notes and children (and some of their parents!) would rather text a friend than give me an accurate history in my office, I leave for another time. It should, however, cause us all to delve into a discussion within our families of how we can properly apply technology to our advantage and use it in a proper manner.

Technology surrounds me at work on a constant basis. Our medical records are completely computerized. I can pull up a patient’s “chart” from any office or even from home if need be. I can send a prescription to a pharmacist in seconds to save families time and help reduce prescribing errors. Families can contact me for non-emergency questions through the patient portal on our website and find useful information at tenaflypediatrics.com. Having teenagers put appointments on their phones or to text them prior to another Gardasil appointment significantly improves their compliance and improves vaccination rates. I use apps like ePocrates to help me check for drug interactions if a patient is taking multiple medicines. Lactmed helps me determine whether a certain product or prescription is safe for a breastfeeding mother and her baby. For families looking for parenting advice beyond what is provided in the office, I recommend Healthychildren.org and its app. Managing weight in our children remains a top priority. Choosemyplate.gov and My Fitness Pal app are both great tools. These are all respectable resources, but they work best when integrated into a medical home where a family is treated respectfully and where one’s overall health is a top priority.

There is no “personal touch” from Dr. Google. None of these websites or applications can replace a reassuring or sympathetic gesture during a face-to-face encounter in the office. I’ve yet to see WebMD call a family a few days later to make sure their child is doing better. These are basic human elements that we cannot afford to lose.

What is medicine going to be like in the next few years? What leap in technology that exists only at the fringes of our imagination awaits us? I do not have such answers. Maybe a search on Google will help....

Dr. Joshua Menasha currently practices at Tenafly Pediatrics. He completed his Pediatric Internship and Residency at Mt. Sinai School of Medicine and is a graduate of Mt. Sinai School of Medicine. Dr. Menasha is also an Attending Physician at Englewood Hospital and Medical Center, Hackensack University Medical Center and The Valley Hospital. He is Board Certified in both Pediatrics and Human Genetics. Dr. Menasha worked as a Pediatrician for several years in Bergen County prior to joining Tenafly Pediatrics in 2012.

If you would like to make an appointment or have a medical concern that requires attention, please contact your physician’s office at the following numbers:

Tenafly: (201) 569-2400

Fort Lee: (201) 592-8787

Clifton: (973) 471-8600

Paramus: (201) 262-1140

Oakland: (201) 651-0404

Park Ridge: (201) 326-7120

Office Hours:

Monday-Friday 8:30am - 5:00pm

Evening Checkups Available!

Weekends: Call for Emergency

By Dr. Joshua Menasha