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What is a Non-Banking Financial Company (NBFC)?A Non-Banking Financial Company (NBFC) is a company registered under the Companies Act, 1956 engaged in the business of loans and advances, acquisition of shares/stocks/bonds/debentures/securities issued by Government or local authority or other marketable securities of a like nature, leasing, hire-purchase, insurance business, chit business but does not include any institution whose principal business is that of agriculture activity, industrial activity, purchase or sale of any goods (other than securities) or providing any services and sale/purchase/construction of immovable property. A non-banking institution which is a company and has principal business of receiving deposits under any scheme or arrangement in one lump sum or in installments by way of contributions or in any other manner, is also a non-banking financial company (Residuary non-banking company).2. What does conducting financial activity as “principal business” mean?Financial activity as principal business is when a company’s financial assets constitute more than 50 per cent of the total assets and income from financial assets constitute more than 50 per cent of the gross income. A company which fulfils both these criteria will be registered as NBFC by RBI. The term 'principal business' is not defined by the Reserve Bank of India Act. The Reserve Bank has defined it so as to ensure that only companies predominantly engaged in financial activity get registered with it and are regulated and supervised by it. Hence if there are companies engaged in agricultural operations, industrial activity, purchase and sale of goods, providing services or purchase, sale or construction of immovable property as their principal business and are doing some financial business in a small way, they will not be regulated by the Reserve Bank. Interestingly, this test is popularly known as 50-50 test and is applied to determine whether or not a company is into financial business.3. NBFCs are doing functions similar to banks. What is difference between banks & NBFCs?NBFCs lend and make investments and hence their activities are akin to that of banks; however there are a few differences as given below:i. NBFC cannot accept demand deposits;ii. NBFCs do not form part of the payment and settlement system and cannot issue cheques drawn on itself;iii. deposit insurance facility of Deposit Insurance and Credit Guarantee Corporation is not available to depositors of NBFCs, unlike in case of banks.4. Is it necessary that every NBFC should be registered with RBI?In terms of Section 45-IA of the RBI Act, 1934, no Non-banking Financial company can commence or carry on business of a non-banking financial institution without a) obtaining a certificate of registration from the Bank and without having a Net Owned Funds of ₹ 25 lakhs (₹ Two crore since April 1999). However, in terms of the powers given to the Bank, to obviate dual regulation, certain categories of NBFCs which are regulated by other regulators are exempted from the requirement of registration with RBI viz. Venture Capital Fund/Merchant Banking companies/Stock broking companies registered with SEBI, Insurance Company holding a valid Certificate of Registration issued by IRDA, Nidhi companies as notified under Section 620A of the Companies Act, 1956, Chit companies as defined in clause (b) of Section 2 of the Chit Funds Act, 1982,Housing Finance Companies regulated by National Housing Bank, Stock Exchange or a Mutual Benefit company.5. What are the requirements for registration with RBI?A company incorporated under the Companies Act, 1956 and desirous of commencing business of non-banking financial institution as defined under Section 45 I(a) of the RBI Act, 1934 should comply with the following:i. it should be a company registered under Section 3 of the companies Act, 1956ii. It should have a minimum net owned fund of ₹ 200 lakh. (The minimum net owned fund (NOF) required for specialized NBFCs like NBFC-MFIs, NBFC-Factors, CICs is indicated separately in the FAQs on specialized NBFCs)6. What is the procedure for application to the Reserve Bank for Registration?The applicant company is required to apply online and submit a physical copy of the application along with the necessary documents to the Regional Office of the Reserve Bank of India. The application can be submitted online by accessing RBI’s secured website https://cosmos.rbi.org.in . At this stage, the applicant company will not need to log on to the COSMOS application and hence user ids are not required. The company can click on “CLICK” for Company Registration on the login page of the COSMOS Application. A window showing the Excel application form available for download would be displayed. The company can then download suitable application form (i.e. NBFC or SC/RC) from the above website, key in the data and upload the application form. The company may note to indicate the correct name of the Regional Office in the field “C-8” of the “Annex-I dentification Particulars” in the Excel application form. The company would then get a Company Application Reference Number for the CoR application filed on-line. Thereafter, the company has to submit the hard copy of the application form (indicating the online Company Application Reference Number, along with the supporting documents, to the concerned Regional Office. The company can then check the status of the application from the above mentioned secure address, by keying in the acknowledgement number.7. What are the essential documents required to be submitted along with the application form to the Regional Office of the Reserve Bank?The application form and an indicative checklist of the documents required to be submitted along with the application is available at www.rbi.org.in → Site Map → NBFC List → Forms/ Returns.8. What are systemically important NBFCs?NBFCs whose asset size is of ₹ 500 cr or more as per last audited balance sheet are considered as systemically important NBFCs. The rationale for such classification is that the activities of such NBFCs will have a bearing on the financial stability of the overall economy.B. Entities Regulated by RBI and applicable regulations9. Does the Reserve Bank regulate all financial companies?No. Housing Finance Companies, Merchant Banking Companies, Stock Exchanges, Companies engaged in the business of stock-broking/sub-broking, Venture Capital Fund Companies, Nidhi Companies, Insurance companies and Chit Fund Companies are NBFCs but they have been exempted from the requirement of registration under Section 45-IA of the RBI Act, 1934 subject to certain conditions.Housing Finance Companies are regulated by National Housing Bank, Merchant Banker/Venture Capital Fund Company/stock-exchanges/stock brokers/sub-brokers are regulated by Securities and Exchange Board of India, and Insurance companies are regulated by Insurance Regulatory and Development Authority. Similarly, Chit Fund Companies are regulated by the respective State Governments and Nidhi Companies are regulated by Ministry of Corporate Affairs, Government of India. Companies that do financial business but are regulated by other regulators are given specific exemption by the Reserve Bank from its regulatory requirements for avoiding duality of regulation.It may also be mentioned that Mortgage Guarantee Companies have been notified as Non-Banking Financial Companies under Section 45 I(f)(iii) of the RBI Act, 1934. Core Investment Companies with asset size of less than ₹ 100 crore, and those with asset size of ₹ 100 crore and above but not accessing public funds are exempted from registration with the RBI.10. What are the different types/categories of NBFCs registered with RBI?NBFCs are categorized a) in terms of the type of liabilities into Deposit and Non-Deposit accepting NBFCs, b) non deposit taking NBFCs by their size into systemically important and other non-deposit holding companies (NBFC-NDSI and NBFC-ND) and c) by the kind of activity they conduct. Within this broad categorization the different types of NBFCs are as follows:I. Asset Finance Company (AFC) : An AFC is a company which is a financial institution carrying on as its principal business the financing of physical assets supporting productive/economic activity, such as automobiles, tractors, lathe machines, generator sets, earth moving and material handling equipments, moving on own power and general purpose industrial machines. Principal business for this purpose is defined as aggregate of financing real/physical assets supporting economic activity and income arising therefrom is not less than 60% of its total assets and total income respectively.II. Investment Company (IC) : IC means any company which is a financial institution carrying on as its principal business the acquisition of securities,III. Loan Company (LC): LC means any company which is a financial institution carrying on as its principal business the providing of finance whether by making loans or advances or otherwise for any activity other than its own but does not include an Asset Finance Company.IV. Infrastructure Finance Company (IFC): IFC is a non-banking finance company a) which deploys at least 75 per cent of its total assets in infrastructure loans, b) has a minimum Net Owned Funds of ₹ 300 crore, c) has a minimum credit rating of ‘A ‘or equivalent d) and a CRAR of 15%.V. Systemically Important Core Investment Company (CIC-ND-SI): CIC-ND-SI is an NBFC carrying on the business of acquisition of shares and securities which satisfies the following conditions:-(a) it holds not less than 90% of its Total Assets in the form of investment in equity shares, preference shares, debt or loans in group companies;(b) its investments in the equity shares (including instruments compulsorily convertible into equity shares within a period not exceeding 10 years from the date of issue) in group companies constitutes not less than 60% of its Total Assets;(c) it does not trade in its investments in shares, debt or loans in group companies except through block sale for the purpose of dilution or disinvestment;(d) it does not carry on any other financial activity referred to in Section 45I(c) and 45I(f) of the RBI act, 1934 except investment in bank deposits, money market instruments, government securities, loans to and investments in debt issuances of group companies or guarantees issued on behalf of group companies.(e) Its asset size is ₹ 100 crore or above and(f) It accepts public fundsVI. Infrastructure Debt Fund: Non- Banking Financial Company (IDF-NBFC) : IDF-NBFC is a company registered as NBFC to facilitate the flow of long term debt into infrastructure projects. IDF-NBFC raise resources through issue of Rupee or Dollar denominated bonds of minimum 5 year maturity. Only Infrastructure Finance Companies (IFC) can sponsor IDF-NBFCs.VII. Non-Banking Financial Company - Micro Finance Institution (NBFC-MFI): NBFC-MFI is a non-deposit taking NBFC having not less than 85% of its assets in the nature of qualifying assets which satisfy the following criteria:a. loan disbursed by an NBFC-MFI to a borrower with a rural household annual income not exceeding ₹ 1,00,000 or urban and semi-urban household income not exceeding ₹ 1,60,000;b. loan amount does not exceed ₹ 50,000 in the first cycle and ₹ 1,00,000 in subsequent cycles;c. total indebtedness of the borrower does not exceed ₹ 1,00,000;d. tenure of the loan not to be less than 24 months for loan amount in excess of ₹ 15,000 with prepayment without penalty;e. loan to be extended without collateral;f. aggregate amount of loans, given for income generation, is not less than 50 per cent of the total loans given by the MFIs;g. loan is repayable on weekly, fortnightly or monthly instalments at the choice of the borrowerVIII. Non-Banking Financial Company – Factors (NBFC-Factors): NBFC-Factor is a non-deposit taking NBFC engaged in the principal business of factoring. The financial assets in the factoring business should constitute at least 50 percent of its total assets and its income derived from factoring business should not be less than 50 percent of its gross income.IX. Mortgage Guarantee Companies (MGC) - MGC are financial institutions for which at least 90% of the business turnover is mortgage guarantee business or at least 90% of the gross income is from mortgage guarantee business and net owned fund is ₹ 100 crore.X. NBFC- Non-Operative Financial Holding Company (NOFHC) is financial institution through which promoter / promoter groups will be permitted to set up a new bank .It’s a wholly-owned Non-Operative Financial Holding Company (NOFHC) which will hold the bank as well as all other financial services companies regulated by RBI or other financial sector regulators, to the extent permissible under the applicable regulatory prescriptions.11. What are the powers of the Reserve Bank with regard to 'Non-Bank Financial Companies’, that is, companies that meet the 50-50 Principal Business Criteria?The Reserve Bank has been given the powers under the RBI Act 1934 to register, lay down policy, issue directions, inspect, regulate, supervise and exercise surveillance over NBFCs that meet the 50-50 criteria of principal business. The Reserve Bank can penalize NBFCs for violating the provisions of the RBI Act or the directions or orders issued by RBI under RBI Act. The penal action can also result in RBI cancelling the Certificate of Registration issued to the NBFC, or prohibiting them from accepting deposits and alienating their assets or filing a winding up petition.12. What action can be taken against persons/financial companies making false claim of being regulated by the Reserve Bank?It is illegal for any financial entity or unincorporated body to make a false claim of being regulated by the Reserve Bank to mislead the public to collect deposits and is liable for penal action under the Indian Penal Code. Information in this regard may be forwarded to the nearest office of the Reserve Bank and the Police.13. What action is taken if financial companies which are lending or making investments as their principal business do not obtain a Certificate of Registration from the Reserve Bank?If companies that are required to be registered with the Reserve Bank as NBFCs, are found to be conducting non-banking financial activity, such as, lending, investment or deposit acceptance as their principal business, without seeking registration, the Reserve Bank can impose penalty or fine on them or can even prosecute them in a court of law. If members of public come across any entity which does non-banking financial activity but does not figure in the list of authorized NBFC on RBI website, they should inform the nearest Regional Office of the Reserve Bank, for appropriate action to be taken for contravention of the provisions of the RBI Act, 1934.14. Where can one find list of Registered NBFCs and instructions issued to NBFCs?The list of registered NBFCs is available on the web site of Reserve Bank of India and can be viewed at www.rbi.org.in → Sitemap → NBFC List. The instructions issued to NBFCs from time to time are also hosted at www.rbi.org.in → Notifications → Master Circulars → Non-banking, besides, being issued through Official Gazette notifications and press releases.15. What are the regulations applicable on non-deposit accepting NBFCs with asset size of less than ₹ 500 crore?The regulation on non-deposit accepting NBFCs with asset size of less than ₹ 500 crore would be as under:(i) They shall not be subjected to any regulation either prudential or conduct of business regulations viz., Fair Practices Code (FPC), KYC, etc., if they have not accessed any public funds and do not have a customer interface.(ii) Those having customer interface will be subjected only to conduct of business regulations including FPC, KYC etc., if they are not accessing public funds.(iii) Those accepting public funds will be subjected to limited prudential regulations but not conduct of business regulations if they have no customer interface.(iv) Where both public funds are accepted and customer interface exist, such companies will be subjected both to limited prudential regulations and conduct of business regulations.16. What does the term public funds include? Is it the same as public deposits?Public funds are not the same as public deposits. Public funds include public deposits, inter-corporate deposits, bank finance and all funds received whether directly or indirectly from outside sources such as funds raised by issue of Commercial Papers, debentures etc. However, even though public funds include public deposits in the general course, it may be noted that CICs/CICs-ND-SI cannot accept public deposits.Further, indirect receipt of public funds means funds received not directly but through associates and group entities which have access to public funds.17. What are the various prudential regulations applicable to NBFCs?The Bank has issued detailed directions on prudential norms, vide Non-Banking Financial (Deposit Accepting or Holding) Companies Prudential Norms (Reserve Bank) Directions, 2007, Non-Systemically Important Non-Banking Financial (Non-Deposit Accepting or Holding) Companies Prudential Norms (Reserve Bank) Directions, 2015 and Systemically Important Non-Banking Financial (Non-Deposit Accepting or Holding) Companies Prudential Norms (Reserve Bank) Directions, 2015. Applicable regulations vary based on the deposit acceptance or systemic importance of the NBFC.The directions inter alia, prescribe guidelines on income recognition, asset classification and provisioning requirements applicable to NBFCs, exposure norms, disclosures in the balance sheet, requirement of capital adequacy, restrictions on investments in land and building and unquoted shares, loan to value (LTV) ratio for NBFCs predominantly engaged in business of lending against gold jewellery, besides others. Deposit accepting NBFCs have also to comply with the statutory liquidity requirements. Details of the prudential regulations applicable to NBFCs holding deposits and those not holding deposits is available in the section ‘Regulation – Non-Banking – Notifications - Master Circulars’ in the RBI website.18. Please explain the terms ‘owned fund’ and ‘net owned fund’ in relation to NBFCs?‘Owned Fund’ means aggregate of the paid-up equity capital, preference shares which are compulsorily convertible into equity, free reserves, balance in share premium account and capital reserves representing surplus arising out of sale proceeds of asset, excluding reserves created by revaluation of asset, after deducting therefrom accumulated balance of loss, deferred revenue expenditure and other intangible assets. 'Net Owned Fund' is the amount as arrived at above, minus the amount of investments of such company in shares of its subsidiaries, companies in the same group and all other NBFCs and the book value of debentures, bonds, outstanding loans and advances including hire purchase and lease finance made to and deposits with subsidiaries and companies in the same group, to the extent it exceeds 10% of the owned fund.19. What are the responsibilities of the NBFCs registered with Reserve Bank, with regard to submission on compliances and other information?A. Returns to be submitted by deposit taking NBFCsNBS-1 Quarterly Returns on deposits in First Schedule.NBS-2 Quarterly return on Prudential Norms is required to be submitted by NBFC accepting public deposits.NBS-3 Quarterly return on Liquid Assets by deposit taking NBFC.NBS-4 Annual return of critical parameters by a rejected company holding public deposits. (NBS-5 stands withdrawn as submission of NBS 1 has been made quarterly.)NBS-6 Monthly return on exposure to capital market by deposit taking NBFC with total assets of ₹ 100 crore and above.Half-yearly ALM return by NBFC holding public deposits of more than ₹ 20 crore or asset size of more than ₹ 100 croreAudited Balance sheet and Auditor’s Report by NBFC accepting public deposits.Branch Info Return.B. Returns to be submitted by NBFCs-ND-SINBS-7 A Quarterly statement of capital funds, risk weighted assets, risk asset ratio etc., for NBFC-ND-SI.Monthly Return on Important Financial Parameters of NBFCs-ND-SI.ALM returns:(i) Statement of short term dynamic liquidity in format ALM [NBS-ALM1] -Monthly,(ii) Statement of structural liquidity in format ALM [NBS-ALM2] Half yearly,(iii) Statement of Interest Rate Sensitivity in format ALM -[NBS-ALM3], Half yearlyBranch Info returnC. Quarterly return on important financial parameters of non deposit taking NBFCs having assets of more than ₹ 50 crore and above but less than ₹ 100 croreBasic information like name of the company, address, NOF, profit / loss during the last three years has to be submitted quarterly by non-deposit taking NBFCs with asset size between ₹ 50 crore and ₹ 100 crore.There are other generic reports to be submitted by all NBFCs as elaborated in Master Circular on Returns to be submitted by NBFCs as available on www.rbi.org.in → Notifications → Master Circulars → Non-banking and Circular DNBS (IT) CC.No.02/24.01.191/2015-16 dated July 9, 2015 as available on www.rbi.org.in → Notifications.20. Whether the circular on Lending against shares dated August 21, 2014 is applicable to existing loans also?The Circular is applicable from the date of the circular and therefore the Circular shall not apply on those transactions which have been entered into prior to the date of the Circular. However, the guidelines will be applicable in case of roll-over/ renewal of loans. Guidelines will not apply to transactions where documents have been executed prior to the date of the circular and disbursement is pending.21. Will the circular on Lending against shares be applicable on restructured accounts?No. the Circular will not be applicable on restructured accounts22. Will the Circular on Lending against shares be applicable on those loans where the primary security is not shares/ units of mutual funds?Loans which are against the collateral of multiple securities and it is specifically agreed to in the agreement that primary security would be something other than shares/ units of mutual funds, LTV would not be applicable. However, reporting requirements shall remain. In cases where such differentiation is not made (thereby NBFCs can off-load shares at the instance of a default), LTV would be applicable.23. Whether LTV for loans issued against the collateral of shares is to be computed at scrip level or at portfolio level?LTV would be computed at portfolio level.24. Whether PoA/ Non-Disposal undertaking structure by whatever name called is covered under the Circular on Lending against shares?Yes, the Circular would be applicable and the type of encumbrance created is immaterial.25. Does the definition of “companies in a group” as given in Systemically Important Non-Banking Financial (non-deposit accepting or holding) companies Prudential Norms Directions, 2015 apply in respect of concentration of credit/ investment norms.No, the definition of “companies is a group” is only for the purpose of determining the applicability of prudential norms on multiple NBFCs in a group.26. Whether acquisition/ transfer of shareholding of 26 per cent or more of the paid up equity capital of an NBFC within the same group i.e. intra group transfers require prior approval of the Bank?Yes, prior approval would be required in all cases of acquisition/ transfer of shareholding of 26 per cent or more of the paid up equity capital of an NBFC. In case of intra-group transfers, NBFCs shall submit an application, on the company letter head, for obtaining prior approval of the Bank. Based on the application of the NBFC, it would be decided, on a case to case basis, whether the NBFC requires to submit the documents as prescribed at para 3 of DNBR (PD) CC Kjøpesenter Gjøvik & Hamar. 065/03.10.001/2015-16 dated July 9, 2015 for processing the application of the company. In cases where approval is granted without the documents, the NBFC would be required to submit the same after the process of transfer is complete.27. NBFCs are charging high interest rates from their borrowers. Is there any ceiling on interest rate charged by the NBFCs to their borrowers?Reserve Bank of India has deregulated interest rates to be charged to borrowers by financial institutions (other than NBFC- Micro Finance Institution). The rate of interest to be charged by the company is governed by the terms and conditions of the loan agreement entered into between the borrower and the NBFCs. However, the NBFCs have to be transparent and the rate of interest and manner of arriving at the rate of interest to different categories of borrowers should be disclosed to the borrower or customer in the application form and communicated explicitly in the sanction letter etc.28. RBI permits NBFCs to hedge their exposure through dealing in IRFs. Currently, IRFs are on single stock 10 yr 8.40% 2024 security. The Composition of Balance Sheet is mix of fixed/ floating interest rate and different credit profile. Whether 10 yr single security can be used for hedging 2-3 yr liability and asset (Duration adjusted) or can be used for investment in other long tenor securities or corporate bonds. Alternatively, whether IRFs can be used holistically for hedging assets and liabilities in dynamic interest rate scenarios within total Balance Sheet amount and within hedging definition?IRF may be used to hedge interest rate risk associated with single asset/ liability or a group of assets/ liabilities. Hence, NBFCs are permitted to use duration based hedging for managing interest rate risk.29. Whether NBFCs as trading member can participate in the IRF market only for hedging or can also take trading position?As per extant guidelines NBFCs with asset size of ₹ 1,000 cr and above are permitted to participate in IRF as trading members. While, trading members of stock exchanges are permitted to execute trades on their own account as well as on account of their clients, banks and PDs have been allowed to deal in IRF for both hedging and trading on own account and not on client’s account. Similarly, NBFCs as trading members are permitted to execute their proprietary trades and not to undertake transactions on behalf of clients.C. Residuary Non-Banking Companies (RNBCs)30. What is a Residuary Non-Banking Company (RNBC)? In what way it is different from other NBFCs?Residuary Non-Banking Company is a class of NBFC which is a company and has as its principal business the receiving of deposits, under any scheme or arrangement or in any other manner and not being Investment, Asset Financing, Loan Company. These companies are required to maintain investments as per directions of RBI, in addition to liquid assets. The functioning of these companies is different from those of NBFCs in terms of method of mobilization of deposits and requirement of deployment of depositors' funds as per Directions. Besides, Prudential Norms Directions are applicable to these companies also.31. We understand that there is no ceiling on raising of deposits by RNBCs, then how safe is deposit with them?It is true that there is no ceiling on raising of deposits by RNBCs. However, every RNBC has to ensure that the amounts deposited with it are fully invested in approved investments. In other words, in order to secure the interests of depositor, such companies are required to invest 100 per cent of their deposit liability into highly liquid and secure instruments, namely, Central/State Government securities, fixed deposits with scheduled commercial banks (SCB), Certificate of Deposits of SCB/FIs, units of Mutual Funds, etc.32. Can RNBC forfeit deposit if deposit instalments are not paid regularly or discontinued?No. Residuary Non-Banking Company cannot forfeit any amount deposited by the depositor, or any interest, premium, bonus or other advantage accrued thereon.33. What is the rate of interest that an RNBC must pay on deposits and what should be maturity period of deposits taken by them?The minimum interest an RNBC should pay on deposits should be 5% (to be compounded annually) on the amount deposited in lump sum or at monthly or longer intervals; and 3.5% (to be compounded annually) on the amount deposited under daily deposit scheme. Interest here includes premium, bonus or any other advantage, that an RNBC promises to the depositor by way of return. An RNBC can accept deposits for a minimum period of 12 months and maximum period of 84 months from the date of receipt of such deposit. They cannot accept deposits repayable on demand. However, at present, the only RNBCs in existence (Peerless) has been directed by the Reserve Bank to stop collecting deposits, repay the deposits to the depositor and wind up their RNBC business as their business model is inherently unviable.D. Definition of deposits, Eligible / Ineligible Institutions to accept deposits and Related Matters34. What is ‘deposit’ and ‘public deposit’? Is it defined anywhere?The term ‘deposit’ is defined under Section 45 I(bb) of the RBI Act, 1934. ‘Deposit’ includes and shall be deemed always to have included any receipt of money by way of deposit or loan or in any other form but does not include:i. amount raised by way of share capital, or contributed as capital by partners of a firm;ii. amount received from a scheduled bank, a co-operative bank, a banking company, Development bank, State Financial Corporation, IDBI or any other institution specified by RBI;iii. amount received in ordinary course of business by way of security deposit, dealership deposit, earnest money, advance against orders for goods, properties or services;iv. amount received by a registered money lender other than a body corporate;v. amount received by way of subscriptions in respect of a ‘Chit’.Paragraph 2(1)(xii) of the Non-Banking Financial Companies Acceptance of Public Deposits ( Reserve Bank) Directions, 1998 defines a ‘ public deposit’ as a ‘deposit’ as defined under Section 45 I(bb) of the RBI Act, 1934 and further excludes the following:a. amount received from the Central/ State Government or any other source where repayment is guaranteed by Central/ State Government or any amount received from local authority or foreign government or any foreign citizen/ authority/ person;b. any amount received from financial institutions specified by RBI for this purpose;c. any amount received by a company from any other company;d. amount received by way of subscriptions to shares, stock, bonds or debentures pending allotment or by way of calls in advance if such amount is not repayable to the members under the articles of association of the company;e. amount received from directors of a company or from its shareholders by private company or by a private company which has become a public company;f. amount raised by issue of bonds or debentures secured by mortgage of any immovable property or other asset of the company subject to conditions;fa. any amount raised by issuance of non-convertible debentures with a maturity more than one year and having the minimum subscription per investor at ₹ 1 crore and above, provided it is in accordance with the guidelines issued by the Bank.g. the amount brought in by the promoters by way of unsecured loan;h. amount received from a mutual fund;i. any amount received as hybrid debt or subordinated debt;j. amount received from a relative of the director of an NBFC;k. any amount received by issuance of Commercial Paper.l. any amount received by a systemically important non-deposit taking non-banking financial company by issuance of ‘perpetual debt instruments’m. any amount raised by the issue of infrastructure bonds by an Infrastructure Finance CompanyThus, the directions exclude from the definition of public deposit, amount raised from certain set of informed lenders who can make independent decision.35. Which entities can legally accept deposits from public?Banks, including co-operative banks, can accept deposits. Non-bank finance companies, which have been issued Certificate of Registration by RBI with a specific licence to accept deposits, are entitled to accept public deposit. In other words, not all NBFCs registered with the Reserve Bank are entitled to accept deposits but only those that hold a deposit accepting Certificate of Registration can accept deposits. They can, however, accept deposits, only to the extent permissible. Housing Finance Companies, which are again specifically authorized to collect deposits and companies authorized by Ministry of Corporate Affairs under the Companies Acceptance of Deposits Rules framed by Central Government under the Companies Act can also accept deposits also upto a certain limit. Cooperative Credit Societies can accept deposits from their members but not from the general public. The Reserve Bank regulates the deposit acceptance only of banks, cooperative banks and NBFCs.It is not legally permissible for other entities to accept public deposits. Unincorporated bodies like individuals, partnership firms, and other association of individuals are prohibited from carrying on the business of acceptance of deposits as their principal business. Such unincorporated bodies are prohibited from even accepting deposits if they are carrying on financial business.36. Can all NBFCs accept deposits? Is there any ceiling on acceptance of Public Deposits? What is the rate of interest and period of deposit which NBFCs can accept?All NBFCs are not entitled to accept public deposits. Only those NBFCs to which the Bank had given a specific authorisation and have an investment grade rating are allowed to accept/ hold public deposits to a limit of 1.5 times of its Net Owned Funds. All existing unrated AFCs that have been allowed to accept deposits shall have to get themselves rated by March 31, 2016. Those AFCs that do not get an investment grade rating by March 31, 2016, will not be allowed to renew existing or accept fresh deposits thereafter. In the intervening period, i.e. till March 31, 2016, unrated AFCs or those with a sub-investment grade rating can only renew existing deposits on maturity, and not accept fresh deposits, till they obtain an investment grade rating.However, as a matter of public policy, Reserve Bank has decided that only banks should be allowed to accept public deposits and as such has since 1997 not issued any Certificate of Registration (CoR) to new NBFCs for acceptance of public deposits.Presently, the maximum rate of interest an NBFC can offer is 12.5%. The interest may be paid or compounded at rests not shorter than monthly rests. The NBFCs are allowed to accept/renew public deposits for a minimum period of 12 months and maximum period of 60 months. They cannot accept deposits repayable on demand.37. In respect of companies which do not fulfill the 50-50 criteria but are accepting deposits – do they come under RBI purview?A company which does not have financial assets which is more than 50% of its total assets and does not derive at least 50% of its gross income from such assets is not an NBFC. Its principal business would be non-financial activity like agricultural operations, industrial activity, purchase or sale of goods or purchase/construction of immoveable property, and will be a non-banking non-financial company. Acceptance of deposits by a Non-Banking Non-Financial Company are governed by the rules and regulations issued by the Ministry of Corporate Affairs.38. Why is the RBI so restrictive in allowing NBFCs to raise public deposits?The Reserve Bank's overarching concern while supervising any financial entity is protection of depositors' interest. Depositors place deposit with any entity on trust unlike an investor who invests in the shares of a company with the intention of sharing the risk as well as return with the promoters. Protection of depositors' interest thus is supreme in financial regulation. Banks are the most regulated financial entities. The Deposit Insurance and Credit Guarantee Corporation pays insurance on deposits up to ₹ One lakh in case a bank failed.39. Which are the NBFCs specifically authorized by RBI to accept deposits?The Reserve Bank publishes the list of NBFCs that hold a valid Certificate of Registration for accepting deposits on its website: www.rbi.org.in → Sitemap → NBFC List → List of NBFCs Permitted to Accept Deposits. At times, some companies are temporarily prohibited from accepting public deposits. The Reserve Bank publishes the list of NBFCs temporarily prohibited also on its website. The Reserve Bank keeps both these lists updated. Members of the public are advised to check both these lists before placing deposits with NBFCs.40. Whether NBFCs can accept deposits from NRIs?Effective from April 24, 2004, NBFCs cannot accept deposits from NRIs except deposits by debit to NRO account of NRI provided such amount does not represent inward remittance or transfer from NRE/FCNR (B) account. However, the existing NRI deposits can be renewed.41. Can a Co-operative Credit Society accept deposits from the public?No. Co-operative Credit Societies cannot accept deposits from general public. They can accept deposits only from their members within the limit specified in their bye laws.42. Can a Salary Earners’ Society accept deposits from the public?No. These societies are formed for salaried employees and hence they can accept deposit only from their own members and not from general public.43. Is nomination facility available to the Depositors of NBFCs?Yes, nomination facility is available to the depositors of NBFCs. The Rules for nomination facility are provided for in section 45QB of the Reserve Bank of India Act, 1934. Non-Banking Financial Companies have been advised to adopt the Banking Companies (Nomination) Rules, 1985 made under Section 45ZA of the Banking Regulation Act, 1949. Accordingly, depositor/s of NBFCs are permitted to nominate one person to whom the NBFC can return the deposit in the event of the death of the depositor/s. NBFCs are advised to accept nominations made by the depositors in the form similar to one specified under the said rules, viz Form DA 1 for the purpose of nomination, and Form DA2 and DA3 for cancellation of nomination and change of nomination respectively.44. How does the Reserve Bank come to know about unauthorized acceptance of deposits by companies not registered with it or of NBFCs engaged in lending or investment activities without obtaining the Certificate of Registration from it?NBFCs that ought to have sought registration from RBI but are functioning without doing so are committing a breach of law. Such companies are liable for action as envisaged under the RBI Act, 1934. To identify such entities, RBI has multiple sources of information. These include market intelligence, complaints received from affected parties, industry sources, and exception reports submitted by statutory auditors in terms of Non-Banking Financial Companies Auditor’s Report (Reserve Bank) Directions, 2008. Further, the State Level Co-ordination Committees (SLCC) is convened by RBI in all the States/UTs on quarterly basis. The SLCC is now chaired by the Chief Secretary/ Administrator of the concerned State/UT and has, as its members, apart from the Reserve Bank, the Regional Directorate of the MCA/ ROC, local unit of SEBI, NHB, Registrar of Chits, ICAI, Economic Intelligence Unit of the State Police and officials from Law and Home Ministries of the State Government. As all the relevant financial sector regulators and enforcement agencies participate in the SLCC, it is possible to quickly share the information and agree on an effective course of action to be taken against entities indulging in unauthorized and suspect businesses involving funds mobilization from public.45. Can Proprietorship/Partnership Concerns associated/not associated with registered NBFCs accept public deposits?No. Proprietorship and partnership concerns are un-incorporated bodies. Hence they are prohibited under the RBI Act 1934 from accepting public deposits.46. There are many jewellery shops taking money from the public in instalments. Is this amounting to acceptance of deposits?It depends on whether the money is received as advance for delivering jewellery at a future date or whether the money is received with a promise to return the same with interest. The money accepted by Jewellery shops in instalments for the purpose of delivering jewellery at the end of the period of contract is not deposit. It will amount to acceptance of deposits if in return for the money received, the jewellery shop promises to return the principal amount along with interest.47. What action can be taken if such unincorporated entities accept public deposits? What if NBFCs which have not been authorized to accept public deposits use proprietorship/partnership firms floated by their promoters to collect deposits?Such unincorporated entities, if found accepting public deposits, are liable for criminal action. Further NBFCs are prohibited by RBI from associating with any unincorporated bodies. If NBFCs associate themselves with proprietorship/partnership firms accepting deposits in contravention of RBI Act, they are also liable to be prosecuted under criminal law or under the Protection of Interest of Depositors (in Financial Establishments) Act, if passed by the State Governments.48. What is the difference between acceptance of money by Chit Funds and acceptance of deposits?Deposits are defined under the RBI Act 1934 as acceptance of money other than that raised by way of share capital, money received from banks and other financial institutions, money received as security deposit, earnest money and advance against goods or services and subscriptions to chits. All other amounts, received as loan or in any form are treated as deposits. Chit Funds activity involves contributions by members in instalments by way of subscription to the Chit and by rotation each member of the Chit receives the chit amount. The subscriptions are specifically excluded from the definition of deposits and cannot be termed as deposits. While Chit funds may collect subscriptions as above, they are prohibited by RBI from accepting deposits with effect from August 2009.E. Depositor Protection Issues49. What are the salient features of NBFC regulations which the depositor may note at the time of investment?Some of the important regulations relating to acceptance of deposits by NBFCs are as under:The NBFCs are allowed to accept/renew public deposits for a minimum period of 12 months and maximum period of 60 months. They cannot accept deposits repayable on demand.NBFCs cannot offer interest rates higher than the ceiling rate prescribed by RBI from time to time. The present ceiling is 12.5 per cent per annum. The interest may be paid or compounded at rests not shorter than monthly rests.NBFCs cannot offer gifts/incentives or any other additional benefit to the depositors.NBFCs should have minimum investment grade credit rating.The deposits with NBFCs are not insured.The repayment of deposits by NBFCs is not guaranteed by RBI.Certain mandatory disclosures are to be made about the company in the Application Form issued by the company soliciting deposits.50. What precautions should a depositor take before placing deposit with an NBFC?A depositor wanting to place deposit with an NBFC must take the following precautions before placing deposits:That the NBFC is registered with RBI and specifically authorized by the RBI to accept deposits. A list of deposit taking NBFCs entitled to accept deposits is available at www.rbi.org.in → Sitemap → NBFC List. The depositor should check the list of NBFCs permitted to accept public deposits and also check that it is not appearing in the list of companies prohibited from accepting deposits, which is available at www.rbi.org.in → Sitemap → NBFC List → NBFCs who have been issued prohibitory orders, winding up petitions filed and legal cases under Chapter IIIB, IIIC and others.NBFCs have to prominently display the Certificate of Registration (CoR) issued by the Reserve Bank on its site. This certificate should also reflect that the NBFC has been specifically authorized by RBI to accept deposits. Depositors must scrutinize the certificate to ensure that the NBFC is authorized to accept deposits.The maximum interest rate that an NBFC can pay to a depositor should not exceed 12.5%. The Reserve Bank keeps altering the interest rates depending on the macro-economic environment. The Reserve Bank publishes the change in the interest rates on www.rbi.org.in → Sitemap → NBFC List → FAQs.The depositor must insist on a proper receipt for every amount of deposit placed with the company. The receipt should be duly signed by an officer authorized by the company and should state the date of the deposit, the name of the depositor, the amount in words and figures, rate of interest payable, maturity date and amount.In the case of brokers/agents etc collecting public deposits on behalf of NBFCs, the depositors should satisfy themselves that the brokers/agents are duly authorized by the NBFC.The depositor must bear in mind that public deposits are unsecured and Deposit Insurance facility is not available to depositors of NBFCs.The Reserve Bank of India does not accept any responsibility or guarantee about the present position as to the financial soundness of the company or for the correctness of any of the statements or representations made or opinions expressed by the company and for repayment of deposits/discharge of the liabilities by the company.51. Does RBI guarantee the repayment of the deposits collected by NBFCs?No. The Reserve Bank does not guarantee repayment of deposits by NBFCs even though they may be authorized to collect deposits. As such, investors and depositors should take informed decisions while placing deposit with an NBFC.52. In case an NBFC defaults in repayment of deposit what course of action can be taken by depositors?If an NBFC defaults in repayment of deposit, the depositor can approach Company Law Board or Consumer Forum or file a civil suit in a court of law to recover the deposits. NBFCs are also advised to follow a grievance redress procedure as indicated in reply to question 57 below. Further, at the level of the State Government, the State Legislations on Protection of Interest of Depositors (in Financial Establishments) empowers the State Governments to take action even before the default takes place or complaints are received from depositors. If there is perpetration of an offence and if the intention is to defraud, the State Government can even attach properties.53. What is the role of Company Law Board in protecting the interest of depositors? How can one approach it?When an NBFC fails to repay any deposit or part thereof in accordance with the terms and conditions of such deposit, the Company Law Board (CLB) either on its own motion or on an application from the depositor, directs by order the Non-Banking Financial Company to make repayment of such deposit or part thereof forthwith or within such time and subject to such conditions as may be specified in the order. After making the payment, the company will need to file the compliance with the local office of the Reserve Bank of India.As explained above, the depositor can approach CLB by mailing an application in prescribed form to the appropriate bench of the Company Law Board according to its territorial jurisdiction along with the prescribed fee.

Q. What are some fun facts about pediatricians?What Pediatricians Really Want To Tell Parents - ChilldadDo you plan on taking an active role in your kids’ health and well-being, or will you leave that completely up to your Pediatrician?Recently I took a moment to sit down with a very successful, charming and intelligent Pediatrician (okay, my wife) to ask her what issues she would like new parents to take ownership of when it comes to their kids’ health.Below are her answers, in no particular order, supported by additional research and studies:1. There Is No Healthy JuiceSteven Depolo/FLICKRAccording to a study published in Pediatrics, children who drank at least one sugary drink per day were 43 percent more likely to become obese than children who drank less on average or none at all. “Juice is just like soda,” says pediatric obesity specialist Robert Lustig. “There is no difference.” Juice is full of sugar, it’s high in calories and it’s dangerous.2. Fevers Are Okayilona75/DepositphotoNormal fevers between 100° and 104° F (37.8° – 40° C) are actually good for sick children. They turn on the body’s immune system and help it to fight infection. Unless your child is experiencing an extremely high temperature over 104, you don’t need to panic or go to the ER or call your Pediatrician. Instead, treat with liquids, rest and Children’s Tylenol or Motrin.3. Co-sleeping = No Sleepingmelis82/DepositphotoAccording to a study in the Journal of Developmental and Behavioral Pediatrics, “The longer children co-slept, the worse their sleep habits—including shorter sleep duration and frequent awakenings.” This isn’t to say that if you let them co-sleep, your kids are guaranteed to have sleep issues. But the odds are against you. New parents need to make a decision on this early on, and they believe the science, commit to not co-sleeping. It may not be easy at first, but your family will benefit in the long run.4. Have Your Children Vaccinatedcandyboximages/DepositphotoThe debate over vaccinating children stems from an article published in 1988 linking the MMR vaccine to autism. However, that article has since been discredited and retracted by the journal that published it. Read what the Center for Disease Control has to say on the issue here. Or what the World Health Organization says here. Or this interesting anecdotal evidence, from a woman who grew up unvaccinated and contracted many of the diseases vaccines could have prevented, such as whooping cough, polio, measles, Haemophilus influenzae, and rubella.The fact is, vaccines are safe, they save lives and your child should have all of them according to the recommended schedule.5. Daddy Doesn’t Knowhttp://i.imgur.com/YaEedqD.webmIf you’re a father who is a primary caregiver, or equally and actively involved in your family’s child-rearing, you are probably up to speed on the finer details of your kids’ health history. However, many fathers who bring their children to the yearly check up simply don’t have all the necessary personal information about their kids that the doctor needs. “When was your child’s last physical?” “Any rashes?” “Any problems at school?” If you can’t answer these questions, it can create complications for the physician and slow down the well visit. It’s important that whichever parent takes the child to the doctor — mom or dad — be well versed in that child’s health and well being, so make sure you have this information at the ready.6. Your Child Doesn’t Always Need Antibioticsphoto-deti/Deposit photoAntibiotics are NOT the appropriate treatment for most sicknesses that hit kids. According to the CDC:“Antibiotics do not fight infections caused by viruses like colds, flu, most sore throats, bronchitis, and many sinus and ear infections.”Taking antibiotics will not cure the infection, will not keep other people from getting sick, will not help your child feel better, may cause harmful side effects and may contribute to antibiotic resistance. The fact is, when it comes to a viral infection, you have to ‘let it run its course’ and simply treat the symptoms until the virus is gone.7. Read To Your Kidsilona75/DepositphotoAccording to the American Academy Of Pediatrics, Parents should read aloud to their infants every day and continue to do so at least until their children enter kindergarten, the academy’s Council on Early Childhood advised. “Reading regularly with young children stimulates optimal patterns of brain development,” the academy’s report said. That, in turn, “builds language, literacy, and social-emotional skills that last a lifetime.”And this isn’t an income-class issue. According to the National Survey of Children’s Health, only 33% of children in poverty are read to every day, and in family incomes four times greater than the poverty level, 40% of children do not get a daily dose of reading.Reading to your kids is one of the simplest things you can do that will have lasting, long-term health benefits for children.8. Be “Patient”bst2012/DepositphotoYears ago, our parents and grandparents seemed to understand this intuitively: if the doctor is late, it’s for a good reason.If your pediatrician is running an hour late, consider the possibility that they’ve been in the room with an obese 13 year old girl who is being bullied at school and having suicidal thoughts, or something similarly intense that requires extra time and consideration.Plan out your day by allotting a few hours for the visit in case the Pediatrician can’t see you exactly on time, even if they want to. And bear in mind, when it’s your turn, your child will get the same level of care and attention.9. Don’t Be RashRecommended! Click To Buy On AmazonJust like fevers, most of the time you don’t need to call your Pediatrician for medical advice when your child has a rash. If your child is not febrile, not itching, and generally not bothered, give it some time. Only use fragrance free, dye free products and moisturize. Apply some Vaseline or Eucerin or Aquaphor, cover it up, and wait. If you don’t see improvement after a few days, then it would be appropriate to call your Pediatrician.10. TV In The BedroomReanas/DepositphotoHaving a TV in a child’s bedroom contributes to poor health in a myriad of ways. Studies show that if your child has a TV in their bedroom they are more likely to:Have a weight problemHave sleep disturbances by affecting melatonin productionHave nightmaresHave lower scores on standardized testsSmoke (twice as likely as other adolescents)Eat more fast food and sodaIf you’re not convinced, do a test run: take the TV out of their bedroom and track the results over the course of a few weeks. You might be surprised.Conclusion: It’s About YouPediatricians are in the unique position of having to work through 3rd parties (parents) in order to provide health care for their patients (children). You can make their job easier and your kids healthier by following some of the tips above, such as: eliminating juice, not co-sleeping, reading aloud with your kids daily and removing TVs from their bedrooms. Although you should rely on your Pediatrician to provide general medical guidance and prescribe medication when necessary, ultimately, you are the one who is responsible for your child’s health and well-being.12 Secrets of the Pediatrician's OfficeMondays have the longest waits.VeerIf you're thinking you can bring your kid in for a well visit first thing Monday, be out by mid-morning, and squeeze in a grocery-shopping trip by lunchtime, forget it. Pick any other weekday, because Mondays are crammed with appointments for kids who got sick over the weekend. So when should you schedule that visit? Wait times are often shorter -- and the staff is fresh and friendly -- for the first appointment in the morning (Tuesday through Friday) or after lunch. Avoid anything right after walk-in hours.2 of 13The office website or blog is your friend.Fancy Photography/ VeerThirty-six percent of docs spend only 11 to 15 minutes with their patients, and 20 percent lower that time to 1 to 10 minutes. Make these minutes count by doing some quick research in advance. Many practices post frequently asked well-visit questions online. "They're typically about feeding, elimination, sleep, activity, developmental milestones, safety, and family-history issues," says Anne Francis, M.D., a pediatrician in Rochester, New York. Looking over these questions can guide you in pinpointing any potential problems.3 of 13You can book an extra-long office visit.Lara RobbyWorried your baby needs something more than a scrip for antibiotics? If you think her problem might tie up the doc for more than ten minutes (maybe you're worried about chronic constipation), schedule a consult. Docs can get frustrated when you hit them with a bombshell at the end of a visit. "In my practice, six visits are usually ten minutes," says Ari Brown, M.D., a pediatrician in Austin, Texas. "Consultations can last 30 minutes to an hour."4 of 13The office will remember if you're naughty or nice.PhotoAlto/ MattonWhen you're stuck in the waiting room for more than an hour with a crying baby, you wish you could be in a good mood. Well, try. The more pleasant you are, the more help you'll get from the staff; they have the power to give your visit that little nudge that makes all the difference. If you're nice, the office staff will be more than likely to squeeze you in when you phone in a pinch before your big beach vacay.5 of 13It's okay to play faves.Lara RobbyOnly 6 percent of moms surveyed in a recent American Baby Magazine poll like all doctors in a pediatric practice equally. Say you originally signed on with Dr. Grinch, but you had to see another doctor (let's call him Dr. Nice) when your baby had a bad diaper rash. Want to switch? Chances are, Dr. Grinch won't even notice; if he does, he won't give it a second thought. Doctors want their patients to see whomever they feel comfortable with. Henry Collins, M.D., a pediatrician in a six-doctor group in Fairfield, California, says not to worry at all: "People come and go frequently. Patients don't need to worry about switching."6 of 13You don't have to wait in the waiting room.Kaysh ShinnThe most stressful part of a visit isn't meeting with the doctor. It's surviving the waiting room, where sick kids are more likely to recite the Gettysburg address than cough into their sleeve. You'll spend 20 minutes, on average, in that germ-filled space. If the wait is long, tell the receptionist you'll be in the hallway. She might agree to call your cell when a room is ready. Or you can peek in every five minutes.7 of 13You can BYOT (Bring Your Own Toys).PhotoAlto/ MattonCleaners can only work so much magic, especially on a pediatrician's toy bin. Offices are wiped down daily, but there's no way to sanitize every wheel of every toy truck. And even when toys are cleaned, some viruses still stay put, researchers at the University of Virginia found in a 2008 study. Cold viruses can live longer than 24 hours on some surfaces. So if you're worried that your child might catch something, bring your own bag of tricks to keep her entertained.8 of 13Nothing irks your doc more than your cell.Bryan McCayThat Beyonce ringtone makes you smile, but it won't thrill the doctor. During the appointment, turn off your cell or put it on silent. If your phone rings or beeps when the doctor is talking -- and worse, if you answer -- she'll question whether she's getting through to you. "It's distracting, it wastes time, and it really makes it difficult to get information to parents," says Meg Tomcho, M.D., a pediatrician in Montrose, Colorado. Other dubious parental behavior: missing scheduled appointments; not notifying the receptionist before asking the doc to check a sibling (if little bro does have a sinus infection, the staff needs to pull his chart so the doctor can update the record); and sending a child in with a babysitter who can't answer a single question about the history of that rash.9 of 13Free samples aren't always a good thing.Blaine MoatsYou think, Jackpot! Free medicine! But wait a sec before accepting samples; they could actually result in your paying more in the long run. The first couple of go-rounds might be free. When you fill the Rx, though, you may pay more for that drug than you would for a generic (samples are typically available for newer, brand-name drugs). Plus, samples can have serious consequences. In 2008, researchers from the Cambridge Health Alliance in Massachusetts warned that pediatric samples carry "significant safety considerations." Four of the 15 most frequently distributed samples had warnings indicating serious risks.10 of 13That $100 copay? Your doctor isn't concerned.iStockHe's not worried about prescription costs inflating your credit card bill. And it's a good bet that he doesn't know how much you'll pay for different drugs. So if you're concerned about a drug's cost, ask about other options when the pediatrician writes an Rx -- he won't think you're a cheapskate. And ask the pharmacist to call the office if your bill at the drugstore is unexpectedly large. "We can often do something cheaper with generics," says Sarah Lester, an M.D. in Andover, New Hampshire.11 of 13You create an easier office visit for your child.iStockphotoDocs appreciate a helpful hint now and then. Some kids do better on the exam table, others on your lap, so speak up. "Parents should communicate If the child has a phobia, like, 'Johnny will freak if you touch his hair,'" Dr. Anne Francis, M.D., a pediatrician in Rochester, New York, says. It also helps to keep your explanations to the child positive. Say things like, 'This medicine will make you better. The examination will be fun. Dr. Anne will be checking your tummy.'" And if there's a chance of pain, be honest, but put it in a positive light: Tell your child that the shot will hurt some but will keep her healthy.12 of 13No, they won't call with your child's test results.Image Source/ VeerIn the craziness of cold and flu season, things can fall through the cracks. Details about phone consultations are usually noted in your baby's chart, but not always. Things can move too fast for offices to keep up. "Sometimes the patient returns in 48 hours after the first visit, and we don't have a record of the previous encounter in the chart yet because we're waiting for transcripts," Dr. Brown says. It's okay to follow up, especially if you're expecting lab results or a call from the doctor.13 of 13And then there's the wait!Kaysh ShinnAnticipating a longer-than usual wait? Use this list to pack your bag:Toys: A doctor's play kit can quell the anxiety of waiting for a checkup. Some fun-loving pediatricians will let their young patients "help" with the exam.Art Supplies: Advertised as "mess-free," Craoyla Color Wonder markers can't do any damage -- colors show up only on special paper ($7-$19; Target, Online Shopping for Electronics, Apparel, Computers, Books, DVDs & more). A spiral-bound notebook and pen will also do for doodling.Books: Snuggle Puppy allows for lots of smooches and "oooooohs" ($6, bookstores). Froggy Goes to the Doctor tells the story of Froggy, who is nervous about his checkup ($6, bookstores).Snacks: Pack something substantial for yourself, such as a Luna or Lara bar. It will keep your stomach from growling when the doctor finally arrives.Essentials: Carry diapers, hand sanitizer, snacks that don't make a mess, sippy cups with water, stickers, and the phone number for your pharmacy so the office can call in prescriptions.25 Things Your Child's Pediatrician Won't Tell You | Reader's DigestWant to avoid the wait?Schedule your appointment for the middle of the week, and ask for the first time slot of the morning or right after lunch. Follow these secrets to finding the best doctors, according to doctors. GRAYSOLIDWe'll prescribe antibiotics even though studies say not toEven though studies show that antibiotics for ear infections are rarely better than watching and waiting for kids over age two to get better, many of us prescribe them anyway. We want to feel like we're doing something. If I prescribe an antibiotic and a few days later your child feels better, I look like a genius. These tips will help you make the most of your next doctor's appointment. YOOTTANA TIYAWORANANWant to make vaccines less painful for your child?Ask if you can breastfeed while we give your infant his shots. Or if you have an older child, see if we can use cold spray or a numbing cream to decrease the pain. Make sure that you don't believe these 10 myths about vaccines. BILLION PHOTOSDon't try to fit your second kid into your child's appointmentDon't ask if I'll take a "quick look" at the sibling who doesn't have an appointment. If your mom went with you to the gynecologist, would you ever say, "Doc, would you mind putting her on the table and giving her a quick look?" Every patient deserves a full evaluation. These are signs that your doctor is a keeper (and signs that they're not!). ASLYSUNWe're on a tight scheduleSometimes we have less than 10 minutes per patient, so make the most of your time and ask about the most pressing problems first. If you have a lot of questions, request an extra-long appointment. These are the most common lies that patients tell their doctors. MONKEY BUSINESS IMAGESWe don't always follow our own adviceEven though I tell you to let your baby cry himself back to sleep once he's older, don't ask me if I always followed that advice with my own kids. I didn't. MONKEY BUSINESS IMAGESAlways ask for a nurse in an emergencyIf you have an urgent concern and the front desk tells you there are no appointments available, ask for a nurse and explain your situation. Often she or he can work you in even if the schedule indicates there's no time. These are 50 secrets nurses wish they could tell you. PRESSMASTERDon't delay treating your child because you want me to see the symptomsPeople do this a lot: "I didn't give him Tylenol, because I wanted you to feel the fever." "I didn't use the nebulizer because I wanted you to hear the wheezing." Trust me, I will believe you that the child had a fever or was wheezing. Delaying the treatment only makes your child suffer. RIDODon't scare your childAs soon as you say "He doesn't like it when you look in his ears," you remind your child of the last time and set us up for another failure. Be matter-of-fact: "It's time for the doctor to look in your ears." ESB PROFESSIONALBeware of germsSure, we have a "sick" waiting room and a "well" waiting room, but no studies show it really makes a difference. Germs are everywhere, and we can't disinfect after each patient. My advice? Bring your own toys, and if your child touches anything, give him some hand sanitizer. SAROJ KHUENDEEDon't threaten your childrenDon't tell your kid the doctor will give him a shot if he doesn't behave. I won't. ALTANAKAWe go by what the insurance companies sayInsurance companies won't pay us to check complex problems at a well visit. So if your child has been complaining of headaches for months, I may tell you to make another appointment. I literally won't get paid if I investigate the headaches while you're here. Watch out for these secrets that health insurance companies are keeping from you. MEGAFLOPPWe love kidsPediatricians are among the lowest-paid doctors, making half as much as many specialists. We get pooped, peed, and thrown up on—and worse. But we love helping kids, and that's why we do it. GOODLUZWe don't want to create anxiety in your kidsKids have figured out that “This won’t hurt” is code for “This is going to hurt,” and they get all worked up. It’s really best to not even use the word hurt. It just creates anxiety. MONKEY BUSINESS IMAGESDon't diagnose your kids over the InternetIf you want to do a little Internet research in advance, go for it. But please don’t use a website to diagnose your kids and come in asking for a specific remedy. KINGADon't ask me questions when I'm off the jobDon’t ask me medical questions about your child when you see me at the grocery store, pool, or library. When I’m out with my kids, I just want to be a parent. PRESSMASTERWe listen to drug repsIf I prescribe a newer, more expensive medication, it may be because a drug rep just left my office. They constantly bring us presents and flatter us, and their only goal is getting us to prescribe the latest medication, which is usually no better than the older ones. In fact, the older ones have a longer safety track record and really should be the ones we prescribe first. GEMPHOTOOlder children can be diagnosed with a phone callMost visits to the pediatrician, particularly for older children, are unnecessary. It may only take a phone call to find out that your child’s fever, cold, sore throat, ear infection, and even pink eye will most likely get better on its own. DRAGON IMAGESWe immunize our own childrenDo you really believe that we’d be recommending vaccines if we had any concerns about their safety? Almost all pediatricians immunize their own children. MARLON LOPEZ MMG1 DESIGNYes, you can talk to your pediatrician on the phoneBe persistent, be polite, and explain to the staff that you have a pressing, personal issue that you think would be best handled over the phone. We’ll call back as soon as we can. MONKEY BUSINESS IMAGESHave a last-minute form for summer camp you need us to fill out?Show up with a smile and some homemade cookies, and we will get it done. I can name two patients off the top of my head who always bring baked goods, and everyone in the office knows and loves them. MARTIN GARDEAZABALWe often have no idea what a particular medicine costsIf your jaw drops at the price the pharmacy gives you, call us back and see if we can prescribe something else. MEGAFLOPPStop typing on your smart phone!When I’m talking to your child, I need you to pay attention. He is not going to tell me everything I need to know. YUTTANA HONGTANSAWATDon't give children under six cold medicineWhen you tell me you gave a decongestant to your toddler, I cringe. Studies show that cold medicines never work well for children under age six, and the risk of overdose and side effects far outweigh any benefit. SYDA PRODUCTIONSListen to your intuitionYou know your child better than anyone, and that’s why when you tell me something “isn’t right,” my ears perk up. HALFPOINTView as SlideshowSources: Pediatricians David L. Hill, MD, in Wilmington, North Carolina; Robert Lindeman, MD, in Framingham, Massachusetts; Allison Fabian, DO, in Grand Rapids, Michigan; Amanda Moran, MD, in Charlotte, North Carolina; Roy Benaroch, MD, author of A Guide to Getting the Best Health Care for Your Child; and a pediatrician in Virginia who preferred not to be named.Pediatricians And Their World: 10 Facts You Should Know - A Knowledge ArchiveJune 12, 2015A doctor or a medical practitioner who specializes in children and their health treatments is called a Pediatrician. The science which deals with the same branch is termed as Pediatrics. It groups the new born babies, children, and adolescents, with an age limit of usually upto 18 years.The history of Pediatric science ages back to the 1800s, however, the Swedish physician Nils Rosén von Rosenstein is considered as the founder of today’s modern Pediatrics.A Pediatrician is a graduate from a reputed medical school and should have finished his 3 years of Pediatrics residency program. He also must have passed his American Board of Pediatrics exams and to remain certified, has to qualify his regular education requirements as well from time to time.In short, a doctor who has specialized training in emotional, physical and behavioral needs of a child is termed as a Pediatrician. Ten Interesting facts about Pediatricians/Pediatrics are as follows:The Pediatrics field was first discovered by the French. They were the first to realise that a child should be addressed by a different doctor as their needs are different.Some of its traces are also found in Ancient India where a child’s doctor was addressed as ‘kumara bhrtya’. ‘Sushruta Samhita’, the ayurvedic text, also mentions Pediatrics.The word Paediatrics is derived from two Greek words, ‘pais’ meaning child and ‘iatros’ meaning doctor.In the era 1800s, the first tutorial of Pediatric was taught, as a part of one of the medical specialties.The first Pediatrics hospital was discovered in the year 1802 and was named Hôpital des Enfants Malades in Paris.The first Pediatric book was published in the year 1472.To define, Pediatricians are doctors who deal with anyone from a new born baby to teenagers up to the age of 18.They are the right set of doctors who will help you with your baby’s immunizations.Pediatrician also helps you track your child’s health and development. You can discuss issues related to your child’s growth and well being with him.In the early years, this science focused more on diseases to do with young people, and slowly the study evolved around kids.How to find a Pediatrician?If you are ready to deliver, then be calm and concentrate on that. It’s a hospital’s job usually to arrange for a Pediatrician. After your delivery, the hospital provides you with a pediatrician who will come on rounds every couple of hours to keep a close watch on your baby.How frequently does one has to visit him?After you are discharged from the hospital, its better to keep your new born under his surveillance every 72 hours preferably for the first couple of months, and then slowly the number of visits will reduce. He will also guide you with the immunization process, motor skill development checks, nutrition and fitness needs.What is the need for regular child visits?So that he can keep a constant check on your child’s growth and development, in every aspect. He will also help analyze and treat your child’s illness and other related health problems. Also, if your child needs care beyond pediatrician’s expertise, then he can also guide you to collaborate with specialists.Are there any subspecialties for Pediatrics?Yes, there are numerous other branches which route out of this term, few are Adolescent medicine, Developmental and Behavioral Pediatrics, Pediatric cardiology, Pediatric critical care, Pediatric dermatology, Pediatric emergency medicine, Pediatric infectious disease, Pediatric neurology, Pediatric psychiatry and Social Pediatrics.What about the salary package?The approx figure paid to a Pediatrician in the year 2014 was $178,197, according to Salary.com. Also, as per The U.S. Bureau of Labor Statistics report, Mississippi topped the 2013 charts, paying a salary of $219,830 annually. However, it varies from country to country, state to state.10 Interesting Pediatrician FactsFriday, October 3rd 2014. | HealthPediatrician Facts provide the information about the general practice of medicine. Even though many people consider it as a new medical field, people are encouraged to learn it. You are served with various kinds of specializations such as rheumatology, cardiology, endocrinology, immunology and many more. Get the detail facts about Pediatrician here:Pediatrician Facts 1: ChildrenPediatrician will refer you to visit the pediatric specialist if your children develop chronic or even serious disease. It will be better if you can prevent the diseases with healthy lifestyle.Pediatrician Facts 2: treating the children and teenagersPediatrician’s main job is to treat the children and teenager. When your baby was born until he or she is 18 years old, you have to see pediatrician when your kids are sick or injured.Pediatrician FactsPediatrician Facts 3: The Frequency Of VisitThe frequency of visit to the pediatrician is slowly decreased when the children get older. During the child time, you should never forget to get the right immunizations for the kids to make their body strong.Pediatrician Facts 4: several of treatmentThe main focus of pediatrician is on the preventive care. Their treatment involves with the behavioral and physical problems.Pediatrician JobPediatrician Facts 5: ImmunizationsThe immunizations will be given to the children by pediatrician when the children are born until they come in the school age.Pediatrician Facts 6: the children’s health and developmentPediatrician also tracks the record of the development and health of the children. When you visit pediatrician, the parents can discuss anything related to the growth of their children. Find out nursing facts here.Pediatrician picPediatrician Facts 7: Selection Of PediatricianAfter the children were born, you can select the pediatrician for kids. If you are confused to find out the right pediatrician, you can ask the hospital about it. They can arrange the first appointment with the pediatrician for you and the kids.Pediatrician Facts 8: a medical specialtyLet’s trace the history about pediatrician. In 1800s, the first lesson of pediatric was taught for the first time. It was included as one of the medical specialties.Pediatrician PracticePediatrician Facts 9: Little Book On Diseases In ChildrenThe first book about Pediatric was published for the first time in 1472. In the early age, this medical specialty focused more on the diseases among the young people.Pediatrician Facts 10: salaryCan you guess the salary of a pediatrician?Pediatrician RolesIn a year, they can get $154,295 in United States.To become a pediatrician is not easy. You need to complete four years in Medical school. Are you impressed with facts about pediatrician?5 Interesting Facts about Pediatricians - AGC PediatricsMost people don’t take the time to acknowledge the differences between Pediatricians and General Practitioners. AGC Pediatrics has compiled a list of the top 5 facts about Pediatricians that you should know.1.) Their Schooling Totals Over 11 yearsMost people don’t know the difference between each different type of doctor’s training. Pediatricians go through numerous levels of schooling:4 Years in an Undergraduate Program4 Years in a Medical School12 Months (Minimum) in a Pediatric Internship2 Years (Minimum) Residency in a Hospital for your specialty2.) Their Overall Goal is Preventative CareMost of the patients that a Pediatrician will see are there for preventative care, such as newborns and infants. While some patients are there to find a solution to more serious conditions, much of a Pediatrician’s daily routine is composed of administering vaccines and immunizations to children.3.) 33 Different Types of PediatriciansFrom General Pediatricians to a Child Neurologist, Pediatricians treat every aspect of a child’s health. Ranging from Specialized specialists to General Pediatricians, pediatricians can be located in hospitals, clinics, and private practices.4.) Proactively Stop Disease SpreadBecause one of their primary goals is preventative care, Pediatricians have a part in actively eradicating the world of diseases, such as small pox and tuberculosis. In the past, these diseases have targeted children and young adults. Now vaccines prevent children from ever having to experience deadly diseases.5.) They Grow with PatientsOne of the most unique aspects of being a Pediatrician is that you grow with your patients. As your patient grows, you are able to watch them develop their personalities and become independent.Pediatrician Power Point PresentationPediatrician8 Interesting Facts About Pediatricians - HRFndNov 9, 2014A pediatrician is a medical doctor who specializes in the care of children. Interestingly enough, the study of medicine from a child’s perspective is relatively new on the world’s stage – the first children’s hospital was created in 1802.1. It’s a Specialized SpecialtyBeing a pediatrician is considered a specialty in the medical field. This is further enhanced if a pediatrician decides to focus on one particular area, such as neurology. In this case the doctor would be a specialized specialist.2. There’s a Cutoff AgeChildren gain their own medical authority at the age of 16, rather than 18. This is the normal age that pediatricians stop seeing patients. They focus on patients that need parental consent.3. Get the GPBefore seeing a pediatrician, most households will actually see their general practitioner. This is because the added cost of seeing a pediatrician isn’t necessary in order to prescribe medications, apply bandages, or even sew up a nasty little cut. The pediatrician steps in to help when there’s a chronic problem that won’t respond to other treatments.4. That’s a Long TimeFor the average pediatrician, it takes 11 years of schooling to become licensed. This includes 4 years of schooling at a college or university, 4 years of medical school, which is followed by a 12 month internship in pediatrics and a 2 year stint in residence.5. VaccinatePediatricians will monitor the vaccination records of all children in the families that they have agreed to see. Although some anti-vaccine groups have begun to pop up around the world, vaccines have done a lot to help remove very harmful diseases from humanity. Polio, smallpox, and others were virtually eliminated until vaccine resistance groups began to form.6. It’s ProactiveMany pediatricians focus on proactive treatments in order to stop a disease before it starts. These treatments begin with vaccines, but will also include behavioral and physical development as well. If a child’s growth charts begin to show declines in their curves, then interventions may happen to correct these problems.7. Make a ChoiceIf you know that you will be having a child, either from being born or through adoption, you can select a pediatrician before his/her arrival. Make an appointment with any potential pediatricians and discuss what your needs will be. This will help you locate a doctor in a sometimes extremely competitive health care environment.8. That’s a LotIn the United States, the average pediatrician makes about $150k per year annually. It is pretty common for a standard work week for a pediatrician to be at least 70 hours.What Pediatricians Really Want To Tell Parents - ChilldadConclusion: It’s About YouPediatricians are in the unique position of having to work through 3rdparties (parents) in order to provide health care for their patients (children). You can make their job easier and your kids healthier by following some of the tips above, such as: eliminating juice, not co-sleeping, reading aloud with your kids daily and removing TVs from their bedrooms. Although you should rely on your Pediatrician to provide general medical guidance and prescribe medication when necessary, ultimately, you are the one who is responsible for your child’s health and well-being.KidsABOUT THE AUTHORMichael BermanHusband and father of two who works as a professional writer, having sold screenplays to Sony, Disney, MGM and Showtime among others. Always on the look out for solid, useful information to share with other parents on CHILLDAD - Chilldad.93 RESPONSESReap Marketing Try the New Pediatric Urgent Care Clinic Cedar ParkMay 27, 2015[…] Source: ChillDad […]Jennifer December 13, 2014 Most of the article is pretty good… the point about vaccinations is short-sighted… people do not base their decision on an old study, many don’t even know about the old study… They are concerned about ingredients that the CDC admits are in the vaccinations on their website. They base their concern on actually knowing children who have been vaccine-injured and the enormous rate of children having autism, severe allergies, and learning problems… They base it on the fact that doctors are often not honest in dealing with them about vaccinations. It is too broad to say that all children should have all vaccines at the scheduled time. It is also silly to say that children will die if you don’t vaccinate them…. You know very well that not all children will automatically die if they are not vaccinated…. there is risk both ways….Logic would say that SOME children might not benefit as much from vaccination as much as other children…. at least then, some truth would be inching in…. I can’t say that all vaccinations are all bad, but I would never say that they are all good, and as long as the medical profession tries to say that they are all good, people will not trust them.When a doctor can say, “Let’s be careful about how we approach this….” and is at least open to dialogue, then I can actually consider vaccination. If a doctor wants to increase awareness of vaccination, he first has to read what parents are reading on the internet and go through, step by step, in a logical way in showing why a vaccine is safe… Honestly, most doctors do not know how to explain this or they don’t care to…. it is easier to scare with anecdotal stories, which, btw, is the same tactic by anti-vax people….Fear is never a good basis for making a decision. Dialogue is the only way to work through it…. dismissing the problems is causing MORE problems.Michael November 3, 2014 Sorry, the co-sleep suggestion is effed because the journal article cited has obviously not taken a broader cultural view of sleep and sleep norms. If it had, it would recognize that the American/western view of sleep — 8 hours of uninterrupted sleep under covers with no animals in the dark — is a cultural and historical anomaly. That means that any disruption caused by co-sleeping can’t be measured by that 8-hour-uninterrupted standard because it’s not a biological norm; it’s cultural. If you want to slag co-sleeping, say it’s incompatible with our sleep schedules and definitions of good sleep in our culture. Don’t say it’s bad in absolute terms. Michael Berman November 11, 2014 The co-sleeping point isn’t because of concerns of ‘interrupted’ sleep, it is because of the evidence pointing to sleep difficulties for those children later in life. Here is re-post from comments above, from Dr. Canapari, on his experiences:Craig Canapari MDNovember 10, 2014I personally could not agree more with your point about cosleeping. This has become such a weirdly politicized issues. Much of the research regarding the benefits of cosleeping has either been in small studies or has been based on misinterpretations by, say, Dr. Sears: http://ideas.time.com/2012/05/10/the-science-behind-dr-sears-does-it-stand-up/ The fact is, I see families in Sleep Clinic over and over who have coslept and, years, later, are struggling to get their child to sleep through the night. It may work for some families but it does not for many others. As to the ethnographic reasons for cosleeping– we live in a society very different from thousands of years ago.Great post BTW. Sunira November 25, 2014 I’m with you. Most people TODAY in countries everywhere sleep with their babies. And they’re not just goat farmers that have no choice like some people seem to believe. I come from an indian family, and we all coslept growing up. Most people on that side of the planet cosleep. Guess how many of us are doctors, engineers and other demanding careers? We need our sleep. And we know how to do it from thousands of years of doing it historically. I wouldn’t be surprised if a western family doesn’t know how to cosleep effectively… it’s not what they’re used to. My parents and I coslept and it lead to both me and my brother sleeping more effectively and my PARENTS sleeping much more effectively during the rougher months. I have an enormous family with countless kiddos and they all cosleep. It’s not a biggie. We all got our own beds when we became Scuola Bilingue a Modena / Toddlers depends on the family, the person, and the sleep history outside of the influence of co-sleeping….but cosleeping is definitely a viable option, not the worse option.Joy November 2, 2014 Couple of things. First about antibiotics. You said they don’t cure most sinus and eat infections. I think that might be misleading. While antibiotics don’t cure virus infections they will cure bacterial infections which are the primary cause of sinus and ear infections. However, most mild cases of these infections will clear up on their own and antibiotics aren’t needed because it will make kids resistant. According to two of my children’s pediatricians. The way it is written can give a first time parent who is still learning the ropes the false idea that they do not need to take their child to the dr. for infections. Same with the fever, while a fever is a sign that the immune system is working, just because 103 is normal, doesn’t mean we shouldn’t have it checked out. It could be serious and ignoring it because it will likely go away could cause serious harm. I was told by my son’s first pediatrician that if it’s above 101 or causes the child to be lethargic or behave differently if below 101 to come in. It may just be a cold or it could be pneumonia. Secondly, as for wait times. Keep in mind parents that the 5 minutes you are late throws the dr off their schedule by 5 min and after 12 patients being 5 min late, the dr is now behind an hour. Things happen, I know so if you’re going to be late call ahead. I’m sure the office would be willing to the next person in line early and give you their time slot. I find that I am fortunate. My son’s psychiatrist runs on time everyday and has you reschedule if you are late. I love it and yes, I’ve been rescheduled. I’m not late anymore. Their pediatricians office is pretty much on time too. Never had to wait longer than 30 min in the waiting room, on a busy day and I am usually out within an hour to hour and half. Don’t know how they manage when no one else can, but they do and I always get their full attention and never feel rushed. My sister in laws have waited up to 4 hrs in the waiting room for their pediatrician. Lastly, to the author and any doctors here. If you have a list of things you want to tell your patients, tell them. There is no need to let your patients/parents be ignorant. One of the reasons I love my pediatricians is because they educate me about my children’s health and in return I don’t waste their time diagnosing a cold. reginald harry January 23, 2015 Not true… most ear and sinus infections are NOT caused by bacteria. The vast majority are viruses and do not need antibiotics. Fevers rarely need to be seen by a doctor unless there is another coexisting symptom (lethargy, decreased urine output, no tears, abdominal pain, rash, etc).Lauren October 31, 2014 There is a lot of whining in response to this blog. Two comments. First, it’s a blog, which means he can write whatever he wants and you have the right not to read it. Second, the title implies that the only people who are truly justified in disagreeing with these points are Paediatricians. You were all clearly interested in finding out what frustrates Paediatricians so why get so mad at the author? Don’t shoot the messenger! (I agree the gif should go). Michael Berman November 1, 2014 Lauren — appreciated. When a blog post covers vaccinations, co-sleeping and physician ‘lateness’, you can expect some blowback, those are hot-button topics. Nobody wants to hear negatives about a style of parenting that they engage in. Parenting is a personal issue — one of the most personal issues — and I can understand why people get defensive. That said, this post has been shared almost 70,000 times, so I think the majority of people find the majority of points to be useful information. I have heard this information for the last 10 years via my wife and frankly much of it didn’t sit well with me either when she first began discussing it with me. Take co-sleeping. As a young man I thought falling asleep with the kids would be the greatest. But after I saw the magic of having them learn to sleep in their own beds early on, I was sold. Does this mean they can’t crawl in your bed from time to time? Of course not. It just means get them to learn how to self-sleep as soon as possible, to the benefit of the whole family. Or take fruit juice: I used to think fruit juice was healthy. Now my kids mostly drink water. Do they have a Capri Sun during half-time at a soccer game. Of course. The points in the article are meant to establish a base-line, and then you can ‘bend it’ from time to time. Unfortunately, it’s inverted in America today. The baseline is juice, and the ‘bend’ is having a glass of water. Again, with vaccines: I was anxious and almost unwilling to have them get their first vaccinations. Now I feel ignorant for putting superstition over science. I learned a lot not just from my wife, but from the community of physicians I’ve met over the years. They are, to a T, amazing people. And they put up with a lot of from a lot of uninformed parents. If they can handle that, I can certainly handle a few blog comments. As for the gif, what can I say, it makes me laugh, as the baby clearly isn’t harmed. Is it a stereotype of the ‘bumbling father’? Sure. Am I the subject of the stereotype myself? As a dad and caregiver for my kids, I sure am. Are dads not as informed about their kids’ medical history as moms? They aren’t. If the stats don’t sit well with people, I can’t do much about that. I think the real take-a-way from point #5 is that whoever comes to the visit needs to know the medical history of the child so things move expeditiously, especially seeing as point #8 (lateness) is such a point of contention. Thanks for your comments and I hope you come back to read more. We have an article coming up about discipline, still doing the research, but it should have a lot of meat in it. Be well…Lauren November 2, 2014 You’re a stronger ‘man’ than I. (Guess that’s why I don’t have a blog, I’d lose all my waking hours getting wound up). I agree that many issues in parenting, mostly fueled by interactions on social media, are trigger topics. The difference here is that your sources are more robust than most, though largely ignored by many commentors (a minority, I agree) who prefer to continue the spread of anecdotal ‘evidence’ and personal opinion as fact. I didn’t go in to Paediatrics because I couldn’t stand the parents (I prefer looking after grumpy old men with crappy hearts). Give your wife a high five from me for putting up with people like me (pretty sure there must be science to back up that having a sick small person makes you lose a few rational neurons). Michael Berman November 2, 2014 She sends a high-five right back at ya. Comments are great, imo. I’ve been a professional writer for 20 years and have gotten endless notes from Hollywood executives so my skin is sufficiently thick. Appreciate your words, and look forward to being treated by someone as affable as you when I become a grumpy old man with a crappy heart!Neil October 31, 2014 According to a study published in Pediatrics, children who drank at least one sugary drink per day were 43 percent more likely to become obese than children who drank less on average or none at all. “Juice is just like soda,” says pediatric obesity specialist Robert Lustig. “There is no difference.” Juice is full of sugar, it’s high in calories and it’s dangerous.Actually the study says nothing of the sort. It looked at “sugar sweetened beverages” which meant soda and “fruit drinks” like Hi-C NOT 100% juice (it explicitly did not include 100% juice in its study). The idea that we can lump 100% juice in with added sugars is completely untrue. In fact there are things like: http://www.ncbi.nlm.nih.gov/pubmed/23234248 Saying that 100% juice can be very good for you. Michael Berman November 1, 2014 The problem Neil is the recommended servings of 100% juice: 4-6oz for children up to 6, and 8-12oz children over. The childhood obesity epidemic is due to Americans blowing past recommended servings in all areas. Approximately 35 percent of children between the ages of 1 and 6 consume 2 CUPS of juice or more per day, which is well above what is recommended for this age group, according to a June 2012 article published in “Diabetes Forecast.” We have a juice problem in this country and Pediatricians want parents to understand that. 100% juice may be the lesser of two evils, but it is still part of the problem due to overconsumption.Anna October 30, 2014 Michael – as a mom of 3 RAISED kids (26, 24 and 20) and they are all doing well in life, I agree wholeheartedly with all of your advice. Did I break most of those rules while raising them? Yep. I think the advice is common sense and I’m just not sure why the comments posted here are so adversarial. Chill people. Michael Berman October 31, 2014 Thanks, Anna!Alex Sweat October 30, 2014 I did like this article. If have to disagree on the co-sleeping though. My youngest two still sleep with us. 4 and 6, when they wake up in the middle of the night. The reason for that mainly is because they got used to it while my 6 year old was a year and a half and started having seizures. And I co-slept with my babies because I couldn’t stand being away from them. As far as the tv, my oldest two have one in their room, but don’t you think you should base that on parenting? Limiting their time? Making sure they aren’t sneak watching when they should be sleeping? They’ve never had nightmares, they are very active, in all sports, have good grades, and we don’t eat fast food hardly at all, and smokers start smoking, I’m guessing to the fact they have parents or family that smokes. Not because of a tv in their bedroom. And what about frozen juice? Lol Michael Berman November 1, 2014 There are always exceptions to every rule, these points are mostly to establish a baseline. Kids shouldn’t have a TV in their bedroom. Yours do, sounds like they are doing fine, so what is there to say? This advice is meant to establish the baseline for parents who have questions. There are doubtless millions who buck this advice and kids turn out great, happy and healthy, like yours.Lauren October 29, 2014 In response to #1, what about low sodium V8? My daughter loves that stuff. Michael Berman October 30, 2014 re: low sodium V8 – Better than juice, but not recommended over water.Kelly October 29, 2014 This article is one persons deluted idea of what parenting should be!!!!! Absolute Crap! Do not agree with most things on this list! Michael Berman November 1, 2014 sp. deluded. Thanks for the feedback.Jack October 29, 2014 It is a lot easier to be patient with doctors when they don’t charge to fill out forms, don’t bill you if you don’t call to cancel 24 hours in advance and don’t work in buildings that charge $20 for parking. Michael Berman November 1, 2014 Agree. Wife’s practice doesn’t charge for missed appointments. Consider finding physician who doesn’t?HeligKo October 29, 2014 #5 just sits wrong. I am sure the pediatricians report it as such, but I am guessing there is a larger percentage of SAHM in their sampling than SAHD. I would guess in families with SAH-parent, that parent is best versed in what is going on with the details of the kids. Its kind of their job, when they are the SAH-parent. I suspect the disparity between moms and dads who both work full time would be less. It would be an interesting study for someone to do.David October 29, 2014 I got to this page because my wife sent me a link, this is what is wrong with the internet. All these points you make, none are sourced, it’s just irresponsible to say stuff and the only thing you have to back it up is you talked to your wife…really?I wish there was a more reputable source on the internet when it comes to the topic of our kids health. Maybe like an institution dedicated to advancing medicine without the hearsay of misinformed minds. Oh… how about the Mayo clinic. http://www.mayoclinic.org/healthy-living/childrens-health/expert-answers/fruit-juice/faq-20058024 seriously people, your children deserve better than getting advice off a blog. Michael Berman October 29, 2014 Points 1, 2, 3, 4, 6, 7 & 10 are sourced. As far as juice – From Mayo Clinic website — “Beverages: Stick to water and unflavored milk (most of the time).” http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/expert-blog/kids-and-sugar/bgp-20056149. david October 29, 2014 You are correct, I was rather rash in my commenting, I had a chance to look through more of your website and it is full of useful advice and it’s very well curated. I can see why my wife has it bookmarked. Color me surprised that many of the things I was curious about (funding college education and educating my kids on good music) you discuss in great detail. I am a fan and thank you for putting out such a good resource, I will definitely be back.Heather October 29, 2014 This…this post is why we go to a family doctor who does OB and who strives to balance himself instead of a pediatrician. Our doctor respects us, offers his very knowledgeable advice and recommendations and let’s us then make educated decisions about our health and our kids. The key is that we are responsible and he provides the tools to make those decisions. Just as a point on vaccinations, they do have inserts that advise about possible side affects like any drug or medication. They are not 100% safe. They have risks which should not be ignored. We are not opposed to vaccination. We have had a child violently react to a vaccination, but we understand that is not always the case. Offer a parent good, non-fear based information to make good decisions, whatever that means for each family.Mary October 29, 2014 While a lot of these are good, I had to disagree wholeheartedly with discouraging co-sleeping. I feel like it is more of a cultural decision – not a health decision. There is nothing inherently unhealthy about co-sleeping and it seems when people discourage it, it’s usually fear-based, or poorly researched, or based on a cultural bias rather than proof. Nothing wrong with co-sleeping not being someone’s cup of tea, but there is also nothing wrong WITH co-sleeping for families all over the entire world who co-sleep and have lower infant mortality rates than we have in the U.S.Noah October 28, 2014 On number 9, I agree with the general premise… but also found some pediatricians to be extreme pains in not paying attention to skin issues. At our daughter’s 4 month checkup, my wife brought our 2.5 year old son with who had a couple of sores on the back of his leg that weren’t healing. We weren’t looking for a diagnosis, but she just wanted to ask if the doctor thought we should make an appointment for our son to have it examined. The doctor looked at it for 2 seconds and said it was molluscum, a generally harmless but annoying skin condition. Two days later he sprung bumps up over much of his arms and legs (which would not be uncommon with molluscum), and the sores started looking worse (which doesn’t really make sense with molluscum). We made an appointment with a pediatric dermatologist to see if they could suggest anything to help with the molluscum because it seemed to be getting pretty bad, but that takes a couple of weeks to be seen with a new patient. In the interim, everything kept getting worse. We called the pediatrician 4 times over that span. Each time, they refused to make an appointment, saying it was just molluscum, they don’t make appointments relating to previously diagnosed molluscum. Less than 24 hours before his appointment with the dermatologist, he sprung out in a full body rash. The dermatologist determined in about 3 seconds that it was not molluscum. It was staph, and the full body rash was some either secondary viral infection or an allergic reaction that likely sprung up so badly because of the staph. Thankfully it wasn’t MRSA and the staph went away fairly quickly, but the rash left scars on his arms and knees (we’re not sure if those will go away on their own or not), and, less than a month later, he sprung up another full body rash. Now, there’s of course the possibility that the second rash was something wholly unrelated, but it’s also very possible the staph triggered an immune reaction. We’ve switched pediatricians in response, and, have concerns about the long term ramifications (is the scarring permanent? Is this a skin issue he’s going to now spend his whole life dealing with?) significant enough that we aren’t ruling out contacting an attorney. So while I agree, if your kid develops a mild rash, doesn’t have a history of skin issues, or has skin issues that are generally mild, you’re well aware of and resolve quickly without intervention, no need to call a doctor. But a doctor’s office ignoring multiple pleas to come in has made my wife and I hyperobservant and, quite honestly, giant pains in the rear on rash issues at least in the short to mid-term.Trevor October 28, 2014 As a Health Care Professional I have no problem even with waiting to see the doctor comment. I do have a huge issue with pushing vaccines on parents! Everyone knows darn well that if pharmaceutical companies didn’t run this “free” country then vaccines would not be shoved down our throats. Why don’t other countries push for vaccines? In fact some ban certain ones. I know a research scientist physician friend of ours that makes immunizations but tells everyone not to get them and he refused to have his kids get them. They are grown and very health physicians today. The only reason he does his job is because he gets paid over $150 per hour. Yes, that was $150 per hour by drug companies. Also, why are things such as cosmetics run through the testing mill to make sure they are safe but there are no true extensive testing vaccines? Again, other countries have done tests and, surprise, they won’t allow vaccines to be mandatory or they ban them. Lastly, why are there more well respected physicians like the neurosurgeon at John Hopkins now speaking up about his research of increased neurological complications among people getting immunizations? He says that the fillers being used, ever since the push of immunitaions back in 80’s and 90’s, are now showing signs of neurological problems. I could go on but this is a start. Nicole October 29, 2014 i find it ignorant of your friend to make the vaccines if he has such bad things to say about them. If he thinks they are so horrible then being greedy for the money is just as terrible. Annie October 29, 2014 Absolutely agree! I could see the reasoning behind every point except the insistence on vaccines. A better piece of advice would be to fully research them yourself, as a parent, know the risks and benefits, and make a wise decision with the respectful help (not the condescending enrolling) of your pediatrician. It’s for this reason that I choose pediatricians who are comfortable and respectful of our INFORMED CHOICE not to vaccinate our children. Carrie October 31, 2014 Informed choice…educated by the internet. Medical school does not equal WebMD. Unfortunately everyone in our country feels entitled to make what they believe are informed choices. Why even pay a doctor for his skills and knowledge then? Certainly you can figure out how to do everything he does on the internet or on a blog…nope. They are professionals for a reason. Maybe you are one too…I don’t know. But I know there are a lot of people out there who are not. And yet we all think we know everything about everything because we read 5 articles about it on the internet. Bee October 30, 2014 I think anyone who makes $150/hour should be able to save up enough to be able to eventually go get a job he is passionate about. That’s a shame to work in a career that you don’t support. It’s also a shame that we live in a country that your choice is not really a choice. The schools, doctors, friends all assume you will get vaccinated so you have to be REALLY convinced to avoid it.Michelle October 28, 2014 As a pediatrician, I felt this had several great points. Of course, I also feel the need to comment on point 8 and the various comments from readers. As a physician who is frequently running late, I admittedly find the whole system flawed on both sides. I certainly value everyone’s time, and as a mother, I know how hard it can be to get kids out of the house. However, I also take pride in my job and vowed to provide the best care to each patient, no matter what. Though the system often “limits” the time allotted for each patient, and people are scheduled for a specific time, sick kids come in and unanticipated problems arise. As a pediatrician it is very frustrating when families show up late because it throws off the timing of everyone scheduled after them. Most of the time, I’m running late because of a patient (or several) who was late. Add in any “surprise” issue and soon the doctor is “very late”. My practice always gives the option of waiting or rescheduling, and we do our best to keep parents updated of timing, but sometimes things just go awry. Also understand that just because a doc is running late, it doesn’t mean they will rush your appointment and provide substandard care. I personally will do whatever I need to give the right care (which often means I am missing lunch). Most parents who know me understand and accept that. I feel communication with any waiting parents is key and can limit distress for everyone involved. But it also helps if everyone, both families and physicians, do their best to be early or on time. I know I rambled but this is a hot button topic in our office.Natalie October 28, 2014 I don’t usually comment on these sort of things, but I am particularly bothered by #8. This is an attitude some doctor’s have that some people’s time is not as valuable as others’ or their own. Appointments are made for a reason; to meet at a scheduled time. If the doctor is on time, but not the patient, does the patient still get to see the doctor? If it is more than about 15 minutes, then usually not. If someone is coming into the office with a particularly time consuming problem, then whoever makes the appointment for that patient needs to be clear that they need extra time from the doctor so it doesn’t push back other appointments in the day. The doctor’s office should then allow for more time in the doctor’s schedule for that patient or the doctor should consider referring the patient to a specialist who might have more time for a specific concern. If a person has a particularly urgent situation then they need to consider that they could be waiting around a long time for a doctor and should perhaps go somewhere else where they could be seen much sooner. Not to be harsh, but it really does reflect poorly on the doctor and often on the practice as a whole when a doctor (or more than one at a practice) has a reputation of being late for appointments. It is one of the attributes that people judge a good medical practice on. I am a SAHM to young children and my friends and I frequently talk about doctors. We know which ones we like and which ones to avoid and a doctor who is late can quickly get a bad reputation for that. A really good doctor (practice) would never expect a patient to still be waiting a half hour or more (certainly an hour) after their appointment time and they would work the patient in at the patient’s earliest convenience if that were to happen. I understand that doctors can be late from time to time, however, being more than 15-20 minutes late on a regular basis is just unacceptable. In the same respect, a really good parent is on time and prepared for the appointment as well, whether it be the mom or the dad. And yes, dads can be good parents, too, with respect to taking their kids to their doctor appointments! Margaret October 28, 2014 I disagree. If I have to wait a little longer to see the doctor, because he or she is attending to an emergency, I completely understand. Similarly, if it were my child in which the doctor found an unexpected abnormality which required more time, I wouldn’t want him or her to rush out at the 15 minute mark. Doctors don’t always know what is going to walk through the door, and so they can’t always predict exactly how much time each appointment will take. You should just feel happy that your child has never been sick enough to require one of those longer visits. Natalie October 28, 2014 Waiting a “little longer” for a doctor is fine and waiting a long time once or twice is acceptable, it’s when it becomes “longer than 20 minutes on a regular basis” that it becomes problematic or if it is, say, 45 minutes to an hour more than a few times. Emergencies should be taken (and usually are taken) to the emergency room, not the pediatrician, so pediatricians don’t typically deal with a lot of emergencies. If an unexpected abnormality arises, then it really shouldn’t take more than about 15-20 minutes longer to plan the next course of action with the parent. The parent cannot expect the doctor to give them another 45 minutes to an hour of their time for this in addition to their appointment. My pediatrician is excellent and I rarely wait long nor have I ever waited more than 45 minutes (one time I did wait about 45 minutes, but it was only once in several visits so that is fine.) And don’t assume that my children (like I said, I have young children) have never been sick enough to require “one of those longer visits.” Claudia October 29, 2014 I am an RN in a busy pediatrics office. To be truthful, the long wait is due to the need for productivity. Re: numbers. Pts are scheduled every 15 min, which is not realistic, but very very common. Ryan October 30, 2014 Just a few comments. I sometimes read comments but rarely comment of people’s comments. Now I am not a peds physician as I am family practice. A few points. I stress out about really only one thing in the office and that is running late. I hate being behind for the fact that I don’t like letting my patients wait. I do understand that people have to adjust their work schedule, take the day off, find a babysitter, etc. I respect that fact and even if they are late I will still see them (unless they are over 25 mins and I have another patient waiting to be seen me). I often work in patients on my lunch and quite often don’t get more than 5 minutes if at all to eat. I am sure that no one likes not getting a lunch, but I don’t complain because these patients need to see me. I know from experience you get less “oh by the way” things in peds as you do with adults. I will say that sometimes the reason the appointment was made by the patients is much different than what is discussed in the room. The same thing can be said that what is told to the medical assistant or nurse is different than what I hear. So when I get a visit for “med refill” this can be 1 med or 5 or even more. I know this is more of a problem with adults than kids. This does happen during peds visits as well as the parent brings a laundry list in to discuss then expects to have a well child check completed and gets mad when you tell them you don’t have the time to do all of those things. It only takes one visit/patient to throw you behind 30 mins or more. Now I take my time with my patients. I let them talk, listen and answer their questions. I am very detail oriented and I am very big on educating patients. Doing this takes more time thus the reason most of my visits are 30 mins long and not 15. (Remember again I see mostly adults). I try to not double book patients due to this. I call my patients with their labs, imaging results and other tests (whether normal or abnormal) myself due to the fact that if the patient has a question I can answer it. I try to practice and do things for patients as I feel if I was the patient what would I want. So do I complain when I am calling a worried mom or a patient at 8 pm letting them know their test results. No I don’t because I feel this is my job. Our office has Saturday hours to prevent patients having to go to the urgent care or ER. Believe me I would rather be doing other things on the weekend besides working. Every office and physician is different, but my patients love it and if needed will wait 30 mins, 45 mins or more (not always behind) because they understand the time that I am giving one patient will be the same as their appointment. If you want to be seen by a doc that is on time, quick but maybe not as thorough than that is ok. Your time is precious. It would be nice to let patients know that the physician is behind and get updated. However I don’t know if I sometimes know how long an appointment is going to take. I often walk into an appointment with the thought this should be quick and easy when in reality it took forever. I am not going to walk out of a room in a middle a visit to say can you let my next patient know I am going to be 15 minutes. I feel that I am very realistic. In whatever case the patient needs to find a provider who they feel comfortable with and can establish a good relationship with. That is my take as a physician but that is what I see and understand as a patient as well. Natalie October 31, 2014 I don’t think people go to the doctor expecting to get educated, I think they go expecting to get treatment, a diagnosis, a check-up, and so on. At least I don’t. Although I think it is good in theory to help educate patients so that they can possibly better help themselves, I don’t think it is realistic or practical to allow educating patients to take much more time than what an office visit allows. My own primary care provider (adult doctor) habitually runs VERY late and when it is my turn to see her she always takes so much time “educating” me. Last time it was how the veins work in my legs (because I was having swelling issues) and the time before that it was how the knee is constructed (because I was having long-term knee pain.) I felt like I was getting anatomy lessons and just wanted to say, “Thank you, but if I wanted to hear all of that I would have asked and I really do need to be on my way because I already spent an hour waiting to see you.” I can always look up and read about how my veins or my knees work myself. I don’t see this doctor very often so I am willing to put up with her being so late each time. I feel that doctors are paid what they are to have the knowledge that they do (they need to pay med school loans, after all) to medically treat people. I don’t feel that it needs to be the doctor’s responsibility to educate the patients. Patients need to have responsibilities for their own health, too. If there’s time in an appointment to educate and a doctor isn’t running behind, then great, but I think if they are running late, then as unfortunate as it may be, spending time on educating the patient should probably be kept to a minimum, if done at all. I think focusing less on educating the patient could reduce your stress levels and help keep you closer to being on time for your appointments. It may be kind of sad, but I think people generally value a doctor who doesn’t make them wait too long over a doctor who teaches them something about the body. Perhaps providing handouts could be a compromise. Sometimes things go in one ear and out the other anyway in the doctor’s office, especially if you aren’t feeling well.Shane October 28, 2014 Solid points. I share others’ concerns about 5, but it’s the 3rd point that I think could be communicated better.You make a deterministic statement, A = B. If folks were to only read that, it communicates that co-sleeping is always bad. (Research in Japan and Taiwan suggests otherwise…) But in your explanation, you say that it’s actually a probabilistic relationship.Bad form. Michael Berman October 28, 2014 Thanks for the compliment about the solid points. #3 headline is bold in its correlation, yes, but most Pediatricians are going to advise against co-sleeping, if only because the dramatically increased risk for SIDS. So the headline is devised to communicate to someone who is only reading bullet points that co-sleeping, from a Pediatrician’s point of view, should be avoided. Shane October 28, 2014 If you’re contending that it’s okay for pediatricians to make deterministic (A always causes B) claims based on probabilistic findings from research, then I’m going to have to push back again.The studies that show the increased SIDs rates, for example, are conditional on many factors (such as smoking in the home, alcohol consumption, etc.). In fact, there are families with low risk factors that show no significant increased probabilities.Blanket recome stations fail to capture these important differences and can lead to the propagation of misinformation.Candace October 28, 2014 There are also studies showing co-sleeping (when done safely and purposefully by a breastfeeding mother) reduces SIDS rates. The emphasis should be on educating about safe sleeping–not scaring parents about something natural that has been done safely for most of human history. Rachel October 28, 2014 Yep, Statement #3 is a problem. Anthropologically and historically speaking, co-sleeping is the norm. Baby having his/her own bedroom is a pretty recent cultural phenomenon linked to how we’re removing the “social” part from “social primates,” as well as how rich we all are. Saying it’s bad parenting to have your child snooze in physical contact with you is straight up not scientific. Bradford October 31, 2014 SIDs is a myth…Kate November 1, 2014 I also have to disagree regarding co-sleeping. It appears you’ve lumped all types of co-sleeping arrangements into the “bad” category without regard for legitimate science proving otherwise. When done safely, with the infant in a separate but close bassinet or attached crib, there are plenty of mutually beneficial aspects which make it worth considering. Michael Berman November 1, 2014 Co-sleeping refers to “the practice of sleeping in the same bed with one’s infant or young child”. Ashley November 1, 2014 Incorrect if done correctly Co sleeping reduces the risk of sids. My son has slept with me since birth and when he doesn’t sleep with me he has nightmares and doesn’t sleep well. Autumn November 1, 2014 Co-sleeping, when done right, is safer than putting a child to sleep in a crib ( especially if that crib is in a separate room.) Just because we can’t regulate the safety standards of co-sleeping (like banning a drop-side crib) doesn’t make the practice as a whole unsafe. How about we educate parents who choose to co-sleep rather than black-list the ptactice as a whole.Terri November 2, 2014 Overall, there seems to be a mild increase in SIDS when co-sleeping. You can make things ssafer by not smoking, no drugs or alcohol ect, however the risk still appears at this point to be there. You’re ( or your wife ) is not wrong in this statement. Most people can’t decipher evidence and only choose to believe the stuff that benefit them. Craig Canapari MD November 10, 2014 I personally could not agree more with your point about cosleeping. This has become such a weirdly politicized issues. Much of the research regarding the benefits of cosleeping has either been in small studies or has been based on misinterpretations by, say, Dr. Sears: http://ideas.time.com/2012/05/10/the-science-behind-dr-sears-does-it-stand-up/ The fact is, I see families in Sleep Clinic over and over who have coslept and, years, later, are struggling to get their child to sleep through the night. It may work for some families but it does not for many others. As to the ethnographic reasons for cosleeping– we live in a society very different from thousands of years ago.Great post BTW. Michael Berman November 10, 2014 Thanks, Craig… Appreciate the insightful comments from your experience.Mary Katz October 28, 2014 Parent shaming at its finest. My husband & I work both crazy hours at careers we love. Co-sleeping is, and always has been, a life saver for us. Not only does it give us sleep we need, but it’s an awesome time to steal more cuddles with the kids (I had non intention on co-sleeping before having our first, who was a terrible sleeper). It may not for everyone, but please don’t be so dramatic as to put it on a list that includes TV and, gasp, juice.Also, the whole “incompetent dad” bit? Stop. Just stop. Autumn November 1, 2014 Thank you! Co-sleeping is the ONLY way I get to sleep as a breast-feeding mother. Plus, out of all my friends, I would say my kids sleep the best (fall asleep quickly with no anxiety and no nightmares). Co-sleeping may not be the Western norm, but it is the worldwide norm.Sld October 28, 2014 Number 5 bothers me. My husband nor I have ever missed one of our childrens Drs appts. We both are well aware of anything that could be asked about our children even though I am a SAHM and he works 80+ hrs a week. If he can keep up with what is going on at home anyone can. Anyone who doesn’t know those things about their children should reconsider their priorities. As for number 8, that is a cop out. Don’t schedule 3 appts for the same time slot and you won’t be late. Our time is just as valuble as yours.zee October 28, 2014 Re: Juice. I’m not buying it totally. I want to see the research…correlational or causal? What variables were controlled? Any controls put on the endocrine disrupters that regularly leach from common juice containers? Family life style and diet? Also, a renowned pediatric nutritionist, Ellen Satterly, has studied children’s eating habits extensively and found that children who were allowed regular, time-limited, access to sweet foods were less likely to become obese. She found that these kids were more likely to have natural instincts about their limits for sugar as opposed to kids that were not allowed to explore for themselves. So, not completely sold on that one at all.I’m also not buying the co-sleeping argument, based solely on personal experience. No one in our house would sleep at all if we weren’t co-sleeping. And this from someone who was firmly opposed to it pre-baby.allison October 27, 2014 I’m a pediatrician. I agree with most of this with one exception…number 2. Fever is safe in most kids except the Unvaccinated ones. I want to see them in clinic for fevers >102. The risk of meningitis is still very real for these kids. Sad to see because vaccines work so well.Dustin October 27, 2014 Item #5 is poorly delivered, if true…and I’m not convinced that it is. As a father of two newborns that were in the NICU, I was involved as I could be (and still am), while still working 40+ hours/week. I remember coming into the the unit one evening and having the nurse residing over our twins quiz me about their feedings and medication, which mind you was an ever-changing thing. I’m their father, not their physician. That’s what I’m paying you and the hospital for. Review their chart and medical history. Then talk to me about questions you have or what I need to understand as a parent.I also take exception to #8. Doctors are notorious about charging patients when they don’t cancel but feel obliged to keep them in the waiting room for virtually any length of time without so much as a “Hey, a patient is requiring some extended time with Dr. Care. We apologize, but he/she won’t be able to see you at your scheduled time. You may either wait or reschedule at no additional charge.”I’m not sure this post is as informative as it may claim to be; seems more aimed at “parent-shaming” than anything else.joe October 27, 2014 I have the same frustrations when waiting at the doctors office, but I try to think like this:What if it was me back there and during my routine check up they found something abnormal. Oops! Your time is up. Guess we’ll have to discuss that in a week when we can get you back in!Then I’m OK with them running late. bj October 28, 2014 yes, this happens more often than you may think. medical/dental offices are NOT places where it is always possible to know in advance what you are dealing with, the child with suicidal thoughts probably did not call in & mention it requesting an extra hour or 2 of time. thanks for understanding we deal with real people, real problems and they never run on a perfect schedule. Lisa October 30, 2014 Ya know, I think most people understand that doctors have important things that can come up. (Though I’m sure they are also just human and sometimes just got behind for more mundane reasons as well) Regardless of the reasons for being late and keeping people waiting, I think the real problem is often more of customers service, or lack of. As soon as a problem is known and the doctor’s schedule is very delayed, more that 15 min (just like docs give patients running late before making us reschedule or having to re-fit us back into the schedule) the waiting patients should be told the doctor is running behind, about how much behind, and those patients given the option to reschedule if they need to. Instead waiting patients are often left to just wonder and be annoyed or the staff just acts annoyed when we ask “how much longer?”. This is a fairly common issue, especially in the pediatricians office it seems like, and better communication and an openness to allowing the patient to reschedule if they need tocould go a long way to less disgruntled patients. Michael Berman October 28, 2014 Yes, this. Thanks for saying so succinctly and on point.Kimberly October 27, 2014 Number 8 really grates on me. I am so careful to show up early to our appointments and Not Once have we been seen on time. Read that again, not once in 7 years, between numerous doctors in 5 different states. Which means there is a serious problem in staffing and availability that the AMA and doctors should be discussing. There is no point telling patients, who pay for your services and take vacation time to do it, that we are the problem. CB October 29, 2014 As a husband of a physician I can tell you it bothers them as well. The issue is not solely the doctor but an issue that starts with insurance companies. They force visits toto fit in small time slots, based on what they consider to be severity of the issue. Even though that time is not adequate that is all they would on compensate for this time slots. The doctors office then books for that time period according to the insurance company and even though it is not adequate the doctors try to make it work. The office is motivated by profit margins (which is slim in primary care per patient). While the doctor is in the room they must make a judgement call rush the patient or address their issues. The end result is they run behind. I hear them talk about it all the time, but no change. Side note if they hear suicide (as the example presented) they are obligated by law to work through it they cannot leave and walk out.You can ask the office to call you if the doctor is running behind. SCMom October 29, 2014 Please do not blame insurance companies for a physician running behind on their schedule. Most physician groups are owned by corporate systems which place demands on physicians to see a certain number of patients per day, which is unfair to the physician as a professional and the patient (and people accompanying the patient). It is about the group’s profitability, plain and simple and both the physician and the patient are caught in the middle.Dick Davis October 31, 2014 Patient shouldn’t have to ask if the doctor is running late, the staff should keep the patient appraised. How can a doctor be late for 1st appointment of the day? Does he/she have the same obstructions getting to the office for which the patient is to be rescheduled? If a patient has multiple concerns that will require more than the allotted time ask that patient to return later in the day instead of adversely affecting every scheduled patient! Any black moms, dads, kids, or doctors involved?Marc October 27, 2014 Most of the points are obvious, but #5 is seriously uninformed and degrading towards fathers. Generally the person going to the doctor with the kid needs to be informed no matter if it is the mother, the father, or the grandparents! Michael Berman October 28, 2014 Point 5 is true, however the second portion of your comment is a great point and I have re-edited along those lines. Scott October 29, 2014 #5 is not true.You did alter some wording, but the title and Gif are demeaning, and very un-necessarily so.You seem keen on “Daddy Doesn’t Know.” But that is BS. Knowledgeable, involved dads are the norm, not the exception. “Be Up to Date” “Be Informed” “Be Prepared to Answer Questions” all get to your meaning without taking a pot-shot at fathers. Bradford October 31, 2014 i just dropped my newborn on my cellphone!!!Kris October 27, 2014 I am a doctor and a parent. I agree with these, but want to add to the “be patient” part. As a parent who is very busy, it drives me nuts when the doctor is more than 15 min late and nobody has stopped by to give us an update on the timeline. As a doctor, I understand the type of stuff that comes up to delay the appointment, but it is inconsiderate of the patient if the staff doesn’t check in every 15 min with an updated timeline.SKM October 27, 2014 Can we retire the “bumbling Dad” stereotype already? It makes me angry [and I’m a Mom!]. How can we expect Dads to be involved in their children’s lives when we are constantly putting them down?Let me fix it for you:But If you can’t answer these questions with some detail, it’s probably best for everyone if you become informed about your child’s health and well-being. Michael Berman October 28, 2014 Addressed and re-worded. Thanks for feedback. Brad October 31, 2014 And yet still demeaning and poorly written. Mike October 31, 2014 And yet it’s still titled “Dad doesn’t know” coupled with the video of a bumbling oaf-like father dropping his phone on his 3-minute-old infant’s face.I’m so sick of this stereotype. Leave the gender COMPLETELY OUT and just say something like “be prepared with all the relevant information when you visit your pediatrician.” Just sticking in “— mom or dad —” as an aside or afterthought is insufficient.andrea October 27, 2014 hi, I would like to know if in number 1 you refer to boxed juices or you also mean made at home juices. I never give my son the first but always make home made fruit juices (orange, tangerine, apple. pineapple, etc) for him. Thanks a lot! Michael Berman October 27, 2014 Wife says eat the fruit, it’s better. Jeremy October 27, 2014 Juice is empty calories. When drinking juice you get all of the calories and sugar from the fruit without any of the fiber. Pure sugar spikes insulin levels creating a drop in blood sugar after a short period of time. This “low” makes the body send out hunger signals. Concentrated sugars, made at home or out of a box, aren’t the best option. But I would also say if someone loves juices homemade is better than boxed as long as the fruit the juice is made from is quality organic fruit Suzanne October 27, 2014 Agree with both Michael & Jeremy but would add that fiber is key. To avoid the insulin spike & subsequent dip with fructose, include the fiber inherent in eating the whole fruit as it will slow the body’s processing of the food and even out the release of insulin. If you’re blending whole fruit into a smoothie, it’s essentially the same as eating the fruit. If you’re juicing or squeezing, you’re omitting the fiber and, as Michael says, the fruit would be better.Anonymous October 27, 2014 I disagree with #8 the most. I’m sorry but most parents done have a couple hours to wait around for a doctor who can’t properly schedule their patients. Most people have to use their lunch hour, PTO, sick time or unpaid time. Running a few to half hr is one thing but to expect a parent to wait around a couple hrs with a kid (who could be missing school too) is unacceptable. Appointments are for a specific time. I expect to be seeing close to that or told when I check in the dr is running late and given the option of rescheduling or seeing someone else. If you need to cram patients in that much chances are your not spending much time with them anyways. katie October 27, 2014 I agree w you. The additional issue I have with this is that they expect me to be on time but then also expect me to accept them being late. I was about 5 minutes late to a doctor appointment w my son who had been sick for too long w no improvement…my daughter was in a mood and not letting me leave at the proper time and my son wasn’t moving real fast. The receptionist actually told me they may have to reschedule because we were “so late”. Of course by the time I talked to her it was closer to 10 minutes in because she was on the phone when we got there. Not her fault by any means but to tell me my sick kid has to wait to be seen because this 1 time we were late really bugged me.Mayzee October 29, 2014 I think it is rare that the Dr. is an hour late (in my experience anyway). I also have felt that when this happens it is for the reason that someone else’s needs are greater than mine, and I appreciate that the Dr. is taking the time out to spend with the patient that I know she would spend with me if my needs were greater. It is hard to wait with a sick or cranky child, but sometimes the staff can be helpful in offering an extra book, toy, or cup for the fountain.The tv in the room issue is an important one. I have always preached this. My husband grew up with a tv in his room and thinks I’m a bit mean. My saying is “As long as there are books in the world, there will never be a tv in your room.” There are plenty of opportunities for tv watching, and the bedroom doesn’t need to be used for that. Maybe #5 could have avoided all the controversy by simply stating that the caregiver with the most knowledge of the child’s health information should be bringing him to the Pediatrician. In my house there is an imbalance, having nothing to do with anyone’s incompetence. Tracey October 30, 2014 I totally agree!!! Especially since we’ve been 10 mins late to ours before and they’ve made us reschedule. If we can’t be 10 mins late due to an unforeseen circumstance, why can they be 2+ hours behind?Lisa October 30, 2014 As to the doctor running late issue – First – I get that important things might come up and the doctor is running late. I get that and I think most people do. However, if I’m going to have to wait a really long time past my schedule appointment then give me the opportunity to reschedule. The communication is too often really bad to the waiting patients. A little more communication about what is going on and how long the wait is estimated to be, with an apology and the option to reschedule if we need to would go a long way to better customer service. We are ALL busy and have many obligations on our time, not just doctors. Everyone. Besides, a lot of doctors these days threaten to reschedule you if you are more than a certain amount late, usually 10 or 15 min, and still charge a co-pay fee. Fair is fair – I’ll be on time and if for some unforeseen reason I can’t be on time, I’ll let you know as soon as I know and I’ll be open to rescheduling if that works better for your schedule that day. Doctor, you do the same, ok? Ok.Jeff October 26, 2014 Good article but I will have to respectfully disagree wholeheartedly with #5. I am also a spouse of a physician and am always informed about what is going on with my children. To that end, I left my career three years ago to raise our two kids, and have found being a stay-at-home dad (SAHD) to be the most difficult and rewarding job I have ever had. While SAHDs are not the majority, involved dads are more the norm than the exception in today’s world. We also happen to live in a world with EHR and other knowledge, even about our children, at our finger tips. I would be sad to learn that your wife really sees dads in this way at her medical practice. I am proud to say I know more than a few pediatricians that also disagree with only that item of your article. Joe October 27, 2014 Regarding topic #5. True or not true, there is a tactful way to present a case and a demeaning way to do it. The video delivers shows a bumbling dad. As a man, I try not to glorify is the weak moments that I see in women. I would ask the same kindness in return. Michael Berman October 28, 2014 Thanks for the kind words. Article clearly states that are many dads like yourself who are exceptions. However in regards to this it has been subsequently edited to emphasize that both parents should be up-to-speed, whoever is taking child to well visit. Thanks for feedback. Kathy October 29, 2014 I appreciate most of your ideas, however the continuously looping video of the dad dropping his cell phone on the newborn does not translate fairness and, although I can find the humor, it’s still disturbing to watch. Adam November 3, 2014 Sure the content may *somewhat* talk about both parents being up-to-speed, but both the title and image (the 2 most in-your-face components of that section) clearly point the finger at dad. Nurse Leslie November 1, 2014 “If you’re a father who is a primary caregiver, or equally and actively involved in your family’s child-rearing, you are probably up to speed on the finer details of your kids’ health history.” First sentence in that paragraph. What exactly are you disagreeing with??? The article is talking about the fathers that are NOT actively involved in the child’s care.Pediatrician Takes On Anti-Vaxxers' Misconceptions With A Powerful PostApril 27, 2017by LAUREN LEVYThe vaccine debate is one that can easily turn ugly between parents, especially when discussed online. Instead of citing proven research on whether vaccines are harmful to children, some parents simply go off of fear and bash others who vaccinate their children, as well as the doctors who receive payouts from "big pharma" companies for administering what they deem to be harmful medication.One pediatrician decided to get involved in the online dialogue to correct a major misconceptionthat could lead to devastating consequences. Although the fact that doctors receive a kickback from pharmaceutical companies for administering vaccines is a factor in some anti-vaxxers' decisions, this doctor, Mikey, commented on the Refutations to Anti-Vaccine Memes' page on Facebook to explain it further.Actually, we do get one. I'm a pediatrician. It's called a "Quality of Care Bonus" and it DOES NOT COME FROM BIG PHARMA. It comes from BIG INSURA. The INSURANCE companies pay us a bonus for taking good care of our patients. For pediatricians like me, that means making sure that kids have all their vaccines by a certain age.Now, why would an INSURANCE company want to pay for me to give expensive vaccines (that they have to pay for, mind you) to a child if those vaccines were harmful? That would make no sense because the INSURANCE company would have to pay for the extra care that the child requires because of their "vaccine injuries." That would make absolutely NO SENSE.No, the INSURANCE company has made an actuarial decision that by vaccinating my patients, I am reducing their costs by making my patients less likely to need expensive hospital stays and so the insurance company shares some of those costs with us.Oh, and the reason for this, BTW, is the Affordable Care Act, which mandates that physicians be paid based on quality and cost savings, rather than production.And I'm not exactly sure if I do have a price you could pay me to do something I thought was harmful to a patient, but if that price does exist, it's not a number I've ever seen. I didn't bust my ass through four years of university, four punishing years of medical school, and three dreadful years of residency . . . giving up my entire twenties to work in the lowest-paying hardest-working specialty in medicine just so I could hurt kids.The history of pediatrics at Baylor University Medical CenterPercy E. Luecke, Jr, MDIn the long annals of medical history, pediatrics is a young specialty, scarcely 200 years old. Medical writings from antiquity did include diseases in children but only in conjunction with general topics. A few examples follow:The Ebers Papyrus, written about 1552 bc and unearthed in 1872, discussed, among other topics, breastfeeding, a cure for worms, and treatment of eye diseases.Writings of Hippocrates (c. 400 bc) covered cephalhematoma, hydrocephalus, clubfoot, worms, diarrhea, scrofula, asthma, and mumps.Soranus of Ephesus (c. ad 100) described the fingernail test for breast milk quality. (If the droplet clings to the nail, it contains sufficient fat. If not, it is watery.)Galen (c. ad 200) wrote of ear discharge, pneumonia, and intestinal prolapse and described a disorder that corresponds to rickets.Avicenna, the great Arabian physician (c. ad 990), discussed tetanus, worms, convulsions, meningitis, and umbilical abscess.Avenzoor (c. 1150) performed a tracheotomy on a goat.Hieronymus wrote the first important printed book about children in 1583, entitled De Morbus Pusiorum.Among the increasing number of authors who wrote about diseases in children during the 17th and 18th centuries, 2 deserve mention. Thomas Sydenham (1624–1689), the English Hippocrates, wrote on scarlet fever, measles, smallpox, epilepsy, rickets, teething fever, scorbutus (scurvy), and the chorea we know as St. Vitus Dance. Edward Jenner (1749–1823) inoculated an 8-year-old boy with cowpox matter into one arm and 6 weeks later inoculated smallpox matter into the other arm. The boy did not get smallpox, heralding one of the greatest medical benefits of all time: the prevention of disease by immunization .Jenner Vaccinating a Child by Giulio Monteverdi, Genoa. Reprinted from reference 3.By the late 1700s and early 1800s, the need to attend specifically to the care, development, and diseases of children became more apparent, and specialization in pediatrics evolved, particularly in Germany and France. An early, if not the first, specialty organization was the Society for Infant Therapeutics, formed in Germany in 1883.PEDIATRICS IN THE USAAlthough other American physicians were writing about children's diseases, the father of American pediatrics is considered to be Dr. Abraham Jacobi (1830–1919), a German pediatrician, who arrived in New York in 1853 and established the pediatrics chair at the New York Medical College in 1861, organized several pediatric societies, began publication of several pediatric journals, and developed children's departments in several New York hospitals. A prolific writer, he taught extensively about the feeding and hygiene of children (including repeated warnings of the fallacy and danger of washing the infant's mouth—a practice that was condemned as early as 1544 in the writings of Feliz Würz but is still practiced by some today). Along with Jacobi, pioneers such as Luther Emmett Holt in New York, J. Forsyth Meigs in Philadelphia, and William McKim Marriott in St. Louis rapidly expanded the specialty through their writings and teachings. The first separate pediatrics hospital was founded in Philadelphia in 1855. The American Academy of Pediatrics was established in 1930 and the American Board of Pediatrics in 1933.Dr. Abraham Jacobi (1830–1919)