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Helen Dandurand (Host): Welcome back to the Well Within Reach podcast. I'm your host, Helen Dandurand. And today, I'm going to be joined by Dr. Joe Henderson, UChicago Medicine Comer Children's Hospital Pediatric specialist at Riverside, to talk a little bit about Riverside's partnership with Comer Children's Hospital and explore what a pediatric specialist is.

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Host: And we're back with Dr. Joe Henderson. Thanks for joining me today.

Joseph Henderson, MD: Oh, thank you for having me. Good morning.

Host: Good morning. We're glad to have you here. So, can we start? You've never been on the podcast before. Could you just tell us a little bit about your background in healthcare?

Joseph Henderson, MD: Yeah. So, I graduated from the West Virginia School of Osteopathic Medicine. And then, I completed my pediatric training at Orlando Health, Arnold Palmer Hospital in Orlando. For residency, I actually did a fellowship in Pediatric Hematology and Oncology, which is a pediatrician who specializes in children with blood disorders and cancer. Ultimately, after completing the fellowship, I did not pursue a career in Pediatric Hematology and Oncology, but decided to take a position as a pediatric hospitalist.

Host: Awesome. And that's what you're doing now?

Joseph Henderson, MD: That is correct.

Host: Awesome. So, can you start by explaining what a pediatric hospitalist or, you know, sometimes we call it a pediatric specialist, what that is?

Joseph Henderson, MD: Yeah. So, a pediatric hospitalist is a pediatrician who obviously treats kids from zero, so birth, until the age of 18, and they work primarily in the hospital setting. We cover pretty much every corner of the hospital, from the birthing center, the pediatric unit, the pediatric mental health unit, and then also the emergency department.

Host: So, it used to be that your pediatrician, they would come in if you were in the hospital or if you had a baby, that kind of thing. But with a hospitalist, they are someone who's actually here all the time. Is that correct? So, that's kind of the new model.

Joseph Henderson, MD: Yeah, that's correct. So, over time, we found that it was very difficult for our community pediatricians to be pulled from their clinic and have to come in for, say, a delivery. By having a pediatric hospitalist present in the hospital 24 hours a day, we are there immediately to go to a delivery to assist. We are here for emergencies in the emergency department or even on the pediatric floor, which took a little bit of burden off of our community pediatricians.

Host: Absolutely. You mentioned this when you were telling about your background, but can you talk a little bit about the education and training required to become a pediatric hospitalist?

Joseph Henderson, MD: Yeah. So at this time, there are two pathways to becoming a pediatric hospitalist. Everybody has to be board-certified in general pediatrics. But there are two pathways. The first pathway would be our clinical pathway where you have to practice in a pediatric hospitalist setting for at least five years. The other one is after you complete your pediatric training, you actually do a fellowship in Pediatric Hospitalist Medicine. That is a two-year fellowship. Afterwards, you would be then eligible to sit for your pediatric hospitalist board exam.

Host: Cool, that's awesome. Interesting that there are a couple different ways to get there. So, Riverside has this partnership with Comer Children's Hospital, and that's kind of how we have our pediatric hospitalists. Can you tell us a little bit about how that partnership works?

Joseph Henderson, MD: Yeah. So, the partnership works by having a pediatric hospitalist from the University of Chicago cover 24 hours a day, 7 days a week, 365 days a year in the hospital. By doing this, we are able to keep kids closer to home, because that's the ultimate goal. If we can avoid having to transfer a patient to the university or another tertiary center, it saves a lot of time and money, and burden on the family.

Host: Absolutely. But it is a positive that there is that partnership if there were the need to ever arise.

Joseph Henderson, MD: There is. So, one of the benefits is that we have close contact with all the subspecialists, the pediatric subspecialists at the University of Chicago. And we have that direct contact with the tertiary center so that if we do need to transfer somebody, we have policies and guidelines in place to get the patient there quickly.

Host: That's great. It's good to know that there's that security net in that connection there. So, you see, like you said before, patients in the hospital, at the birthing center, in the ER. Can you tell us a little bit about what each of those scenarios might look like?

Joseph Henderson, MD: Yeah. So basically if you come in and you are about to have a baby, you will deliver your baby in our birthing center here at Riverside. If there is a complication during your labor, and the baby would need to have a pediatrician, I would then be present for the delivery of the baby to do their first assessment to make sure that they're okay and help them transition from being inside of you, the mom, to being out here in the wild.

Host: In the world.

Joseph Henderson, MD: Yup, in the world. If not, if your baby comes out and they're healthy, then we will see them once a day, and we'll do their full complete exam. We'll touch base with the family, ask them how breastfeeding is going, how formula feeding is going. We'll talk about how much the baby's lost in terms of their weight, if they're peeing and pooping, et cetera.

Host: Got it. And so, what would like an ER scenario look like?

Joseph Henderson, MD: We do not see every pediatric patient that comes into the emergency department. We are here, and we're available to do a consultation in case the emergency department has a concern or a question, like, "Hey, can you come down and take a look at this child that we just saw?" We don't know if this patient could be sent home or do they need to be admitted or do you think they even need to be transferred?" So, we're available to do that. We're also available in case there is an emergency. And these are far and few between, but if there's a code scenario, we would be available to come down and help run a code with a pediatric patient.

Host: Yeah. And then, otherwise, it's just if there are inpatient pediatric cases that you guys kind of round on daily. Is that right?

Joseph Henderson, MD: Correct.

Host: Awesome. I think this question might be a tricky one because I suspect that it might not be a regular answer, but what would your typical day kind of look like?

Joseph Henderson, MD: So typically, we start in the morning. We round on all of the healthy newborns, or at least most of us try to, because you don't want to go upstairs and see a pediatric patient that, say, has a cold, because you don't want to bring that cold back down to the nursery. So, most of us will see all of our healthy newborns first, and then go upstairs and see our pediatric patients.

After that, we basically are here, and we're available for the next delivery if we need to be, or see those consults that, like we just talked about in the emergency department, or doing general pediatric admissions.

Host: Got it. Awesome. It was an easier answer than I thought.

Joseph Henderson, MD: Yeah.

Host: We're going to take a quick break to talk about finding a primary care provider. Riverside knows that health is your greatest asset, and that your primary care provider is your partner in health. Find a primary care provider that fits your needs at riversidehealthcare.org/primarycare. And we are back with Dr. Henderson. So, how do you work with other healthcare professionals such as pediatricians and specialists and nurses to provide this like comprehensive care for the patients coming in?

Joseph Henderson, MD: Yeah, that's a great question. So, we've been here now, it'd be eight years in August. It's hard to believe that it's been that long.

And

Host: you've been here for eight years?

Joseph Henderson, MD: Yeah, I was here day one.

Host: That's awesome.

Joseph Henderson, MD: So, we have a very good relationship with our community pediatricians. We talk to them pretty much every day. We are here to give them updates on patients that are currently admitted. Say, there's a patient that had a complicated hospital course, we will call them at discharge and give them an update so that they're informed when the patient does follow up with them.

Once a month, we do have a pediatric quality meeting, which is a multidisciplinary meeting that includes nurses, nursing managers, representation from our emergency department as well as pediatricians. At that time, we do go over all of our policies and guidelines, make sure they're up to date. And we also review all of our transfers to try to identify ways that we can improve our care of our patients here at riverside.

Host: Awesome. So, it sounds like there's a really great, you know, team and communication within all of that. And it sounds also like you're able to communicate to those pediatricians exactly what's going on. If any patient says, you know, "I really wish pediatrician were here," that kind of thing, you can assure them, "We're communicating with them." They know what's going on and you've got that relationship there. So, that's really great. How do you support and communicate with those families otherwise of the hospitalized children to make sure they're informed and comfortable?

Joseph Henderson, MD: We try to do family-centered rounds, which encourages the parents to be involved when we come and see the patient. We'll go over the plan for the day with the families. And then, at that point, we'll see if they have any questions or concerns, and that's really their time to voice their concerns so that we can address them.

Host: Great. How do you play a role in creating a child-friendly environment in the hospital to kind of ease stress and anxiety of those young patients you're seeing?

Joseph Henderson, MD: Yeah. So, that's a great question as well. So, we all know that the hospital can be a very scary place, especially for a child. One thing that you will notice is that pediatricians typically don't wear white coats, because it scares the children. So, most of us don't.

The other thing that we do is we try to have distractions in the room, whether that be a stuffed animal or a toy. You can also look at the kid's shirt. And if they're wearing a, say, a Spiderman t-shirt, you can always start talking about Spiderman to try to, like, bring the kid into the conversation and sometimes that really helps alleviate some of their fear when they're in the hospital.

Host: They see that you're someone that's interested in their interests, and they can kind of relax and, yeah, that's really great. So, kind of on the opposite coin, there is the whole, you know, just making sure the child-friendly environment is there. But sometimes there are emergencies and critical situations, and how do you handle those things? Like, what kind of protocols are in place to ensure quick and effective response?

Joseph Henderson, MD: We are lucky in Pediatrics in that pediatric codes are not common. But when they do occur, we do have policies and guidelines in place to make sure that they're run effectively. If a patient does come in and a code is called overhead, we will be paged and we'll be present for the code. We are lucky in that we have the relationship with the University of Chicago, because we have helped enact policies, protocols, and guidelines for specific pediatric emergencies.

So, one other thing that we do have available is what we call the Wheels Up Program with the University of Chicago. So, let's say you are pregnant and you go into preterm labor, we do have the Wheels Up program with the University of Chicago where we can call the Transfer Center, and they will send a team of specialists including respiratory therapist or a nurse practitioner to be available for the time of the baby's delivery to get them stabilized and be able to get them to the tertiary center where they need to be.

Host: That's great. It's good to have that kind of relationship to know that if something were to happen, that they know what's going on and they can get you where you need to be, whatever place is best in that kind of situation. I have a final question here. What are some of the most challenging aspects of your job, and also with that on the other side of the coin, the most rewarding parts of being a hospitalist?

Joseph Henderson, MD: So, I think the most common challenge that we face as a medical professional at this time would be the amount of disinformation that is available online and also present in all of the social media sites. I think we always have to remember that the internet can be a great place for resources, but it's not always correct. Physicians and nurses and other healthcare professionals are not always the ones that are providing that information online. So, just take caution when you're obviously looking for recommendations.

Going back to the question about what is one of the most rewarding things about being a pediatric hospitalist, I would say being able to see a child who comes in and they're sick and the parents are scared. And over the course of their hospitalization, you treat that kid and the kid gets better and you make them a normal kid again. Kids are very resilient and they bounce back pretty fast, and that's one of the most rewarding things that you can see.

Host: That was a great reflection on that. question. Is there anything else that you'd like to add?

Joseph Henderson, MD: One other challenge that I just thought about would be the fact that as a pediatric hospitalist, we don't get to see kids grow up, right? And that's one of the joys of being a community pediatrician is you follow this baby from birth until they're 18. So, you form the lasting relationship with that family.

As a pediatric hospitalist, we see them in the newborn nursery. But then, when they come in and they're being admitted to the Peds floor, they're typically sick, and you don't know the family. So, it takes a while for you to actually create a relationship from scratch. So, I think that would be the other challenge that we face as a pediatric hospitalist.

Host: Definitely. And it could also be, I mean, definitely a challenge, but also a kind of fun challenge to be able to come in and say, "Hey, I'm your safe person. Let's get to know each other." So, that's really great. Well, thank you so much for joining us today, Dr. Henderson. And thank you listeners for tuning into the Well Within Reach podcast brought to you by Riverside Healthcare. For more information, visit riversidehealthcare.org.