'Healthcare Delayed Is Healthcare Denied': A Talk With AAP President Fernando Stein

Hansa Bhargava, MD; Fernando Stein, MD


May 19, 2017

Hansa Bhargava, MD: Hi. I am Dr Hansa Bhargava, a practicing pediatrician, senior medical correspondent for Medscape, and senior medical officer for WebMD. I have the pleasure of having Dr Fernando Stein, president of the American Academy of Pediatrics (AAP), here to discuss some very important issues. Dr Stein, thank you for being here, and welcome.

Fernando Stein, MD: Thank you.

Advocating for Vaccine Safety and Efficacy

Dr Bhargava: The Academy has been steadfast in its unequivocal support for the safety and efficacy of vaccinations. In early February, the Academy served as lead author on a letter from more than 350 organizations that was sent to President Donald Trump, highlighting the robust scientific evidence supporting vaccine safety and effectiveness. In this letter, the groups welcomed the opportunity to meet with the President and members of his administration to share this extensive scientific evidence.

The Academy has also issued its own statement reiterating the safety and importance of vaccines. A director for the Centers for Disease Control and Prevention (CDC) has not yet been nominated by Secretary Price, and the AAP continues to monitor that process, along with other federal-level conversations about vaccines. The AAP's decision to weigh in now sends a strong message about the need for consistent and clear messaging around vaccines. What other efforts are ongoing to reiterate this message?

'Healthcare Delayed Is Healthcare Denied'

Dr Stein: The messaging of the Academy is based on science. We are preoccupied with the lack of appointments to critical offices that have to do with public health policy implementation, and we would like to see individuals who respect science over ideology appointed to those offices.

Dr Bhargava: There is a debate within the healthcare community about whether or not professional medical organizations should be weighing in on such politically charged issues as political appointments by the administration or funding decisions by Congress. Clearly, the AAP believes this is an important role. What would you say to the skeptics, Dr Stein?

Dr Stein: It depends on how you decide to define "politics." But these conversations are not theoretical. There is an aphorism in American lingo that "justice delayed is justice denied." Healthcare delayed is healthcare denied. Putting ideologues in positions that should be ruled by science is going to delay healthcare that decreases morbidity and mortality and, therefore, deny it. It is not a political argument. It is not a theoretical argument. That, for the person that is suffering, is not political or theoretical. It is a real issue that affects their life. It is our business.

Dr Bhargava: Do you think that the gaps in leadership right now in large institutions, such as the CDC and other organizations, under Dr Tom Price could be an issue if there was an epidemic or national health crisis?

Dr Stein: Yes.

Dr Bhargava: What do you suggest pediatricians and other healthcare professionals do to advocate on this issue?

Dr Stein: We have to speak up. We have to get involved. We have to reach out to our patients, because children do not vote. We have to speak up for them.

Dr Bhargava: We are all advocates—whether pediatricians, nurse practitioners, nurses, or other providers. We all have that responsibility to speak up. Would you agree?

Dr Stein: Yes.

Communicating Important Issues to Patients and Families

Dr Bhargava: Social media seems to have a huge impact on decisions that affect industry, such as recently with an airline and the outcry against a commentator in our national media. Do doctors have a role to get important messages in front of larger audiences using social media?

Dr Stein: Absolutely. We have to be where our patients are. I think that the physician has to be on Facebook and on YouTube in a responsible way. We need to offer our patients messaging that is based on science, is verifiable, and can be fact-checked.

Dr Bhargava: A lot of pediatricians have their own websites nowadays and also communicate via Facebook. You had mentioned a way to make this very brief, so that the attention span of parents is met. Can you tell us about that?

Dr Stein: Yes. I do not want to belittle the attention span of parents, because I have a very short attention span myself.

Dr Bhargava: As do I.

Dr Stein: Sometimes, it is just frank limitations of time. They have to cook at the same time they are helping with homework, they have to pick up one in swimming lessons, or whatever. We need to use messaging that is concrete, fact-checked, verifiable, and useful—from picky eating to care of minor injuries, discipline, corporal punishment, and dealing with the sexuality of the preadolescent and the adolescent. We could do a better job at messaging all of this.

Dr Bhargava: That sounds absolutely impactful, and it would be wonderful if we could do that more. Do you have any additional information that you would like to share with us or with clinicians on how we can make a difference in these very relevant issues today?

Dr Stein: There is a plethora of information on

Dr Bhargava: Excellent. Dr Stein, thank you very much for being here today and sharing all of this important information.

Again, as Dr Stein said, get involved. If you believe in these issues or you have concerns about them, make sure you get out there and express them to legislators as well as your patients.

I am Dr Hansa Bhargava from Medscape, and thank you for joining us today.


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