Primary Care Perspectives

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.

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.

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.

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.

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.

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.

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.

Dr. Jonathan Spergel, Chief of Allergy Program at CHOP, dives deep into managing food allergies in children. He highlights the top nine food allergens and shares insights on safely introducing potential allergens to young ones. The conversation covers when to seek allergy testing and the significance of different tests. Additionally, Dr. Spergel discusses exciting advancements in immunotherapy and strategies to help children outgrow these allergies, offering hope and practical advice for families navigating this complex landscape.

Kevin Osterhoudt, an attending physician at CHOP and director of the Poison Control Center, sheds light on the staggering issue of poisoning, the leading cause of injury-related deaths in the U.S. He discusses common exposures in children and the alarming rise of opioid overdoses, stressing the critical role of naloxone. Osterhoudt also addresses the hidden dangers of household items and social media challenges. With insights on snake bites in Pennsylvania and safe hand sanitizer use during the pandemic, he emphasizes the importance of vigilance and prevention.

Lori B. Feldman-Winter, an internationally-recognized expert in breastfeeding education, shares her wealth of knowledge on breastfeeding guidelines. She discusses the profound health benefits of exclusive breastfeeding, especially in the first six months. The conversation covers crucial contraindications to breastfeeding, such as certain maternal health conditions. Feldman-Winter also emphasizes strategies for managing conditions like hyperbilirubinemia in newborns and highlights the vital role pediatricians play in supporting breastfeeding mothers effectively.