Primary Care Perspectives

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!

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. 

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 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. 

Kary Rappaport, a senior feeding and swallowing specialist at Solid Starts, shares nearly two decades of expertise in infant feeding. She explains the concept of baby-led weaning, highlighting how it encourages self-feeding and helps infants explore solid foods. Kary contrasts choking with gagging, stresses the importance of introducing allergens early, and offers practical tips for parents on portion sizes and food textures. She emphasizes using a variety of nourishing foods, including meats on the bone, to enhance mealtime experiences.

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.

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 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.

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. 

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