Turn a Kind Eye-Offering Positive Reframing.

This essay describes the importance of physicians using positive reframing with patients.

Mission Impossible? Managing the American Academy of Pediatrics' Obesity Guideline.

A primary care pediatrician casts a skeptical eye at the American Academy of Pediatrics Obesity Guideline. Using back-of-the-envelope calculations, she explains that meeting the guidelines would swamp her office, hospital, and the country's clinicians in a manner that is unrealistic. Warning against the alienation that boots-on-the-ground clinicians experience when guidelines are too theoretical to be practical, she suggests alternative avenues for addressing this public health issue.

Spielberg's Secret.

This essay describes how a podcast inspired a physician's new approach to complimenting patients and colleagues and the benefits gained.

Waiting for a Heart Valve-You Can't Go Back.

This essay describes a family of physicians waiting for a heart valve for their vivacious 95-year-old aunt.

The Last Note.

In this narrative medicine essay, a pediatrician shares her reflections on final pediatric visits, channeled through her grandmother's rules of etiquette.

Assessment of Screening Tools to Identify Substance Use Disorders Among Adolescents.

Importance: Efficient screening tools that effectively identify substance use disorders (SUDs) among youths are needed. Objective: To evaluate the psychometric properties of 3 brief substance use screening tools (Screening to Brief Intervention [S2BI]; Brief Screener for Tobacco, Alcohol, and Drugs [BSTAD]; and Tobacco, Alcohol, Prescription Medication, and Other Substances [TAPS]) with adolescents aged 12 to 17 years. Design, Setting, and Participants: This cross-sectional validation study was conducted from July 1, 2020, to February 28, 2022. Participants aged 12 to 17 years were recruited virtually and in person from 3 health care settings in Massachusetts: (1) an outpatient adolescent SUD treatment program at a pediatric hospital, (2) an adolescent medicine program at a community pediatric practice affiliated with an academic institution, and (3) 1 of 28 participating pediatric primary care practices. Participants were randomly assigned to complete 1 of the 3 electronic screening tools via self-administration, followed by a brief electronic assessment battery and a research assistant-administered diagnostic interview as the criterion standard measure for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnoses of SUDs. Data were analyzed from May 31 to September 13, 2022. Main Outcomes and Measures: The main outcome was a DSM-5 diagnosis of tobacco/nicotine, alcohol, or cannabis use disorder as determined by the criterion standard World Mental Health Composite International Diagnostic Interview Substance Abuse Module. Classification accuracy of the 3 substance use screening tools was assessed by examining the agreement between the criterion, using sensitivity and specificity, based on cut points for each tool for use disorder, chosen a priori from previous studies. Results: This study included 798 adolescents, with a mean (SD) age of 14.6 (1.6) years. The majority of participants identified as female (415 [52.0%]) and were White (524 [65.7%]). High agreement between screening results and the criterion standard measure was observed, with area under the curve values ranging from 0.89 to 1 for nicotine, alcohol, and cannabis use disorders for each of the 3 screening tools. Conclusions and Relevance: These findings suggest that screening tools that use questions on past-year frequency of use are effective for identifying adolescents with SUDs. Future work could examine whether these tools have differing properties when used with different groups of adolescents in different settings.

Hello, My Name is Doctor.

This essay describes a physician's opinion of why using only a first name can be confusing rather than aiding in resolving inequalities between physicians and other hospital staff or patients.