Primary Care Perspectives

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

Twins account for 3% of live births in the US and are at risk of higher rates of fetal growth restriction, congenital anomalies, twin-twin transfusion syndrome, twin anemia polycythemia sequence, selective fetal growth restriction, and cord entanglement. In this episode, Michael Posencheg, MD, a Children's Hospital of Philadelphia neonatologist and father of twins talks to us about the care of #twins beyond the #NICU including developmental assessments, tandem feeding, safe sleep practices, and more.

Talking with teenagers can feel challenging, but in this episode, Kenneth Ginsburg, MD, MSEd, an attending physician in the Division of Adolescent Medicine and the Co-Director of the Center for Parent and Teen Communication at Children's Hospital of Philadelphia, shares lessons learned from his years of research and experience with adolescents. Dr. Ginsburg's approach to teen communication focuses on facilitating youth to develop their own solutions through a strengths-based approach. Listen to learn his communication framework and for more resources that will enhance how you communicate with teen patients. 

Contact with infected bats is the most common cause of human rabies deaths in the US, but dog rabies remains common worldwide. Learn about other wildlife that can carry rabies, post-exposure prophylaxis, high-risk hobbies and careers, and what rabies can teach us all. Andrew Steenhoff, MBBCh, DCH, attending physician in the Division of Infectious Diseases at CHOP and Medical Director of CHOP's Global Health Center joins us in Episode 173 for a fascinating review of rabies in the US and globally, so we can all aim to prevent this disease in children. 

According to the CDC, approximately 0.6% of children aged 0-17 have active epilepsy, so in a school of 1,000 students, this means 6 of them could have epilepsy. Adolescence is a time when patients have more autonomy in caring for their chronic disease and have changes in lifestyle factors, which could be risk factors for increased seizures. In this episode, Lawrence Fried, MD, a pediatric neurologist, and Zia Gajary, MD, a primary care pediatrician, help us understand how to counsel teen patients and their caregivers about managing epilepsy during adolescence, including topics such as driving, sports, contraception, drugs, college, and more! Their HRSA grant has enhanced teen epilepsy education at CHOP and they share their tips in this podcast episode.

The Children's Hospital of Philadelphia (CHOP) advocacy curriculum has a rich history of teaching pediatric residents how to incorporate being an advocate into their career as a pediatrician. Noreena Lewis, JD, the Co-Director of the Community Pediatrics and Advocacy Program (CPAP), explains the various ways pediatricians can engage in advocacy, some of the biggest hurdles for resident advocates, strategies for engaging with communities and creating sustainable projects as a trainee, and examples of CHOP resident advocacy projects. Noreena recommends the CHOP Office of Community Impact as a great starting point for anyone interested in starting their advocacy journey! You can also read her article in Pediatrics (Feb 2024) entitled "A Qualitative Study of Resident Advocacy Work." This episode is such an inspiring conversation about an important topic for all pediatricians and medical educators!

New research has led to the approval of sickle cell gene therapy and CHOP has played a big role in both the research and implementation of this innovative treatment. In this episode, Dr. Abraham Haimed, an attending in the Division of Hematology at Children's Hospital of Philadelphia, explains how a patient's own hematopoietic stem cells can be edited to block the expression or function of a certain gene and reactivate normal fetal hemoglobin to cure sickle cell disease. While this treatment happens outside the primary care world, it is important for general pediatricians to understand how this treatment works and what to look out for after a patient receives gene therapy. 

A recent publication in Pediatrics by George Dalembert, MD, MSHP and Aditi Vasan, MD, MSHP helps us learn more about how to use an antiracist approach to social care integration in primary care. In this episode, Drs. Dalembert and Vasan walk us through the recommendations made in their commentary with actionable steps for how we can all integrate social care interventions equitably into our practices. Learn about what the work that we are implementing at CHOP thanks to the Clinical Futures research and get inspiration for your own practice changes. 

As of 2020, 20% of new HIV diagnoses were among young people aged 13-24 years. Primary care pediatricians can play an important role in the prevention of HIV through standard, non-stigmatizing sexual health and HIV prevention care, which is why we are talking about PrEP with Sarah Wood, MD, MSHP, and Zoe Gould, LCSW. Learn about the role of PrEP, administration, barriers to care, and ways to start integrating HIV screening and PrEP initiation into your practice.