Calling The Doctor ‘Uncle’
Interviewed by Lisa Asato
Wednesday - October 03, 2007
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Who do you take care of here?
We cover anyone from newborn to 18 years of age, and occasionally up to 21 years of age. We encourage them to transition to an adult physician when they hit 18. So that means we take care of them from the moment they’re born to probably when they go off to college. And there are specialized pediatricians, called neonatologists, who take care of premature infants. So we can take care of babies who you can fit into your hands up to big high school athletes who are twice as big as I am.
What do your patients call you?
They can call me Dr. Mih (pronounced “me”) or Uncle Bryan is fine, too, or just plain Uncle. Pediatricians as a whole are probably a little bit more casual about how they’re addressed. We want their visit to the pediatrician to be something they look forward to or at least be something they don’t fear too much.
Yes, doctor visits can be scary to a small child. How can parents help?
I think it’s comforting to most kids to prepare them before hand. Parents should also try not to scare them. I hear this a lot, they’ll say, “If you’re bad the doctor’s going to give you a shot.” So I think it’s helpful if the parents don’t use that as a threat and instead tell them, “We’re going to the doctor because he’s going to help you feel better.”
You’ve worked and trained at Kapiolani Medical Center for Women & Children for four years, including a year as chief resident. Is there one universal question that parents ask?
One common thing is when their child is ill they ask if their child needs antibiotics. Usually they don’t need antibiotics because antibiotics treat bacteria and most colds are caused by viruses. More recent studies have shown that (antibiotics) may be harmful because you increase the antibiotic resistance. That’s not to say antibiotics are bad, but you shouldn’t treat with an antibiotic when you don’t have a bacterial infection. When you do have a bacterial infection, definitely these are the times you reserve your antibiotics for.
In the Information Age, parents can seek medical information on the Internet, where some sites are better than others as far as reliable information. Which sites do you recommend?
Probably the best place to go is the American Academy of Pediatrics website, www.aap.org. And there’s our local chapter, www.hawaiiaap.org. Each hospital will also have its own web-site, too. Ours is www.kapiolani.org. There are also sites like the Centers for Disease Control, www.cdc.gov, which has a lot of information on immunizations and what you need to prepare for before you travel. A very user-friendly site I’d recommend is www.kidshealth.org, which has different sections for parents, teens and younger kids.
You wanted to discuss “preventive guidelines.” What is that?
As pediatricians we do what is called anticipatory guidance, which means talking to the parents about things that may happen before they occur, so they’re prepared. So between 6 to 9 months we start talking about childproofing their house because they start crawling around and getting into things. A little before 2 years of age you start talking about toilet training. Between 3 or 4 you start thinking about when they might want to start preschool and to make sure they have the shots they need.
We’re heading into the fall right now. What’s your preventive advice for the season?
When kids go back to school they all exchange viruses, so the No. 1 thing to have children do is to wash their hands. That’s really key. But it’s good for the adults to wash their hands and model good behavior as well so the kids know, “Every time I shake hands with someone, every time I go to the bathroom or right before I eat, I should wash my hands.”
The other component is to get your flu vaccine. I’m glad the schools are doing that now so everyone has an opportunity to get one. If you’re not able to get it at school, then definitely check with your pediatrician, and see if you need a flu shot as well.
What do you say to parents who have concerns about vaccines?
There’s a lot of publicity about whether vaccines are necessary, what components go into them and whether they are 100 percent safe. Some people are worried about mercury being in vaccines as a preservative, but it has been eliminated from vaccines for children under 2, and almost all vaccines now are mercury-free. Vaccines are actually quite safe, much safer than driving around in a car.
I can say from my perspective that vaccines have been really great for public health. They prevented a lot of diseases so well that it is rare to see anyone with diseases like polio or measles.
Children’s health issues such as childhood obesity and exposure to second-hand smoke are-also important to you.
There’s a lot of things we could talk about. But those are the ones at the top of the list of things that you can change really easily that definitely improve the health of your kids. I like to think that as a pediatrician we leave the world a better place for kids and the next generation. ... So I also try to take care of the environment, try to encourage clean air, clean water, clean transportation, safety. Those are all important things, so it’s interesting how a lot of what pediatricians can achieve is not exactly medical, but something that the community can do together.
What’s a rewarding aspect of your job for you?
When I was in my rotations as a medical student I really enjoyed when the patients were children. It’s really rewarding because the kids, they play with you, they’ll give you thank you notes with cute pictures on them. Pediatricians get to really prevent disease and guide kids to be healthy. Also pediatricians enjoy working with kids, and they don’t mind listening to some crying because they’re really committed to making sure the kids feel better.
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