Welcome!

Pediatric Physicians, PC is a friendly and welcoming medical practice for your children. Our two offices in Alpharetta and Roswell are staffed by devoted, board-certified pediatricians, practicing the best state-of-the-art pediatric care from newborns to teens, including a 100% commitment to keep your children up to date on vaccines.

We’re easy to reach by telephone–no annoying phone tree!–and there’s plenty of free parking right at the doors of both offices. Same-day sick appointments are always available.

We’re here when you need us, and we’re here to help.

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Getting the most out of your child’s checkup

The Pediatric Insider

© 2014 Roy Benaroch, MD

In a recent post, I wrote about the value of a yearly checkup with your child’s doctor—it can be a whole lot more helpful than a quick sports physical at the local quickie-clinic. You can be sure to get the most out of your child’s checkups with these tips.

First, and most important at all, go to the visit. You’d be surprised how often children are brought by a cousin or aunt or sitter. Sometimes they bring a list of questions from mom—but what kind of a way is that to communicate? Even better: if both parents have questions, both of you should try to go to the physical. I like meeting both parents. And we’ll all get more out of the visit together.

Bring records of any visits with other doctors, Emergency Departments, and urgent care centers. If your child has been prescribed medications from other docs, bring those, too. Let’s use this as an opportunity to make sure all of the records and straight and all in one place.

Bring questions! A typed list, scribbled notes on a receipt, or a few words typed in a phone app—I’ve seen it all. Any kind of list is a good idea. You won’t get answers if you don’t remember your questions. Bonus pro-tip: put your questions in order, starting with the one you’re most concerned about.

If possible, don’t bring other children (especially young, distracting siblings). I know it’s not always practical, but if you can possibly set up a time for just the child, parents, and doctor to be in a room together, we can best focus on the star of the show. If you do have to bring siblings (and I understand, sometimes you just have to bring the whole family), try to bring something for them to do. Crayons, iPads, whatever you’ve got.

If for some reason you can’t make it on time, reschedule the visit. You’ll get more out of a rescheduled well check than a rushed well check. If you have to cancel, please call ahead of time—at my office, we always have a waiting list of people hoping to grab a cancelled slot. Do someone else a favor and call ahead of time if you can’t make it to your appointment.

Talk with your child in advance about what to expect. The doctor is going to check “down there”, which is OK for the doctor to do as long as mom or dad is in the room (when kids get older, I’ll ask mom and dad to leave—expect that by the teenage years.) We just want to make sure everything is OK, and that means everything. OK?

There may be some things you don’t want to talk about in front of the child. Maybe school problems, or bullying, or maybe there’s marital problems that are stressing your child out. These are all good questions, and sometimes it can be awkward to bring them up. If it’s a quick question, slip the nurse a note that you need a moment alone with the doc. If you think you need more private time with the physician, call ahead and ask how your doctor’s office likes to handle that. It’s unfair to leave a child alone in the room for a long time while you talk secretly with the doctor—and it makes the kids very, very nervous. It might be best to set up a separate time for parents to come in.

For visits with school-aged or other children, be prepared to let your child talk. I know you’ve got questions, too, and we’ll get to those—but I first want to make sure your child knows this is his visit. He gets to talk first. That drives some parents crazy, but that’s the way it works best.

A yearly checkup with your child’s doctor should be more than a time to get a form signed for soccer. It’s a chance to catch up and make sure someone is looking at “The Big Picture.” Parents and doctors both want to make sure that these checkups are valuable for the children and families. Be prepared, and you’ll get the most out of the visit.

republished from Dr. Roy’s blog

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HPV vaccine Questions and Answers

What’s HPV?

HPV stands for Human Papilloma Virus. Strains of this virus cause cancer in both boys and girls. At Pediatric Physicians, we use a brand of HPV vaccine called “Gardasil” which prevents infections caused by 4 strains of this virus—including the ones that can lead to cancer.

Who should get the HPV vaccine? When?

The CDC and all of the doctors in our practice recommend the HPV vaccine series for all boys and girls, starting with the first dose at age 11-12. For the vaccine to be effective, three doses have to be received. The vaccine works best if all three doses are given before any potential exposure to the virus.

After the first dose, the second dose can be given two months later. After the second dose, the third dose can be given four months later. If too long an interval occurs between doses, that’s OK—just start with the next dose. Doses do not have to be repeated.

How is HPV transmitted?

People usually catch HPV through sexual activity. Intercourse is not required. Occasionally, a newborn can catch HPV during birth, which can lead to very severe breathing problems.

HPV is so common that almost all of us will be infected with at least one strain during our lives. In the USA, there are 79 million people with HPV infections currently, and 14 million people catch the virus each year.

Why start vaccinating so young?

The CDC and other health authorities recommend starting the HPV series at age 11-12 years. Giving this vaccine at age 11-12 gives a more robust, stronger, and long-lasting immune reaction than administering it to older teenagers. All three doses should be received prior to exposure, and by starting early you’re more likely to ensure that your children are protected when they need it.

How will this vaccine help my child?

The CDC estimates there will be 26,900 new cases of HPV-related cancers each year—and these can be prevented by HPV vaccines. The most common cancers caused by this virus are cervical cancer in women, and throat cancer, mostly in men.  The more young people are vaccinated, the more this vaccine can help prevent transmission of this virus to everyone.

Though most people who catch HPV clear the virus and have no symptoms, we cannot predict who will develop a persistent infection that can lead to cancer.

What side effects should I expect?

HPV vaccination is very safe, and serious side effects are very, very rare. The only common side effects are pain at the injection site, and, more rarely, fainting after the vaccine is given.

Where should I look for more information?

Visit http://www.cdc.gov/hpv/ for comprehensive, detailed information about HPV and the HPV vaccine.

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Your child’s doctor should be doing your child’s checkups

The Pediatric Insider

© 2014 Roy Benaroch, MD

Yearly checkups for school-aged and older kids can be a great opportunity to help your child stay healthy. Don’t skimp by relying on a cheapo sports physical at a local drug store. They cannot offer the kinds of important things your own doctor’s office can do for your child at a yearly well check.

We’ll review old issues and problems. Still getting those migraines? Last year, we talked about school problems—how is that going now? Walk-in clinics don’t have access to those old records, and don’t care what happened to last year’s problems. We do.

Speaking of old records: checking a height and weight is a crucial way to know if your child is growing as expected. But you can’t know what those numbers mean if you only check them once. We can look at the trends—is your child growing along an expected path, or has something strange happened this last year? Is puberty progressing as expected?

Following trends isn’t just important for physical growth, but also for cognitive and social development—all of these skills can be followed, to make sure your child is OK. Not everyone has to be able to do the same things at the same ages, but we should be able to see new skills developing at an expected rate. It’s not a one-time check, at least not if you want these things checked correctly.

A lack of prior records also means that the quickie clinic can’t assess your child’s vaccine status. These days, it’s especially important to keep your child protected. We’ve got great, effective, and safe vaccines to prevent cancer, pertussis, and meningitis. Let’s make sure your child has what he needs to stay safe, and also to fulfill what he needs for school.

Medical care is sometimes fragmented. A child might visit the Emergency Department for a broken wrist, and then be referred to an orthopedist. Or maybe your child is taking medications prescribed by an allergist, or an asthma specialist, or a psychiatrist. Maybe your teenager had wisdom tooth surgery, and had a reaction to the anesthetic. Your “main doctor”—your child’s pediatrician or family practice doc—has the one office where all of these records need to be. Your yearly checkup is a great time to review the year’s health issues, and make sure everything is documented clearly in one place. Coordinating care between doctors is a crucial role for your child’s primary care doc, who can help prevent medical errors and duplications of testing. We’ll help make sure nothing falls between the cracks.

An essential component of a yearly well checkup is anticipatory guidance. What challenges can you expect this year? Since all children are different, good anticipatory guidance relies on a knowledge of he child as an individual: what are her strengths, and weaknesses? What sorts of things are likely to go well, and what other things might be more of a stumbling block? For anticipatory guidance, we’ll sometimes talk about school, or diet, or exercise, or relationships. Whatever will help your child the most, and whatever will help mom and dad cope with what’s coming next. It’s not a cookie cutter approach. Guiding a family through the challenges of raising a child is not something that’s done best with checklists and preprinted sheets. Knowing a family is what makes this part of the checkup valuable.

One other thing: yearly checkups help create a bond between child and doctor. We get to know them, they get to know us. If something does go wrong, your child will feel much more comfortable working with a doctor that’s known and trusted. Children do sometimes get rare, serious, or perplexing diagnoses. Believe me, you’ll be glad that your children (and you!) feel comfortable with their doctor when it’s needed most.

Your sports physical at the quick-cheap-clinic might get you a signature on a form—and if that’s all you want, by all means, use them. But you will get what you pay for.

Ironically, all ACA-compliant health care plans cover well checks for children with no cost-sharing—no copays, no deductibles, as long as it’s a current plan that meets federal standards. Most insured families pay nothing out of pocket for these yearly checkups, even without a coupon.

Your children deserve more than a minute at a clinic. They deserve, once a year, a visit with their own doctor, devoted to their own health. Not just a quick physical, but a comprehensive review of where they’ve been, where they are, and where they’re going. That’s what a real checkup is all about.

Republished from Dr. Roy’s Blog

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Where should your children go for after-hours medical care?

We know children don’t always get sick at convenient times, and sometimes you need your children to be seen when our office is closed. Though your “medical home” is with us, good after-hours care is sometimes essential. Fortunately, you have reliable choices for quality after-hours pediatric care in the Atlanta area.

Kids Time Pediatrics is an extension of our office, open weekdays in the evenings from 6-9 and on Saturday and Sunday from 1-7 (there are also special holiday hours, usually posted on our website.) At Kids Time, your child will always be seen by a board certified pediatrician—not by a “physician extender” who may not have pediatric experience. Waiting times tend to be less at Kids Time than at the other options, and with many insurance plans you’ll pay the same copay at Kids Time that you would pay at our office. Think of Kids Time as an ordinary pediatric office that happens to be open after hours, seeing the same kinds of things that we see in our office. Kids Time has multiple locations, including ones in Alpharetta and East Cobb—visit their web site for more information.

Children’s Healthcare of Atlanta (CHOA) Urgent Care Centers are in many neighborhoods. They can see any basic pediatric healthcare issue, and can also do x-rays and limited blood tests. Hours are usually 11 am-9 pm on weekdays, and 9 am – 9 pm on weekends (there are shorter hours on holidays.) Waits can sometimes be long, and many insurance plans have higher out-of-pocket expenses at urgent care centers than at our office. CHOA urgent care centers do NOT do sedation for procedures or IV fluids.

The Children’s Healthcare of Atlanta Emergency Departments at Scottish Rite and Egleston are open 24/7, 365 days a week, and are the best place for seriously ill children to be evaluated. They can handle anything, though waits can be long and visits to emergency departments can be very expensive for families.

There are many adult-oriented facilities that also offer to see children after hours, including clinics in drugs stores and adult urgent care centers. The providers working in these places are not pediatricians—they’re often not doctors at all—and may not have pediatric training or experience. We don’t think their care is up to the standards of a real pediatric facility, and we don’t encourage families to use them. Your children deserve better than a minute in a clinic.

In the table below are many common health conditions, and our initial suggestions for after-hours care. This list isn’t meant to be complete, and can’t account for every child’s individual circumstances. If you’d like more-specific guidance, please give us a call. One of our pediatricians is always available for emergency phone consultations for patients in our practice.

You can download a After hours care 2014 flyer of this document, including our care suggestions, here.

  Kids Time CHOA Urgent Care CHOA Emergency Department
Allergies *    
Allergic reaction (without breathing problems) *    
Asthma attack (mild) *    
Asthma attack (trouble breathing after treatment)     *
Bite *    
Broken bone (obvious broken bone)     *
Broken bone (suspected)   *  
Burn (minor) *    
Burn (large, or major)     *
Cast-related problems     *
Cold *    
Cough *    
Cut (minor, needs stitches)   *  
Cut (needs sedation for stitches)     *
Cut (won’t stop bleeding)     *
Dehydration     *
Diarrhea without dehydration *    
Ear pain *    
Ear infection *    
Ear wax removal *    
Fever (older than 2 months) *    
Fever (under 2 months of age)     *
Flu *    
Headache *    
Head injury (no loss of consciousness) *    
Head injury (sustained loss of consciousness)     *
Laryngitis *    
Pink eye *    
Pneumonia (no trouble breathing) *    
Pneumonia (trouble breathing)     *
Poisoning Call  1-800-222-1222
Rash *    
Sedation for any procedure     *
Seizure     *
Shock     *
Sinus infection *    
Sore throat *    
Sprain   *  
Sting *    
Stomach ache *    
Strain   *  
Swimmer’s ear *    
Urinary tract infection *    
Vomiting (without dehydration) *    
Vomiting (with dehydration)     *

 

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Fighting mosquitoes: It’s us versus them!

Prevention

Try to keep your local mosquito population under control by making it more difficult for the insects to breed. Empty any containers of standing water: tires, empty flowerpots,  birdbaths, gutters, and drainage pipes.

Biting mosquitoes are most active at dusk, so that’s the most important time to be vigilant with your prevention techniques. Light colored clothing is less attractive to mosquitoes.

Use a good mosquito repellent. The best-studied and most commonly available active ingredient is DEET. This chemical has been used for decades as an insect repellant and is very safe. Two other agents that are effective insect repellants are picaridin and oil of lemon eucalyptus. Other products, including a variety of botanical ingredients, work for only a very short duration, or not at all.

Consider yard sprays or traps to reduce the local mosquito population.

Treatment

After any mosquito bite, give an oral antihistamine like Zyrtec or Claritin. Typical doses are listed below. For kids who get bitten a lot, it is best to give an oral antihistamine daily, before the bites.

Apply a topical steroid, like OTC hydrocortisone 1%, twice a day. If bites are severe we may need to see your child, to consider prescribing a stronger topical steroid like triamcinolone or desonide. Do not use strong prescription steroids near the eyes.

Come see us if you are worried or there are signs of infection: pain or worsening swelling/redness/warmth that continues to get worse even 24 hours after the bite.

Antihistamine doses (these are dosed ONCE A DAY):

  Age 2-6 Age 6 and up
Claritin 1 tsp 2 tsp or

1 adult pill

Zyrtec 1 tsp 2 tsp or

1 adult pill

More about mosquito bite prevention and treatment, and why some kids get bitten more than others

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