Primary Care Perspectives

Food Allergies and Parental Anxiety (Episode 216)

Wed, 06 May 2026 11:08:43 -0400

81% of food allergy parents report significant worry about their child. We know that food allergies and anxiety are both common childhood diagnoses, but in this episode we explore the correlation and how we as pediatricians can help recognize when is this anxiety helpful and when is this anxiety unhelpful? In this episode, learn from Tamara Hubbard, MA, LCPC, a licensed clinical professional counselor and family therapist, and Megan Lewis, MSN, RN, PCNP, a Pediatric Nurse Practitioner in the CHOP Division of Allergy and Immunology.

We have discussed on this podcast before in Episode 143 how to help children who have both food allergies and anxiety, but in this episode, we focus on the parent-child dyad and how parental anxiety may impact a child.

Transition of Care for Patients with Autism and Intellectual Disabilities (Episode 215)

Thu, 23 Apr 2026 12:46:08 -0400

Transition of care from pediatric to adult medicine is sometimes a stressful process, but adolescents with autism and intellectual disabilities have additional considerations and steps that should be taken to make this transition optimal. In this episode, Stacy Ellen, DO, Karin Roseman, LCSW, and Mary Stephens, MD, MPH, from St. Christopher's Hospital for Children tell us about their medical home model, practical tools for preparing for transition, and resources for pediatric primary care providers.

Autism Spectrum Disorder Myths and Expert Advice (Episode 214)

Tue, 14 Apr 2026 14:57:50 -0400

Why does autism spectrum disorder attract so many myths? In this episode, Kate Wallis, MD, MPH, a developmental behavioral pediatrician, explains why there are so many questions about autism and gives us some expert answers and advice. We discuss acetaminophen, leucovorin, assisted communication, vaccines, and more!

#AutismAcceptanceMonth

Contraception Counseling in Primary Care (Episode 213)

Mon, 23 Mar 2026 21:48:22 -0400

Contraception counseling is an important part of comprehensive primary care for adolescents. The past decades have drastically changed the landscape of available contraception options. However, with so many options, contraception counseling can seem overwhelming. In this episode, Gladyne Confident, M.D., an attending in the Division of Adolescent Medicine at Children’s Hospital of Philadelphia, addresses the basics of contraception counseling, how to approach misinformation about contraceptives, and more, using a nuanced and patient-centered approach.

Special thanks to our guest host, Julia Pickel, MD, a pediatric resident at CHOP completing an Advanced Skills in Podcasting.

The Relationship Between Food Allergies and Eczema (Episode 212)

Wed, 04 Mar 2026 07:54:39 -0500

Eczema, or atopic dermatitis, is common, but it is rare that a food allergy causes atopic dermatitis. In this episode, CHOP allergist Katie Kennedy, MD, explains that only about 25% of children with severe atopic dermatitis have flares driven by foods. She also discusses the pitfalls of allergy testing, approaches to identifying food triggers, and when to refer to an allergist.

Dr. Kennedy talks about beef tallow and eczema, but for more information view Pediatric Health Chat. CHOP also has a Clinical Pathway for the Evaluation/Treatment of Children with Suspected Atopic Dermatitis. For more information on CHOP's Allergy Program, visit: Allergy Program | Children's Hospital of Philadelphia

#foodallergies #eczema

Communicating About Vaccines (Episode 211)

Wed, 18 Feb 2026 10:43:48 -0500

There is a lot of information online about vaccines-- some good, some bad. This means that patients are coming to their primary care providers with more vaccine questions. In this episode, Lori Handy, MD, MSCE, and Charlotte Moser, MS, from the CHOP Vaccine Education Center discuss communication skills that clinicians can use in discussing vaccines with patients and families to provide clarity, build trust, and open dialogue.

Another resource with good information for patients and families on common vaccine myths is CHOP's Pediatric Health Chat.

#vaccines

Caring for Immigrant Patients in Pediatrics (Episode 210)

Wed, 04 Feb 2026 16:46:00 -0500

In this episode, pediatric residents, Drs. Frances Avila-Soto and Michelle Rose, discuss the challenges immigrant families face while seeking healthcare. They also discuss how access to healthcare has been impacted by recent policy changes, what to do when ICE presents to a clinical space, and how pediatricians are uniquely equipped to advocate for immigrant patients. They hope that this episode leaves clinicians feeling more confident in caring for immigrant families and in their ability to continue advocating for their patients.

For more information on the CHOP Pediatric Residency Program, visit: Pediatrics Residency Program | Children's Hospital of Philadelphia

Topical Fluoride Dental Varnish in Pediatric Primary Care (Episode 209)

Fri, 23 Jan 2026 09:27:12 -0500

Did you know that in the early 1900’s, a dentist figured out that people who had high levels of fluoride naturally occurring in their water supply had very low rates of tooth decay? This led to further research and ultimately community-wide fluoridation programs. Today, many places have fluoride in the water, toothpaste, and applied topically by the dentist or pediatrician. In this episode, we talk about topical fluoride dental varnish with Brian Jenssen, MD, MSHP, a CHOP researcher with Clinical Futures and the Possibilities Project, whose QI project on fluoride varnish was published in Pediatrics in October 2025. While fluoride continues to be a hot topic in the news, learn from Dr. Jenssen why we should embrace it in pediatric primary care.

Hearing Loss Comorbidities (Episode 208)

Thu, 08 Jan 2026 15:44:47 -0500

Many people do not know the difference between the terms deaf, Deaf, and Hard of Hearing, so in this episode we discuss the diverse landscape of hearing loss. Michael Hoffman, PhD and Matthew E. Fasano-McCarron, PsyD, discuss why some comorbidities may be more common in patients with hearing loss and some of the challenges in making diagnoses of comorbidities such as autism, ADHD, and intellectual disability. We also discuss the impact of language deprivation on the brain and how it impacts development, particularly psychosocial functioning. For more information on services for hearing loss and speech disorders offered at CHOP, visit the Center for Childhood Communication.

Helmet Heroes: A pediatric resident advocacy project on bike helmet education and distribution (Episode 207)

Wed, 17 Dec 2025 15:04:17 -0500

Pediatric residents, Drs. Kelly McNult and Colleen Lynch, explain how they created an advocacy project related to bike helmets inspired by their personal experiences with patients and the loss of a colleague, Dr. Barbara Friedes. In this episode they not only explore how to execute an advocacy project as a resident but also teach us more about the effectiveness of bike helmets, how to ensure helmets fit, and other bike helmet anticipatory guidance.

Peanut Allergy Prevention: What we have learned from early introduction (Episode 206)

Mon, 08 Dec 2025 22:40:41 -0500

In the early 2000’s pediatricians recommended delaying the introduction of highly allergenic foods, like peanut, but we saw that the rates of peanut allergy continued to rise. However, the 2015 LEAP trial showed that early introduction was better. In fact, the LEAP trial found an 81% decrease in peanut allergies by age 5 in children who had an early introduction. In this episode, Stanislaw J. Gabryszewski, MD, PhD, discusses what we have learned in the decade since the LEAP trial and explains his recent study on how these guidelines have impacted the rates of peanut allergies in children.

Pediatric Dentistry and Sleep Disorders (Episode 205)

Tue, 25 Nov 2025 09:00:38 -0500

In this episode, Andrew Cohen, DMD, who is board certified in dental sleep medicine and a comprehensive restorative dentist, explains how anatomy, behavior, and overall health impacts sleep-related breathing. We discuss common issues like mouth-breathing, teeth grinding, thumb-sucking, and extended pacifier use and how these impact dental health and sleep. For more information, visit the CHOP Sleep Center.

Opinions expressed in this episode are those of Andrew Cohen, DMD, and not necessarily representative of Children's Hospital of Philadelphia.

Pediatric Asthma in Viral Season (Episode 204)

Wed, 12 Nov 2025 10:32:50 -0500

We learned a lot about pediatric asthma during the COVID-19 pandemic, including how significant the impact of viruses is on causing asthma flares. In this episode, Shikha Saxena, MD, from our Children's Hospital of Philadelphia Division of Pulmonary Medicine, Pulmonary Asthma Program, and Pulmonology and Allergy Personalized Asthma (PAPA) Clinic, discusses ways to help keep asthma in good control through the viral season. We discuss when to use inhaled corticosteroids, school-based management approaches, and navigating insurance coverage challenges. Also, Dr. Saxena reinforces the importance of getting a flu shot!

Football Protective Equipment and Concussion Risk (Episode 203)

Tue, 28 Oct 2025 08:38:40 -0400

Can you reduce the risk of concussion through specialized protective equipment? In this episode, two of our Minds Matter Concussion Program experts, Kristy Arbogast, PhD, and Christina Master, MD, FAAP, CAQSM, FACSM, FAMSSM, discuss whether the specialized equipment used by NFL players has evidence in pediatric athletes. We also learn other ways that parents, coaches, and trainers can mitigate concussion risk and how we can keep young athletes safe. This episode is a mix of physics and physical education classes, and you are certain to learn a lot about football protective equipment!

Oral Immunotherapy (Episode 202)

Wed, 08 Oct 2025 10:11:27 -0400

Imagine intentionally eating an allergen to re-teach your immune system to overcome this allergy? That's what our CHOP Allergists are doing in the Oral Immunotherapy Program and it is life changing science in practice! In this episode, Antonella Cianferoni, MD, PhD, explains oral immunotherapy including the immunologic process, the logistics for patients, and managing the risk of anaphylaxis. A great episode for providers and families!

SUDC: Sudden Unexplained Death in Childhood (Episode 201)

Wed, 17 Sep 2025 10:49:17 -0400

Less well known that SIDS, SUDC is a category of death for a child 12 months of age or older that remains unexplained after a thorough investigation. In this episode, Richard Goldstein, MD, Director of the Roberts Program on Sudden Unexplained Death in Pediatrics and Associate Professor of Pediatrics at Harvard Medical School, teaches us more about SUDC including possible causes, how to navigate this diagnosis with families, and where the research is leading us.

200th Episode Anniversary Special: 9 years of medical education podcasting at CHOP

Tue, 02 Sep 2025 09:38:53 -0400

A special surprise guest joins us for the 200th episode anniversary! In this episode we explore why CHOP started a medical education podcast, how topics/guests are chosen, and what impact the podcast has had on listeners. Get behind-the-scenes with host and creator, Katie Lockwood, MD, MEd, and learn about the important role of podcasting in medical education.

Poison Control: Celebrating 40 years of poison prevention at CHOP

Wed, 20 Aug 2025 11:54:08 -0400

This year the Children's Hospital of Philadelphia (CHOP) Poison Control Center celebrates it's 40th anniversary! In this episode, Fred Henretig, MD, one of the founders of the Poison Control Center reviews the history of how the Center came to be and it's role in keeping children safe and healthy in 2025. Robert Bassett, DO, teaches us about how the Poison Control Center operates and what the most common poisoning threats are today and how to prevent them. Meanwhile, Katie Lockwood, MD, MEd, shares that her family has called, so make sure you have 1-800-222-1222 saved in your phone and listen to this fascinating episode for more tips on poison prevention!

Dengue Fever (Episode 198)

Mon, 04 Aug 2025 19:27:30 -0400

Dengue fever is a mosquito-borne viral illness that can have serious complications. In this episode, Lori Handy, MD, MSCE, an attending in the Division of Infectious Diseases and Associate Director of the Vaccine Education Center at CHOP, explains the symptoms of dengue, why the vaccine is uncommonly used, and how to manage fever in a returning traveler. With half of the world's population living where dengue is common, this is an important infection for us to all know about and keep on the differential!

Cannabis Hyperemesis Syndrome (Episode 197)

Thu, 17 Jul 2025 12:25:42 -0400

Marijuana use by teens has been stable over the past few decades with 1 in 5 high schoolers using marijuana regularly. However, THC levels in marijuana have increased and we are seeing more Cannabis Hyperemesis Syndrome (CHS). In this episode, Adam Kronish, MD, explains current trends in marijuana use, the physiology of CHS, and what we can do in primary care to identify and manage this condition.

Delivering Serious News: Advice from a pediatric hematologist and oncologist (Episode 196)

Mon, 30 Jun 2025 15:50:29 -0400

Delivering serious news is unfortunately a part of pediatrics. While some believe that we are inherently either good or bad at this skill, we know that is not true and that you can learn how to do this well. In this episode, Julie W. Stern, MD, the Director of Outreach Services with the Division of Oncology at Children's Hospital of Philadelphia, shares best practices and lessons learned from years of having difficult conversations.

Teplizumab (Tzield) and Type 1 Diabetes Prevention (Episode 195)

Wed, 18 Jun 2025 11:16:51 -0400

Tzield or Teplizumab, is a CD3-directed monoclonal antibody to delay the onset of Stage 3 Type 1 Diabetes in adults and pediatric patients aged 8 years and older. This is an important new treatment option because when diabetes is recognized in the early stages (Stage 2), there is an approved treatment that has been shown to delay the need for insulin by about 2-3 years. In this episode, Neha S. Patel, DO, who is an Associate Professor of Pediatrics and an attending physician in the Division of Pediatric Endocrinology and Diabetes at Children's Hospital of Philadelphia, teaches us what we need to know about Tzield and how patients can access it.

Secondary Trauma and Self Care with Dr. Jessi Gold (Episode 194)

Thu, 05 Jun 2025 11:22:08 -0400

Jessi Gold, MD, MS, shares some of the lessons from her book, How Do You Feel: One doctor's search for humanity in medicine, including managing emotions, addressing burnout, and exploring self-identity. This episode feels like self-care! Learn the difference between secondary trauma, burnout, PTSD, and why healthcare workers are particularly at risk for experiencing trauma. Dr. Gold not only explores the current state of healthcare worker mental health but gives actionable ideas to help the helpers!

Medical Education on Social Media: Advice from Paul Tran, MD, of @alimentaryschool (Episode 193)

Mon, 19 May 2025 10:27:56 -0400

Paul Tran, MD, a pediatric gastroenterologist and medical educator, empowers and encourages medical learners through his comedic online medical education, using the handle @alimentaryschool. Listen as we discuss how he got started, the anatomy of a post, and how to respond to online criticism. In addition, we hear about his viral posts and why he's always carrying a notebook.

Medication and Surgical Options for Metabolic and Bariatric Care of Adolescents (Episode 192)

Wed, 07 May 2025 15:47:15 -0400

Two experts from the CHOP Bariatric Program, Joy Collins, MD, and Elizabeth Parks Prout, MD, MSCE, update us on the state of pediatric obesity, the current medication and surgical management options, and the outcomes of these interventions. The Adolescent Bariatric Program at CHOP is a unique collaboration between our Health and Well-being Clinic, surgeons at CHOP and HUP, clinical psychologists, a clinical dietician, a social worker, and a physical activity specialist. In this episode, Drs. Collins and Prout discuss the psychosocial impacts of bariatric surgery and their team-based, holistic approach to treating patients.

ADHD Treatment: How psychosocial interventions can be used with children and adolescents (Episode 191)

Thu, 17 Apr 2025 17:15:18 -0400

An estimated 11.4% of US children are diagnosed with ADHD. In this episode, Thomas Power, PhD, ABPP, Director of the Center for Management of ADHD at CHOP, discusses a new Clinical Pathway for the Evaluation and Treatment of ADHD and how primary care providers can utilize and promote psychosocial interventions for ADHD. We discuss behavioral parent training, peer interventions, school supports, emotion regulation, and more, in this fascinating episode!

Vaccine-preventable Infections Review: Lessons learned from a viral social media post (Episode 190)

Fri, 04 Apr 2025 08:38:31 -0400

In light of the recent measles outbreaks, Scott Krugman, MD, MS, FAAP, created a series of social media posts about vaccine-preventable infections. In this episode, he shares pearls from those posts so that we can learn more about these illnesses, which many practicing pediatric providers have never seen outside textbooks thanks to the success of vaccines. He also talks about how his social media posts were received online and why they were so popular.

Growth Hormone Deficiency Treatment: Understanding short stature, treatment goals, and side effects (Episode 189)

Mon, 24 Mar 2025 11:08:50 -0400

In this episode, we discuss the definition and work-up of short stature as well as treatment of growth hormone deficiency. Marissa Kilberg, MD, MSEd, an attending physician in the Division of Endocrinology and Diabetes teaches us about who might qualify for growth hormone deficiency treatment, possible side effects, the logistics of treatment, and when treatment is not indicated. Dr. Kilberg offers primary care providers strategies about the work-up that can be done in primary care as well as management pearls for patients on growth hormone therapy.

Anaphylaxis: Definition, cases, and new treatment options for children with allergies (Episode 188)

Wed, 05 Mar 2025 11:10:57 -0500

In this episode, Juhee Lee, MD, an attending physician in the Division of Allergy and Immunology at CHOP, discusses some of the nuanced ways anaphylaxis can present and reviews the diagnostic criteria for anaphylaxis. We use a few cases to apply the diagnostic criteria to real-world challenges and discuss how to manage patients with anaphylaxis in the outpatient setting. Dr. Lee teaches us about what's new in anaphylaxis treatment, including intranasal epinephrine, and when patients need to carry epinephrine auto-injectors. Lastly, we review the CHOP Clinical Pathway for the Evaluation/Treatment of Children with Anaphylaxis, which is a great resource.

Goat milk-based infant formula: niche formula or mainstream option? (Episode 187)

Thu, 20 Feb 2025 17:49:35 -0500

Sine 2023, both the FDA and AAP have supported the use of goat milk-based infant formula, but awareness of this option still lags and many think of it as a niche product. Ari Brown, MD, a board-certified practicing pediatrician in Austin, Texas, the author of the best-selling Baby 411 book series, and Kabrita’s Chief Medical Advisor, teaches us more about why families would choose a goat milk-based formula and the safety data behind its use in the US. Dr. Brown also gives us a great review of all of components of formula and what we should be looking for in the ingredients. In this episode, we also discuss the risks of homemade infant formula, raw milk, and unregulated formula, and Dr. Brown shares her experience in working in both the formula industry and in her pediatric clinic.

Sports Participation for Athletes with Cardiac Disease: Lessons from the CHOP Sports Cardiology Clinic (Episode 186)

Wed, 05 Feb 2025 16:50:42 -0500

In honor of American Heart Month, Jonathan Edelson, MD, an attending cardiologist at Children’s Hospital of Philadelphia (CHOP) and the Medical Director of the CHOP Sports Cardiology Clinic, talks with Katie Lockwood, MD, MEd, about sports participation for athletes with cardiac disease. Dr. Edelson addresses the importance of physical activity for children with cardiac conditions and how exercise plans should be individualized based on a child’s cardiac condition so that they can meet their exercise goals safely. Learn about the unique CHOP Sports Cardiology Clinic and how they guide athletes and may coordinate care with cardiologists and primary care providers. #HeartMonth @HeartCare4Kids #Cardiology2025 #CHOPHeartWarrior #SportsCardiology

Asthma Inhaler Management: Education, insurance coverage, & troubleshooting pediatric issues (Episode 185)

Wed, 22 Jan 2025 11:31:29 -0500

70-80% of patients do not use their asthma inhaler properly and use deteriorates over time. As Dr. Lockwood admits, many providers also don't know how to use some of the inhaler types out on the market and asthma medication shortages have led to prescribing challenges lately, so in this episode, Marcia Winston, MSN, RN, CPNP-PC, AE-C, a nurse practitioner with the Division of Pulmonary and Sleep Medicine at Children's Hospital of Philadelphia, walks us through various inhaler types and troubleshoots management issues. We also discuss the implementation of the 2020 GINA guidelines SMART therapy recommendations, use of and cleaning aero chambers, and a poster guide to identify mystery inhalers!

Retinoblastoma- (Episode 184)

Mon, 06 Jan 2025 10:44:48 -0500

Although relatively rare with 300 cases per year in the United States, we look for retinoblastoma at every well visit. Amish Shah, MD, PhD, a neuro-oncologist at CHOP, educates us on the epidemiology, presentation, management, and prognosis of retinoblastoma, as well as how partnership between Children's Hospital of Philadelphia and Wills Eye Hospital has improved outcomes for children.

Responding to In-Flight Emergencies: Is there a Doctor On-Board? (Episode 183)

Wed, 18 Dec 2024 09:11:46 -0500

Become better prepared to respond to an emergency situation on an airplane through the experience of an emergency medicine physician at Nemours Children's Health, Steven Selbst, MD. In this episode, Dr. Selbst and Dr. Lockwood discuss why healthcare providers should respond to emergencies, the most common types of emergencies, what supplies are on board, and the resources available to responders.

Iron-deficiency Anemia (Episode 182)

Wed, 11 Dec 2024 11:34:56 -0500

Iron plays a crucial role in many vital functions and in this episode, Char Witmer, MD, Clinical Director of Hematology at Children's Hospital of Philadelphia, gets us excited about hepcidin, ferritin, reticulocyte counts, and more! We discuss why premature infants are particularly vulnerable to iron-deficiency anemia, how to provide supplementation, dietary sources of iron, laboratory measurements of iron, and more in this fascinating episode on anemia.

Baby-led Weaning: A method to introduce solids and encourage self-feeding for infants (Episode 181)

Thu, 21 Nov 2024 12:00:57 -0500

Have you ever seen a baby eating a chicken drumstick? Or gnawing on a whole strawberry or broccoli floret? Many healthcare providers may not have learned about baby-led weaning and therefore, may not teach parents about this method of introducing solids and teaching babies about self-feeding. In this episode, Dr. Katie Lockwood and Kary Rappaport, OTR/L, MS, SCFES, IBCLC, a senior feeding and swallowing specialist on the team at Solid Starts, discuss the differences between choking and gagging, serving sizes at different ages, feeding challenges, handling allergens, and more, just in time for Thanksgiving!

Social Media for Healthcare Professionals

Mon, 11 Nov 2024 10:51:14 -0500

Healthcare professionals may use social media for a variety of purposes including developing a professional network, increasing personal awareness of news, listening to experts, and/or consulting colleagues. It can also be a tool to disseminate research, market practices, engage in health advocacy, and engage with professional organizations. Increasingly we are seeing health care professionals provide health information to the community and engage with patients on social media platforms. On this episode, Anjuli Gans, MD, a pediatrician at Karabots Pediatric Care Center in West Philadelphia, a CHOP Care Network primary care practice, who is known online for her site Resilient Rascals and its popular Instagram account of the same name with 141,000+ followers, discusses the rules of engagement, how to fight mis/dis-information, and why healthcare providers might want to create a social media account.

Epilepsy Surgery for Drug-Resistant Epilepsy (Episode 179)

Mon, 21 Oct 2024 12:26:30 -0400

Of the roughly 500,000 US children with epilepsy, 30% will continue to have seizures despite medication management. This seizure burden can have significant impacts on a child’s development, school performance, social life, sports participation, driving ability, mental health, and more. In this episode, we talk about surgical approaches to drug-resistant epilepsy and explore some of the newest advances in neurosurgery with Benjamin Kennedy, MD, an attending neurosurgeon and the Director of Epilepsy and Functional Neurosurgery in the Division of Neurosurgery at Children’s Hospital of Philadelphia.

Financial Planning Tips for Physicians (Episode 178)

Wed, 09 Oct 2024 12:33:00 -0400

Financial planning is not often taught to physicians but is an important topic! In this episode, Sam Lewis, CFP®, ChFC®, MQFP®, Founder of SJL Financial, LLC, guides us through how we should think about life insurance, disability insurance, loan repayment, contract negotiations, savings accounts, wills, retirement, and more! While financial planning is an individual decision, this episode provides a general framework to start thinking about financial wellness.

Tethered Cord in Pediatrics (Episode 177)

Mon, 23 Sep 2024 10:55:52 -0400

Gregory Heuer, MD, PhD, a Children's Hospital of Philadelphia neurosurgeon, explains tethered cord, including the embryologic development, diagnosis through imaging, clinical signs and symptoms, surgical approaches, and long-term prognosis. As a co-author of the CHOP Clinical Pathway on Tethered Cord Release, Dr. Heuer provides insight into what to expect after surgery, which is helpful to anyone involved in the care of patients with a tethered cord.

School Lunch Nutrition Updates with USDA FNS (Episode 176)

Mon, 09 Sep 2024 16:20:35 -0400

In 2010, Congress passed the Hunger-Free Kids Act to help ensure that every American child has access to a balanced school lunch. This is important because many children rely on schools to meet a large portion of their daily nutritional needs. Parents and pediatricians should be aware that new rules will gradually place limits on added sugars and reduce sodium, among other changes. In this episode, we talk with Cindy Long, Deputy Under Secretary for Food and Nutrition Service, about school meal standards and how they impact children. #schoollunch #nutrition #pediatrics

Twins (Episode 175)

Mon, 26 Aug 2024 14:27:28 -0400

Twins account for 3% of live births in the US and are at risk of higher rates of fetal growth restriction, congenital anomalies, twin-twin transfusion syndrome, twin anemia polycythemia sequence, selective fetal growth restriction, and cord entanglement. In this episode, Michael Posencheg, MD, a Children's Hospital of Philadelphia neonatologist and father of twins talks to us about the care of #twins beyond the #NICU including developmental assessments, tandem feeding, safe sleep practices, and more.

Teen Communication: Learning language to build character, resilience, and relationships (Episode 174)

Mon, 12 Aug 2024 11:10:48 -0400

Talking with teenagers can feel challenging, but in this episode, Kenneth Ginsburg, MD, MSEd, an attending physician in the Division of Adolescent Medicine and the Co-Director of the Center for Parent and Teen Communication at Children's Hospital of Philadelphia, shares lessons learned from his years of research and experience with adolescents. Dr. Ginsburg's approach to teen communication focuses on facilitating youth to develop their own solutions through a strengths-based approach. Listen to learn his communication framework and for more resources that will enhance how you communicate with teen patients.

Rabies (Episode 173)

Mon, 22 Jul 2024 17:13:32 -0400

Contact with infected bats is the most common cause of human rabies deaths in the US, but dog rabies remains common worldwide. Learn about other wildlife that can carry rabies, post-exposure prophylaxis, high-risk hobbies and careers, and what rabies can teach us all. Andrew Steenhoff, MBBCh, DCH, attending physician in the Division of Infectious Diseases at CHOP and Medical Director of CHOP's Global Health Center joins us in Episode 173 for a fascinating review of rabies in the US and globally, so we can all aim to prevent this disease in children.

Epilepsy and Teens: Counseling advice on managing epilepsy as an adolescent (Episode 172)

Mon, 08 Jul 2024 10:07:32 -0400

According to the CDC, approximately 0.6% of children aged 0-17 have active epilepsy, so in a school of 1,000 students, this means 6 of them could have epilepsy. Adolescence is a time when patients have more autonomy in caring for their chronic disease and have changes in lifestyle factors, which could be risk factors for increased seizures. In this episode, Lawrence Fried, MD, a pediatric neurologist, and Zia Gajary, MD, a primary care pediatrician, help us understand how to counsel teen patients and their caregivers about managing epilepsy during adolescence, including topics such as driving, sports, contraception, drugs, college, and more! Their HRSA grant has enhanced teen epilepsy education at CHOP and they share their tips in this podcast episode.

Advocacy Curriculum in Pediatric Residency Education (Episode 171)

Mon, 17 Jun 2024 11:16:18 -0400

The Children's Hospital of Philadelphia (CHOP) advocacy curriculum has a rich history of teaching pediatric residents how to incorporate being an advocate into their career as a pediatrician. Noreena Lewis, JD, the Co-Director of the Community Pediatrics and Advocacy Program (CPAP), explains the various ways pediatricians can engage in advocacy, some of the biggest hurdles for resident advocates, strategies for engaging with communities and creating sustainable projects as a trainee, and examples of CHOP resident advocacy projects. Noreena recommends the CHOP Office of Community Impact as a great starting point for anyone interested in starting their advocacy journey! You can also read her article in Pediatrics (Feb 2024) entitled "A Qualitative Study of Resident Advocacy Work." This episode is such an inspiring conversation about an important topic for all pediatricians and medical educators!

Sickle Cell Gene Therapy (Episode 170)

Thu, 06 Jun 2024 14:48:27 -0400

New research has led to the approval of sickle cell gene therapy and CHOP has played a big role in both the research and implementation of this innovative treatment. In this episode, Dr. Abraham Haimed, an attending in the Division of Hematology at Children's Hospital of Philadelphia, explains how a patient's own hematopoietic stem cells can be edited to block the expression or function of a certain gene and reactivate normal fetal hemoglobin to cure sickle cell disease. While this treatment happens outside the primary care world, it is important for general pediatricians to understand how this treatment works and what to look out for after a patient receives gene therapy.

An Antiracist Approach in Primary Care

Mon, 20 May 2024 09:48:01 -0400

A recent publication in Pediatrics by George Dalembert, MD, MSHP and Aditi Vasan, MD, MSHP helps us learn more about how to use an antiracist approach to social care integration in primary care. In this episode, Drs. Dalembert and Vasan walk us through the recommendations made in their commentary with actionable steps for how we can all integrate social care interventions equitably into our practices. Learn about what the work that we are implementing at CHOP thanks to the Clinical Futures research and get inspiration for your own practice changes.

Pre-exposure Prophylaxis (PrEP): HIV Prevention for Adolescents

Mon, 06 May 2024 13:16:54 -0400

As of 2020, 20% of new HIV diagnoses were among young people aged 13-24 years. Primary care pediatricians can play an important role in the prevention of HIV through standard, non-stigmatizing sexual health and HIV prevention care, which is why we are talking about PrEP with Sarah Wood, MD, MSHP, and Zoe Gould, LCSW. Learn about the role of PrEP, administration, barriers to care, and ways to start integrating HIV screening and PrEP initiation into your practice.

Primary Care Perspectives: Episode 167-- Nutrition Advice for Premature Babies at Discharge from the NICU

Wed, 24 Apr 2024 11:12:42 -0400

The CHOP Neonatal Intensive Care Unit is working on enhancing communication of nutrition plans to primary care providers when infants are discharged. In this episode, Sarvin Ghavam, MD, an attending neonatologist and Kristina Spaide, MS, RD, CNSC, clinical nutrition manager, identify the unique nutritional needs of premature babies, common feeding concerns, and nutrition management pearls for the transition from NICU to home.

Primary Care Perspectives: Episode 166-- Marfan Syndrome

Sat, 13 Apr 2024 16:40:39 -0400

How well do you know the stigmata of Marfan Syndrome, which are an important components of the pre-participation sports physical? Staci M. Kallish, DO, a clinical geneticist at Children's Hospital of Philadelphia reviews how the clinical diagnosis of Marfan Syndrome is made and tools that can be used in screening and diagnosis. Also, learn about the CHOP Cardiovascular Connective Tissue Disorders Clinic and how they can help in the evaluation and management of patients with connective tissue disorders.

Primary Care Perspectives: Episode 165-- Stuttering

Wed, 20 Mar 2024 14:32:27 -0400

While many famous figures, including President Biden, have worked to decrease the stigma around stuttering, there are still significant psychosocial effects for many children who stutter. Joseph Donaher, PhD, CCC-SLP, a speech language pathologist at the Center for Childhood Communication at Children's Hospital of Philadelphia, teaches us about the natural history of stuttering, when to refer to a speech therapist or other clinician, and how we can help support the well-being of these children. This is an important listen for pediatricians, parents, and teachers!

Primary Care Perspectives: Episode 164-- Medical Legal Partnerships in Primary Care

Wed, 06 Mar 2024 13:53:44 -0500

How can lawyers and pediatricians work together to improve patient care? Osarugue Osah-Edoh and Andrew Yang, lawyers at Community Legal Services of Philadelphia and in the CHOP Medical Legal Partnership, educate us on how lawyers embedded in the healthcare setting support patients and their families with critical legal needs.

Primary Care Perspectives: Episode 163-- Immune Dysregulation

Wed, 21 Feb 2024 14:44:06 -0500

Inflammation, recurrent infections, fevers and rashes, and poor growth may all be ways that immune dysregulation presents in primary care patients. Edward Behrens, MD, Chief of the Division of Rheumatology at Children's Hospital of Philadelphia, discusses the Dysregulated Immune Response Team (DIRT) and their innovative approach to immune dysregulation management. Using a multidisciplinary team, precision medicine, collaborative research, and care coordination, the DIRT program is improving care for patients with rare diseases.

Primary Care Perspectives: Episode 162-- Ankyloglossia

Wed, 07 Feb 2024 13:22:40 -0500

Google searches for tongue tie, or ankyloglossia, have doubled in the past five years and the number of infants having frenotomies is also increasing. Helping us understand the tongue anatomy and sort out myths surrounding tongue ties is Adva Buzi, MD, an attending physician in the Division of Otolaryngology at Children's Hospital of Philadelphia. Together, we discuss diagnosis, indications for referral, potential benefits/risk of frenotomy, and the myths surrounding ankyloglossia.

Primary Care Perspectives: Episode 161: Artificial Intelligence Use in Pediatrics

Wed, 24 Jan 2024 13:26:37 -0500

How is artificial intelligence (AI) already being used in pediatrics and how will we use it in the future? In this episode, Bimal Desai, MD, MBI, FAAP and Kevin Johnson, MD, MS, FAAP explain not only how we use AI currently, such as using an ambient scribe, but also how we can use AI in the future, including augmented imaging. We explore the benefits of AI for patient outcomes, concerns about data privacy, and anticipatory guidance for our patients.

Primary Care Perspectives: Episode 160- Eating Disorders and Diet Culture

Thu, 11 Jan 2024 11:18:38 -0500

Diet culture seems pervasive in our society and impacts our children and adolescents. In this episode, Nicole Cifra, MD, MPH, MHPEd, Assistant Professor of Clinical Pediatrics in the Division of Adolescent Medicine at Children’s Hospital of Philadelphia discusses the influence of diet culture, signs of eating disorders, and ways to have a weight neutral approach with patients. Early identification of eating disorders has a huge impact on prognosis and primary care providers play a crucial role in this identification.

Primary Care Perspectives: Episode 159 - Clinician Well-being: The Buzz Around Burnout

Fri, 22 Dec 2023 21:04:00 -0500

With their diverse work experience and unique skill sets, advanced practice providers (APPs) are able to contribute to not only the wellbeing of patients but also that of other providers. Bridget Sullivan Garmisa, MSN, MS, CRNP, RD, nurse practitioner at Children’s Hospital of Philadelphia, shares her perspective as an APP and gives insight into clinician well-being and burnout, including the varying degrees of burnout among different roles, driving factors like workplace inequality, as well as ways to spark joy in the workplace; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 158 - Magnesium: Pros and Cons of Supplementation

Thu, 07 Dec 2023 15:21:00 -0500

As the fourth most abundant mineral in the body, magnesium is essential for regulating many bodily functions. But as a supplement — especially over the counter — it could do more harm than good. Neil Patel, PharmD, BCOP, Director of Retail and Specialty Pharmacy and Investigational Drug Service at Children's Hospital of Philadelphia, reviews different formulations and potential contraindications, and shares dosing considerations and general guidelines for treating pediatric constipation and migraine management; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 157 - Counseling for Pre-Diabetes

Mon, 13 Nov 2023 09:31:00 -0500

Unlike diabetes, the first line of treatment for prediabetes isn’t medication — but rather lifestyle modifications. Rachana D. Shah, MD, MsTR, Medical Director of the Healthy Weight Program at Children’s Hospital of Philadelphia, reminds primary care physicians about therapeutic options, reviews the American Academy of Pediatrics’ most recent screening guidelines, highlights the risk factors of prediabetes plus how to manage it; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 156 - Lipid Screening

Thu, 19 Oct 2023 17:50:00 -0400

“To fast or not to fast?” When it comes to cholesterol screening, that is the question. Rachel Shustak, MD, and Jordy Martino, MSN, CRNP, an attending cardiologist and a nurse practitioner with the Lipid Heart Clinic at Children's Hospital of Philadelphia, respectively, provide answers to that age-old question plus non-pharmacologic approaches proven to lower cholesterol levels; and more. By taking the ideal screening ages, lifestyle changes and diet recommendations from the American Academy of Pediatrics (AAP) and translating them into real, practical tips for reducing the risk of cardiovascular disease, they help to settle a longstanding debate among primary care physicians. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 155 - Vaccine Hesitancy

Thu, 28 Sep 2023 16:35:00 -0400

If there’s one lesson the COVID pandemic taught us, it is that public health lives on a local level — and in order to learn from the community, we must listen to the individual. Angela K. Shen, ScD, MPH, Visiting Research Scientist at the Vaccine Education Center at Children’s Hospital of Philadelphia, addresses growing concerns over vaccines and how physicians can help not only ease the worries of parents but also rebuild trust amidst the spread of misinformation; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 154 - Nirsevimab (Beyfortus)

Mon, 18 Sep 2023 09:43:00 -0400

For the first time, a preventative medicine is available to protect infants and high-risk toddlers from respiratory syncytial virus (RSV). Lori Handy, MD, MSCE, attending physician in the Division of Infectious Diseases at Children's Hospital of Philadelphia, details the science behind the monoclonal antibody, nirsevimab (Beyfortus) and its importance, safety and efficacy, side effects, administration and proven benefits, such as a decrease in morbidity, as shown by clinical trials; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 153 - Fatal Poisonings

Wed, 30 Aug 2023 21:46:00 -0400

It’s hard to call an opioid overdose an accident when it happens to a young child — at home and under supervision. Some fatal poisonings are deliberate or even malicious. But such is the opioid epidemic. Christopher E. Gaw, MD, MBE, assistant professor at Nationwide Children’s Hospital, shares the latest findings from his recent study on fatal poisonings among young children. His findings include common themes, risk factors and demographic characteristics among victims; the shift from prescription to synthetic opioids; and as a result, how the emergency department has had to adapt to better counsel families on childproofing and preventing accidental ingestions; examples of community involvement and intervention; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 152 - Torticollis: 3 Types and Takeaways

Tue, 08 Aug 2023 15:59:00 -0400

When thinking about physical therapy, babies may not necessarily come to mind. But in the case of congenital muscular torticollis patients, PT can have a profound impact on their motor development into early childhood. Meredith Caverow, PT, DPT, and Kristen Kouvel, PT, DPT, PCS, physical therapists at Children’s Hospital of Philadelphia, offer primary care pediatricians the top three takeaways from their new clinical pathway: how to detect and distinguish between the three main types of torticollis, including common physical exam findings as well as anomalies to look out for, and why that distinction is important; when to consider referrals for further evaluation by a physical therapist and what parents can do with their child at home for an early as possible resolution. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 151 - Syphilis: Prevalence and Prevention

Thu, 27 Jul 2023 13:09:00 -0400

Snuffles, Hutchinson teeth and saber shins — what do these things all have in common? They are symptoms of syphilis. Also known as the “great mimicker,” syphilis can present itself in many ways. Ericka Hayes, MD, attending physician in the Division of Infectious Diseases at Children's Hospital of Philadelphia, addresses the growing problem of congenital syphilis and the rising rates of transmission from mother to child; describes the common symptoms at birth or in early infancy as found in the newborn nursery and at early newborn checkups, including the classic syphilis rash and its variations; stresses the importance of universal STI screening for teens in prevention; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 150 - ADHD Medication Management

Thu, 13 Jul 2023 15:06:00 -0400

Through no fault of their own, ADHD medications often bear the misconception of being ineffective — or worse, unsafe — yet they are the first line of treatment used by many physicians, including primary care pediatricians. Katrina A. Fletcher, MD, attending psychiatrist in the Department of Child and Adolescent Psychiatry and Behavioral Sciences at Children's Hospital of Philadelphia, provides a broad overview of ADHD medications, including the highs and lows of varying treatments, from increased productivity to loss of appetite; the trial and error in determining the correct dosing; adjuncts such as behavioral interventions; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 149 - The Future of Pediatrics

Thu, 29 Jun 2023 15:54:00 -0400

Did you know that in the late 19th and early 20th centuries, there were “milk stations” that provided supervision of infant feeding and growth? The roots of pediatric care can be traced back to those early days, and there have been considerable changes since. With no signs of slowing down, pediatric care continues to evolve at a rapid pace. Katie K. Lockwood, MD, MEd, a pediatrician and holder of a Distinguished Endowed Chair in the Department of Pediatrics at Children's Hospital of Philadelphia, and Alex Fiks, MD, MSCE, a pediatrician, academic investigator, and the Director of both Clinical Futures (Research Center of Emphasis) and the Possibilities Project: Innovation at CHOP, review the present, past and future state of pediatric primary care, which includes the pros and cons of the electronic health record (EHR) and its evolution; the innovation of clinical decision support tools and its effect on patient outcomes; pediatric career outlooks, including expected labor shortages; and more while also offering supporting evidence and advice to trainees. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 148 - Managing Sinus Infections

Wed, 14 Jun 2023 11:26:00 -0400

Have you heard that babies can’t get sinusitis because they don’t have sinuses? Not true! Mark Rizzi, MD, attending physician in the Division of Otolaryngology (ENT) at Children’s Hospital of Philadelphia, provides a useful review for primary care, including: an overview of sinus formation by age; allergic rhinitis and other pre-disposing factors; how to decide if a routine URI has become sinusitis and antibiotics are warranted (you don’t necessarily need to wait 10 days); neti pots, nasal steroids and other adjuvant treatments; complications to look out for, including unremitting headache for intracranial spread; prevention tips; when to refer to ENT or the ER; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 147 - Somatic Symptom and Related Disorder

Thu, 01 Jun 2023 11:57:00 -0400

Somatic symptoms are real; we all experience them. One Canadian study found that somatic complaints account for more than 25% of all primary care visits. Samuel Neher, MD, pediatric hospitalist at the Children’s Hospital of Philadelphia, introduces a new clinical pathway for Somatic Symptom and Related Disorder (SSRD) that suggests a standard of care for these symptoms. Goals are to build empathetic rapport with patients and families; encourage somatic symptom treatment alongside diagnostic testing; and promote strong communication and collaboration among the interdisciplinary care team. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 146 - Caring for Children in Foster Care

Tue, 09 May 2023 08:01:00 -0400

Each year in the U.S., more than 400,000 children are in foster care. Jennifer Keim, MD, MPH, primary care pediatrician at the Nicholas and Athena Karabots Pediatric Care Center of Children’s Hospital of Philadelphia, provides a review of important considerations in primary care for these vulnerable children, including: explanations of common terms, such as medical foster homes, resource parents, respite care, and more; the significance of placement instability and a trauma-informed approach to care; resources such as CHOP’s Fostering Care Program for outpatient assessment, and CASA volunteers; consent and confidentiality issues and how to sort through them; defining permanency, aging out and other outcomes and a review of national and local statistics; and more. Published May 2023. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 145 - Intellectual Disabilities Clinical Pathway Review

Wed, 19 Apr 2023 14:55:00 -0400

CHOP has a new primary care clinical pathway for the diagnostic evaluation of development delay and intellectual disability. Its co-authors, Elana Huang, MD, primary care pediatrician, CHOP Care Network, and Hana Alharbi, MBBS, MS, pediatric geneticist, University of Tabuk, Saudi Arabia (who did a fellowship at CHOP), review the pathway and how it might help a primary care practitioner, including information about: testing tiers; limits of newborn screening panels; non-genetic test recommendations; which subspecialties to refer to for certain symptoms; recommendations for next steps when encountering recognizable syndromes; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 144 - Neighborhoods and Children’s Health

Wed, 29 Mar 2023 16:41:00 -0400

It’s estimated that 20 percent of variation in health outcomes is due to medical and healthcare system factors. Environment makes up a significant portion of the other 80 percent. Stephanie Mayne, PhD, MHS, epidemiologist and research scientist at PolicyLab at Children’s Hospital of Philadelphia, provides information to help primary care clinicians understand neighborhood-level social determinants of health, including: the roots of disparities in resources by neighborhood and how this affects children; specific neighborhood attributes that impact sleep and mental health, such as noise, violence, pollution, tree canopy and green space; suggestions for how to advocate for interventions; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 143 - Anxiety with Food Allergies

Mon, 13 Mar 2023 16:36:00 -0400

Lunch at school. A birthday party. Dinner out. For kids with food allergies, everyday activities can be fraught. Megan Lewis, MSN, RN, CRNP, nurse practitioner and program manager, Food Allergy Center at Children’s Hospital of Philadelphia, and James (JP) Senter, MD, a third-year resident at CHOP, review: the extent to which food allergies affect quality of life for children and families; oral immunotherapy; Scale of Food Allergy Anxiety (SOFAA); tips for talking to patients with food allergies about anxiety; how history of anaphylaxis can lead to anxiety; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 142 - Mental Health and Congenital Heart Disease: A Review

Mon, 20 Feb 2023 12:43:00 -0500

Children born with congenital heart disease (CHD), the most common birth defect in the U.S., are at greater risk for emotional and behavioral health concerns. Lyla El-Messidi Hampton, PhD, ABPP-CN, pediatric neuropsychologist and co-director of the Cardiac Kids Developmental Follow-up Program at CHOP, and Nicholas Seivert, PhD, psychologist in the Cardiac Center at CHOP, review the many reasons for increased mental health risk among children with heart defects, especially single ventricle patients, and provide information about: importance of early identification and intervention; ADHD meds for CHD patients; the higher rate of autism spectrum disorders in this population; the parental distress loop; screening in primary care, and red flags; places to refer at CHOP; and more. Published February 2023. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 141 - Managing Pediatric Migraine Headaches in Primary Care

Mon, 13 Feb 2023 16:51:00 -0500

Are occipital headaches always cause for alarm? What if the headache is always on the right side or the left side? What is a thunderclap headache? Ishani Kumar, MD, pediatric headache fellow, Division of Neurology, Children’s Hospital of Philadelphia, provides a review to help primary care providers manage migraine headaches, including: tips for taking a headache history; red flags; distinguishing a migraine from a tension headache; explaining aura with headache; use of NSAIDs and triptans for pain; use of nutraceuticals for prevention; how to counsel patients about when improvements from treatment may begin (usually at least 8 weeks); when to refer for outpatient imaging and to neurology; when to send to the ER for urgent imaging or work-up; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 140 - Preventing Weight-based Harm in the Primary Care Setting

Fri, 27 Jan 2023 07:36:00 -0500

How can pediatricians move away from “diet culture” and encourage children and teenagers to have healthy relationships with food, exercise and their bodies? Two experts from the Eating Disorder Assessment and Treatment Program at Children’s Hospital, Eleanor Benner, PsyD, MA, psychologist, and Kerri Heckert, MS, RD, LDN, clinical dietician, discuss: suggestions for how pediatricians can talk about weight, nutrition and exercise without causing harm; socioeconomic factors that affect eating and activity; tips to offer parents, such as avoiding “fat talk”; encouraging kids to eat intuitively; limits to the usefulness of BMI; acknowledging weight bias in healthcare provider decision-making; explaining “body positivity” and “body neutrality”; red flags and what to do if there is suspicion for an eating disorder; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 139 - Disability Awareness

Tue, 10 Jan 2023 14:14:00 -0500

Approximately one-quarter of Americans have disabilities. How can primary care pediatricians better support the health and goals of patients with disabilities? Danielle Barber, MD, PhD, attending physician, Division of Neurology, Children’s Hospital of Philadelphia, discusses: the World Health Organization’s International Classification of Functioning, Disability and Health (ICF); making care decisions based on the child’s wishes and goals, such as swimming; fostering the growth of a disability identity; presumptions in diagnosing everyday ailments in patients with disability; how community integration and the ability to function affect quality of life and perceived good health; changes in the office setting to improve the patient experience; suggestions for resources and “first steps”; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2023 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 138 - Hyperbilirubinemia: A review of updated guidelines

Tue, 20 Dec 2022 13:16:00 -0500

Updated clinical practice guidelines for management of hyperbilirubinemia – including revised phototherapy thresholds – were published in August, the first major change since 2004. Joanna Parga-Belinkie, MD, attending neonatologist, Division of Neonatology, Children’s Hospital of Philadelphia, provides a review for the nursery and primary care clinic, including a new name for “breastfeeding jaundice”; determining risk for isoimmune hemolytic disease; the importance of G6PD in bilirubin results; the limits of visual assessment of jaundice; using transcutaneous bilirubin meters in primary care; answers to parent questions such as, “Will sunlight help jaundiced babies?”; management of “rebound bili”; tools to help measure phototherapy thresholds by age as you adjust to the new guidelines; and more. Published December 2022. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 137 Sex-Trafficking and Sexual Exploitation of Youth

Thu, 01 Dec 2022 17:07:00 -0500

The Adolescent Protective Collaborative (APC) at Children’s Hospital of Philadelphia is dedicated to providing a specialized medical home for youth who have experienced or are at high risk for sex trafficking. Primary care physicians can be partners in identifying and helping children who are victims. Guests Kali Hackett, MSW, MPH, a public health social worker and clinical services coordinator for the APC, Polina Krass, MD, a fellow in Emergency Medicine and co-founder of the APC, and Anish Raj, MD, a fellow in Child Abuse Pediatrics and co-founder of the APC, provide an overview and practical information, including: defining sex trafficking and commercial exploitation of children (CSEC); red flags in history, complaints, and physical exam; the effects of exploitation beyond reproductive health; an explanation of the Adolescent Protection Collaborative, including what a clinic visit entails for the child and how the team works with other community organizations; and what a primary care physician can do to identify and help victims, including detailed suggestions for how to have the initial conversation, how to ask questions, and what to do if the child confirms they are abused. Kali Hackett, MSW, MPH, a Public Health Social Worker and the Clinical Services Coordinator for the APC Polina Krass, MD, a Fellow Physician in Emergency Medicine and Co-Founder of the APC Anish Raj, MD, a Fellow Physician in Child Abuse Pediatrics and Co-Founder of the APC This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 136 Is That a Bull’s Eye? Is Tick-testing a Thing? And More!

Tue, 08 Nov 2022 15:40:00 -0500

Lyme disease can be challenging to distinguish from many common pediatric infections. Michael Russo, MD, attending physician in the Division of Infectious Diseases at Children’s Hospital of Philadelphia, reviews: disease history and incidence; disease stages, including early localized, early disseminated, and late; tips for distinguishing the Lyme-related symptoms bull’s-eye rash, facial palsy and arthritis from other ailments; indications for testing (and why tick-testing isn’t advised); amoxicillin, doxycycline, and ceftriaxone for different manifestations; duration of treatment; indications for post-exposure prophylaxis; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 135 - SMART Therapy for Asthma: A Review and Practical Tips

Fri, 28 Oct 2022 13:54:00 -0400

The new SMART guidelines for children whose asthma is not well controlled, including use of one inhaler for maintenance and rescue, was a significant change to which both caregivers and providers are still adjusting. Tyra Bryant-Stephens, MD, Medical Director of the Community Asthma Prevention Program and Chief Health Equity Officer of the Center for Health Equity at Children's Hospital of Philadelphia, reviews: who is eligible for SMART; signs and symptoms of asthma that is not well controlled; case examples; tips for discussing the changes with parents; tips for SMART prescription-writing; benefits of the new guidelines; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 134 - Reflux Redux: A Review of Primary Care Management of GERD

Wed, 12 Oct 2022 16:05:00 -0400

More than half of infants experience gastroesophageal reflux (GER) and 10-20% have gastroesophageal reflux disease (GERD), and guidelines for this issue often change. Here to help clear up confusion is Jefferson Brownell, MD, pediatric gastroenterologist, Children’s Hospital of Philadelphia. He first provides a review of red flags for referral to GI or the emergency room, and then an overview of GERD in otherwise healthy babies, including: scheduled small-volume feedings; thickening options; amino acid formulas and other formula options; positioning during sleep; medication options; duration of meds and how to wean; counseling families hesitant to start meds; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 133 - Giftedness with Thomas Flynn

Thu, 29 Sep 2022 09:27:00 -0400

Primary care physicians can play a key role in helping patients who are intellectually and cognitively gifted get the resources they need, including children who may otherwise be missed. Thomas Flynn, PhD, a pediatric neuropsychologist at Children’s Hospital of Philadelphia, discusses: characteristics a primary care physician can look for that may predict a high likelihood of being gifted; pros and cons of knowing a child’s IQ; variabilities in testing; racial and ethnic disparities in identifying intellectually gifted children; the pediatrician’s role in advocating for testing for children; “twice exceptional” children who are gifted and have ADHD or a learning disability; impact of giftedness on mental health; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 132 - Diagnosing Lupus

Wed, 14 Sep 2022 11:51:00 -0400

Lupus is one of the most common diseases in pediatric rheumatology, but it is complicated to diagnose because its symptoms can be broad and nonspecific, creating overlap with other diagnoses. Sarah Bayefsky, MD, a pediatric and adult rheumatology fellow at Children's Hospital of Philadelphia and the Hospital of the University of Pennsylvania, and Melissa Argraves, MD, MSEd, a pediatric rheumatologist at Nationwide Children’s Hospital, discuss what a primary care physician should look for if suspecting pediatric-onset lupus — a disease that is seen primarily in teenagers, and in particular females of color. They explain the nuances of possible symptoms; what can be observed during a clinical visit; what labs to order; and what a PCP should keep an eye on if a patient has been diagnosed with lupus. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 131 - Understanding Vaccine Hesitancy in Black Families

Tue, 30 Aug 2022 15:54:00 -0400

In the U.S., Black women are 3 times more likely to experience infant mortality and previously healthy Black children are 3.4 times more likely to die within 30 days after a surgery. What do these statistics – and many others around healthcare, housing and other topics – have to do with vaccine hesitancy? Everything. Latasha Easter, MD, a pediatric resident at Children’s Hospital of Philadelphia, provides an overview of: disparities in immunization rates; the historical context for distrust of the medical establishment and government among Black patients, and the importance of acknowledging it; the CASE Approach, a framework for conversations with hesitant families; sample conversations and responses; an HPV vaccination success story; social media as an information source; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 130 - Swimmer’s Ear or Something Worse?: A Review of Otorrhea

Thu, 11 Aug 2022 08:36:00 -0400

Did you know that lack of canal swelling should be a red flag in physical exam of otorrhea? Ryan Ruiz, MD, MS, attending physician, Division of Otolaryngology, Children’s Hospital of Philadelphia, provides a broad review, covering: key physical exam findings that indicate otitis externa; using antibiotic ear drops and/or oral antibiotics; when to culture; the role of cerumen; when to bring patients back to evaluate tympanic membrane closure; guidelines for water precautions, including for children with ear tubes; evaluating for acute mastoiditis; assessments after trauma; tools an ENT and audiologists have at their disposal that primary care doesn’t; and more. Published August 2022. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 129 Mental, Emotional, Social and Physical Health

Thu, 28 Jul 2022 11:22:00 -0400

The Philadelphia Youth Sports Collaborative has more than 70 member organizations that help promote leadership, grit, and other important skills through sports. Beth DeVine, executive director, Philadelphia Youth Sports Collaborative, explains the term “sports-based youth development” and provides an overview of the organization’s goals and role, including trauma-informed coaching, outcome measurement, equitable access, sports as a promoter of social and emotional learning, differences between benefits to boys and girls, and more. She also provides advice on how pediatricians can encourage kids to participate in beneficial sports programs, including pointing them to rec centers and specific resources. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 128 Climate Change and Children’s Health

Wed, 13 Jul 2022 13:13:00 -0400

Climate change has many health effects, yet doctors and patients don’t routinely discuss this topic. Harleen Marwah, MD, MS, a pediatric resident at Children’s Hospital of Philadelphia who is the founder of Medical Students for a Sustainable Future,provides an overview of the many ways climate changes affects children’s health, including prenatal health and mental health. Presented with overwhelming information about climate change, doctors may struggle to know how to put helpful steps into practice. Dr. Marwah discusses ideas for how pediatricians can incorporate anticipatory guidance and screening questions related to climate change into practice,with the goal of helping families navigate the changing environment; how doctors can participate in advocacy; and the one step every doctor, no matter how busy,can take today to help address climate change. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 127 - Managing Oral Allergy Syndrome in the Primary Care Setting

Mon, 27 Jun 2022 20:40:00 -0400

How can a primary care physician be sure their patient’s oral allergy syndrome (OAS) is not another type of allergy that may require more aggressive management? Katie Kennedy, MD, attending physician, Division of Allergy and Clinical Immunology, Children’s Hospital of Philadelphia, discusses: how to get a history to distinguish between OAS and IgE-mediated food allergies and seasonal/environmental allergies; the importance of pollen patterns in your region and a review of cross-reactive foods; why kids with OAS react differently to raw and cooked food (raw apples vs. apple pie); whether to recommend antihistamines; differentiating between contact rashes (such as from strawberries and tomatoes) and OAS; how to evaluate whether the child may be at risk for systemic reaction (and should carry epinephrine); can a child outgrow OAS; when to refer to a pediatric allergist, plus a review of the treatments the allergist might suggest; and more. Published June 2022. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 126 - Sleep-related Death in Infants Is Common and Preventable

Fri, 03 Jun 2022 15:54:00 -0400

In Philadelphia, sleep-related deaths (including SIDS, accidental suffocation, and unknown cause) are the second-highest cause of infant mortality, after prematurity. Two pediatricians, Roy Hoffman, MD, MPH, Medical Director, Fatality Review Program, Philadelphia Department of Public Health, who sees patients at a health department-run community health center (Health Center #6), and Stacey Kallem, MD, Director, Division of Maternal, Child, & Family Health at Philadelphia Department of Public Health, provide an overview, including: incidence and factors; racial-ethnic disparity; a review of barriers to safe sleep and ideas for effective counseling for prevention; ways to help parents get support, including for lactation and smoking cessation; genomic sequencing and other research into medical causes for sleep-related deaths; practical tips to share with parents; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 125 - Emergency Room or Not?

Mon, 16 May 2022 14:59:00 -0400

Parents worry when a child hits their head. This podcast will help inform the important decisions you need to make as a primary care provider, including whether to send them to the emergency room. Daniel Corwin, MD, MSCE, an emergency medicine physician and researcher at Children’s Hospital of Philadelphia, discusses acute (less than 24 hours) head trauma in otherwise healthy children, reviewing: the 6 criteria for each age group; why criteria for children younger than 2 are different (and the reassuring research behind the criteria); severe injury mechanisms; how to advise parents about keeping the child awake and what to watch for; the 9 features of the visio-vestibular exam; changes in concussion management and “return to normal” criteria; when to refer to a concussion specialist; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 124 - Psychology-based Interventions Help Kids with Chronic Pain

Fri, 06 May 2022 09:53:00 -0400

One in 4 children will have an episode of chronic pain before they reach adulthood, and kids with chronic pain are 3 times as likely to suffer anxiety or depression. How can primary care pediatricians help de-stigmatize the role of psychology in treatment for chronic pain? Jessica Collins, PsyD, and Christina Holbein, PhD, psychologists who run Comfort Ability workshops at Children’s Hospital of Philadelphia for kids with chronic pain, discuss: common diagnoses that come with chronic pain and discomfort; evidence-based interventions for chronic pain, including the role of cognitive behavioral therapy; differences in reporting of pain and discomfort based on culture and race, and how language barriers affect reporting; how to recognize and address bias in pain management referrals and suggestions for how to help families overcome barriers to resources; a review of CHOP resources for chronic pain, including Comfort Ability; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 123 - Inequities in Chlamydia Screening

Fri, 08 Apr 2022 15:04:00 -0400

Chlamydia is the most commonly reported bacterial disease in the U.S., and half of the 1.8 million cases reported in 2019 were in youth. A recent publication by Kenisha Campbell, MD, MPH, and Sarah Wood, MD, MSHP, adolescent medicine physicians at Children’s Hospital of Philadelphia, showed providers are much more likely to screen Black adolescent females for chlamydia than white females. In a review of their study, the two doctors discuss how to address biases as individual providers and as practices or systems, and: a review of chlamydia screening guidelines, prevalence of asymptomatic cases, and effects of untreated infections; the recently modified CDC treatment guidelines, with doxycycline now preferred; when to still consider using azithromycin; when to refer to adolescent medicine; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 122 - Updated Developmental Milestones

Fri, 01 Apr 2022 10:04:00 -0400

Less than a quarter of children with developmental disabilities receive early intervention services before age 3. The recent update to the “Learn the Signs: Act Early” guidelines is a step toward more children and families getting help sooner. Kate Wallis, MD, MPH, a developmental behavioral pediatrician at Children’s Hospital of Philadelphia, reviews: how and why the changes were made; how evaluating milestones when 75% of the age group is meeting them (rather than the previous rate of 50%) affects the wait-and-see approach; why it was important to add milestones for the 15- and 30-month visits; how the milestones may be helpful to parents; and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 121 - When Social Skills Are a Struggle

Wed, 16 Mar 2022 07:56:00 -0400

Friendships and social bonds are integral to children’s health. How can a pediatrician help those struggling with social skills? Emily DePaul, BS, MPH, MA, who is a clinical research coordinator for the PriCARE Parenting Program and runs group social skills training for children with autism spectrum disorders (ASD), provides an overview of the importance of social skills and possible diagnoses in children who have delays or deficits (consider ADHD and anxiety, in addition to ASD). She explains group social skills training, why these programs are valuable, and how a caregiver or pediatrician can find them; and provides tips and real-world advice pediatricians can use in practice (for example, how to help with issues like volume control and personal space, simple coping strategies, and how to encourage “perspective-taking”). If you’re searching for reasons to be positive and hopeful, hearing DePaul will help: A believer in social skills training at a very young age, she has received funding to start a social skills program (called First Friends) for toddlers and preschoolers. And her description of the resiliency of the ASD children in her groups during the pandemic – they had to do group social skills training on Zoom! – is inspiring. Published March 2022. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 120 - Evaluating Neutropenia in Primary Care

Tue, 22 Feb 2022 10:05:00 -0500

How should a primary care physician evaluate neutropenia, and decide when it’s time to worry? Kandace Gollomp, MD, pediatric hematologist, Children’s Hospital of Philadelphia, discusses: tips for evaluating a CBC with differential; absolute neutrophil count (ANC) parameters for mild/moderate/severe neutropenia; when to worry about increased risk of infection, both in previously well children and in those with risk factors; a review of risk factors; lymphopenia, granulocytopenia and agranulocytosis and how they are different; benign ethnic neutropenia; post-infectious neutropenia and when you should re-check the CBC; when an infectious history should raise a red flag; when to order a peripheral smear or refer a patient to hematology for bone marrow biopsy or other evaluation; and more. Published February 2022. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 119 - Primary Care in the Opioid Epidemic

Thu, 03 Feb 2022 09:44:00 -0500

Neonatal abstinence syndrome (NAS) and neonatal opioid withdrawal syndrome (NOWS) have skyrocketed as a result of the ongoing opioid epidemic. Celina C.S. Migone, MD, attending neonatologist, CHOP at Einstein Montgomery, discusses inpatient management of NAS and NOWS, including a new scoring system (replacing the Finnegan) and a move away from pharmacologic management (morphine dosing), and how the changes have had downstream effects that may require a new approach to supporting babies and families in primary care. She reviews: withdrawal symptoms providers may see; which substances are safe for breastfeeding and which are contraindicated; plans of safe care, which are begun during pregnancy and should be in place for a year after the baby is born; developmental monitoring; the CHOP NAS/NOWS inpatient clinical pathway and why it’s helpful to outpatient providers; and more. Published February 2022. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 118 - Infant Nutrition

Fri, 21 Jan 2022 14:20:00 -0500

The AAP recommends that infants get 400 IUs of vitamin D per day; fewer than 40% meet this guideline. Erica Schwab, RD, LDN, a clinical dietitian who supports the Division of Gastroenterology, Hepatology and Nutrition at Children’s Hospital of Philadelphia, discusses: why most babies, whether breast- or formula-fed, need vitamin D supplementation; how to know when to stop supplementation; good sources of vitamin D for babies transitioning to solid food; why Vitamin D is vital to the health and growth of babies; a review of rickets (breast-fed, non-supplemented infants are at highest risk); and risk groups that may require additional vitamin D supplementation, including preemies. She also provides a review of iron guidelines, including: when to start and stop iron supplementation for breast-fed infants; tips for getting babies to take iron; how to take a dietary history to ascertain whether supplementation is needed; differences between U.S. and European formulas; where to refer for complicated cases; and more. Published January 2022. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 117 - Managing Anxiety in the Primary Care Setting

Mon, 10 Jan 2022 12:56:00 -0500

Anxiety disorders collectively are the third most common psychiatric condition in children. Katrina Fletcher, MD, psychiatrist, and Jason Lewis, PhD, psychologist, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, review: tools to screen and assess anxiety disorders; other diagnoses to consider in your differential or as co-morbidities; medical causes and medications that can cause anxiety symptoms; importance of time course (such as abrupt onset) in your differential; types of anxiety disorders; how to determine severity; what is cognitive behavioral therapy (CBT); when to initiate an SSRI and tips for discussing antidepressants with patients and families; how to know if a treatment plan is working and when to taper or discontinue SSRIs; how to help families navigate anxiety disorders, such as encouraging healthy sleep, diet and exercise; CHOP’s new clinical pathway for anxiety disorders; and more. Published January 2022. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2022 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 116 - Creative Approaches to Connection

Thu, 16 Dec 2021 11:08:00 -0500

Chalkin’ Your Walkin’ is a pandemic-era project to chalk inspirational messages on the South Street Bridge in Philadelphia, over which many healthcare workers walk and bike to work. The messages are created by Katie Woo Castelo, MSN, CRNP, a nurse practitioner in the Emergency Department at Children’s Hospital of Philadelphia, with help from her kids. In this 15-minute episode, Castelo explains why she started chalking your walking, and the response to the effort. She also provides useful ideas for how to encourage and connect with children and teenagers during the pandemic, and how to stay connected and support one another as healthcare workers. Published December 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 115 - FPIES: A Complex Allergy

Mon, 06 Dec 2021 09:04:00 -0500

Food protein-induced enterocolitis syndrome, or FPIES, is a rare and different food allergy with a complex etiology and management. Amy Dean, MPH, RD, CSP, LDN, clinical dietitian, Gayle Diamond, MD, attending gastroenterologist, Terri Brown-Whitehorn, MD, attending allergist, who all work together in the FPIES Clinic at Children’s Hospital of Philadelphia, provide a review. Their discussion includes: symptoms and how FPIES may present in the primary care setting; tips for getting a useful history for diagnosis; how FPIES is different from other food allergies; which foods are the most common causes; what is acute FPIES; respecting parent fear of FPIES reactions, which can be upsetting; tips on diet modification; why a multidisciplinary approach, including allergy and GI, is important; an overview of how CHOP manages FPIES; biomarker research that may lead to a diagnostic test; and more. Published December 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 114 - Grief in Children

Tue, 09 Nov 2021 11:32:00 -0500

One in 5 children will experience the death of a loved one before age 18. Consuelo Cagande, MD, Division Chief, Community Care and Wellness Program, Children’s Hospital of Philadelphia, reviews the difference between grief and mourning; how children may grieve differently and the William Worden stages, which may be more applicable than the Kubler-Ross model; “masked” somatic and behavioral symptoms that may indicate grief; suggestions for how to help a child experiencing grief; how children of different ages may grieve; the importance of asking the family about their cultural norms for grieving; distinguishing between PTSD and grief; COVID and grief; resources to direct families to; and more. Published November 2021.

Primary Care Perspectives: Episode 113 - A Review of Juvenile Idiopathic Arthritis

Thu, 21 Oct 2021 07:22:00 -0400

Symptoms tend to be worse in the morning. Approximately a quarter of cases present without pain. And erythema is not generally a sign. Jay Mehta, MD, MS, attending physician, Division of Rheumatology, Children’s Hospital of Philadelphia, reviews juvenile idiopathic arthritis (JIA), one of the most common chronic diseases of childhood. He discusses: questions for a useful history; what to look for on physical exam; why labs aren’t super-helpful in diagnosis; symptoms that may indicate an oncologic cause; JIA classification criteria (a review of subtypes); potential genetic and environmental etiologies, including association with the microbiome; treatment paths, including steroid injections, low-dose methotrexate, TNF inhibitors, and tailored biologics, and why NSAIDs are no longer advised; complications of untreated arthritis, including uveitis and blindness; and more. Published October 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 112 – Real-world Nutrition Tips for the Primary Care Setting

Thu, 07 Oct 2021 08:15:00 -0400

Bridget Sullivan Garmisa, MSN, MS,CRNP, RD, a nurse practitioner and registered dietitian at a Children’s Hospital of Philadelphia primary care practice, discusses: tips for helping parents deal with picky eaters; importance of role-modeling by parents; how to help parents with common household challenges, such as having time to prepare a healthful dinner; suggestions for breakfasts teenagers might actually eat; healthful, easy-to-pack lunches; what to do when food options are limited, such as from vending machines and corner stores; ideas for on-the-go snacks; why sports drinks are a no-go; how to talk to kids and families about their food decisions; introducing cost savings as a motivator to modify food habits; and more. Published October 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 111 - Acupuncture in Pediatrics: A Review

Tue, 28 Sep 2021 07:50:00 -0400

More and more pediatric healthcare systems are incorporating acupuncture for pain management and other purposes. Dr. Winona Chua, attending physician, Division of General Pediatrics, and Douglas McDaniel, licensed acupuncturist, Cancer Center, Children’s Hospital of Philadelphia, discuss: a review of what acupuncture is, its history, and theories about why it is effective for some patients; why research in acupuncture in pediatrics has been limited; licensing for acupuncturists; how CHOP is using acupuncture; conditions for which acupuncture may be indicated and how a primary care physician can refer; how to explain acupuncture to children, who may fear needles; insurance coverage for acupuncture; and more. Published September 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 110 - Sleep Disordered Breathing

Mon, 13 Sep 2021 12:32:00 -0400

Sleep-disordered breathing, including snoring and sleep apnea, affects up to 17 percent of youth, and the AAP recommends screening for it at every visit. Ariel Williamson, PhD, DBSM, psychologist, and Ignacio Tapia, MD, attending pulmonologist, of the Sleep Center at Children’s Hospital of Philadelphia, provide a review of high-risk populations for sleep-disordered breathing; how to screen for sleep-disordered breathing; what to ask parents to distinguish between primary snoring and obstructive sleep apnea; when to refer for a sleep or CPAP study; how to help prepare a patient for a sleep study; the information a sleep study yields and what will be reported to the provider; the importance of sleep hygiene/routine and sleep duration; when to recommend melatonin; daytime symptoms that may be caused by sleep disruption; the link between sleep and mental health; and more. Published September 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 109 - Picture This: Incorporating Visual Art into Practice

Wed, 25 Aug 2021 07:46:00 -0400

A team discusses a CHOP program called Picture This, in which colorful and interactive murals are used in primary care exam rooms to encourage parent-child interaction and facilitate care. Danielle Erkoboni, MD, primary care pediatrician, CHOP Care Network, Melanie Hoynoski, CCLS, STRS, child life specialist at CHOP, and Steve Wilmot, MSW, Associate Vice President of Primary Care, CHOP, talk about the goals of the mural project; how the visual environment in which a child receives care can change the patient-family experience; the importance of play and visual arts to children; how murals or other types of art can prompt conversations and be incorporated into care; and more. Published August 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 108 - Postpartum Depression in Dads and Partners

Thu, 05 Aug 2021 07:53:00 -0400

Did you know that if a new mom is suffering from postpartum depression, the chances are high that the new dad or partner may be struggling as well? David Levine, MD, pediatrician and board member, Postpartum Support International, discusses perinatal mood and anxiety disorders(PMADs) in dads, partners, and adoptive parents. Among the topics: prevalence and risk factors for postpartum depression and other mood issues in dads and partners; cultural attitudes, including factors that keep dads from asking for help and the lack of public role models for struggling dads; how to include dads and partners in screening during obstetric or newborn care; use of the Edinburgh postnatal depression scale; how postpartum depression in dads may affect bonding with the infant; what to do if you suspect postpartum depression in a dad or partner; and more. Published August 2021.

Primary Care Perspectives: Episode 107 - Managing Suspected Extremity Fractures

Mon, 26 Jul 2021 07:55:00 -0400

As children and teenagers return to summer activities and school sports, particularly after the pandemic down-time, injuries, including fractures, are on the rise. Brendan Williams, MD, attending pediatric orthopaedic surgeon, Sports Medicine and Performance Center, Children’s Hospital of Philadelphia, discusses: physical exam findings that raise suspicion for fractures; the Ottowa Ankle Rules; clavicle fractures in older children (not newborns); how skeletal maturity changes fracture management decisions; pain management and immobilization guidance for sprains; when to send patients who are still in pain for follow-up evaluation or additional imaging; injury prevention advice to share with patients and families; when to send patients straight to the emergency room; and more. Published July 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 106 - Acne

Thu, 01 Jul 2021 07:26:00 -0400

Acne is one of the most common skin conditions, affecting about 80% of all teens. While some teens will only experience mild symptoms, others may develop scarring, hyperpigmentation and negative psychosocial effects. Amanda Shepard-Hayes, MD, an Attending Pediatrician specializing in dermatology at Children’s Hospital of Philadelphia, discusses the importance of recognizing and treating this condition; the combination of factors that cause acne including hormone level changes during puberty or when certain drugs (i.e., corticosteroids, oral birth control) are started or stopped; the different types of acne lesions, and when distribution patterns may indicate a more serious health issue; treatment goals and therapies including topical and systemic medications. In many cases, combination therapy is appropriate, which includes low-dose benzoyl peroxide to kill the bacteria and tretinoin to halt the development of new acne lesions. Recurrent acne that occurs in young children (aged 1 to 7), or in unusual places (like the groin area), should be sent for further evaluation. Published July 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 105 - What to Know About Lice/Scabies in the Primary Care Setting

Thu, 24 Jun 2021 07:24:00 -0400

Did you know that the pincers of head lice are perfectly suited to the caliber of children’s hair? And they need a blood-meal every 24 hours to survive? If you hate lice – and love puns – tune in for this discussion with Albert Yan, MD, pediatric dermatologist, Children’s Hospital of Philadelphia. He reviews: the epidemiology of lice, including why they may be more common in certain types of hair; distinguishing between nits and dandruff during exam; treatments for lice and resistance to permethrin and pyrethrum; and newer treatment options like spinosad and topical ivermectin. Scabies are also discussed: a review of transmission, findings and risk factors; where to look for lesions; correctly applying permethrin for scabies; differential diagnosis for scabies; secondary infections from scabies; when to consider referral to dermatology for lice or scabies; and more. Published June 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 104 - Menstruation and Period Poverty

Wed, 09 Jun 2021 08:26:00 -0400

At what age should pediatricians worry if a patient hasn’t had their first period? How can they help patients manage chronic period pain?What is “period poverty” and how can doctors help? Shelby Davies, MD, a fellow in the Division of Adolescent Medicine, Children’s Hospital of Philadelphia, discusses a variety of period-related topics, including: a review of the normal sequence of puberty and menarche and a normal menstrual cycle; etiologies of amenorrhea and how to evaluate for different causes ; laboratory tests to consider in cases of primary and secondary amenorrhea; a review of causes and management suggestions for irregular cycles and heavy flow; a review of management options for dysmenorrhea, including effectiveness of different OTC painkillers; an explanation of menstrual cups and reusable period underwear, alternatives to tampons and pads that are increasingly popular; a discussion of “period poverty” and the barriers some teenagers face in managing their periods, and how doctors can screen for this and help; and more. Published June 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 103 - Feeding Concerns in Children

Wed, 26 May 2021 07:46:00 -0400

Colleen Lukens, PhD, psychologist, and Sherri Cohen, MD, MPH, medical director, the Pediatric Feeding and Swallowing Center, Children’s Hospital of Philadelphia, discuss how their multidisciplinary clinic would manage this case, and review: some underlying causes for feeding disorders; common reasons for referral to the center; when an additional referral to GI might be appropriate; important feeding milestones; positive, simple strategies to recommend to parents of picky eaters; and more. Published May 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 102 - Effective Communication w/ Behavioral Health Patients

Tue, 11 May 2021 14:05:00 -0400

Approximately 15% of school-age children and adolescents in the U.S. are thought to have an emotional or behavioral disorder, and nearly two-thirds receive no formal mental health care. Pediatricians are increasingly being called on to screen for and treat mental health problems. Billie Samantha Schwartz, PhD, a Psychologist in the Department of Child and Adolescent Psychiatry and Behavioral Sciences at Children's Hospital of Philadelphia, sits down to tackle common communication challenges faced by primary care providers, and how to find a common factors approach (as recommended by the AAP) to build into practice. Published May 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 101 - Environmental Pediatrics: A Conversation with Leo Trasande

Thu, 22 Apr 2021 07:26:00 -0400

Parents often have questions about organic foods and environmental toxins such as BPA and phthalates. This conversation will help provide answers. Leonardo Trasande, MD, MPP, Jim G. Hendricks, M.D. Professor of Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, and author of “Sicker, Fatter, Poorer: The Urgent Threat of Hormone-disrupting Chemicals to Our Future...and What We Can Do” discusses a range of topics, including why environmental medicine is important in pediatrics; the importance of studying disease-related costs of chemicals; racial disparities in exposures to pesticides and other harmful chemicals; and information about topics parents often ask about, such as benefits of organic food, minimizing phthalate exposure, plastics versus glass, BPA and BPA-like chemicals in canned food and drinks, the safest water (probably from your tap!), safe baby food, and more. Published April 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 100 - The Addiction Inoculation

Tue, 06 Apr 2021 07:23:00 -0400

In celebration of the 100th episode of the Primary Care Perspectives podcast, Dr. Katie Lockwood welcomes a special guest, author Jessica Lahey, to discuss her most recent book, “The Addiction Inoculation: Raising Healthy Kids in a Culture of Dependence.” Lahey, whose perspective is informed by her own recovery from alcohol addiction and her experiences as a writing teacher and parent, writes for The New York Times and The Washington Post and is the author of the bestseller “The Gift of Failure: How the Best Parents Learn How to Let Go So Their Kids Can Succeed,” from 2015. Here she shares insight on topics including: countering myths about drinking and drugs (such as “everyone does it”); the gateway hypothesis; how pediatricians can be an ally for parents and teenagers in decision-making around alcohol and drugs; the AAP guidelines for substance abuse in youth; tips for effective discussions with teenagers; and more. Published April 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 99 - Balancing Act: Assessing Vestibular Disorders

Thu, 25 Mar 2021 10:41:00 -0400

A baby who can’t sit up by 7 months of age. A “clumsy” child who struggles with tasks such as riding a bike. A teenager experiencing dizziness 2-3 months after concussion. What do these patients have in common? They may benefit from assessment for a vestibular disorder. Robert O’Reilly, MD, attending physician, Division of Otolaryngology, and director, Balance and Vestibular Program, Children’s Hospital of Philadelphia, discusses vestibular issues in children and teenagers. Includes: a review of the vestibular apparatus; clinical symptoms and signs of chronic vestibular issues; review of common causes of vestibular issues; when to refer for post-concussion dizziness or post-concussion positional vertigo; and more. Published March 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 98 - Virtual Learning Ergonomics

Tue, 02 Mar 2021 15:12:00 -0500

Ergonomics is the science of fitting a given environment to a person, to limit exposure to physical stressors that could lead to discomfort or injury. Ian Leahy, PT, DPT, a physical therapist with the Sports Medicine and Performance Center at Children’s Hospital of Philadelphia, discusses: the basics of a good home set-up; whether to recommend a standing desk; advice to help parents avoid unnecessary costs; tips for laptop users; importance of variability of position; tips to encourage movement; how static positions can cause adaptive shortening and trigger soft-tissue injury with return-to-sport; what to ask in the history to elicit information about home learning set-ups; relationship between forward head posture and new onset of headache; and more. Published March 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 97 - Cardiac Complications of COVID-19 in Children

Tue, 16 Feb 2021 13:41:00 -0500

Matthew Elias, attending cardiologist, Children’s Hospital of Philadelphia, discusses COVID-19’s impact on the heart and how it affects outpatient care for children who have recovered. Includes: a refresher on clinical symptoms of myocarditis, which vary by age and can be subtle; review of EKG findings with myocarditis (again, tricky); other cardiac effects of COVID; the potential for long-term cardiac effects; lack of knowledge about the extent to which other pediatric viruses affect the heart; significance of troponin levels in adults versus children; guidelines for return to sport following COVID infection, with age and severity of infection as factors; when to consider referral for EKG and outpatient cardiology evaluation; symptoms of multisystem inflammatory syndrome in children (MIS-C); differences between MIS-C and Kawasaki disease; whether patients with congenital heart disease are at higher risk; and more. Published February 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 96 - Intimate Partner Violence: A Mom and Survivor

Tue, 09 Feb 2021 13:27:00 -0500

Fifteen million children are exposed to intimate partner violence (IPV) in the U.S. every year, with 50% of those exposures severe. This podcast offers perspective from Kalena Brown, an advocate and mother whose primary care pediatrician helped her and her three children safely leave a domestic violence situation; Ashlee Lynn Murray, MD, MPH, attending physician, Emergency Department, Children’s Hospital of Philadelphia; and Melissa Dichter, MSW, PhD, associate professor, Temple University School of Social Work. They discuss the importance of routine screening for IPV in primary care; barriers to disclosure; co-occurrence of IPV and child abuse; how to screen under and over the age of 2; safety in screening and documentation; how to manage a positive screen; how to offer support when the family isn’t ready to be directed to resources; importance of longitudinal relationships between pediatricians and families; and more. Published February 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 95 - Eating Disorders: An Update for Primary Care Pediatricians

Tue, 26 Jan 2021 13:01:00 -0500

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. Published January 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 94 - Celiac Disease: What Pediatricians Need to Know

Wed, 06 Jan 2021 13:22:00 -0500

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. Published January 2021. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2021 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 93 - Medical Ethics and COVID-19 Vaccines

Fri, 18 Dec 2020 11:47:00 -0500

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. Published December 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 92 - Challenging Patient Behaviors

Mon, 14 Dec 2020 14:56:00 -0500

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. Published December 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 91 - Integrative Approaches to Treating Autism

Sun, 22 Nov 2020 22:16:00 -0500

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. Published November 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 90 - Teaching Health Equity through Poetry and Narrative Medicine

Wed, 11 Nov 2020 14:05:00 -0500

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. Published November 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 89 - Managing Food Allergies in Children

Thu, 29 Oct 2020 13:18:00 -0400

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. Published October 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 88 - Preventing Poisoning

Mon, 12 Oct 2020 07:29:00 -0400

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. Published October 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 87 - Breastfeeding Guidelines for Pediatricians

Thu, 24 Sep 2020 07:19:00 -0400

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. Published September 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 86 - Childhood Literacy

Tue, 08 Sep 2020 07:37:00 -0400

Why are there so many children in cities like Philadelphia that aren’t proficient readers? 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. Published September 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 85 - Culinary Medicine

Fri, 28 Aug 2020 08:51:00 -0400

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. Published August 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 84 - Coronavirus and Children with Immunodeficiencies

Fri, 14 Aug 2020 14:00:00 -0400

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. Published August 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 83 - Managing Tics and Tic Disorders in Children

Tue, 28 Jul 2020 07:48:00 -0400

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. Published July 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 82 - Youth Sports and Coronavirus

Wed, 15 Jul 2020 10:10:00 -0400

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. Published July 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 81 - Hypermobility and Inherited Connective Tissue Disorders

Tue, 30 Jun 2020 11:35:00 -0400

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. Published June 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 80 - Pediatric Cancer Care During a Pandemic

Tue, 09 Jun 2020 08:22:00 -0400

With fewer children seeking care due to physical distancing, the early detection of pediatric cancers is being impacted. Julie Stern, MD, Director of Outreach Services for the Division of Oncology at Children’s Hospital of Philadelphia, discusses how children with cancer may present differently during the COVID-19 pandemic and how pediatricians can optimize physical exams in telemedicine settings to screen for malignancies, common early presentations of a malignancy to watch for, what to include in initial lab workups, how to reassure parents it’s safe to seek care in this time and more. Published June 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 79 - Positive Parenting During a Pandemic

Wed, 27 May 2020 09:53:00 -0400

Parenting challenges faced in typical times are heightened by the COVID-19 pandemic, and both parents and children may be feeling stressed. In this episode, Emily DePaul, MPH, MAC, and Linda McWhorter, PhD, talk about positive parenting during a pandemic and the PriCARE Parenting Program, which focuses on providing a toolbox of parenting techniques to increase positive behavior and build a strong caregiver-child relationship. They offer advice and tools to help address some of the common concerns and challenges parents are facing during COVID-19. Published May 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 78 - Innovation and Improvement in Pediatrics

Fri, 15 May 2020 10:16:00 -0400

This episode’s guests Flaura Winston, MD, PhD, Founder and Scientific Director of the Center for Injury Research and Prevention, and Daria Ferro, MD, a pediatric hospitalist, discuss all things related to innovation and quality improvement, particularly during the times of a pandemic. They talk about the “innovation ecosystem” at Children’s Hospital of Philadelphia, where the goal is to efficiently, effectively, and safely address acute pain points in pediatric healthcare with sustainable, actionable solutions that can be widely shared -- especially important in a time when we need to get solutions out there safely but quickly. Published May 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 77 - Newborn Care During the COVID-19 Era

Thu, 23 Apr 2020 11:53:00 -0400

In the age of COVID-19, many families are wanting to leave the hospital as soon as possible after delivering a new baby. But is it the right thing to do? Joanna Parga-Belinkie, MD, attending neonatologist at Children’s Hospital of Philadelphia, talks about the many factors that must be considered for the health and safety of both mothers and newborns, key newborn screenings, the role primary care providers can play in monitoring infants who were discharged early, resources for new mothers, and more. Published April 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 76 - Identifying Signs of Child Abuse and Neglect

Tue, 14 Apr 2020 10:43:00 -0400

Child abuse is unfortunately very common, and in the setting of a pandemic like COVID-19, the risk is elevated. Cindy Christian, MD, talks about the factors that increase the risk for abuse during a pandemic, such as heightened stressors facing families and the fact that children are not visible to those who often recognize and report abuse, like teachers and pediatricians. She also discusses what pediatricians can do to identify possible signs of abuse and neglect, specific injuries that warrant closer evaluation, recommendations for documentation and reporting, and more. Published April 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 75 - NIDCAP

Fri, 20 Mar 2020 10:05:00 -0400

Preterm birth results in multiple challenges, both short term in newborn intensive care units, and long term in the neurodevelopmental outcomes of these babies. gretchen Lawhon, PhD, RN, CBC, FAAN, a clinical nurse scientist at Abington-Jefferson Health’s Division of Neonatology, discusses how scientific advances continue to inform how we care for these vulnerable patients, with an emphasis on protecting a baby’s developing brain in the context of their specific behaviors, environment, and family unit. Published March 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 74 - Lead Exposure, Screening, and Management of Lead Poisoning

Tue, 03 Mar 2020 11:50:00 -0500

Kevin Osterhoudt, MD, emergency medicine physician and Medical Director of the Poison Control Center at Children’s Hospital of Philadelphia, covers all things lead – common sources of lead exposure, long-term effects on children, screenings for blood lead levels, lead poisoning, and management of lead poisoning. Published March 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 73 - Identifying and Treating Early Cardiovascular Disease

Mon, 17 Feb 2020 07:48:00 -0500

Pediatric cardiologist Shohba Natarajan, MD, talks about identifying and treating patients at risk for early cardiovascular disease. She identifies pediatric diagnoses that put a child at risk, what to look for in family history, and discusses the important role that primary care pediatricians play in cardiovascular disease screenings and identifying patients who may not otherwise be considered high risk. Published February 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 72 - Endocrine Laboratory Evaluations

Thu, 06 Feb 2020 07:44:00 -0500

Pediatric endocrinologist Marissa Kilberg, MD, gives a refresher on the hypothalamic pituitary adrenal (HPA) axis and endocrine labs, including a breakdown of what is being looked at and how to best evaluate adrenal function of a pediatric patient. Published February 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 71 - Adverse Childhood Experiences in Primary Care

Wed, 22 Jan 2020 14:55:00 -0500

Roy Wade Jr., MD, PhD, MPH, MSHP, a researcher and pediatrician at Primary Care, Cobbs Creek, discusses adverse childhood experiences (ACEs) and their life course impact on the health and well-being of kids. He talks about how primary care pediatricians can assess for ACEs and help address these experiences by collaborating with agencies in our community that are directly addressing these issues with patients and families, current research trends and advocacy efforts, and much more. Published January 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2020 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 70 - Telepsychiatry: Expanding Access to Mental Health Care

Wed, 08 Jan 2020 16:40:00 -0500

Lan Chi “Krysti” Vo, MD, an attending psychiatrist at Children’s Hospital of Philadelphia, discusses the current landscape of mental health care in the United States, the need for specialized child and adolescent psychiatrists, and how telepsychiatry has the potential to expand access to mental health services for more patients. Published January 2020. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 69 - Recognizing and Treating Febrile Seizures

Wed, 18 Dec 2019 14:15:00 -0500

While any child can experience a febrile seizure, they are most common between the ages of 18 and 24 months. Sara Fridinger, MD, an attending pediatric neurologist at Children’s Hospital of Philadelphia, talks about causes, signs and symptoms of febrile seizures, as well as how to differentiate between simple and complex febrile seizures and when to take action. Published December 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 68 - Evaluating Lacerations in Primary Care

Thu, 12 Dec 2019 16:54:00 -0500

Sarah Fesnak, MD, an attending physician in the Emergency Department at Children’s Hospital of Philadelphia, discusses the evaluation and management of lacerations in primary care. Appropriate referrals to the Emergency Department and the wound follow-up after repair are reviewed. Published December 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 67 - Management of Amplified Musculoskeletal Pain (AMPS)

Wed, 27 Nov 2019 09:22:00 -0500

Sabrina Gmuca, MD, MSCE, and David Sherry, MD, pediatric rheumatologists at Children’s Hospital of Philadelphia, explain the intense pain experienced by children with amplified musculoskeletal pain syndrome (AMPS), common causes and presentations of amplified pain, and evidence-based interventions that can help manage pain in these patients. Published November 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 66 - Diagnosis and Treatment of Spinal Muscular Atrophy (SMA)

Fri, 15 Nov 2019 15:45:00 -0500

Pediatric neurologist Elizabeth Kichula, MD, PhD, discusses the pathophysiology and clinical presentation of spinal muscular atrophy (SMA), prenatal screening, diagnosis and treatment for this neurodegenerative disease. Published November 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 65 - Young Men’s Health

Tue, 29 Oct 2019 12:00:00 -0400

Zachary McClain, MD, a pediatrician specializing in adolescent medicine and Medical Director of CHOP’s Young Men’s Clinic, talks about taking care of teenagers, in particular young men. He covers strategies for addressing common teen concerns, such as sexuality and sexual function, how to normalize topics that may be uncomfortable to discuss, common testicular pathology, importance of routine testicular exams, and more. Published October 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 64 Anesthesia in Pediatrics

Thu, 10 Oct 2019 10:45:00 -0400

Children and infants have different needs than adults when it comes to anesthesia. Ronald Litman, DO, ML, talks about how anesthesia in children is different than anesthesia in adults, commonly used medications, recent research around maximizing comfort as well as risks associated with anesthesia, and how pediatric anesthesiologists are specially trained to help kids cope and prepare them for surgery. Published October 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 63 - Diagnosing and Treating Acute Flaccid Myelitis

Fri, 27 Sep 2019 10:44:00 -0400

Pediatric neurologist Sarah Hopkins, MD, MSPH, talks about the presentation, diagnosis, and management of acute flaccid myelitis (AFM), including how to distinguish it from other similar neurologic diseases. Published September 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 62 - HPV Management in Adolescent and Young Adult Patients

Wed, 18 Sep 2019 11:51:00 -0400

The most common sexually transmitted infection in the United States, HPV (and HPV vaccinations) is a hot topic for primary care providers. Aletha Akers, MD, MPH, FACOG, an attending physician in the Division of Adolescent Medicine at Children’s Hospital of Philadelphia, discusses HPV symptoms, screening recommendations, transmission and prevention, long-term implications, the latest studies looking at the impact of the HPV vaccine, and more. Published September 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 61 - Healthcare of Children in Foster Care

Wed, 28 Aug 2019 09:57:00 -0400

Between 400,000 – 500,000 children are in foster care in the U.S. on any given day. Because children in foster care have a higher prevalence of physical, developmental, dental, and behavioral health conditions than any other group of children, the AAP has identified them as a population with special healthcare needs. Pediatric residents Drs. Zoe Bouchelle, Shari Gitlin, and Josh Sperling discuss the unique healthcare needs of children in foster care with Dr. Kristin Fortin, attending physician with Safe Place and the Center for Child Protection and Health at Children's Hospital of Philadelphia. Published August 2019 This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 60 - Scoliosis Diagnosis and Treatment

Tue, 13 Aug 2019 09:22:00 -0400

Ian Lahey, PT, DPT, OCS, SCS, CSCS, FAAOMPT, a Physical Therapist with the Sports Medicine and Performance Center at CHOP, discusses the latest non-surgical treatments for scoliosis in children, including guidelines for wearing braces and the benefits of scoliosis rehab, plus the importance and challenges of furthering research in this field. Published August 2019 This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 59 - Vitamin D in Children

Tue, 23 Jul 2019 08:48:00 -0400

Clinical Director of Endocrinology at CHOP, Andrew Calabria, MD, talks about forms and sources of vitamin D, the role it plays, targets for vitamin D intake for infants and children, when vitamin D supplements are called for, preventing vitamin D deficiency and rickets, and more. Published July 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 58 - e-Cigarettes

Mon, 01 Jul 2019 11:13:00 -0400

E-cigarette Use in Adolescents Based on recent data, up to 20% of high school students regularly use e-cigarettes. 1 in 5 high school students and 1 in 20 middle school students are regularly using these products. Brian Jenssen, MD, MSHP, talks about concerning trends in adolescent e-cigarette use, different vaping devices, exposure risks related to harmful chemicals in these products, the latest regulations, and what pediatric healthcare providers need to know about the effects e-cigarettes can have, specifically on adolescents and teens. Published July 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 57 - Medical Care of Transgender and Gender-diverse Youth

Tue, 25 Jun 2019 10:36:00 -0400

Teens who identify as transgender have high rates of depression, anxiety, eating disorders, substance abuse, self-harm and suicide. Primary care providers are in a unique position to inquire about gender development as part of routine well-child care and be a trusted source of support and information for patients and families. Sarah Hart-Unger, MD, endocrinologist at Joe DiMaggio Children’s dives into the endocrine issues and how pediatricians can provide gender-affirmative medical care for transgender and gender-diverse youth. Published June 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 56 - Preseptal vs. Orbital Cellulitis

Tue, 28 May 2019 07:44:00 -0400

Gil Binenbaum, MD, MSCE, reviews Children’s Hospital of Philadelphia’s new clinical pathway on the management of patients with suspected preseptal or orbital cellulitis, including the differential diagnosis, physical exam for orbital signs, reasons for admission, and outpatient management of preseptal cellulitis. Published May 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 55 - Fever in Children

Wed, 15 May 2019 10:54:00 -0400

Paul Offit, MD, Director of the Vaccine Education Center and attending physician in the Division of Infectious Diseases at Children’s Hospital of Philadelphia, defines fever in children and talks about counseling families about the benefits of fevers. He discusses strategies for treating fevers appropriately, with emphasis on why treating fever with antipyretic drugs is often NOT the right thing to do. Published May 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 54 - Occupational Therapy

Mon, 29 Apr 2019 08:10:00 -0400

In honor of National Occupational Therapy Month, occupational therapist Ashley Binkowski, MS, OTR/L, CKTP, talks about what an occupational therapist can do for a child, examples of when a child might need occupational therapy in an outpatient setting, issues commonly seen at different ages, tips for pediatricians when dealing with sensory challenges, and more. Published April 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 53 - Custody Issues

Wed, 10 Apr 2019 10:38:00 -0400

Licensed social worker Sara Kurlansik, MSW, LSW, discusses how primary care providers can help children and families deal with divorce and separation. The episode covers custody issues that frequently come up in primary care and offers tips for physicians to share with parents to ease the transition for children when parents are separating. She also discusses the importance of keeping the focus on the child when issues arise in the office. Published April 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 52 - Skin Cultures

Wed, 27 Mar 2019 08:00:00 -0400

Pediatric dermatologist Patrick McMahon, MD, talks about when skin cultures may be indicated for various skin conditions in children. He talks through common examples seen by pediatricians, such as tinea corporis and tinea capitis, when to culture versus when to proceed with treatment following your clinical judgement, tips for obtaining a quality culture, and more. Published March 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 51 - Positional Plagiocephaly

Mon, 11 Mar 2019 07:51:00 -0400

Jesse Taylor, MD, Chief of the Division of Plastic and Reconstructive Surgery at Children’s Hospital of Philadelphia sits down to discuss positional plagiocephaly (development of a flat spot on a baby’s head), the impact of the Back to Sleep campaign, risk factors for developing plagiocephaly, how it can be clinically differentiated from craniosynostosis and more. Published March 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 50 - Cardiovascular Sports Physical

Wed, 27 Feb 2019 15:21:00 -0500

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. Published February 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 49 - Neurodevelopment and Congenital Heart Disease

Fri, 08 Feb 2019 07:52:00 -0500

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. Published February 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 48 - Management of Polycystic Ovarian Syndrome in Adolescents

Wed, 30 Jan 2019 07:42:00 -0500

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. Published January 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 47 - Environmental Toxins and Plastics

Sun, 13 Jan 2019 20:43:00 -0500

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. Published January 2019. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2019 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 46 - Functional Medicine

Tue, 18 Dec 2018 08:46:00 -0500

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. Published December 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 45 - Precocious Puberty

Wed, 12 Dec 2018 08:49:00 -0500

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. Published December 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 44 - Teen Pregnancy

Thu, 29 Nov 2018 11:31:00 -0500

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. Published November 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 43 - Diabetes Management

Mon, 12 Nov 2018 08:26:00 -0500

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. Published November 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 42 - Teen Driving Safety

Mon, 22 Oct 2018 08:24:00 -0400

Motor vehicle crashes are the leading cause of death for U.S. teens. Flaura K. Winston, MD, PhD, founder of the Center for Injury Research and Prevention at Children’s Hospital of Philadelphia, talks about teen driving safety and how pediatricians play an important role in preventing teen crashes through counseling and education. Published October 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 41 - Newborn Screening

Thu, 11 Oct 2018 09:25:00 -0400

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. Published October 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 40 - Quality Improvement in Healthcare

Tue, 25 Sep 2018 08:36:00 -0400

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. Published September 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 39 - Car Seat Safety

Mon, 17 Sep 2018 07:50:00 -0400

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. Published September 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 38 - Role of Subconscious Racial Bias or Implicit Bias

Wed, 29 Aug 2018 07:38:00 -0400

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. Published August 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 37 - What’s New in Concussion Care

Thu, 16 Aug 2018 08:23:00 -0400

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. Published August 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 36 - Managing Anxiety in Children and Adolescents

Mon, 30 Jul 2018 10:15:00 -0400

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. Published July 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 35 - IBD Screening in Primary Care

Mon, 09 Jul 2018 10:25:00 -0400

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. Published July 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 34 - Urology in Primary Care

Thu, 28 Jun 2018 08:35:00 -0400

Christopher Long, MD, an attending pediatric urologist at Children’s Hospital of Philadelphia, discusses common urology topics that come up in a primary care setting. The episode includes advice for counseling families on both the risks and benefits of circumcision, when retraction of foreskin is recommended, and when to refer to a pediatric urologist for other common urologic conditions such as retractile and undescended testes, hydroceles, bedwetting, UTIs, and more. Published June 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 33 - Transition To Adult Care

Thu, 14 Jun 2018 08:49:00 -0400

In this episode about transitioning to adult care, Dava Szalda, MD, an Attending Physician in the Division of Oncology at Children's Hospital of Philadelphia, talks about guidelines for transitioning patients to adult care, assessing the “readiness” of a patient to transition to adult care, how providers can help prepare patients for the transition, and more. Published June 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 32 - Nutrition of Premature Infants

Tue, 29 May 2018 07:49:00 -0400

In this episode about preemie nutrition, Margaret (Mimi) Girten, RD, CSP, LDN, a clinical dietitian at Children's Hospital of Philadelphia, talks about the unique nutrition needs of premature infants, including: special formulas for preemies; when to supplement with a multivitamin; clinical nutrition, feeding and breastfeeding resources; when to introduce solids; tips for dealing with a picky eater as a child grows, and more. Published May 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 31 - Kidney Stones in Children

Tue, 15 May 2018 10:01:00 -0400

Over the past 20 years, the probability of having a kidney stone before the age of 18 has approximately doubled. In this episode, Gregory Tasian, MD, attending urologist at Children’s Hospital of Philadelphia, explores why, including factors like temperatures and medication, which have emerged in recent studies as contributing factors. He also discusses signs and symptoms, recurrence risks, and a collaborative approach to providing care for children and adolescents with stone disease. Published May 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 30 - Probiotics and Prebiotics

Fri, 27 Apr 2018 12:29:00 -0400

Maria Mascarenhas, MBBS, a pediatric gastroenterologist and nutrition pediatrician at Children’s Hospital of Philadelphia, defines the role of probiotics and prebiotics, how to increase them in your diet or through supplements, and the conditions for which they have been most studied. Published April 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 29 - PATTERNS Project: Predicting Missed Appointments

Thu, 19 Apr 2018 08:09:00 -0400

In this episode, Robert Grundmeier, MD, attending physician and Director of Clinical Informatics at Children’s Hospital of Philadelphia, discusses the multiple factors that contribute to missed patient appointments, the impact of this issue, and both current and future solutions to this problem. Using data from a recent pilot study, Dr. Grundmeier offers ideas for how our electronic health records can help prevent missed appointments and improve access to care. (PATTERNS: Predictive Analytic Technology to Eliminate Repeat No Shows) Published April 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 28 - The Anti-Inflammatory Diet

Mon, 26 Mar 2018 08:07:00 -0400

This episode explores the origins, health benefits, and uses of the anti-inflammatory diet with Maria Mascarenhas, MBBS, an attending physician and Medical Director of the Integrative Health Program at Children's Hospital of Philadelphia. She discusses the data-based origins of the diet; foods to focus on, including a sample menu for kids; and how the diet can help improve outcomes and health, especially for patients with chronic conditions attributed to inflammation. Published March 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 27 - Autism Screening and Management

Thu, 08 Mar 2018 09:38:00 -0500

Kate Wallis, MD, a fellow with the Division of Developmental and Behavioral Pediatrics at Children's Hospital of Philadelphia, talks about autism screening using the M-CHAT, signs of autism spectrum disorder, cultural and language considerations, management of common comorbidities like food selectivity, and more. She also discusses how pediatricians can support parents and siblings of children with autism spectrum disorder. Published March 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 26 - Lymphadenopathy Evaluation in Primary Care

Tue, 20 Feb 2018 07:40:00 -0500

Julie Stern, MD, attending physician with the Division of Oncology at Children's Hospital of Philadelphia, talks about the examination and evaluation of lymph nodes, and the diagnostic work-up for abnormal nodes. Also, how to approach difficult conversations with patients and families, when to refer to oncology services, and what resources are available to primary care physicians with diagnostic dilemmas. Published February 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 25 - Stridor

Fri, 02 Feb 2018 12:40:00 -0500

Ian Jacobs, MD, Medical Director of the Center for Pediatric Airway Disorders at Children's Hospital of Philadelphia, discusses common causes of stridor, including croup, foreign body aspiration, and laryngomalacia. He also talks about the most dangerous foreign body ingestions in young children and the latest clinical advances and research underway in the airway clinic at CHOP. Published February 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 24 - Constipation in Children

Mon, 08 Jan 2018 13:53:00 -0500

In this episode, Jennifer Webster, MD, a pediatric gastroenterology fellow at Children’s Hospital of Philadelphia, discusses childhood constipation. She covers things like diagnostic criteria, signs of constipation, treatment, tips for increasing dietary fiber intake in toddlers, related diagnoses, and more. Published January 2018. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2018 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 23 - Pediatric Dermatology: Common Skin Problems in Kids

Mon, 04 Dec 2017 08:31:00 -0500

In this episode, pediatric dermatologist James Treat, MD, from Children’s Hospital of Philadelphia, talks about a variety of dermatology issues commonly seen in primary care. Topics discussed include eczema treatment, congenital skin lesions and hemangiomas, evaluating irregular moles, acne, molluscum, contact dermatitis, and when to refer to dermatology. Published December 2017.

Primary Care Perspectives: Episode 22 - Managing Peanut Allergies

Thu, 09 Nov 2017 09:14:00 -0500

In this episode, David Hill, MD, PhD, a fellow in the Division of Allergy at Children’s Hospital of Philadelphia, discusses the prevalence and incidence of peanut allergies, how to safely introduce peanuts to infants, and how to evaluate children for peanut allergy in context of new guidelines and recent research. Published November 2017.

Primary Care Perspectives: Episode 21 - Common Pediatric ENT Issues

Tue, 17 Oct 2017 14:16:00 -0400

In this episode, Adva Buzi, MD, an attending physician in the Division of Otolaryngology at Children's Hospital of Philadelphia, discusses a variety of common ear, nose and throat issues encountered in primary care settings, including strep throat, chronic otitis, sinusitis and more. Published October 2017.

Primary Care Perspectives: Episode 20 - Caregiver Depression

Mon, 02 Oct 2017 11:27:00 -0400

In this episode, CHOP PolicyLab experts Rhonda Boyd, PhD, Marsha Gerdes, PhD, and James Guevara, MD, MPH, discuss caregiver depression. Mothers of young children and those with fewer economic resources are at particularly high risk for caregiver depression, making young patients in disadvantaged households particularly vulnerable. Learn how pediatricians can more effectively screen for and intervene in caregiver depression. Published September 2017.

Primary Care Perspectives: Episode 19 - Gender Identity and Sexuality

Wed, 06 Sep 2017 13:43:00 -0400

This episode explores development of gender identity and sexuality with Linda Hawkins, PhD, MSEd, LPC, co-director of the Gender & Sexuality Development Clinic at Children's Hospital of Philadelphia. She discusses common developmental stages, gender language, and when to refer to a gender specialist. She also offers advice for how providers can talk to both patients and parents about gender and sexuality, and other ways to best support them. Published September 2017. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2017 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 18 - Helping Families Achieve Breastfeeding and Lactation Goals

Fri, 18 Aug 2017 08:03:00 -0400

Meg Kawan, MD, MPH, IBCLC, a pediatrician at CHOP’s Karabots Pediatric Care Center, talks about how pediatricians can help families achieve breastfeeding goals and manage breastfeeding and lactation obstacles, such as medicine contraindications, initiation barriers, low milk supply and tongue ties. She offers advice for talking to families about the health benefits of human milk, and finding lactation support and resources in your community. Published August 2017. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2017 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 17 - NaturePHL: Improving Kids’ Health with Outdoor Play

Tue, 01 Aug 2017 11:35:00 -0400

Despite the proven benefits of spending time outside, there are many barriers to getting kids their much-needed time outdoors, including time, accessibility and safety. Christopher Renjilian, MD, a primary care sports medicine physician and adolescent medicine fellow at Children’s Hospital of Philadelphia, discusses NaturePHL, a new program dedicated to solving this problem; the unique benefits of nature-based play; and how pediatricians can be ambassadors for outdoor play for kids and families. Published August 2017. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2017 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 16 - Integrative Medicine

Mon, 10 Jul 2017 07:45:00 -0400

Maria Mascarenhas, MBBS, Medical Director of the Integrative Health Program at Children’s Hospital of Philadelphia, defines a modern approach to integrative health and how it can play a complementary role in primary care. She discusses the three categories of integrative health as designated by the NIH, how primary care providers can stay up-to-date on new integrative therapies, as well as current services being offered at Children’s Hospital, including acupuncture, massage, yoga, and integrative nutrition, among others. Published July 2017. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2017 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 15 - Measles

Thu, 22 Jun 2017 09:19:00 -0400

In 2000, measles was eliminated from the United States due to the effectiveness of the MMR vaccine. However, outbreaks have been occurring across many states. Dr. Kristen Feemster, MD, MPH, MSHPR, FAAP, attending physician in the Division of Infectious Diseases and Director of Research for the Vaccine Education Center, explains the reasons for the resurgence of this highly contagious infection. She also talks about the effectiveness and safety of the MMR vaccine and other prevention measures to help stop the spread of measles. Published June 2017. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2017 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 14 - Mentoring

Wed, 31 May 2017 13:33:00 -0400

Beth Rezet, MD, Vice Director of the Pediatric Residency Program at Children's Hospital of Philadelphia, discusses the importance of mentoring in the development of future pediatricians. She shares advice for both mentor and mentee on how to establish the most effective relationship and deal with challenging situations. Published May 2017. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2017 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 13 - Teen Sleep

Fri, 12 May 2017 13:46:00 -0400

It’s no surprise that teenagers don’t get enough sleep, and pediatricians often field questions from concerned parents. In this episode, Billie Schwartz, PhD, a Psychologist in the Department of Child and Adolescent Psychiatry and Behavioral Sciences at Children’s Hospital of Philadelphia, talks about all things related to teen sleep, including promoting good sleep hygiene, what underlying issues might be causing sleep problems, and more. Published May 2017. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2017 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 12 - Positive Parenting

Thu, 04 May 2017 14:00:00 -0400

At any given time, approximately 11 to 20 percent of children in the U.S. meet diagnostic criteria for a behavioral health disorder. Joanne Wood, MD, MSHP, Attending Physician at Children’s Hospital of Philadelphia and a faculty member at CHOP’s PolicyLab, talks about a research project focused on positive parenting to improve problem behaviors in preschool-age children (PriCARE). Published May 2017. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2017 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 11 - Smoking Cessation

Mon, 17 Apr 2017 07:55:00 -0400

In Philadelphia, 40 to 50 percent of children have biologically confirmed rates of secondhand smoke exposure. Brian Jenssen, MD, a primary care pediatrician with Children’s Hospital of Philadelphia and a faculty member at CHOP’s PolicyLab, talks about this problem and how primary care pediatricians can help parents and caregivers quit smoking to improve the health of children. Published April 2017. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2017 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 10 - Pre-exposure Prophylaxis for HIV

Wed, 29 Mar 2017 09:55:00 -0400

Sarah Wood, MD, an Adolescent Medicine fellow at Children's Hospital of Philadelphia, discusses what's new in the prevention of HIV, which patients are high-risk for HIV, and local resources for HIV care. Published March 2017. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2017 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 9 - Tuberculosis

Wed, 15 Mar 2017 12:38:00 -0400

Despite increased funding, control measures and medications, tuberculosis (TB) remains as problem in the U.S. Jane Gould, MD, a pediatric TB consultant with the Philadelphia Department of Public Health, discusses TB trends, risk factors for developing TB disease, treating latent TB, screening for TB, and more. Published March 2017. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2017 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 8 - Carbon Monoxide Poisoning

Thu, 23 Feb 2017 14:36:00 -0500

Mamata Senthil, MD, a Fellow in the Emergency Department at Children’s Hospital of Philadelphia, shares tips for preventing carbon monoxide poisoning, which is particularly prevalent during the winter months. She discusses common sources of CO, symptoms of CO poisoning that may resemble typical flu symptoms, how to avoid exposure, and more. Published February 2017. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2017 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 7 - Refugee Health

Thu, 09 Feb 2017 09:07:00 -0500

As primary care pediatricians are often first to care for refugee children when they arrive in the US, it’s important to understand the unique needs of this community and know about available resources to help us provide the best care. Katherine Yun, MD, MHS, Attending Physician with Children’s Hospital of Philadelphia’s Refugee Health Program and PolicyLab faculty member, discusses resettlement trends, medical screening guidelines, resettlement organizations in Philadelphia, refugee programs, and more. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2017 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 6 - Noise-induced Hearing Loss

Thu, 26 Jan 2017 10:49:00 -0500

In 2011, 1 in 5 adolescents in the U.S. were reported to have permanent hearing loss attributed to noise exposure. Children’s Hospital of Philadelphia Audiologist Frank Wartinger, AuD, discusses the prevalence, risk factors and prevention strategies for noise-induced hearing loss. Published January 2017. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2017 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 5 - Community-acquired Pneumonia

Wed, 11 Jan 2017 13:45:00 -0500

Jeffrey Gerber, MD, Attending Physician in the Division of Infectious Diseases at Children's Hospital of Philadelphia walks us through common pathogens, treatment guidelines and the challenges physicians often face in diagnosing pneumonia. See CHOP’s recently updated pneumonia pathway for more information. Published January 2017. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2017 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 4 - Food Insecurity

Wed, 14 Dec 2016 08:28:00 -0500

Pediatricians play an important role in screening for food insecurity, a problem that impacts many families. Saba Khan, MD, Medical Director of Children's Hospital of Philadelphia's Healthy Weight Program, discusses how providers can screen for food insecurity at well visits, ways to advocate for access to healthy food at the local level, and the important role pediatricians can play in referring families to nutrition programs and other community resources. Published December 2016. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2016 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 3 - Meningitis B Vaccine Recommendations

Fri, 02 Dec 2016 11:13:00 -0500

Meningitis B Vaccine Recommendations: In light of new recommendations from the AAP, ACIP and CDC surrounding the use of two recently licensed meningococcal B vaccines, Paul Offit, MD, Director of the Vaccine Education Center at Children’s Hospital of Philadelphia, sits down to address some common questions related to these recommendations. Published December 2016. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2016 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 2 - Influenza Vaccine Recommendations for 2016-2017

Thu, 03 Nov 2016 09:40:00 -0400

In June 2016, the CDC’s Advisory Committee on Immunization Practices (ACIP) voted that the intranasal vaccine should not be used this season due to low efficacy from 2013 to 2016. Susan Coffin, MD, MPH, Attending Physician and Clinical Director of the Division of Infectious Diseases at Children’s Hospital of Philadelphia, explains the new influenza vaccine recommendations for the 2016-2017 season and talks about new information revealed in recent studies, timing and supply. Published September 2016. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2016 by Children's Hospital of Philadelphia, all rights reserved.

Primary Care Perspectives: Episode 1 - Zika Virus

Thu, 03 Nov 2016 09:38:00 -0400

As our knowledge of the Zika virus and the current landscape of outbreaks continues to evolve, how can pediatricians stay current with clinical management guidelines? In this episode, Julia Shaklee Sammons, MD, MSCE, hospital epidemiologist and medical director of the Department of Infection Prevention and Control at Children’s Hospital of Philadelphia, discusses the current guidelines on Zika. Published September 2016. This podcast is for general informational and educational purposes only and is not to be considered as medical advice for any particular patient. Clinicians must rely on their own informed clinical judgment in making recommendations to their patients. ©2016 by Children's Hospital of Philadelphia, all rights reserved.