Primary Care Perspectives

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!

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 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. 

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. 

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!

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. 

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. 

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!

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.  

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.