Primary Care Perspectives: Podcast for Pediatricians

Kerri Heckert, MS, RD, LDN, CEDRD-S, clinical dietitian, and Eleanor Benner, PsyD, psychologist, of the Eating Disorder Assessment and Treatment Program at Children’s Hospital of Philadelphia (CHOP), discuss the most recent (and more inclusive) diagnostic criteria for anorexia and bulimia; the relatively new diagnosis ARFID (Avoidant Restrictive Food Intake Disorder); the role of growth charts in diagnosis; red flags to look for in a primary care setting; strategies for promoting positive body image; indications for inpatient admission; CHOP’s inpatient protocol for eating disorders; resources for parents; family-based treatment; how to make a referral, and more.

In this episode, Arunjot Singh, MD, MPH, attending physician and Co-Director of the Center for Celiac Disease at Children’s Hospital of Philadelphia (CHOP), talks about when and how to start celiac screenings, genetic links to other autoimmune diseases, common presentations of celiac disease in a primary care setting, understanding IgG levels, role of different diagnostic tests and biopsy, how pediatricians can monitor celiac patients on an ongoing basis, vaccine considerations, and more.

In this episode, we explore the ethical considerations around the development and distribution of SARS-CoV-2 vaccines with Chris Feudtner, MD, PhD, MPH, Director of Research for the Justin Michael Ingerman Center for Palliative Care and Endowed Chair in Medical Ethics at CHOP. He discusses how are advisory groups are deciding who will receive priority immunization given limited supply, logistical distribution challenges, the question of equitable access, ethical considerations of including kids in vaccine trials, the mandate question, counseling parents and more.

In this episode, Katie Lockwood, MD, sits down with a panel of experts to talk about CHOP’s clinical pathway for the management of challenging behaviors in children. Vicky Scheid, MD, Pediatrician, Melanie Hoynoski, Child Life Specialist, and Julie Ginsburg, MSN, CPNP-PC, AE-C, Ambulatory Nursing Practice Specialist, share strategies to support and promote proactive management of behavior safety needs of patients with the goal of improving care experiences for patients, families and staff. Topics include support resources, planning and preparation, de-escalation techniques, biopsychosocial pain management strategies and more.

Autism effects as many as 1 in 54 children. In this episode, we focus on alternative treatments. Amanda Bennett, MD, MPH, developmental pediatrician and clinical chair of the Autism Integrated Care Program at Children’s Hospital of Philadelphia, talks about why families look to integrative medicine for treatment of autism, and dives into the safety and efficacy of some common integrative approaches, such as gluten-free diets, equine therapy, vitamin supplements, music therapy, social skills training, melatonin, CBD and more.

Dr. Irene Mathieu is an academic pediatrician, writer, educator and public health researcher focused on teaching health equity through the medical humanities. In this episode, she defines narrative medicine and discusses the role of poetry as a narrative medicine tool. She also explores how narrative medicine impacts medical education, particularly looking at outcomes such as empathy, tolerance for ambiguity, and burnout, as well as how narrative medicine frames how we teach medical students and residents about health equity, power differentials and more.

Jonathan Spergel, MD, PhD, Chief of Allergy Program at CHOP, covers the top 9 most common food allergens, current recommendations for when and how to safely introduce potential food allergens, when to refer to an allergist for testing, when different tests (skin, IgE or RAST testing) are indicated, outgrowing allergies, and exciting research underway around immunotherapy and other treatment advances.

Poisoning is the number one cause of death due to injury in the U.S. In this episode, Kevin Osterhoudt, MD, Medical Director of CHOP’s Poison Control Center, talks about common poison exposures in children, unexpected poisons, the use of naloxone for opioid overdose, identifying toxidromes, advice for pediatricians counseling parents to protect children from poisoning, popular social media “challenges” to watch for, and more.

Guest Lori B. Feldman-Winter, MD, MPH, is internationally-recognized for her work related to breastfeeding education programs and nutrition policy, and serves as Chair of the American Academy of Pediatrics (AAP) Section on Breastfeeding. She joins us to talk about all things breastfeeding, including benefits, contraindications, jaundice, managing hypoglycemia in breastfeeding newborns, lactogenesis, tools for pediatricians to support breastfeeding moms, and more.

Danielle Erkoboni, MD, a pediatrician at CHOP’s Care Network location in Norristown, and Trude Haecker, MD, Medical Director of Global patient Services and Reach Out and Read, talk about the complex factors that impact literacy skills, long-term impact related to lack of literacy or low proficiency in reading, how pediatricians can address these disparities in their practice and at a policy level, early literacy programs available to families, and much more.

Maria R. Mascarenhas, MBBS, Director of Integrative Health, and Tracey F. Jubelirer, MD, Integrative Oncology Medical Director, talk about what culinary medicine is and how it is different than nutrition; how it can be used to provide evidence-based nutrition guidance, translating research into practical advice for patients; how to use food and nutrition as part of a patient’s healthcare goals; how culinary medicine is being deployed at Children’s Hospital of Philadelphia; practical tips for pediatricians to use in their practice, and more.

Kathleen E. Sullivan, MD, PhD, Chief of the Division of Allergy and Immunology at Children’s Hospital of Philadelphia, sits down to discuss the risk of COVID-19  in children who are immunocompromised. She talks about early findings from international research about how COVID-19 impacts patients with different immunodeficiencies, the role of convalescent plasma, vaccines, school considerations, preventative care, and more.

Pamela Pojomovsky McDonnell, MD, a pediatric neurologist with the Division of Neurology at Children’s Hospital of Philadelphia, defines tics and tic disorders. Topics covered include distinctive features of a tic, typical presentation of tics seen in primary care, common questions from parents, when to refer to neurology, Tourette’s syndrome, causes, medications, current studies and more.

Naomi Brown, MD, and Matthew Grady, MD, pediatric sports medicine specialists in the Division of Orthopaedics at Children’s Hospital of Philadelphia (CHOP), talk about factors for a safe return to youth sports after coronavirus shutdowns, strategies teams can use to mitigate risk, and what to do in case of COVID-19 symptoms or exposures. They also offer advice for student-athletes as they seek to return to play, the importance of re-conditioning to prevent injury, and other advice for players, parents, and coaches to consider as they weigh pros and cons of getting back to sports.

When is a child just flexible, and when do we say they’re hypermobile? Staci Kallish, DO, a clinical geneticist in the Division of Human Genetics at Children’s Hospital of Philadelphia, talks about hypermobility, covering topics such as red flags for joint hypermobility, what systemic symptoms might indicate a potential inherited connective tissue disorder, and how primary care providers can screen for features of potential syndromes.