PM Pediatrics
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Dr. Christina Johns
Senior Medical Advisor, PM Pediatrics

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The Mystery of the Medical Conference

My dad used to travel a lot for work and go to many academic medical conferences. I always wondered what he did all day. At the time it seemed like it was hanging around for most of it attending committee meetings and then some fancy dinners at night. Well, now I know.

Work travel is intense. There’s a whole bunch of prep work at home that’s involved even before I start to get myself packed. I make sure there’s enough food in the fridge; lay out the school uniforms for the number of days that I’m gone, and type out the daily schedule that includes phrases such as “garbage day tomorrow” as if this is new information for the people living here for the past 15 years. Then, and only then, do I start to get my own act together. (And I’m not even getting into the advance work required to prepare presentations etc.) By the time I get on the plane or mode of travel towards the event my head is usually in the game to be focused and productive, and I have a great time. My kids like to FaceTime me and see every hotel room I stay in, and I immerse myself in work for a few days.

Then it’s time to return.

Is anyone else completely WIPED OUT, in the most awesome way, when they return home from several days of work travel or an academic conference or trade show or whatever? My dad never seemed to be, but of course he never had to do all the prep work beforehand described above and his return nearly always involved just himself, not the collateral effect of outstanding kid related issues for my brother and me since my mom mostly handled us and our activities. But back to today. I’ve just returned from the Pediatric Urgent Care Conference, hosted by my organization, PM Pediatrics, and while it was fantastic and I’m about to share a few highlights today, I still feel like I’m in a bit of a fog. But there was some good stuff shared there, and I’d like to pass that on.

Got in a session at the gym before the keynote presentation!

Telemedicine.

First. Telemedicine. Like it or not, virtual medical visits are here. This is a hot issue right now and there many people who are both for and against using this evolution in technology for medical purposes. Those who believe in telemedicine see it for the good that it can do: make clinical care more convenient and accessible and bring healthcare into people’s homes, even providing a solid way to give medical access to people who for whatever reason may have difficulty getting it. But telemedicine has to be done RIGHT to be done well: currently there’s a fair amount written about how telemedicine is synonymous with bad medicine: too many inappropriate antibiotic prescriptions written for children, misdiagnoses, disconnection from primary care and the medical home, etc. But done well, this emerging field has enormous potential, which I’ve written a bit about previously.  At the conference, telemedicine experts provided a hands-on workshop for clinicians to understand not only how to use some of these impressive devices, but also to think smartly about their limitations and scope of use. Nothing can or should replace an in-person evaluation for a medical condition, especially an urgent one, but telemedicine can be a helpful triage system and in some straightforward cases a diagnosis maker. Systematizing the process to do it responsibly and effectively is a must, and is something that is being actively worked on by many. So I don’t think it’s wise to count telemedicine out right at the beginning.

drs. raskas and cohen demonstrate telemedicine devices

Practice Management.

Another interesting aspect of the conference was the expert panel which addressed the starting up and running of a pediatric urgent care office. It’s one thing to know how to perform the clinical care, but it’s another thing altogether to write a business plan, find the right space, hire the right people, and get the word out in the community. From attorneys to HR expertise to marketing, this panel shared their “secret sauce” of elements that need to come together to create a top quality, safe, convenient, and sustainable operation. This involves things like finding an office space that has ample parking, is well lit, and near oft-frequented commercial enterprises. Business 101, right? Well, add in safety compliance and contracts issues and other hoops to jump through and even the most determined clinicians could lose steam in wanting to establish themselves. We want first rate physicians who are lifelong learners, always improving, practicing  the latest standard of care to be the ones setting up a reliable shop in our communities, right, so sharing some well honed knowledge about this from seasoned experts is valuable and time and headache-saving for those just getting started.

ask the experts panel from the 2016 pediatric urgent care conference

Patient Experience.

The patient experience—the PX— is an increasingly popular topic in urgent care, and was addressed at this conference as well. Leaders in the field shared tips on fostering positive language—(i.e. don’t say “why are you here?” instead say “what are you most concerned about today?”), staff training, and circling back with patients for feedback after the visit. I’m sure I don’t need to tell you that the patient experience is important and that service excellence is a key part of care delivery, but as a whole medicine has been a bit late to the party in acknowledging this as a top feature. It doesn’t come naturally to everyone, so we need to offer ongoing education in best practices of how to ensure that patients are not only treated accurately but cared for well in as many offices as possible.

Hands-on Practice.

The suturing/splinting and “foreign body removal” workshops were well attended too. Nothing beats hands on, practical simulation experience in medicine, and this group practiced different types of suture placement into chicken legs purchased from the local grocery store, and worked on removing beads and raisins from silicone nose and ear models using a variety of techniques—from super glue to using a tiny “alligator” forceps. As the popular saying goes, practice makes perfect, and working on these skills in a simulated setting really comes in handy on that random Saturday night at 10:15pm when a parent brings in their toddler who has strategically inserted a mushy corn kernel up their left nostril.

dr. christina johns helps during a suture workshop

This entry is merely a snapshot of the amazing learning that transpired (intensely) over 3 days. In addition, there was a concussion review, a highlight of the top 10 game changing articles from the last year, and even a little bit of disaster medicine as well. As for me, I gave 2 lectures, participated in one panel discussion, led one workshop and facilitated another, so I was pretty busy. I didn’t miss out on having a fabulous dinner, or 3, but I sure was happy to see my kids after several days away, even when my daughter said to me: “So, mom, what on earth did you DO ALL DAY at the conference?” Dad, here’s to you! I hope I’m making you proud.

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