May 19, 2023

This Week

  • Top of Mind - Telehealth Services
  • New Guidelines for Breast Cancer Screenings
  • Look How Much We Have Lost as Black Americans
  • The Six Most Common Triggers for Asthma
  • What To Do If Your Child Has Diarrhea

Top of Mind

Telehealth has become immensely popular since the COVID-19 pandemic started. I know a lot of doctors do not like it, but they do not have my practice population. I practice in the urban inner city where just getting to the doctor’s office is just the first barrier. Too often appointments are missed because families not only cannot get to see me but cannot get home. If you get help on the phone, no more waiting in long lines at doctor's offices, or spending hours on public transportation just to get basic medical care.


I do think an in-person visit is valuable every once in a while, especially for acute symptoms. However, many visits with patients are simply just that, visits. Increasingly, I depend more on what I hear instead of what I see. Especially with so many streaming services can give you a peak at the patient. More extensive evaluation often requires a blood test or imaging to complete the diagnostic workup anyway.


I know that I will get some push-back from my colleagues and I understand. But during the pandemic, I was able to navigate that period without missing significant disease. Almost always, what you hear determines more about what moves I make than what you see. But to be sure it robs you of some essential information that makes medicine the specialty that it is.


I think that we need a hybrid model, some Telehealth and some in office visits. But I know that the issue will not be negotiated by third party payers on the basis of logic but on the basis of price.

Stay Healthy,

Dr. Mike

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New Guidelines for Breast Cancer Screening

Do They Make Sense for Black Women?


The American Cancer Society has recently released new guidelines for breast cancer screening. According to the new recommendations, women should start receiving annual mammograms at age 45 instead of 40, and after that they can choose to have them every other year. In addition, the manual examination of breasts by a healthcare provider is no longer recommended as a routine screening tool. The rationale for the change is the implication that screening earlier results in too many false positives. Leading to unnecessary diagnostic and biopsy procedures. These new guidelines go against recommendations from a number of women's professional organizations.


Why Is This Important? It is essential that they begin screening as soon as it makes sense scientifically even if the condition is often over diagnosed.

Look How Much We Have Lost as Black Americans

According to the CDC, over the period of 1999 to 2020 if you look at death rates by a number of parameters, the Black population had 1.63 million excess deaths, representing more than 80 million years of potential life lost over the study period.

This is a stark reminder of the price Black Americans pay for health outcomes that are often nowhere near white Americans. It seems that the situation has been getting worse over the past 2 years. After initial progress, excess mortality and years of potential life lost among the US Black population stagnated and then worsened, over the last 2 years.

When you look at health equity in this fashion, it is staggering to think how many mothers, fathers, brothers and sisters, scientists, teachers, and creative artist has America, specifically Black America, lost prematurely, because of the lack of health equity. The list goes on and we should never forget about it.

The 6 Most Common Triggers for Asthma

According to the American Lung Association the 6 most common triggers for Asthma are:

  • Allergies
  • Obesity
  • Smoking
  • Air pollution
  • Health conditions
  • Family history of Asthma

Why Is This Important? If you have significant problems with Asthma, you can control several of these factors:

  • Allergy: If you know your triggers, avoid them. If you are not sure, insist on seeing an Allergist.
  • Obesity: Children and adults who are overweight or obese are at a greater risk of asthma. Obese patients often use more medications, suffer worse symptoms and are less able to control their Asthma than patients in a healthy weight range. And so, you know what to do.
  • Smoking: Indoors or Out Stop

What To Do If Your Child Has Diarrhea


Start with keeping your child hydrated for 12 to 24 hours with:

  • Water
  • Broth or soup
  • Pediatric electrolyte solutions in liquid or freezer pop form


What to feed children with Diarrhea when Diarrhea slows:

Newer recommendation that children continue to eat a nutritious, well-rounded diet, as there is evidence that the intestine heals when the child is fed.” In the past, doctors suggested the "BRAT” diet (bananas, rice, applesauce, and toast) as a solution to help children with diarrhea. Now, many doctors do not recommend it.

In certain cases, chronic diarrhea, or unusually loose stools, try keeping a food diary. For some people, certain foods can trigger diarrhea. If you sense that a particular food is causing a problem for your child, write it down and discuss it with your doctor.

What not to do:

  • Antibiotics are not used to treat infectious diarrhea in children.
  • Always check with your doctor before giving your child over-the-counter diarrhea medications such as Imodium and Pepto-Bismol.
  • Do not give any type of medication to children under age 3 or your grandmother used without first consulting your doctor.

When to call the Doctor:

  • If your child is less than 8 months of age
  • Has blood in the stool
  • Shows signs of dehydration (low urine output, no tears, no spit in the mouth, excessive sleepiness, or low activity level)
  • Is vomiting
  • Has a high fever that does not improve with fever medication
  • Has abdominal distention (swelling or enlargement)

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About the Editor 

Dr. Michael LeNoir is just your neighborhood doc — a world-renowned allergist, a board-certified pediatrician, recognized expert on asthma in inner cities, and the President and Founder of AAWP. Serving the Bay Area since 1977, Dr. LeNoir has dedicated his career to helping African Americans navigate a healthcare system he saw first-hand that is fundamentally build on racial biases. Read More

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