Primary Care Perspectives

Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition that affects feeding, growth, and quality of life, traditionally diagnosed and monitored through repeated endoscopies. Recent advancements include the esophageal string test, a minimally invasive method that captures disease activity through biomarkers rather than tissue biopsies, potentially transforming personalized care for EoE patients. This discussion featur...

Drowning remains one of the leading causes of death for children. In this episode, Drs. Rotherham and Stafford explain the “layers of protection” concept, including swim lesson timing, effective home pool safety measures, and the risks of floatation devices versus life jackets. We also clarify terms like “dry drowning” and dispel myths around water safety. This episode includes key water safety messages that...

The coauthors of a new study in the journal Pediatrics titled “Black Teenage Male and Caregiver Perspectives on Anticipatory Guidance for Police Encounters”, join Katie Lockwood, MD, MEd, in this episode to discuss how pediatricians can help prepare Black youth to safely navigate police interactions. We address the challenges and importance of conversations about racism, especially for racially non-concordant providers,...

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 exp...

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’...

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 ...

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 preparin...

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 contrac...

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, ...

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. 

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 confi...

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 dent...

Many people do not know the difference between the terms deaf, Deaf, and Hard of Hearing, so in this episode we discuss the diverse landscape of hearing loss. Michael Hoffman, PhD and Matthew E. Fasano-McCarron, PsyD, discuss why some comorbidities may be more common in patients with hearing loss and some of the challenges in making diagnoses of comorbidities such as autism, ADHD, and intellectual disability. We also discuss t...

Pediatric residents, Drs. Kelly McNult and Colleen Lynch, explain how they created an advocacy project related to bike helmets inspired by their personal experiences with patients and the loss of a colleague, Dr. Barbara Friedes. In this episode they not only explore how to execute an advocacy project as a resident but also teach us more about the effectiveness of bike helmets, how to ensure helmets fit, and other bike helmet antic...

In the early 2000’s pediatricians recommended delaying the introduction of highly allergenic foods, like peanut, but we saw that the rates of peanut allergy continued to rise. However, the 2015 LEAP trial showed that early introduction was better. In fact, the LEAP trial found an 81% decrease in peanut allergies by age 5 in children who had an early introduction. In this episode, Stanislaw J. Gabryszewski, MD, PhD, discusses ...

In this episode, Andrew Cohen, DMD, who is board certified in dental sleep medicine and a comprehensive restorative dentist, explains how anatomy, behavior, and overall health impacts sleep-related breathing. We discuss common issues like mouth-breathing, teeth grinding, thumb-sucking, and extended pacifier use and how these impact dental health and sleep. For more information, visit the CHOP Sleep Center.

Opinions expressed in th...

We learned a lot about pediatric asthma during the COVID-19 pandemic, including how significant the impact of viruses is on causing asthma flares. In this episode, Shikha Saxena, MD, from our Children's Hospital of Philadelphia Division of Pulmonary Medicine, Pulmonary Asthma Program, and Pulmonology and Allergy Personalized Asthma (PAPA) Clinic, discusses ways to help keep asthma in good control through the viral season. We discus...

Can you reduce the risk of concussion through specialized protective equipment? In this episode, two of our Minds Matter Concussion Program experts, Kristy Arbogast, PhD, and Christina Master, MD, FAAP, CAQSM, FACSM, FAMSSM, discuss whether the specialized equipment used by NFL players has evidence in pediatric athletes. We also learn other ways that parents, coaches, and trainers can mitigate concussion risk and how we can keep yo...