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Routine Care for the Whole Family

J. Christopher McCartie, M.D. discusses the importance of routine health care for the whole family. He shares why your loved ones should not delay care and the need to stay up to date with immunizations. Taking charge of your family's health is more important than ever, and we want to reiterate that it is safe to come in to receive the health care you need at Weill Cornell Medicine.
Routine Care for the Whole Family
Featuring:
J. Christopher McCartie, MD
After graduating from Dartmouth College, where he majored in English, Dr. McCartie received his MD degree from the Johns Hopkins University School of Medicine. 

Learn more about J. Christopher McCartie, MD
Transcription:

Melanie Cole, MS (Host):   There's no handbook for your child’s health, but we do have a podcast featuring world class clinical and research physicians covering everything from your child’s allergies to zinc levels. This is Kids Health cast by Weill Cornell Medicine. I'm Melanie Cole, and I invited you to listen in as we discuss keeping up on routine care for the whole family, the importance of not delaying your care at this time. Joining me is Dr. J. Christopher McCartie. He’s an attending pediatrician at Weill Cornell Medicine. Dr. McCartie, it’s a pleasure to have you with us. This is such an important topic. First, how have you and your team been evolving care for your patients during this pandemic? What's been happening as far as well visits and in-person visits during the pandemic.

J. Christopher McCartie, MD (Guest):   Well from the start of the pandemic, we realized we had the responsibility to continue providing essential primary care and to keep our patients as safe as possible. So back in the spring, we prioritized in office care for newborns and well child visits for children up to 15 months old who needed to stay on track with their routine vaccine schedule. In order to separate healthy children from potentially infectious children, we had one office dedicated to children with fever and other acute illness, and we were only seeing well children in other offices. As the pandemic became more under control in the city, we began seeing children up to four years old and then eventually patients of all ages. We continue to separate healthy children from sick or symptomatic children, but we shifted to doing this in each office. Rather than having one office see sick children, we resumed seeing them in each office, but we see them only at the end of the day so as not to expose healthy asymptomatic children. That’s the system that’s in place today.

Host:   Well, it really has encouraged healthcare providers to be more innovative and creative. While we’re talking about that, how have you been utilizing telehealth to bridge that gap for patients that have concerns and questions for their pediatrician, for parents that have concerns?

Dr. McCartie:   Weill Cornell Medicine has been offering video visits for patients long before the pandemic hit, but with the sudden need to limit the number of patients in our offices—especially those who were having symptoms of illness—we greatly expanded access to our doctors via telehealth. These video visits were available to families isolating at home and not feeling safe to travel let alone enter a doctor’s office. It also allowed us to provide continuity of care for our patients who had temporarily located outside of the city. Now that we’re welcoming all patients back to the office, another important way that we’ve been using the tool of telemedicine is to screen patients before they come in. If children are having symptoms of illness or need a screening test for COVID, we see them first by way of a video visit to help decide if they need to be seen in person. If so, whether they can come in during regular office hours or at the end of the day when we’re seeing sick children.

Host:   So then let’s talk about the importance of keeping up on this routine care for the whole family and especially at this time. Tell us about that, and what are the most important components of an annual wellness exam.

Dr. McCartie:   Well, primary care physicians are always focused on the promotion of wellness and the prevention of illness and injury. Regular office visits for routine care help to identify potential problems before they become major health issues. At a time where we’re all focused on staying well and staying safe, keeping up with routine care can help avoid the need for emergency care. Keeping up with routine immunizations helps avoid easily preventable diseases. The last thing we need during the upcoming winter is a measles outbreak or a bad flu season. Timely routine vaccination is the key to preventing those possibilities. An annual wellness exam and the checkups that we do at even more frequent interval for infants and toddlers include a complete head to toe physical exam, measurements of height and weight, and assessment of development, screenings of vision and hearing. There’s also a variety of age specific screenings. So in infants and toddlers we screen for anemia, lead poisoning, and autism. In older children and teens, we screen for depression and behavioral issues. We also offer anticipatory guidance with tips on nutrition and safety.

Host:   Well, thank you for telling us why it’s so important that people come in for this type of visits because it’s a very comprehensive type of doctor’s appointment. It really is. So as people may be nervous, doctor, about coming in, tell us about some of the safety precautions that you're doing that Weill Cornell Medicine has in place now to assure patients that it’s safe. You mentioned a few of them before but reiterate that because I think it’s such an important point.

Dr. McCartie:   During the bulk of daytime office hours, we are only seeing healthy patients for well visits. These patients have been screened by telephone beforehand to make sure they're not having symptoms of illness and have not had any travel to travel restricted states in the previous two weeks. Our staff is also undergoing daily screening before reporting to week. Potentially infectious patients are reserved for appointments at the end of the day. Our check in and check out procedures are typically being accomplished online to minimize time spent in the waiting room. Fewer physicians are seeing patients at one time, and families are advised that only one parent is allowed per child, again, to decrease traffic and allow social distancing in the waiting room. All of our staff wear masks, and all patients and accompanying family members or caregivers are required to wear masks when in the building, the waiting room, and the exam rooms.

Host:   It’s very reassuring, Dr. McCartie, to hear you go over those protocols. What are physicians recommending now to make sure that all of our kids are up to date on vaccines, including the flu shot which right now with this confluence that we could see with flu season coming up. Tell us about vaccines and the importance and flu shots right now.

Dr. McCartie:   We’re recommending three things. First of all, continue to come to the office for scheduled well visits. Secondly, if you delayed care early in the pandemic make an appointment now to catch up and get back on track. Finally, schedule an appointment for a flu shot. We are in the thick of a flu clinic right now and delivering flu shots every day. In a typical year, we encourage patients to get flu shots to protect them from a potentially harmful illness. This year with the pandemic still in full force, it’s going to be even more important to protect people against preventable illnesses like the flu that give you the same kind of symptoms.  It may cause some excess unnecessary office visits if you're having fever and respiratory symptoms that are due to the flu, and of course we’re going to worry whether it’s a coronavirus infection. If you get a flu shot and can prevent those symptoms and also stay well then you'll be in much better shape.

Host:   It’s so important now, really it is. Another important aspect—and you mentioned this briefly before—is mental health. Both for parents and for children it’s so important right now. How can our primary care providers and indeed our pediatricians help parents and families to handle this new normal as kids are in school, at home, not sure what they can go out and do, sporting activities? Tell us how the pediatrician can help the families with mental health right now.

Dr. McCartie:   When parents bring children in for a well child visit, it’s a chance for us to check in with that family and assess their current state of mental health. This has always been part of the well child visit. We can offer advice and treatment for emerging concerns regarding depression, anxiety, and challenging behavior. We can also offer referrals to mental health behaviors if that’s indicated.

Host:   It really is so helpful for parents right now to have someone that they can turn to and look to. As we wrap up, Dr. McCartie, please reiterate and reassure families that it is safe to come in and how important this continuum of care for their children are to come in for these annual well visits, make sure their vaccines are up to date, including their flu shots. Wrap it up with your truly best advice.

Dr. McCartie:   I moved to New York from New Hampshire at the end of March. I arrived in what was, at the time, the epicenter of the COVID-19 pandemic. So I was understandably anxious about what life and work were going to be like here. I was instantly reassured and put at ease when I saw firsthand the precautions that Weill Cornell Medicine had put in place for the safety of our patients. The online check in, the reduction in waiting room traffic, the pre-visit screenings, the universal requirement for mask usage by all patients, office staff, nurses, and doctors. The separation of healthy and potentially infectious patient populations. It all made sense and it’s been working so well to allow our patients to continue to receive timely primary care. At a time when safety and wellbeing can't be taken for granted, I'm so grateful and impressed that the setting in which I work can offer both a promise of safety and the promotion of health. I don’t see any reason for families to delay care. I encourage patients to come to the office for the routine care they need. I encourage them to come and get that flu shot and their other routine vaccines.

Host:   What a wonderful summary, Dr. McCartie. Thank you so much for all the encouragement and reassurance for families that may be nervous at this time, but the importance of not delaying those annual and routine wellness visits for their children. Weill Cornell Medicine continues to see our patients in person as well as through video visits, and you can be confident of the safety of your appointments at Weill Cornell Medicine. Thank you so much to our guest and to our listeners. That concludes today’s episode of Kids Health cast. Please remember to subscribe, rate, and review this podcast and all the other Weill Cornell Medicine podcasts. For more health tips and updates like these, please follow us on your social channels. I'm Melanie Cole.

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