Primary Care Perspectives: Podcast for Pediatricians

To maximize safe participation in sports, a pre-participation physical evaluation is recommended for all children and adolescents before the season begins. This cardiovascular evaluation should be routinely done at pre-adolescent and adolescent annual well visits, with the goal of identifying medical problems that could have life-threatening complications or require treatment before participation. Maully Shah, MBBS, an attending cardiologist at Children’s Hospital of Philadelphia, discusses what PCPs should know about the cardiovascular sports physical, symptoms and history to look for, and more.

Research shows that about 50 percent of children with a complex congenital heart defect requiring surgical or catheter intervention in the first year of life have some level of neurodevelopmental disability. Alisa Burnham, MD, Lyla Hampton, PhD, and Kate Wallis, MD, MPH, sit down to talk about the importance of routine neurodevelopmental assessments for children born with complex congenital heart disease, deficits to watch for at different ages, follow-ups and support services pediatricians should be aware of and more.

Rachana Shah, MD, attending physician and Director of the Polycystic Ovarian Syndrome (PCOS) Clinic at CHOP, discusses diagnostic criteria and screening for PCOS in adolescents, diseases that mimic PCOS, the first labs that should be considered by primary care providers, appropriate use of ultrasound, and more.

Joanna Parga-Belinkie, MD, a neonatologist at Children's Hospital of Philadelphia, talks about the potential harmful effects of plastics, in particular BPA, phthalates, PFCs and perchlorates; new recommendations from the AAP in response to emerging child health concerns related to environmental toxins; and reasonable recommendations and substitutes pediatricians can suggest to parents to minimize the effects of plastics and other environmental toxins on children.

What is functional medicine? Pediatrician Ann McCarthy, MD, explains what functional medicine is and is not, how it can complement conventional medicine to help patients find relief from chronic conditions, the focus on addressing underlying causes of symptoms, and more.

Maria G. Vogiatzi, MD, an attending physician in the Division of Endocrinology at Children's Hospital of Philadelphia, discusses how precocious puberty is defined, what causes it, how it is diagnosed and more.

Sarah Dziedzic, MSW, a social worker at Children’s Hospital of Philadelphia, offers advice for primary care pediatricians when discussing options counseling with a newly pregnant teenager, including how to talk to the teen, identifying a trusted adult, and assessing coping ability and safety, as well as planning for next steps.

Jessica Lilley, MD, Division Chief of Endocrinology at the Mississippi Center for Advanced Medicine, talks about how a new-onset diabetic might present in a pediatrician’s office, the variety of presentations and symptoms to watch for at different ages, risk factors for type 1 diabetes, what tests primary care providers should start with and more.

In this episode, Rebecca Ahrens-Nicklas, MD, PhD, a senior research scientist and attending physician with the Metabolic Disease Program and Division of Human Genetics at Children’s Hospital of Philadelphia (CHOP), talks about the evolution of universal newborn screening and resources for providers. She discusses how families and providers are notified of results and how CHOP specialists partner with primary care providers in cases where newborns require immediate care.

Quality improvement in healthcare is typically defined as a framework to systematically improve the way we deliver care to patients. Elena Huang, MD, Director of Quality for the CHOP Care Network talks about what QI means in a pediatric healthcare setting; what it takes to start a QI project and key stakeholders to engage; how to identify opportunities for improvement; how PDSA cycles (plan, do, study, act) work; how physicians can earn MOC Part 4 credits; resources for getting more involved in QI; and more.

Research shows that nearly 95 percent of parents are not using car seats properly. Alisa Baer, MD, a nationally-certified child passenger safety instructor, sits down to talk about all things car seat safety, including common installation mistakes, tips for installing car seats correctly, how pediatricians can play a role in improving usage, car seats for children at different ages, and more.

Tiffani Johnson, MD, an expert in pediatric emergency care and ethnic health disparities, discusses subconscious racial bias and what impact it has in a healthcare setting. She talks about the difference between stereotypes and implicit bias, how subconscious bias can impact patient-provider communication as well as treatment decisions and disparities, ways to examine and explore your own unconscious biases, and more.

In this episode, Christina L. Master, MD, FAAP, CAQSM, Co-Director of the Concussion Care for Kids: Minds Matter program at Children’s Hospital of Philadelphia, talks about all things concussion — symptoms, when to seek medical care after head injury, common myths and misconceptions about concussions, current research, and more.

Billie Schwartz, PhD, discusses the ways that anxiety presents in pediatric primary care patients, when and how to refer to Behavioral Health, and strategies primary care providers can use with patients in their offices to manage anxiety.

The incidence of inflammatory bowel disease (IBD) seems to be increasing in children. Pediatric gastroenterologist Betsy Maxwell, MD, MS, talks about the theories as to why that might be happening, including an overlap between genetic factors, the immune system, the microbiome, and environmental triggers. She discusses the evaluation of suspected IBD in primary care, the unique way IBD can present in infants, and what’s new in IBD treatment.