Primary Care Perspectives

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-up strategies. In addition, we explore how acute treatments parallel migraine therapies, recommended lifestyle modifications, and preventive medications.

For more information on CVS or to refer to CHOP GI, visit: Division of Gastroenterology, Hepatology and Nutrition | Children's Hospital of Philadelphia

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, and public health.

We’re joined by Dr. Marva Schödel, co-author of a recent paper on adolescent vaccine self-consent, to unpack the real-world impact of this approach. This research was done with the Pediatric Research Consortium (PeRC), a primary care practice-based research network at Children’s Hospital of Philadelphia. Dr. Schödel is, as of the time of publication, an employee of Merck, who manufactures the HPV vaccine, Gardasil 9. 

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 counselor and family therapist, and Megan Lewis, MSN, RN, PCNP, a Pediatric Nurse Practitioner in the CHOP Division of Allergy and Immunology.  

We have discussed on this podcast before in Episode 143 how to help children who have both food allergies and anxiety, but in this episode, we focus on the parent-child dyad and how parental anxiety may impact a child.

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 model, practical tools for preparing for transition, and resources for pediatric primary care providers. 

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 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, addresses the basics of contraception counseling, how to approach misinformation about contraceptives, and more, using a nuanced and patient-centered approach.

Special thanks to our guest host, Julia Pickel, MD, a pediatric resident at CHOP completing an Advanced Skills in Podcasting.

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 about beef tallow and eczema, but for more information view Pediatric Health Chat. CHOP also has a Clinical Pathway for the Evaluation/Treatment of Children with Suspected Atopic Dermatitis. For more information on CHOP's Allergy Program, visit: Allergy Program | Children's Hospital of Philadelphia

#foodallergies #eczema

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, build trust, and open dialogue. 

Another resource with good information for patients and families on common vaccine myths is CHOP's Pediatric Health Chat. 

#vaccines

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 leaves clinicians feeling more confident in caring for immigrant families and in their ability to continue advocating for their patients.

For more information on the CHOP Pediatric Residency Program, visit: Pediatrics Residency Program | Children's Hospital of Philadelphia

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 talk about topical fluoride dental varnish with Brian Jenssen, MD, MSHP, a CHOP researcher with Clinical Futures and the Possibilities Project, whose QI project on fluoride varnish was published in Pediatrics in October 2025. While fluoride continues to be a hot topic in the news, learn from Dr. Jenssen why we should embrace it in pediatric primary care.