JAMA Reports on Online Physician Ratings

In the February 2014 issue of the Journal of the American Medical Association, the results of a multiple year study were revealed.  The study sought information on what is important to prospective patients when searching for a new doctor. Among the obvious answers were things such as whether or not the doctor would accept the patient’s healthcare coverage as well as the convenience of the location, but there was also a new trend: the way doctors are perceived online has an impact. Nearly 60% of those surveyed stated that a physician’s ratings online were either somewhat important (40%) or very important (19%).

That means that to almost 20% of the population, online reviews are critical in deciding whether or not you should be someone’s physician. Of those patients who sought out a doctor based on online reviews, 35% picked their doctor based on positive reviews, at the same time, 37% of people reported that they avoided doctors with bad reviews. When doctors take no action to protect and strengthen their name online, they are neglecting a crucial and growing avenue for new patients to find them.


What is the Difference Between Ptosis and Dermatochalasis of the Upper Eyelid?

What is the Difference Between Ptosis and Dermatochalasis of the Upper Eyelid?

By Dr. Jay Older, MD

Ptosis (short for blepharoptosis) describes a droopy upper eyelid caused by muscle weakness or paralysis. Dermatochalasis refers to excess upper  eyelid skin that, if extensive enough, could cause a droopy upper lid. Ptosis  repair is accomplished by strengthening or, in rare cases, replacing the muscle function that opens the eye.  An upper eyelid blepharoplasty is a surgical procedure for removing excess upper eyelid  skin and sometimes fat. (Removal of excess skin and/or  fat from the lower eyelid is also called a blepharoplasty.)  If the upper eyelid is droopy enough to cause some superior vision loss, the ptosis repair or blepharoplasty might be considered medically necessary and be covered by insurance. A visual field test done in the doctor's office is often performed to measure the amount of superior field loss.  If either condition does not cause sufficient superior field loss, the procedure would be considered cosmetic.   Upper lid blepharoplasty and ptosis repair can be done together through a single incision. The surgery is often done as an outpatient procedure.

At-home exercises that burn calories

By Brooke Strickland


Gym memberships can be expensive and many times they go unused because after a long day, sometimes people just want to be home, not at a gym full of perspiring people.  And, on the weekends, going to the gym requires time dedication that some people just aren’t willing to give up. 

So, what are some ways that you can exercise at home (or close to home) without big, bulky equipment?

Walking:  This one is pretty obvious, but it’s a great way to burn calories and shed some extra pounds. If the weather is nice, it’s great to get outside and take a walk.  If it isn’t a nice day outside, that’s ok, you can still get a lot of walking in while you’re inside the house.  Buy a pedometer and set a goal for yourself.  Do all of your chores and household duties around the house with the pedometer and see how many steps you can take in a day.  If you have a flight of stairs, go up and down the stairs a few extra times so you can get more aerobic exercise in.

Pushups and jumping jacks:  Jumping jacks might give you flashbacks of gym class in junior high, but they’re a good cardio workout.  Do 10 or 15 in the morning and 10 or 15 at night on a regular basis.  Pushups are hard, so you might need to start slowly on these, but these are great for building muscle and burning calories.  Start on your knees if you have to or you can also do some standing against a wall and pushing back.

Sit-ups: If you’re out of shape, these might be difficult, but as long as you are flexing your core and you feel the muscles working in your abdominal region, you’re burning calories and building stronger muscles. So even if you just start out at five sit ups a day, that’s ok! Just slowly work your way up to more and you’ll be on the road to a flatter stomach.

Jog, jog, jog:  Want to catch up on your latest shows?  Grab some supportive shoes, turn on the TV, and run in place while you’re watching TV.  Or, if TV isn’t your thing, turn on some upbeat music and start jogging in place.

The goal: keeping active.  You don’t have to pay huge money in membership fees to gyms that you might not use consistently.  Instead, focus on getting active in your own home – you’ll be more comfortable and you’ll be more likely to stay focused. 

What is an outer ear infection?

By Brooke Strickland

An outer ear infection is often called swimmer’s ear.  It is an infection of the outer ear canal; this is the canal that runs from the eardrum to the external part of your ear and head.  These types of infections can happen in children and adults. 

What causes outer ear infections?

Moisture: This type of infection is often called swimmer’s ear because it is often caused by moisture that is built up after submerging your head in water like you do when you swim.  This buildup of water can create a damp area inside the canal.  This is a perfect place for growing bacteria.  

Irritation or abrasions: If you sleep with ear plugs all the time, wear hearing aids, put your fingers in your ears often, or use cotton swabs (q-tips) in your ears, there is an increased risk of developing an outer ear infection.   This is because the lining of your canal is very sensitive and if any type of scratch or damage occurs, bacteria can enter quickly and turn into an infection.

What are the symptoms?

There are several signs that you might have an outer ear infection.  Your ear will likely hurt when you touch it, especially if you tug on it.  You may also feel itching inside the canal or your hearing may be stifled.  You might also feel like your ear is “full” and there may be clear fluid or pus leaking from the ear.  Fever may be present, but not always. 

What is the treatment?

The first step is to clean any discharge from the ear to open the canal.  Then, eardrops are usually prescribed.  With some infections, more treatment may be needed including antifungal drugs, steroids to alleviate inflammation, oral antibiotics, or acidic medications to restore proper antibacterial equality to the ear. 

To avoid developing an outer ear infection, use a hair dryer to help dry your ears out after getting them wet.  In addition, try not to use foreign objects to clean your ear canal.  To avoid any damage, try putting a few drops of mineral oil into the canal to help loosen earwax buildup.  If you use ear plugs, sanitize them with alcohol after using them so bacteria won’t form. 

It’s very important to take quick action and contact your doctor if you have the symptoms of an outer ear infection. If left untreated for a significant amount of time, the infection can spread to surrounding tissues.  This can lead to a serious and sometimes life-threatening infection.  

Feeding your baby solid food too early can cause future problems

By Brooke Strickland

A recent study published in Pediatrics found that infants are beginning a solid-food diet too soon.  In prior years, the American Academy of Pediatrics suggested that babies could start eating cereal or baby food between four and six months old.  In 2012, the recommendations were changed.  It’s now suggested that babies don’t start solids until they are at least six months old.  The study interviewed 1,334 moms that filled out questionnaires about their child’s eating habits.  The results showed that 40% of mothers were giving their babies solid food too early, with nearly one in 10 giving solids before they were four weeks old.  They also found that babies that were on a formula-only diet were twice as likely to be introduced to solids earlier than babies that were fed breast milk only.  Feeding an infant solid food too early can increase their risk for obesity and diabetes, and can also lead to allergies and eczema. The top reasons why mothers fed their kids solid food too early was because they thought their baby was old enough (90%) or because their baby seemed hungry a lot (71%).  Others (55%) said that their doctor or nurse said it was ok. (1)

The findings clearly demonstrated that there were mixed messages on when the right time was to start solid foods.  Nevertheless, the best thing to do for an infant is to breastfeed exclusively for six months. Then, start incorporating solid foods slowly.  If breastfeeding isn’t possible, formula is the next best option and should continue for six months before introducing solids.  There are also some general questions you can ask to see if your baby is ready for solids.  These include:

-Can he/she sit up and hold head up without assistance?

-Has your baby doubled his/her birth weight?

-Can your baby take food off the spoon and swallow it?

-Does your baby seem interested in food, such as following it with his/her eyes or opening the mouth when he/she sees food coming towards the mouth?

These signs will help you determine if it’s the right time to start introducing solid foods.  Listen to the cues your baby is giving you, but also be mindful of what your doctor and the American Academy of Pediatrics suggest.  This is a winning formula for a healthy, happy baby.


Falco, Miriam. “Too-Early Solid Food Could Lead to Problems For Babies.” The Chart.  March 25, 2013. http://thechart.blogs.cnn.com/2013/03/25/too-early-solid-food-could-lead-to-problems-for-babies/ Accessed April 23, 2013.