Pediatric Pulse

"What's Up, Docs?" is a forum for pediatricians, by pediatricians, to share your perspectives, voices, and ideas.

So, what's on your mind?  Docs, tell us what's up!

Niyi Omotoso, MD FAAP

Contra Costa/Solano Area Director & Chapter Immunization Representative, CA-AAP 1

"We all have become too familiar in recent times with vaccine hesitancy. Last Spring 2023 at a regional immunization coalition conference, I witnessed the stories. Two parents, who are now vaccine advocates, described their journey from being vaccine confident to vaccine hesitant. The key factor they both elaborated on was their loss of trust in their child’s primary care provider. They noted how their fears/concerns were not validated and sowed doubts." . . . 

Amna Khan, EDI Champion, M.D, FAAP

"June marks our annual celebration of Pride Month and offers us an important opportunity to review and recommit to the multifaceted ways that we can serve as good allies to LGBTQI+ children and families.  As pediatricians, we often are the trusted guide families turn to during childhood and adolescence when questions regarding gender, gender identity, and sexual orientation are explored by our patients." . . .

Amna Khan, MD FAAP

EDI Champion, Chapter 1 AAP 

"As the weather turns toward perpetual bright, blue skies and warm sunshine, our pull heightens to spend much-needed, unplugged time enjoying nature and its many innumerable benefits.  Although intuitive, research substantiates that equitable access to clean and safe green spaces is essential to both our mental and physical well-being." . . .

Diane Dooley, MD, FAAP

Mental Health Committee Chair, CA-AAP 1

"Do you ever have questions about how to manage your patients’ behavioral health problems, such as depression, ADHD or anxiety?  Good news!  Pediatricians and primary care providers throughout California now have a statewide psychiatry consultation and support program designed to increase timely access to mental health care for children, youth and their families." . . .

Mark M. Simonian, MD

"As pediatricians, we are continually seeking ways to improve our practice workflow and enhance the care we provide to families. One of the most promising tools at our disposal is generative AI. The American Academy of Pediatrics (AAP) recognizes the significant potential of AI in clinical practice and is actively developing strategies and policies to ensure these technologies are implemented safely and effectively, without causing harm to clinicians or families." .  . . 

Renee Wachtel, Chair, CAC1 Committees on Development and Behavior & School Health, CA-AAP 1

 "Part of the anticipatory guidance that we provide to families with young children is to minimize screen time.  This advice  seems to employ common sense but has not had much of a research base to explain the harm that screen time may cause to young children. A recent prospective study from Japan provides strong support for the screen time limitation. In this study (Takahashi et al JAMA Ped 2023:177 (10) 1039-1046) 7097 mother-infant pairs were followed from birth and questioned about the child’s screen use at 1 year of age." . . .

Neel Patel, MD, FAAP

 

"I hope everyone is now ready to enjoy May flowers and celebrate the outdoors.  Springtime brings new energy and time for rejuvenation!  In that regard, it is time for Chapter 1 area director elections.  All areas are up for election this year!   First and foremost, we would like to thank the current area directors who have led and supported our chapter members with amazing enthusiasm and spirit." . . .

Renee C. Wachtel, MD, FAAP

"As we know, developmental surveillance conducted routinely in well child visits is fundamental for the detection of children at risk for developmental delay. This study was a cross-sectional, nationwide retrospective study using data from about 1000 maternal child health clinics including 839,574 children birth to age 6 years involved in 309,181 well child visits." . . . 

Renee C. Wachtel, MD, FAAP

"As every pediatrician is aware, there is a HUGE problem with ADHD medication shortages. And if the ADHD medication shortage wasn’t frustrating enough, apparently certain ADHD medications have doubled or tripled in cost since the shortage began in October 2022. According to a December 2023 report, the prices that retail community pharmacies pay for specific dosages of methylphenidate and dexmethylphenidate doubled from late 2022 to December 2023." . . .

Amna Khan, MD, FAAP

 "A maternal death is defined by the World Health Organization as, “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes”. . . . 

Jim Carpenter, MD, MPH, FAAP

"The first Child Death Review team in California was started by Dr. Michael Durfee in 1978 in Los Angeles.  His impetus was discovering that a child who died from child abuse or neglect was inconsistently documented by death certificate, state homicide data or state child abuse reporting.  PC11666.7 in 1989 allowed the creation of DRTs with the sharing of confidential information between various agencies so that cases of child abuse-related fatalities would not be missed." . . .

Shazeen Suleman, MD, MPH, FAAP

"Studies have shown that children receive more preventative care when their parents have health insurance. As pediatricians that care for immigrant children, we can help our eligible patients and their families the care they need and deserve by supporting their enrollment in Medicaid!" . . . .

Katrina Marks, PGY2 & Lena C. Van Der List, DO, FAAP

"As a busy clinic day wraps up, I start to tackle the mountain of paperwork sitting on my desk. Under a pile of school forms, prescription orders, and other various tasks vying for my attention, I spot my primary election sample ballot. Some coworkers comment about how many candidates are on the ballot and how long the polling lines were for the last election, and I overhear others wonder if their vote is even worth the effort." . . . .

Renee C. Wachtel, MD, FAAP

"Pediatricians are rightly concerned about the wait times for Autism Spectrum Disorder (ASD) Diagnostic Assessment for young children. Since the AAP Bright Futures recommends ASD specific screening at 18 and 24 months, pediatricians are aware that 1 in 36 children in their practice will have ASD.". . . .

Gracie Wilcox, MD, MPH, FAAP

"Every time I open my email I feel bombarded by articles on physician burn-out. I woke up on a recent Saturday knowing I had a busy morning of hospital rounds, followed by a busy Saturday clinic, after which I’d return to the hospital for more rounds; all of this would be accompanied by seemingly non-stop phone calls from parents, ED physicians and nurses." . . . .

Amna Khan, MD FAAP

"This month’s health equity focus is on food insecurity, defined as the “lack of adequate and dependable food resources for families to maintain a healthy and active lifestyle”. The COVID-19 pandemic increased US national rates of food insecurity in children from 1 in 7 households to 1 in 4 households.  Food insecurity has long been associated with poor health status, developmental risk, mental health problems and poor educational outcomes in children.  With the end of federal and state wide COVID subsidies, such as the child tax credit, complicated by the rising rates of inflation in our state, food insecurity continues to rise. " . . . .

Chrysa Cheronis, MD

From the safety of my home across the Atlantic, I watch the war in Ukraine unfold. The humanitarian crisis that has developed is not just limited to the loss of power, heat, and running water for many Ukrainian cities – civilians are now running for their lives as residential areas throughout the country are targets for bombardment. Attempts to flee these areas are further impeded, as heavy shelling is preventing the safe passage of humanitarian columns with Ukrainian and foreign citizens, as well as the delivery of medicines and food. . .

Andrew Brennan, M.D.

"'When was the last time you saw your pediatrician'

'Oh, he doesn’t have a pediatrician.'

I was taken aback by this response as typically, families reply immediately with their pediatrician’s name or the many valid reasons they haven’t scheduled an appointment..."

Ruzan Orkusyan, MD, MPH

I was on vacation, enjoying a hot summer day at the community pool. I had hoped to unplug from work and turn off my pediatrician brain. My 10-year-old cousins begged to go to the jacuzzi and I reluctantly joined them. What happened next has prompted me to think...

Magi Gabra, MD, MS

“Hey team, we’re getting a PICU admit… another suicide attempt.” 

My teammates and I sigh. I see my co-residents’ faces fall and can almost feel their shoulders slump. Only a few days ago we had a sad case of a bright, promising adolescent who had been struggling with depression for years and had shown improvement but due to shortage of mental health professionals during the pandemic, was not seen by a therapist or psychiatrist for several months...

Emma Squire, MD

I try to ask this question at all of my regular well child checkups. It’s an easy segue to counseling on the importance of varied nutrition and adequate physical activity as part of a healthy lifestyle. Prior to this year, this question was usually met with giggles and stumped faces before finally blurting out an answer. (I’ve heard answers ranging from French fries, to apples, to artichokes)...

Meghan Schmitt, MD

As I near the end of my intern year, I reflect on all that I have learned from my patients. Starting residency in a global pandemic, I have seen more adversity than I ever thought possible in a year: Parental loss, food insecurity, chronic disease, systemic racism, homelessness, abuse, neglect. But I have also seen resilience...

Catherine Nguyen, MD

Measles. 

Chickenpox.

Diphtheria.

These, along with 13 other infectious diseases, must not be forgotten as the COVID-19 vaccination effort is underway. These are diseases that are life-threatening but now...

John Ichiro Takayama, MD, MPH, FAAP

It’s 2021 and I’m thinking of two words to inspire me for the new year. One is “gambaru-na” and the other is “interdependence” and they are interrelated. Gambaru-na, a Japanese term, means “don’t try your best.” In Japan, there is a tradition of “gambaru” (try your best) and a high rate of Karo-shi (“death related to work”), and my interpretation is that overwork is related to poor health outcomes...

Samantha Sechrist, MS-1, Greta Peng, MD and Ali Valdrighi, MD

As the 2020 US presidential election quickly approaches, the call to political advocacy for physicians is of high importance. With the degree of voting misinformation being circulated during this election cycle, it is even more necessary for medical professionals to be a trusted resource for patients...

Lisa Patel, MD

As I write, the West Coast is engulfed in flames. Mid-August brought a searing heat wave along the West Coast, with the highest-ever recorded temperature on Earth at 130 degrees F in Death Valley. Lightning, an extremely rare occurrence in many parts of California, lashed the state, striking 10,000 times in rapid succession over just three days...

Ali Valdrighi, MD and Helen Pu, MD

With the COVID-19 pandemic drawing to a close, the world begins to breathe a sigh of relief as things move toward normalcy. Yet, for healthcare providers, even as work lessens, the physical stress and psychological toll of the numerous tragedies we have witnessed persists and is unlikely to vanish in the near future (1). This stress is amplified for resident doctors who have shouldered a disproportionate...

Nelson Branco, MD, FAAP

It is obvious that the novel coronavirus pandemic has exacerbated and revealed racial inequities in our country and our communities in a way that many of us have never seen. Those of us who work with these children and families may be unsurprised, but it remains to be seen what our country will do to address these issues. Do we have the political will to spend our resources in a way that improves the health of those communities?...