Volume 32 • Number 3 • March 2011
Fighting ‘fever phobia’
for AAP president-elect
Fever, in and of itself, is not known to
endanger a generally healthy child and actually may be beneficial. Still, many caregivers
panic when they see the number on the
thermometer rise past 98.6 degrees and
rush to give their child acetaminophen or ibuprofen.
A new AAP clinical
report addresses the
state of knowledge
about antipyretic usage in children, includ-
ing common concerns, indications, treat-
ment goals, single or combination
therapy, and instructions for
caregivers. It also highlights
the need to educate
patients and families
about fever and “fever
The AAP National Nominating Committee has
selected Mary P. Brown, M.D., FAAP, of Bend, Ore.,
and Thomas K. McInerny, M.D., FAAP, of Rochester,
N. Y., as candidates for AAP president-elect.
Profiles of the candidates and their position statements will be printed in future issues of AAPNews.
Voting begins Sept. 1 and concludes Oct. 1.
‘Tiering’ has allowed some
pediatricians to boost revenue,
but they don’t have to like
by Kristy Kennedy • Correspondent
What’s the Dx? Infant with cough, fever,
wheezing, intercostal retractions
As insurance carriers across the country use
different ways of rating physicians to determine
their payments — a practice sometimes called
“tiering” — pediatricians are paying close attention.
They have to or face the likelihood of losing
“This directly impacts the bottom line,” says
Michael J. Ramsey, M.D., FAAP, who practices
in Alabama. “You can’t be passive about it.”
by H. Cody Meissner, M.D., FAAP
Editor’s note: This monthly column serves to
challenge pediatricians’ visual diagnosis skills on
infectious diseases and provide supporting information on symptoms and treatment.
A 5-week-old male born at term is brought to
your office with a worsening cough that began
five days ago. The infant’s mother has had a severe
cough for three weeks.
Over the past 36 hours, the infant has experienced four episodes of coughing associated
with gagging, gasping and cyanosis. On physical
See ID Snapshot, page 11
A chest radiograph of a 5-week-old male with a cough
that has worsened over the past five days.
Dr. Ramsey says his practice has increased revenue by 2% by meeting criteria required by one
of the main insurance carriers in Alabama. Called
a “value-based reimbursement program,” the
See Tiering, page 12
In this issue
Scientific views on treating
learning disorders, dyslexia
Evidence is still lacking for use of vision training tech-
niques to help children with dyslexia and learning dis-
abilities, according to a new technical report. Page 18
Shedding light on sun’s UVR damage
A new policy and technical report outline dangers of ultraviolet radiation exposure to children and calls on pediatricians to spread the message about tanning beds and skin
cancer. Page 32