Physician perspectives: Dr Nina Shapiro

November's physician perspectives interview is with pediatric physician, Dr Nina Shapiro, about the relationship between doctors and patients, as well as the rise in social media.

In this month's physician perspectives, pharmaphorum's Hannah Blake speaks with the Mattel Children's Hospital UCLA's Dr Nina Shapiro. Dr Shapiro is a leading pediatric ear, nose and throat specialist and shares her thoughts on the importance of keeping up-to-date with evolving medical advice. This issue inspired her to start a blog at http://www.drninashapiro.com/, as this is an outlet for enhanced communication in order to bridge the gap between physicians and patients.

Interview summary

HB: Hello Nina, thank you for taking part in this interview. Can you please tell us a bit about your journey to becoming a pediatric doctor and a bit about what your current role entails?

NS: I've had a passion for becoming a doctor since childhood. My dad is a physician, as is my brother, so I was surrounded by medicine early on. My mom is an artist, so kept some creativity going in the family. In medical school at Harvard, I was drawn to surgical fields, but also loved working with children and families. The specialty of Otolaryngology-Head and Neck surgery enabled me to care for young and old, 'sick' and 'healthy'. However, early in my residency training, I loved nothing more than working with children. I pursued sub-specialty training in Pediatric Otolaryngology, both at the Great Ormond Hospital for Sick Children in London, as well as the Rady Children's Hospital in San Diego, California.

For the last 16 years, I have been a faculty member at the UCLA School of Medicine, as Director of Pediatric Otolaryngology. My current role is that of clinician, teacher, mentor, and researcher. My clinical practice includes the range of pediatric otolaryngologic disorders, including airway problems, sinus disease, sleep apnea, ear disease, and head and neck tumors. I work with medical students and residents on a daily basis. My research areas include early identification of post-transplantation lymphoproliferative disorders in the pediatric solid organ transplant population, improving techniques in adenotonsillar surgery, and population-based studies on pediatric head and neck disorders.

"Throughout academic training, and in academia as a profession, we develop a 'language' by which we communicate with others in our field."

HB: What inspired you to start your blog?

NS: Throughout academic training, and in academia as a profession, we develop a 'language' by which we communicate with others in our field. This is critical, yet can exclude the majority of our patient population. As a clinician, I have always found it very satisfying to communicate with patients and families in a way that is understandable, personable, and approachable. I felt that there were many gaps in communication between physicians and patients, and I enjoy trying to close those gaps. My blog is a means for me to accomplish a few goals: I can provide useful, usable information in accessible way, whereby many of my blogs are primarily 'informational'. I can also express my own opinions on hot-button issues such as vaccine controversies, choking risks, and even just parenting styles. My blog is a lighter form of communication than an academic, peer-reviewed article, yet it can oftentimes reach a broader audience, providing impact on a different level than a trade journal.

HB: You also recently wrote a book called "Take a Deep Breath: Clear the Air for the Health of Your Child", which was published in 2012 and sheds new light on the latest research in pediatric breathing issues, sleep issues, and airway safety. How important is it to stay up-to-date with this latest research (as a doctor and a parent) and how do you go about this?

NS: As I say in the introduction to my book, 'I've been writing this book in my head for years'. It is so important to maintain a dialogue with our patients. I found that in my practice I was answering such important questions on a daily basis. While the patients and I felt satisfied with our discussions, I felt that there was a dearth of basic, yet critical, information on breathing issues in kids. If you think about it, there is really nothing more important than a child's breathing, and we take it for granted until there is a problem. "Take a Deep Breath" empowers parents and caregivers to gain a better understanding of such a significant part of their baby and child's health and wellbeing.

"It is so important to maintain a dialogue with our patients."

Research in breathing disorders, sleep issues, and airway safety continues to evolve, so it is absolutely necessary to stay on top of this. For instance, crib safety continues to change, and it did so between the births of both of my children. As studies continue, we find new subtleties in what was once considered to be safe and 'state-of-the-art' to actually be more dangerous than we had once thought. Sleep safety is somewhat controversial. While it is well-documented and agreed upon that infants should sleep on their backs to minimize the risk of Sudden Infant Death Syndrome (SIDS), it is less clear whether or not co-sleeping is considered to be safe or dangerous.

HB: Bunny Ellerin describes you as one of the "Six Smart Doctors to Follow on Social Media" – how has social media affected your way of working as a physician?

NS: I was so honored to have Bunny Ellerin include me in her list of "Six Smart Doctors to Follow on Social Media", and Bunny's work in the healthcare / social media interface exemplifies the importance of the physician's role in social media. Not only has social media enabled me to connect with smart people, such as Bunny Ellerin, in the healthcare arena, but it has also enabled me to connect with forward-thinking physicians. It has opened my eyes to more varied opinions, thoughts on medicine today and in the future, and has given me exposure to leaders outside of my specialty. As a physician, I have also been able to better understand what is important to patients and families, what is important to physicians from many different angles, and what action can be taken for change in healthcare.

HB: Do you think social media sometimes hinders physicians, because of how easy it is for patients / parents to "Google" their health worries? How can this issue be overcome?

NS: Social media can be a wonderful resource for both physicians and patients, yet it can also be dangerous. There are very few 'guidelines' as to how and where misinformation can be posted. Seeming 'authorities', oftentimes earn such 'authority' based on Hollywood stardom more than academic education, research, and clinical knowledge. This can lead patients down slippery slopes.

As physicians, we must try to defend peer-reviewed medical data in a way that does not sound confrontational. Overcoming this obstacle is a process. Media in all forms allows for all to speak their views, and this is a good thing. But science and opinion are two different things. I think when we can all agree on this, the barriers will be easier to overcome.

HB: How can the relationship between pharma and physicians be improved?

NS: Physicians and pharma are on the same page. We both want what's best for our patients, we want to stay at the cutting edge of medical and surgical advances, and we want to do this judiciously. Both groups hold ourselves to the highest level of ethical conduct. When these premises are upheld, the relationship between physicians and pharma continues to expand.

HB: Where do you see social media and the healthcare industry heading in the future?

NS: I see continued expansion in the link between social media and healthcare. As more physicians become comfortable using social media in their professional lives, there will be continued growth in forums for physicians to communicate new information, present challenging cases to one another, and to connect with patients on a professional level.

At UCLA, we are routinely providing webinars for patients in all areas, ranging from basic medical issues to the highest level breakthroughs in surgical techniques. These webinars are posted on several venues, including the UCLA Health System homepage, Facebook, YouTube, and a Twitter feed on @UCLAHealth and @MCHUCLA (#UCLAMDChat). Many other large academic institutions are providing similar programs for their patients.

HB: Thank you for taking the time to answer my questions.

NS: It was a pleasure! See you online.

About the interviewee:

Dr Nina Shapiro is the Director of Pediatric Otolaryngology (Ear, Nose, and Throat) at the Mattel Children's Hospital UCLA, and Professor of Head and Neck Surgery at the David Geffen School of Medicine at UCLA. She has treated tens of thousands of children with breathing problems, ear problems, and neck tumors.

A graduate of Harvard Medical School, she completed her Otolaryngology training at the Harvard Otolaryngology Program, and received subspecialty training in Pediatric Otolaryngology at the Great Ormond Street Hospital for Children in London, and the Children's Hospital, San Diego.

She is the author of the popular parenting book "Take a Deep Breath: Clear the Air for the Health of Your Child", (World Scientific, 2011) said by NBC's Chief Medical Correspondent, Dr. Nancy Snyderman, to be a 'must have for every parent and grandparent'. She is also the editor of the Pediatric Otolaryngology textbook, "Handbook of Pediatric Otolaryngology" (World Scientific, 2011). She has published over 75 peer-reviewed journal articles, written 14 book chapters, and has presented over 100 academic presentations, both nationally and internationally.

Dr Shapiro is a sought after expert in the media, including print, web, radio, and TV, and is a regular guest on "The Doctors" TV show. Dr Shapiro has partnered with the "got milk?" Dreams Campaign 2013 to be an advocate of improving nighttime habits to improve sleep quality in both kids and adults.

You can find Dr Shapiro tweeting at @drninashapiro or online at www.drninashapiro.com.

Who would you describe as a "smart doctor to follow on social media"?