Tuesday, July 24, 2012

Common Sense Family Doctor turns 3: no more baby (or toddler) steps

"What is a year, after all?" I rhetorically asked an audience of Washington DC-area breast cancer care coordinators yesterday during a talk about the limitations of screening mammography. "It's 365 days. There is nothing magic about a yearly screening interval." So, too, is there nothing magic about a blog enduring for a year, or in the case of Common Sense Family Doctor, three years. But it is a convenient milestone worth celebrating in this, my three hundred and seventeenth post. To date, this blog has been viewed more than 172,000 times. My most popular post, an indictment of the deceptive advertising practices of Life Line Screening, has been viewed nearly seven thousand times.

As a father of three children younger than age 7, I can't help but view the passage of time in child years. A few months after my older son was born, I started working at the Agency for Healthcare Research and Quality. I remember rehearsing my first presentation for the U.S. Preventive Services Task Force (a summary of the evidence on screening for COPD using spirometry) in front of my rapt ten-month old, whom I like to think understood the importance of the occasion. Two months after the birth of my daughter, the USPSTF recommended against screening for prostate cancer in men age 75 and older, which appears to have had a significant effect on clinical practice. (The effect of their new recommendation against PSA screening in all men remains to be seen.) By the time my younger son was born this year, I had long since left AHRQ and was preparing to re-enter the world of academia, where I now direct Georgetown University School of Medicine's Fellowship in Primary Care Health Policy.

By the child year standard, then, Common Sense Family Doctor has passed through infancy and toddlerhood, and is now entering what some child-rearing experts call "the wonder years," that amazing period when children achieve a measure of self-sufficiency but remain comfortingly dependent on mom and dad for most of their daily needs. The blog's growth and visibility has been been helped immensely by regular syndication in KevinMD, The Doctor Weighs In, Prepared Patient Forum, and coming soon, Physician's Weekly. It has also given me the opportunity to write for different audiences in Family Health Guide, U.S. News and World Report, and the AFP Community Blog. Many thanks to all of my readers and fellow health bloggers who have provided validation and encouragement along the way.

What can readers of Common Sense Family Doctor expect in the future? More reflections on the proper role of primary care and prevention, now that the Affordable Care Act appears to be here to stay (and prominent Republicans Bill Frist and Mike Leavitt are publicly supporting state-based health insurance exchanges, which I discussed in a previous series of posts). I also intend to write about innovative ways to improve population health outside of health care - a tricky topic, to be sure, and fraught with ethical/political questions about the appropriate role of governments in improving the heath of their citizens (such as putting restrictions on the size of soda containers). No, I don't believe that any government should have the power to force you to buy a gym membership or eat broccoli, and I've always been a skeptic about the value of dietary guidelines. But I consistently favor happy mediums over hardened ideological positions, and hope that this blog will become wiser as it ages. Of course, you will ultimately be the judge of that.