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151103HealthcareReform1Health care reform has pushed primary care offices like Eugene Pediatrics to rapidly adapt to a multitude of new requirements aimed at improving patients’ health.

Under the new law, a portion of Medicare and Medicaid payments are withheld across the state of Oregon each year. That money is then awarded to individual Coordinated Care Organizations and clinics within those regions, based on “quality metrics” performance, which is determined by the Oregon Health Authority. The same process is happening in every other state in the U.S.  

Eugene Pediatrics has remained a top performing pediatric clinic in our region. What’s our secret? We spent a great deal of time, money and effort to hire new staff, update our computer systems and develop work flows to support the new requirements.  

But the process of improving health care, according to these quality measures, is hitting an interesting roadblock. Under the new law, doctors and hospitals are now judged on their ability to get patients to comply with the medical advice they are given. If they don’t, the payments clinics receive for their services are docked.

Let me give you an example: We know from well-designed research studies that if a parent is hesitant about vaccinating their child, a physician’s advice often fails to change that. So, it is no surprise that nearly one third of the families who come to Eugene Pediatrics do not follow our advice on immunizing their kids. Because of that, our “quality” profile and associated payments will suffer.

If doctors cannot meet the requirements, they are deemed a lower quality clinic and receive fewer reimbursements from insurance. Ultimately, that means they struggle financially to keep their doors open. Or, in an attempt to minimize their losses, some physicians could ask non-compliant patients to leave the practice. In both scenarios, patients may soon find fewer places that will offer them care. If clinics close or patients are “fired,” nobody wins—and a system meant to improve health care will have failed.  

I will be the first to say that I do not have all the answers, but I will ask the tough questions: How can we grapple with the ethical dilemmas created by health care reform? What happens when the rights of an individual to choose how to manage his or her health runs contrary to the health of the larger community? How can we support all patients without being penalized for trying to help those who might not always want to do (or have the capacity to do) what’s best for their health?  

This is an interesting time to be a doctor, certainly unlike any era of health care I have seen in my decades as a pediatrician. But there’s one thing I can guarantee—your physicians at Eugene Pediatrics are working hard, within the framework of health care reform, to demonstrate our quality to the State Health Authority, to private insurers, and most of all to you, our patients and families.

We are dedicated to helping every child be well. We want to partner with families and provide individualized care in a way that puts kids on a path to good health. Without you, we have no purpose.
140916EPA asthma-smDoes your school-aged child have asthma?  If so, now is the time to take steps to be sure the asthma is controlled as the school year gets rolling.

Your pediatricians at Eugene Pediatric Associates urge you to:

  1. Take an updated, written Asthma Action Plan to school and review it with your child’s teacher and front office staff so they know how to handle the asthma. See us if you need an updated written plan.
  2. Take a fresh Ventolin (rescue) inhaler to school for your child.
  3. Be sure your child gets a flu shot this September or October. Influenza illness is especially dangerous for kids with asthma.
  4. Talk to your children and review the symptoms they feel when an asthma attack is starting, and be sure they are comfortable asking their teachers for help when they don’t feel good. 
  5. Watch our instructional video on www.eugenepeds.com about proper technique using asthma wet inhalers.  

Asthma is a chronic and potentially serious health condition. But with proper management, it will not stop your child from living a long, healthy and active life.

140303EPA vaccinationblogA front page article Friday in The Register-Guard highlighted a new law that went into effect March 1 requiring all children who attend school either be vaccinated or have a parent produce evidence that they have been educated about vaccines and still chose not to vaccinate.

Proof of exemption can include a form signed by your child’s physician and a certificate obtained by watching an online education module produced by the State of Oregon about vaccines.

Here is some information I want to share on the new vaccine exemption process:

  • Your pediatricians at Eugene Pediatric Associates believe strongly that vaccinating kids saves lives. We have all seen firsthand the impact of vaccine-preventable diseases on kids. Dr. B vaccinated her own precious children based on many years of experience and confidence in the safety and efficacy of childhood shots.
  • We welcome your questions about shots during your visits at Eugene Pediatrics. You can also read information on vaccines on our website under both the Vaccines and the Resources sections.

Posted by on in News

It’s that time again, folks. Time to get your child vaccinated against the flu? Why? With all that sniffling, sneezing and sharing of space and materials in the classroom, your child is even more prone to infection. And who wants to be sick during the holidays?

Influenza season is unpredictable. It can begin as early as October and can continue through May. The U.S. Centers for Disease Control and Prevention (CDC) recommends that all people 6 months and older be vaccinated against the flu.

That means you, too, parents. Especially those considered “high risk,” including those with asthma, diabetes or chronic lung disease; pregnant women; people 65 years and older; and those who live with or care for others who are high risk of developing serious complications.

We say, “Why risk it?” when the (CDC) estimates that 35 to 50 million Americans, or approximately 25 percent of the population, come down with the flu each year.

Why vaccinate every year?


Whooping cough, also called "pertussis," is hitting the Pacific Northwest. Parents need to take immediate steps to protect their families from this potentially fatal illness. Thus far, 1,100 people in Washington have become sickened, with many children being sent to the hospital. Cases are beginning to emerge in Lane County, and everyone is at risk, especially very young children.

Pertussis is a contagious bacterial illness spread by respiratory droplets in the air. The symptoms start with congestion and cough, which worsen over 1-2 weeks. The cough increases to spasms of severe coughing with sharp inspiratory breaths that sound like a "whoop." This intense phase can last several weeks, followed by a months-long recovery period.

Unfortunately, young infants under 6 months may develop much more severe symptoms, including poor feeding, lethargy and episodes of not breathing (apnea) with blue or purple skin color. These young children are at risk of dying from whooping cough. A similar epidemic in California took the lives of 10 babies in 2010.

Please take the following steps to protect your family as soon as possible:

  • • Immunize your young infants. We encourage you to come to Eugene Pediatrics for your child's first set of vaccines at 6 weeks old (instead of waiting until the 2 month well baby checkup). Call us today to make an appointment.
  • • Immunize older children. Kids 11 years old should receive a tdaP booster shot to protect them. If your child has not been vaccinated or has not received a booster, please call us today to arrange the vaccine.
  • • Immunize yourself and other adult caregivers to protect your children. Anyone age 19 years and older needs a single tdaP shot, which can be administered by your primary care physician or Lane County Public Health Department.
  • • If your child is sick with worsening respiratory illness, please come and see us. Do not send your coughing child to school, camp or daycare.
  • • If you have an infant that is lethargic, feeding poorly or having blue spells, call 9-1-1 for IMMEDIATE medical help.
  • • Don't fool yourself. Staying inside, away from crowds and hand washing will not adequately protect your child from pertussis. The risks associated with the disease vastly outweigh the risk associated with whooping cough vaccination. Talk to us today about any worries you have about giving your child shots to stop the spread of pertussis.

Learn more from Dr. Bradshaw in this interview with KMTR NewsSource 16, as she shares information about the whooping cough epidemic and how to keep your children safe.