Primary Care Perspectives

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.

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.

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.

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!

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.

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.

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.

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.

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.

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.

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.

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.

“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.

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.

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.

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.

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.

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.

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.

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.