Primary Care Perspectives

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. 

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 the impact of language deprivation on the brain and how it impacts development, particularly psychosocial functioning. For more information on services for hearing loss and speech disorders offered at CHOP, visit the Center for Childhood Communication. 

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 anticipatory guidance. 

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 what we have learned in the decade since the LEAP trial and explains his recent study on how these guidelines have impacted the rates of peanut allergies in children. 

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 this episode are those of Andrew Cohen, DMD, and not necessarily representative of Children's Hospital of Philadelphia.

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 discuss when to use inhaled corticosteroids, school-based management approaches, and navigating insurance coverage challenges. Also, Dr. Saxena reinforces the importance of getting a flu shot!

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 young athletes safe. This episode is a mix of physics and physical education classes, and you are certain to learn a lot about football protective equipment!

Imagine intentionally eating an allergen to re-teach your immune system to overcome this allergy? That's what our CHOP Allergists are doing in the Oral Immunotherapy Program and it is life changing science in practice! In this episode, Antonella Cianferoni, MD, PhD, explains oral immunotherapy including the immunologic process, the logistics for patients, and managing the risk of anaphylaxis. A great episode for providers and families!

Less well known that SIDS, SUDC is a category of death for a child 12 months of age or older that remains unexplained after a thorough investigation. In this episode, Richard Goldstein, MD, Director of the Roberts Program on Sudden Unexplained Death in Pediatrics and Associate Professor of Pediatrics at Harvard Medical School, teaches us more about SUDC including possible causes, how to navigate this diagnosis with families, and where the research is leading us. 

A special surprise guest joins us for the 200th episode anniversary! In this episode we explore why CHOP started a medical education podcast, how topics/guests are chosen, and what impact the podcast has had on listeners. Get behind-the-scenes with host and creator, Katie Lockwood, MD, MEd, and learn about the important role of podcasting in medical education. 

This year the Children's Hospital of Philadelphia (CHOP) Poison Control Center celebrates it's 40th anniversary! In this episode, Fred Henretig, MD, one of the founders of the Poison Control Center reviews the history of how the Center came to be and it's role in keeping children safe and healthy in 2025. Robert Bassett, DO, teaches us about how the Poison Control Center operates and what the most common poisoning threats are today and how to prevent them. Meanwhile, Katie Lockwood, MD, MEd, shares that her family has called, so make sure you have 1-800-222-1222 saved in your phone and listen to this fascinating episode for more tips on poison prevention!

Dengue fever is a mosquito-borne viral illness that can have serious complications. In this episode, Lori Handy, MD, MSCE, an attending in the Division of Infectious Diseases and Associate Director of the Vaccine Education Center at CHOP, explains the symptoms of dengue, why the vaccine is uncommonly used, and how to manage fever in a returning traveler. With half of the world's population living where dengue is common, this is an important infection for us to all know about and keep on the differential!

Marijuana use by teens has been stable over the past few decades with 1 in 5 high schoolers using marijuana regularly. However, THC levels in marijuana have increased and we are seeing more Cannabis Hyperemesis Syndrome (CHS). In this episode, Adam Kronish, MD, explains current trends in marijuana use, the physiology of CHS, and what we can do in primary care to identify and manage this condition. 

Delivering serious news is unfortunately a part of pediatrics. While some believe that we are inherently either good or bad at this skill, we know that is not true and that you can learn how to do this well. In this episode, Julie W. Stern, MD, the Director of Outreach Services with the Division of Oncology at Children's Hospital of Philadelphia, shares best practices and lessons learned from years of having difficult conversations. 

Tzield or Teplizumab, is a CD3-directed monoclonal antibody to delay the onset of Stage 3 Type 1 Diabetes in adults and pediatric patients aged 8 years and older. This is an important new treatment option because when diabetes is recognized in the early stages (Stage 2), there is an approved treatment that has been shown to delay the need for insulin by about 2-3 years. In this episode, Neha S. Patel, DO, who is an Associate Professor of Pediatrics and an attending physician in the Division of Pediatric Endocrinology and Diabetes at Children's Hospital of Philadelphia, teaches us what we need to know about Tzield and how patients can access it. 

Jessi Gold, MD, MS, shares some of the lessons from her book, How Do You Feel: One doctor's search for humanity in medicine, including managing emotions, addressing burnout, and exploring self-identity. This episode feels like self-care! Learn the difference between secondary trauma, burnout, PTSD, and why healthcare workers are particularly at risk for experiencing trauma. Dr. Gold not only explores the current state of healthcare worker mental health but gives actionable ideas to help the helpers!

Paul Tran, MD, a pediatric gastroenterologist and medical educator, empowers and encourages medical learners through his comedic online medical education, using the handle @alimentaryschool. Listen as we discuss how he got started, the anatomy of a post, and how to respond to online criticism. In addition, we hear about his viral posts and why he's always carrying a notebook. 

Two experts from the CHOP Bariatric Program, Joy Collins, MD, and Elizabeth Parks Prout, MD, MSCE, update us on the state of pediatric obesity, the current medication and surgical management options, and the outcomes of these interventions. The Adolescent Bariatric Program at CHOP is a unique collaboration between our Health and Well-being Clinic, surgeons at CHOP and HUP, clinical psychologists, a clinical dietician, a social worker, and a physical activity specialist. In this episode, Drs. Collins and Prout discuss the psychosocial impacts of bariatric surgery and their team-based, holistic approach to treating patients. 

An estimated 11.4% of US children are diagnosed with ADHD. In this episode, Thomas Power, PhD, ABPP, Director of the Center for Management of ADHD at CHOP, discusses a new Clinical Pathway for the Evaluation and Treatment of ADHD and how primary care providers can utilize and promote psychosocial interventions for ADHD. We discuss behavioral parent training, peer interventions, school supports, emotion regulation, and more, in this fascinating episode!

In light of the recent measles outbreaks, Scott Krugman, MD, MS, FAAP, created a series of social media posts about vaccine-preventable infections. In this episode, he shares pearls from those posts so that we can learn more about these illnesses, which many practicing pediatric providers have never seen outside textbooks thanks to the success of vaccines. He also talks about how his social media posts were received online and why they were so popular.  

In this episode, we discuss the definition and work-up of short stature as well as treatment of growth hormone deficiency. Marissa Kilberg, MD, MSEd, an attending physician in the Division of Endocrinology and Diabetes teaches us about who might qualify for growth hormone deficiency treatment, possible side effects, the logistics of treatment, and when treatment is not indicated. Dr. Kilberg offers primary care providers strategies about the work-up that can be done in primary care as well as management pearls for patients on growth hormone therapy. 

In this episode, Juhee Lee, MD, an attending physician in the Division of Allergy and Immunology at CHOP, discusses some of the nuanced ways anaphylaxis can present and reviews the diagnostic criteria for anaphylaxis. We use a few cases to apply the diagnostic criteria to real-world challenges and discuss how to manage patients with anaphylaxis in the outpatient setting. Dr. Lee teaches us about what's new in anaphylaxis treatment, including intranasal epinephrine, and when patients need to carry epinephrine auto-injectors. Lastly, we review the CHOP Clinical Pathway for the Evaluation/Treatment of Children with Anaphylaxis, which is a great resource. 

Sine 2023, both the FDA and AAP have supported the use of goat milk-based infant formula, but awareness of this option still lags and many think of it as a niche product. Ari Brown, MD, a board-certified practicing pediatrician in Austin, Texas, the author of the best-selling Baby 411 book series, and Kabrita’s Chief Medical Advisor, teaches us more about why families would choose a goat milk-based formula and the safety data behind its use in the US. Dr. Brown also gives us a great review of all of components of formula and what we should be looking for in the ingredients. In this episode, we also discuss the risks of homemade infant formula, raw milk, and unregulated formula, and Dr. Brown shares her experience in working in both the formula industry and in her pediatric clinic. 

In honor of American Heart Month, Jonathan Edelson, MD, an attending cardiologist at Children’s Hospital of Philadelphia (CHOP) and the Medical Director of the CHOP Sports Cardiology Clinic, talks with Katie Lockwood, MD, MEd, about sports participation for athletes with cardiac disease. Dr. Edelson addresses the importance of physical activity for children with cardiac conditions and how exercise plans should be individualized based on a child’s cardiac condition so that they can meet their exercise goals safely. Learn about the unique CHOP Sports Cardiology Clinic and how they guide athletes and may coordinate care with cardiologists and primary care providers. #HeartMonth @HeartCare4Kids #Cardiology2025 #CHOPHeartWarrior #SportsCardiology

70-80% of patients do not use their asthma inhaler properly and use deteriorates over time. As Dr. Lockwood admits, many providers also don't know how to use some of the inhaler types out on the market and asthma medication shortages have led to prescribing challenges lately, so in this episode, Marcia Winston, MSN, RN, CPNP-PC, AE-C, a nurse practitioner with the Division of Pulmonary and Sleep Medicine at Children's Hospital of Philadelphia, walks us through various inhaler types and troubleshoots management issues. We also discuss the implementation of the 2020 GINA guidelines SMART therapy recommendations, use of and cleaning aero chambers, and a poster guide to identify mystery inhalers!

Although relatively rare with 300 cases per year in the United States, we look for retinoblastoma at every well visit. Amish Shah, MD, PhD, a neuro-oncologist at CHOP, educates us on the epidemiology, presentation, management, and prognosis of retinoblastoma, as well as how partnership between Children's Hospital of Philadelphia and Wills Eye Hospital has improved outcomes for children. 

Become better prepared to respond to an emergency situation on an airplane through the experience of an emergency medicine physician at Nemours Children's Health, Steven Selbst, MD. In this episode, Dr. Selbst and Dr. Lockwood discuss why healthcare providers should respond to emergencies, the most common types of emergencies, what supplies are on board, and the resources available to responders. 

Iron plays a crucial role in many vital functions and in this episode, Char Witmer, MD, Clinical Director of Hematology at Children's Hospital of Philadelphia, gets us excited about hepcidin, ferritin, reticulocyte counts, and more! We discuss why premature infants are particularly vulnerable to iron-deficiency anemia, how to provide supplementation, dietary sources of iron, laboratory measurements of iron, and more in this fascinating episode on anemia. 

Have you ever seen a baby eating a chicken drumstick? Or gnawing on a whole strawberry or broccoli floret? Many healthcare providers may not have learned about baby-led weaning and therefore, may not teach parents about this method of introducing solids and teaching babies about self-feeding. In this episode, Dr. Katie Lockwood and Kary Rappaport, OTR/L, MS, SCFES, IBCLC, a senior feeding and swallowing specialist on the team at Solid Starts, discuss the differences between choking and gagging, serving sizes at different ages, feeding challenges, handling allergens, and more, just in time for Thanksgiving! 

Healthcare professionals may use social media for a variety of purposes including developing a professional network, increasing personal awareness of news, listening to experts, and/or consulting colleagues. It can also be a tool to disseminate research, market practices, engage in health advocacy, and engage with professional organizations. Increasingly we are seeing health care professionals provide health information to the community and engage with patients on social media platforms. On this episode, Anjuli Gans, MD, a pediatrician at Karabots Pediatric Care Center in West Philadelphia, a CHOP Care Network primary care practice, who is known online for her site Resilient Rascals and its popular Instagram account of the same name with 141,000+ followers, discusses the rules of engagement, how to fight mis/dis-information, and why healthcare providers might want to create a social media account.

Of the roughly 500,000 US children with epilepsy, 30% will continue to have seizures despite medication management. This seizure burden can have significant impacts on a child’s development, school performance, social life, sports participation, driving ability, mental health, and more. In this episode, we talk about surgical approaches to drug-resistant epilepsy and explore some of the newest advances in neurosurgery with Benjamin Kennedy, MD, an attending neurosurgeon and the Director of Epilepsy and Functional Neurosurgery in the Division of Neurosurgery at Children’s Hospital of Philadelphia.

Financial planning is not often taught to physicians but is an important topic!  In this episode, Sam Lewis, CFP®, ChFC®, MQFP®, Founder of SJL Financial, LLC, guides us through how we should think about life insurance, disability insurance, loan repayment, contract negotiations, savings accounts, wills, retirement, and more! While financial planning is an individual decision, this episode provides a general framework to start thinking about financial wellness.

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. 

The CHOP Neonatal Intensive Care Unit is working on enhancing communication of nutrition plans to primary care providers when infants are discharged. In this episode, Sarvin Ghavam, MD, an attending neonatologist and Kristina Spaide, MS, RD, CNSC, clinical nutrition manager, identify the unique nutritional needs of premature babies, common feeding concerns, and nutrition management pearls for the transition from NICU to home.