The Cost of Servicing Your Child

Written by Suzanne Berman MD

Several years ago, when I took my car in for servicing, I noticed this clever message printed on the back of the mechanic’s invoice:

This simple, honest explanation of my bill impressed me so much that I kept the invoice. More recently, I’ve thought about using a similar illustration for patients who ask, “I don’t understand why my pediatrician’s bill is so high – I only saw the doctor for about 10 minutes!”

Using the auto mechanic’s model, I’ve taken our practice’s actual expenses for 2010 and broken them down by category, as well as percent of our total budget, to give you an idea of where the money goes.

So with apologies to the creator of the automobile piece, here’s what goes into the cost of servicing your child:

Utilities and rent: 10% We spend a tenth of our budget just keeping the lights on, the telephone ringing, the heat and A/C running, and the rent paid.
Supplies: 9% Nearly another tenth of our expenses go to supplies, both clerical (appointment cards, copy paper, and pens) and medical (gauze pads, diapers, and casting supplies.) The largest single supply expense we have is vaccines; it’s not uncommon for a busy pediatric practice to have many thousands of dollars in vaccine inventory at a time.
Clinical staff: 13% Our nurses and medical assistants are busy from open to close – they weigh and measure our patients, draw blood, give shots, answer medical questions, complete school and camp forms, return phone calls, coordinate referrals, talk to the home health agency, refill prescriptions with the pharmacy. All these astute individuals are friendly and talented; we want to keep them, so we try to pay them well.
Receptionists: 5% Our front office staff answer the phone, verify insurance, check in patients, distribute paperwork, send and receive medical records, mail and fax documents, process co-payments, confirm appointments, order supplies, and more.
Insurance jockeys: 4% We don’t have “car jockeys,” but we do employ three full-time staff who could be described as “insurance jockeys.” These longsuffering individuals send claims to insurance companies (a big task) and argue with insurance companies when payments aren’t made properly (an enormous task, as it’s estimated that 20% of insurance payments are wrong.) They try to keep up with policy changes in the 200+ insurance plans our office sees in a year. They also work with families who need to establish payment plans, need to get insurance, or who are having trouble navigating their insurance plan.
Supervisory staff: 8% All our other staff have to be trained and supervised. Someone has to approve their mileage forms, overtime requests, time clock totals, and benefits changes. Someone has to negotiate scheduling squabbles, process payroll, conduct staff meetings, plan the office’s Christmas party, write policies (then rewrite them when they’re unclear), meet with vendors, fix the computers when they’re acting up, call a plumber when a toddler accidentally flushes a toy down the toilet, and about 384 other major and minor things to keep our office running. These staff also have associated professional costs, like dues and subscriptions.
Building maintenance: 4% Keeping our office clean and well-maintained is hard work for the husband-and-wife team who spend several hours 5 evenings a week cleaning, disinfecting, dusting, vacuuming, waxing, touching up the paint, wiping fingerprints from walls, emptying the trash, getting bugs out of the light fixtures, and more. Seasonally, we also pay a landscaping service (to maintain our grass and plantings) and a guy with a big truck (to salt and de-ice our parking lot). This also includes budgeting for major repairs, like resealing and restriping our parking lot every couple of years, fixing leaks in the ceiling, and cleaning up fallen debris after a bad storm.
Specialized physician training: 22%. This represents the salaries for the pediatricians in our practice and, yes, paying the doctor is the largest single expense in a practice. Much of this goes to the doctor’s personal overhead: Physicians now graduate med school with an average of $150,000 in educational debt.
Capital investment: 6% We use electronic medical records at our office, so all of our staff have their own computers, and there are computers in each of our exam rooms. Computers have to be replaced every few years, as do other electronics, furniture, appliances, and tools.
Taxes: 6% The largest part is payroll taxes for our employees and self-employment taxes for our physicians – but also unemployment tax (federal and state), property tax, professional privilege (license) tax, and sales tax.
Insurance: 7% We pay malpractice insurance for our professional employees, of course, but also insurance on our building and equipment, health/dental/life/disability for our employees, worker’s comp insurance, and some other odds-and-ends premiums.
Fringe pay: 5% This includes vacation/sick pay, holiday pay, and our company’s contributions to our staff retirement plan.
Wage and hour regulations: 1% Overtime wages for our employee constitute nearly 1% of our total annual expenses.

 

When you pay your pediatrician’s bill, your pediatrician certainly takes home a portion of that, but most of it goes to other things to keep the office ready and running. While our practice isn’t necessarily representative of all pediatric practices – and I know from published benchmarks that our practice is atypical in at least a few ways — this hopefully gives a rough idea of where the pediatric healthcare dollar goes.

Suzanne Berman is a practicing general pediatrician in rural Tennessee.

4

Back to School Illnesses… Please Don’t Spread the Lovebugs

Written by Melissa Arca, MD

First of all, realize it’s inevitable: Children will get sick. I have yet to meet a child in school who went the whole school year without coming down with something. That being said, there are measures we can take to lessen the chances of our children falling prey to some of these viruses.

First, I will outline 5 of the most common culprits causing illness in the preschool and school age child during fall and winter. Then I will give you some practical tips on containing these viral bugs.

Hand Foot Mouth Disease: This is most commonly caused by the coxsackie virus and peaks in the summer and early Fall. This virus affects mostly young children (children under 10). The symptoms consist of a fever, decreased appetite, and sore throat. Usually painful mouth sores develop on the tongue, inside of cheeks and back of throat. This may or may not be accompanied by the non-itchy skin rash on palms and soles of feet.

The Common Cold: Your child may be afflicted with this a few times a year. The most common culprit here is the rhinovirus though there are several different viral strains producing symptoms of the common cold. Hence, several colds can be caught during one season. The symptoms vary but most commonly include: stuffy nose, sore throat, cough, mild fever, and sneezing.

The Flu: Ahh… the dreaded flu. Influenza and its various strains cause the dreaded flu symptoms. As opposed to the common cold, the flu gives more pronounced and severe symptoms: high fever (usually over 100.4), sudden onset of symptoms, profound body aches, headache, and general malaise with decreased appetite. With the common cold, respiratory symptoms such as sneezing, congestion and cough are more prominent than in the flu. So far, the only preventive medical defense we have against this is the seasonal flu shot.

Strep Throat: Unlike the above conditions, this one is caused by a bacteria (Group A Strep.) and not a virus. So, this must be treated with antibiotics. So how do you tell the difference from a common sore throat (viral pharyngitis) and strep throat? Here are the key differences: strep throat involves a higher fever (usually above 101 F), red and swollen throat with possible pus formation, absence of cough, and swollen lymph nodes in neck. Strep throat may also be accompanied by abdominal pain, possible vomiting, and a body rash.

Gastroenteritis, aka the “stomach flu,” is caused by several different types of viruses, most notably rotavirus and adenovirus. The most prominent symptoms are vomiting and diarrhea. Some children may only have the vomiting, some only the diarrhea, and the unlucky ones will have both. This may be accompanied by fever and stomach ache. Having the so-called “stomach flu” does not mean you have the “flu” as in influenza.

I picked the above 5 conditions because they are by far the most common this time of year and they are highly contagious. There is just no way around it. Okay, so having thrown all that at you, what can you do to help minimize and contain these nasty viruses?

  1. Frequent hand washing is the number one way to help prevent the spread of these bugs. Encourage and teach your child to wash their hands several times throughout the day. Before eating, after using the potty, after playing outside, etc. Have them sing a song while washing to make sure they wash long enough (ABC song is a good one).
  2. Carry sanitizer. I always wipe my kids’ hands as soon as they get into the car from school. This time of year, it’s just a good habit. Wipe down shopping cart handles too.
  3. Encourage children to sneeze and cough into their arms or a tissue.
  4. Keep children home if they have a fever, are vomiting, or have significant diarrhea. Of special note: keep them home if they have eye drainage, this could signify a conjunctivitis and should be evaluated by a doctor.
  5. Teach them not to share drinking cups or utensils with their friends.
  6. By all means, sanitize the toys and personal items in your house after a bout with any of the above.
  7. Make sure your children get enough sleep, eat well balanced meals, and exercise regularly. All of these will help insure that their immune systems stay in tip top shape.

Treatment: Since the above, with the exception of strep throat, are caused by viruses, antibiotics will not help. Keep your child comfortable by treating their fever with a fever reducer. Give plenty of fluids and rest. With the stomach flu, keep your child’s diet bland and make sure they stay hydrated with small and frequent amounts of liquids.

Possible Complications: Secondary infections can set in following colds or the flu. Ear infections and pneumonia are common secondary infections. Watch for fever recurrence, chest pain, difficulty breathing, or worsening cough. Dehydration can set in following a bout of gastroenteritis. Stay on top of your child’s liquid intake. These conditions should be evaluated by your child’s pediatrician.

Do not hesitate to contact your child’s pediatrician whenever you’re concerned or have questions regarding your child’s health.

Good luck to all of you this fall and winter season. Unfortunately, these bugs will make their way into our households — just make sure your child gets plenty of rest, fluids, and love.

We’ve already battled a short bout of gastroenteritis and a nagging cold. How about you? Have your children been afflicted by any of these back to school bugs yet?

Dr. Arca is a pediatrician, mom of two, writer, and blogger who works part time in a community clinic while raising her two young children. She has become passionate about writing and speaking about motherhood, parenting, and children’s health. She is author of the blog, Confessions of a Dr.Mom and writes a weekly column in her local newspaper, The Sacramento Bee.

2

Brain-eating amoebas, internet info, and risk (oh my!)

Written by David Sullo MD

It was with great sadness that I read of the third case of Naegleria fowleri infection (the “brain-eating amoeba) this summer.  Death in children is always tragic, but especially so when it is so unexpected and brought on by something so innocent as hitting the local swimming hole.

As a physician, I expected parents to be asking about it in the coming days and weeks, so decided to educate myself.  I thought I would write how I went about it, and how I think about it, as there are some good things to be learned about how to find medical info AND interpret it.

My first stop was to Wikipedia for some general info on the bug itself:

http://en.wikipedia.org/wiki/Naegleria_fowleri

Interestingly, it isn’t actually an amoeba as billed in the press, but that’s a tangent.  That then led me to the CDC website, which had more specific information on the actual rate of infections, possible treatments, and prevention strategies:

http://www.cdc.gov/parasites/naegleria/faqs.html

So in the end, there’s a couple of things to say:

a) Get your info from reputable sites.  Note I did not use a site that says “BRAIN eating AMOEBAS can KILL YOU!  Buy our nose spray and you’ll be protected!  Our nose spray is scientifically proven to block all amoebas!”

b) Some things are just tragic.  The CDC site makes an important point, which is that over 10 years there’s been 32 cases of this disease, but millions of people have gone swimming in these same places and NOT gotten this disease.  We’ll probably never know why these very few kids get the disease and the vast majority do not.

c) Modern medicine doesn’t have all the answers, yet.  This disease is almost uniformly fatal because it often is not recognized as Naegleria until late in the illness (or even post-mortem), and there is not a good treatment even when it is diagnosed early.  If we can develop better methods of detection and better treatments, the prognosis for these kids may improve.

d) Educate yourself.  The vast majority of cases are in southern states, in fresh water, and usually in warmer water (hot springs, etc).  There’s been only one case in a northern state (Minnesota).  So if you are going to the beach for a week on the Jersey shore, you can relax.

e) Take reasonable precautions.  You can 100% avoid this by never swimming again, but that’s not what I would call reasonable.  The CDC suggests this:

  • Avoid water-related activities in warm freshwater during periods of high water temperature and low water levels.
  • Hold the nose shut or use nose clips when taking part in water-related activities in bodies of warm freshwater.
  • Avoid digging in, or stirring up, the sediment while taking part in water-related activities in shallow, warm freshwater areas.

f) Remember what’s important.  Remember the 32 cases in 10 years noted above?  In a typical 10 year span, there are 36,000 drownings in the US.  Drownings don’t make national headlines like brain-eating amoeba do, but your child is literally 1000 times more likely to drown than to catch Naegleria.  So don’t lose sleep over the brain-eating amoeba but then take your child on a boat without a life jacket.

I hope this glimpse into the brain of a pediatrician was helpful.  I would also like to extend our sincerest condolences to the families of these children; we can only hope that  the increased public awareness from these cases leads to work on an effective treatment.

Dr. Sullo is a pediatrician at Genesis Pediatrics in Rochester, New York. He admits to having gone to computer camp in 5th grade when everyone else was playing baseball, and is an “Apple Fanboy.” He does his best to offset the geekiness by throwing in some winter backpacking.

29

What I Wish Parents Knew About Medical Billing

Written by Brandon Betancourt

One of the things that I do a lot here at our practice is talk to parents about their health insurance coverage. The conversation is usually about why they have a balance on their child’s account.

Health insurance is very complicated. At our practice, we deal with health insurance all the time and even for us, it gets to be very complicated sometimes.

Today, I had a conversation with a patient’s parent regarding medical billing issues. After explaining some in-and-outs about why we do certain things, the parent mentioned she had no idea things were the way they were and now understands why doctors’ offices have to do what they have to do.

She also mentioned that we should do something to spread the word. She said, “I think it is important for other parents to know this. Otherwise, how are things going to get better?”

I thought her idea to spread the word was very good. Therefore, I decided to summarize our conversation in an effort to help other parents understand, at the very least, a portion of medical health insurance.

Coding — a lot of what doctors do

At a restaurant, generally you’ll get an itemized check that shows all the things you’ve ordered. Doctors do the same thing, but they do it in the medical chart.

Virtually every doctor who accepts health insurance uses codes (called CPT codes) that are assigned to every task they and their staff performs. Everything from a simple blood draw, to immunizations, to the ear check, to specimen handling — all these things are “coded” separately.

Why do docs do it this way?

These codes are used by the patient’s health insurance company to determine the payment amount that the doctor will receive for his or her services. In other words, the health insurance company (the one actually paying for the services) wants to see what was done during a patient’s appointment. Hence, everything the doctor and the staff does has a code.

For example, if you are coming in for a child’s well visit, the pediatrician will submit a “claim” to the insurance company using the following codes:

  • Established Well Visit – 99392
  • Developmental Testing – 96110
  • Hemoglobin – 85018
  • Finger/heel/ear stick – 36416
  • Lead Testing -83655
  • Hearing Screen – 92587

If the child gets immunizations, those have codes too.

  • DTAP-IPV – 90696
  • Flu – 90660

Vaccine administration also uses a distinct set of codes. To further complicate things, some vaccines have a single administration code used with them, and others have multiple administration codes for a single vaccine.

  • Admin – 90460
  • Admin – 90461
Oh, by the way…

Let’s say while you are in the examining room, you ask the doctor, “Ya know doc, little Lisa here has been pulling on her ear lately… she may have an ear infection. Can you check that for me really quick?”

This question requires the doc to perform an entirely different assessment than the well visit the child was getting.

The doctor, in order to show the insurance company that she did a completely different assessment, codes the ear pain diagnosis and adds a 99213 – which is an evaluation and management code that documents in the chart and on the claim to the insurance company that the doctor also checked the patient’s ear.

But we feel like we are being squeezed for every penny

Parents often think when they are looking at the bill that the doctor is nickel-and-diming parents, when in reality, it is the insurance company that requires the doc to show their work in this matter.

The health insurance company doesn’t accept the doctor telling them, “I did a well visit — pay me our agreed-upon fee.” They want to know all the things the doctor did during a patient’s visit so they can decide how much they ought to pay the doctor for his/her services.

Since most patients (or in the pediatrician’s case, parents) don’t pay the doctors directly, but rather the health insurance company, they want to know what took place during the visit so they know how much they ought to pay the doctor.

It is the same as going to the restaurant and getting billed for all the side and extra orders. Although the main meal is accompanied by other things, like french fries or a salad, refills, side orders, substitutions and additions to the order are billed as extra.

Health care services are a la carte as well. 

Why then do patients have balances if insurance ought to have paid?

The insurance policy that a patient has chosen may not pay for all the services the doctor performed. So when the doc’s billing staff submits a claim for a visit, the health insurance company often comes back and says, “We are not responsible for these codes/services; these are the member’s responsibility per the member’s health insurance policy. ”

For example, the health insurance company may say, the policy your patient chose pays for a vision screen, but not for a hearing screen. Or they may say, we cover the well visit code, but not the ear ache code at the same time as the wellness visit.

Doctors get stuck with the bill

The doctor, already having performed services, now has to go to the patient and say, “Hey, remember that school physical I performed and you asked me about little Lisa’s earache? Well, your insurance says that the policy you have doesn’t cover the earache part, so I’d like to be paid for the work I perform in assessing your child’s earache.”

Of course, doctors don’t actually say that, but when a parent gets a bill for the earache, that is in essence what the doc is trying to say to the parent. And if one looks carefully at the  explanation of benefits (that document that the insurance company sends after they process a patient’s claim) one will notice they give an explanation as to why they are not going to pay the doctor for the service.

Funny how things work

Here is an interesting, but crazy fact. In many cases, had the doctor deferred the earache question and told the mom to make another appointment to address that issue during another appointment, the health insurance company would have most likely paid for the office visit.

However, had the doctor done that, the patient would have most likely gotten upset at the doctor.

By treating the earache question during the wellness visit, the doctor runs the risk of not being paid despite doing the work. On the other hand, not addressing the ear ache, the doc runs the risk of upsetting the parent, who will probably think the doc is trying to squeeze another $30 copayment, which is clearly not the case.

Cutting cost — not always a good idea

One of the major problems with this is that patients don’t understand what they are financially responsible for. Or, it’s often the case where patients don’t understand what type of health insurance they’ve purchased.

Just like with anything else, you get what you pay for. But patients overlook this issue when purchasing health insurance. They usually look at the monthly premiums and choose the lowest one. But by doing that, they are often reducing the amount of coverage, which means patients will get stuck with larger portions of their medical bills.

Growing trend to save cost

The health insurance company, in an effort to keep their premiums low, have shifted the cost to customers and their doctors. While in the past health insurance companies may have covered 100%, now they are reducing the monthly premiums but only covering 70% of one’s medical expense. Hence allthe high deductible plans out there.

Why wasn’t I told they insurance doesn’t cover?

In our practice – which is a small three-provider practice – we see on average 60 to 75 patients daily.

Add to that there are virtually thousands and thousands of different health plans. In fact, we have patients whose parents work for the same company, but because they are at different pay grades, have different insurance plans.

The answer is, we don’t have enough manpower or time to sit on the phone verifying every single patient’s healthcare coverage. I know of practices that do, and God bless them. But as a practice we believe it is the patient’s responsibility to find out what is covered and what is not covered. The more time we spend on the phone with a patient’s insurance company, the less time we are able to spend providing health care for our patients.

Moreover…

As a practice, we consider that treating patients based on what the insurance covers and what it doesn’t, instead of treating by what the patient actually needs, is an unethical way to practice medicine.

Although most doctors that I know will take into consideration health insurance stipulations, they will not compromise a child’s health as a result of health insurance restriction and cheap health insurance coverage plans.

I hope this post will give all that read it some insight and perspective on medical billing. If you have a question, or don’t understand why doctors’ office do medical billing, feel free to leave a comment and we will try to address it.

Oh, and thanks for reading…

Brandon Betancourt is a practice administrator for Salud Pediatrics. You can follow him on Twitter  @pediatricinc

2

When Should My child Start Seeing My Adult Physician?

Written by Richard Lander MD FAAP

As a pediatrician I am sometimes asked, “When should my child start seeing my adult physician?”

My answer is not until their early 20’s.

Pediatricians are trained to treat babies, toddlers, children, adolescents and young adults. Pediatric training encompasses four years of medical school and a minimum of three years of residency in pediatrics.

Throughout our career, we are constantly attending conferences and reading journals or medical literature to ensure that we are always current and apprised of cutting-edge pediatric medicine.

Your pediatrician helps you deal with your baby’s acid reflux, guides you on how and when to introduce solid foods and thrills with you when your baby speaks his/her first words.

At your well visits, your pediatrician asks questions to determine if your infant/child is developing properly and if not, you will be directed to the proper place for evaluation. You are counseled on proper nutrition and exercise for your child and encouraged to expose your child to a range of cultural and educational experiences.

When your child is wheezing or crouping in the middle of the night, it’s your pediatrician you call on for help. When your child has a 104 degree fever on a Sunday morning your pediatrician tells you to come over to the office to be examined. It is your pediatrician who is there with you as your child becomes an adolescent and together we deal with adolescent issues such as acne or uncomfortable menstrual cycles.

With some of you, we traverse the difficult terrain of painful adolescent anxieties or drug and alcohol problems. It is your pediatrician you consult for concussions and sprains from sports. When your child begins thinking of college and a future career, your pediatrician is as excited as you are, because your pediatrician has been there with you as your child has grown into a young adult.

It is your pediatrician who takes your child’s phone calls from college to help with a health issue or an emotional problem. When it becomes time to move on to an internist, it is a happy but also sad parting of the ways.

And then of course the fun begins again as your pediatrician begins to care for your child’s child: a very special pleasure for your pediatrician — the second generation.

As you can see, there is no other healthcare professional who knows your child the way your pediatrician knows your child.

The walk-in clinic has no frame of reference; they have not treated your child throughout the years. Many internists and family practitioners do not treat large numbers of children and are therefore not equipped to handle the range of issues involved in treating children and adolescents.

Many non-pediatrician physicians do not have the vaccines needed to keep your child properly immunized. Most do not see patients after hours; they send patients to the emergency department.

With your pediatrician you have grown accustomed to being seen right away and in the office where you are comfortable. Your pediatrician has been trained to deal with your child’s health issues from birth until they are young adults. We know your family and we know your child’s history. We know you and we are always there for you.

Dr. Lander has been practicing pediatrics for 32 years in New Jersey and is the immediate past chairman of the American Academy of Pediatrics Section on Administration and Practice Management.  He says if he had to do it all over again he wouldn’t hesitate to be a pediatrician.

3

Does Your Child Need to Wear a Helmet When Riding?

Written by Joanna E. Betancourt MD FAAP

Recently, two patients of ours had accidents when they were hit by a car while riding their bikes. Both suffered head trauma because they were not wearing their helmets

The American Academy of Pediatrics reminds us that head injuries can occur on sidewalks, on driveways, on bike paths, and in parks as well as on streets. You cannot predict when a fall from a bike will occur. It’s important to wear a helmet on every ride.

Below are four suggestion that could help you get into the habit of telling your kids to wear a helmet.

  • Are you wearing a helmet? We’ve all heard the saying, “…do as I say, not as I do.” But the truth is, children learn best by observing you. Thus, whenever you ride a bike, set a good example and put on your helmet. Not only will this reinforce the message, but you will be setting a good example.
  • Start Early. If your kids are small, have your kids wear a helmet as soon as they start to ride a tricycle or when they are riding as a passenger on the back of an adult’s bike. If your children learn to wear helmets whenever they ride tricycles and bikes, it becomes a habit for a lifetime.
  • No helmet; no bike riding. Don’t let children ride their bikes unless they wear their helmets. Being consistent is a big part of the process. If you allow your children to ride occasionally without their helmets, they won’t believe that helmet use really is important.
  • Use professional athletes as examples. My husband likes to watch the X-Games. For those that don’t know, X-Games are a yearly competition where athletes perform extreme sports such as skateboarding, roller-blading, motorcycle jumping and various other high risk, death defying stunts. All of those athletes wear helmets at all times. Thus, using professional athletes such as those on the X-Games as an example, drives the message home of how important the use of helmets can be.

Your child needs to wear a helmet on every bike ride, no matter how short or how close to home. Many accidents happen in driveways, on sidewalks, and on bike paths, not just on streets. In fact, the majority of bike crashes happen near home. A helmet protects your child from serious injury, and should always be worn. And remember, wearing a helmet at all times helps children develop the helmet habit.

Thankfully, both patients are doing fine. But these incidents are a sure way to remind parents that helmets are very, very important and should always be worn when bike riding, roller-blading or playing hockey. No exceptions!

For information on how to select the right helmet, clink on the link

Dr. Betancourt practices in the western suburbs of Chicago. She has 3 children and loves to ride her bike with her family. She blogs at: http://www.spediatrics.com/blog/

Portable Pools: Real Responsibility, Real Risk

Written by Wendy Sue Swanson MD

I’ve got 2 boys under the age of 5. While reading a Pediatrics article just now my stomach flipped. It’s because I read:

 Children younger than 5 years, especially boys, are at greatest risk from drowning in swimming pools.

The words startled me as pediatrician but as Mama, too. Three thousand children under the age of 5 were treated in the ER each year between 2006-2008 for injuries associated with submersions.

Private pools were the riskiest pools of all. Over half of the children who drowned and died (129/209) did so at their own home. Wrong, terrible, traumatic.

94% of the fatal and nonfatal downing injuries in portable, above-ground pools in the US between 2001 and 2009 were in children younger than 5 years. If you have, or entertain, or care for, or ever have the responsibility for a child under age 5 near water, think about safety ahead of time. That pool you buy at Target for $11.99 comes with real responsibility. That pool you buy at Target for $11.99 comes with real risk. Don’t believe because of a portable or above-ground pool’s size, cost, or convenience, it’s any safer than the ginormous pool at the YMCA. The article this week would suggest it may be alarmingly deceptive from a danger stand-point. Those plastic blow up pools just look so benign…

Click here to continue reading…

Dr. Swanson practicing pediatrician and the mother of two young boys.  She sees patients at The Everett Clinic in Mill Creek, Washington. She is also  on the medical staff at Seattle Children’s and am a Clinical Instructor in theDepartment of Pediatrics at the University of Washington. Dr. Swanson is passionate about improving the way media discusses pediatric health news and influences parents’ decisions when caring for their children.