
Primary Care Perspectives
Primary Care Perspectives is a pediatric podcast hosted by Dr. Katie Lockwood, a primary care pediatrician at Children's Hospital of Philadelphia. Each episode brings in subject-matter experts to discuss hot topics in primary care, focusing on issues that affect the daily practice of pediatricians. The podcast provides general informational and educational content, not specific medical advice.
Episodes

Breastfeeding Updates for Primary Care (Episode 223)
In recognition of National Breastfeeding Month, join host Katie Lockwood, MD, MEd, for a practical conversation on the latest evidence in breastfeeding medicine. Dr. Meg Kawan, pediatrician, breastfeeding medicine specialist, and IBCLC, discusses how pediatricians can better support breastfeeding families—from creating a breastfeeding-friendly office to managing mastitis, navigating tongue-tie, an

Hereditary Hemorrhagic Telangiectasia or HHT (Episode 222)
In this episode, we’re diving into hereditary hemorrhagic telangiectasia, or HHT—a genetic condition that often first shows up in ways pediatricians see every day, like recurrent nosebleeds or unexplained anemia. Nihal Bakeer, MD, a hematologist and Allison Britt, MS, LCGC, a genetic counselor, help us recognize the early signs, understand when to suspect HHT, and evaluate how to manage and refer

Eosinophilic Esophagitis and the Esophageal String Test (Episode 221)
Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition that affects feeding, growth, and quality of life, traditionally diagnosed and monitored through repeated endoscopies. Recent advancements include the esophageal string test, a minimally invasive method that captures disease activity through biomarkers rather than tissue biopsies, potentially transforming personalized care for E

Water Safety and Drowning Prevention in Pediatrics (Episode 220)
Drowning remains one of the leading causes of death for children. In this episode, Drs. Rotherham and Stafford explain the “layers of protection” concept, including swim lesson timing, effective home pool safety measures, and the risks of floatation devices versus life jackets. We also clarify terms like “dry drowning” and dispel myths around water safety. This episode includes key water safety me

Incorporating Anticipatory Guidance for Police Encounters, or "The Talk," in Primary Care (Episode 219)
The coauthors of a new study in the journal Pediatrics titled “Black Teenage Male and Caregiver Perspectives on Anticipatory Guidance for Police Encounters”, join Katie Lockwood, MD, MEd, in this episode to discuss how pediatricians can help prepare Black youth to safely navigate police interactions. We address the challenges and importance of conversations about racism, especially for racially no

Cyclic Vomiting Syndrome (Episode 218)
In this episode, Haley Pearlstein, MD, a CHOP gastroenterologist, discusses cyclic vomiting syndrome (CVS), a pediatric condition marked by recurrent severe nausea and vomiting episodes separated by symptom-free intervals, with a prevalence of up to 3.2% in children. We cover typical presentation in primary care, NASPGHAN guidelines, differential diagnoses including CNS tumors, and diagnostic work

Adolescent Vaccine Consent: Exploring Philadelphia's Self-Consent Regulation for Teens (Episode 217)
In Philadelphia, a 2007 Board of Health regulation allows capable adolescents ages 11–18 to self-consent to vaccines that prevent reportable diseases, recognizing that teen vaccine coverage remains suboptimal in part due to access barriers and inconsistent uptake when decisions rest solely with parents. This episode explores how that policy works in practice and what it means for autonomy, equity,

Food Allergies and Parental Anxiety (Episode 216)
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 couns

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

Autism Spectrum Disorder Myths and Expert Advice (Episode 214)
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)
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, ad

The Relationship Between Food Allergies and Eczema (Episode 212)
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

Communicating About Vaccines (Episode 211)
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, bu

Caring for Immigrant Patients in Pediatrics (Episode 210)
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 l

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

Hearing Loss Comorbidities (Episode 208)
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

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

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

Pediatric Dentistry and Sleep Disorders (Episode 205)
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 Slee

Pediatric Asthma in Viral Season (Episode 204)
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

Football Protective Equipment and Concussion Risk (Episode 203)
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 con

Oral Immunotherapy (Episode 202)
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 gr

SUDC: Sudden Unexplained Death in Childhood (Episode 201)
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 t

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

Dengue Fever (Episode 198)
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

Cannabis Hyperemesis Syndrome (Episode 197)
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)
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 year

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

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

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

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

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

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

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

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

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

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

Retinoblastoma- (Episode 184)
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)
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)
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 measurement

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

Social Media for Healthcare Professionals
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 pro

Epilepsy Surgery for Drug-Resistant Epilepsy (Episode 179)
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 adv

Financial Planning Tips for Physicians (Episode 178)
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 provide

Tethered Cord in Pediatrics (Episode 177)
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

School Lunch Nutrition Updates with USDA FNS (Episode 176)
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

Twins (Episode 175)
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 #tw

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

Rabies (Episode 173)
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 Glo

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

Advocacy Curriculum in Pediatric Residency Education (Episode 171)
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,

Sickle Cell Gene Therapy (Episode 170)
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 certa

An Antiracist Approach in Primary Care
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 practi

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

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

Primary Care Perspectives: Episode 166-- Marfan Syndrome
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

Primary Care Perspectives: Episode 165-- Stuttering
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

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

Primary Care Perspectives: Episode 162-- Ankyloglossia
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 re

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

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

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

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

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

Primary Care Perspectives: Episode 156 - Lipid Screening
“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 takin

Primary Care Perspectives: Episode 155 - Vaccine Hesitancy
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 o

Primary Care Perspectives: Episode 154 - Nirsevimab (Beyfortus)
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, administr

Primary Care Perspectives: Episode 153 - Fatal Poisonings
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 includ

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

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

Primary Care Perspectives: Episode 150 - ADHD Medication Management
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 b

Primary Care Perspectives: Episode 149 - The Future of Pediatrics
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 o

Primary Care Perspectives: Episode 148 - Managing Sinus Infections
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 sinusiti

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

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

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

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