Baby Steps
Advances in pediatric care and technology make life better for area kids and their parents
by Jennifer Updike


When it comes to taking steps to help a sick child, the Internet can be a parent’s best friend … and, at the same time, their worst enemy.


“You have a lot of people who come in to see you who have already looked up their child’s symptoms on WebMD,” says Dr. Charles I. Schwartz, a pediatrician with PennCare for Kids, which is based in Phoenixville. “I do warn patients, though, that just typing symptoms into a search might scare you and make you think your child has something more severe than he actually has. If you type in certain symptoms, it might say you have strep throat … or it might come up with meningitis.”


Beyond its uses for home research, of course, the Internet has significantly changed how pediatric doctors—and, for that matter, doctors of virtually every discipline—treat and interact with patients.


“Now you can be in a room with a patient and look something up at that exact moment,” says Dr. Schwartz, who followed in the footsteps of his father, also a pediatrician. “I used to have a ton of handouts that I would give to patients. Now, beyond the diagnosis, you can say, ‘Go to this website if you would like additional information.’”


(Click here for Suburban Life’s 2012 Top Children’s Physicians report, as compiled by Avvo Inc.)


Recent technological advances are making their presence felt in local pediatric care in other ways, as well. For instance, parents will soon have greater access to their children’s medical records and, as a result, take a more interactive role in managing their family’s health. Prototypes underway at Penn and other area hospitals will soon enable patients to access laboratory tests, request prescriptions and communicate with staff via e-mail, among other uses.


The development is “a bit of a game changer,” according to Dr. Schwartz.


“Essentially it will improve your ability to communicate with a doctor, though maybe not directly,” he says. “People still need human contact, but this will make it easier for patients to access their history. … At the end of the day, a stethoscope is still a stethoscope, and it comes down to the fact that you still have to be a good doctor.”


In some cases, modern advances in pediatric care have more to do with common sense than technology. More and more pediatric practices, for example, now employ separate waiting rooms for different “sets” of patients: those who feel fine; and those who may be feeling under the weather—“sick” rooms vs. “well” rooms.


“It depends on the patient,” says Dr. Schwartz. “When you come to the office, you’re not going to catch a sprained ankle, so it’s up to the parent’s judgment depending on which room the child belongs in. It’s a space issue, but it’s very important to us. After all, we’re trying to keep everybody healthy.”


Still the Same

Likewise, Dr. David A. Bresler has witnessed the positive changes brought about by technology and novel approaches to pediatric care—or, in his case, pediatric dentistry. Dental materials have improved dramatically in recent years, providing better retention for all fillings and better color matches for aesthetic restorations. In addition, digital radiography has become commonplace in many offices, producing X-rays immediately without the use of darkrooms, while exposing patients to reduced amounts of radiation.


Yet, as the saying goes, the more things change the more they stay the same.


“Truthfully, my approach to care has not changed at all since I began my practice 34 years ago,” says Dr. Bresler, who has six offices throughout Philadelphia and its suburbs. “Certain basic principles have always been at the forefront of my practice: Treat each young patient as if they were one of my own kids; treat every parent as if they were my friend; and always plan to do the best treatment for each child, not merely based on their insurance coverage.”


Like Schwartz, Dr. Bresler decided to focus his practice on pediatric care simply to make a difference in people’s lives at the earliest point possible. The “horror stories” he heard from adult patients while he was studying at Temple University’s Kornberg School of Dentistry pushed him to raise a whole generation of kids who, in his words, “looked forward to going to the dentist.”


“We've been very successful in obtaining that goal,” he says. “The secret is simple. Don't talk down to kids. Let them feel your empathy and concern. I’ve always tried to mesh my gears with their gears for a smooth dental visit. It works.”


Similarly, a pediatrician’s greatest asset is the ability to listen attentively before making a qualified diagnosis. Rather than asking yes and no questions, a pediatrician often has to be able to make a diagnosis based on a seemingly insignificant comment or vague symptom, according to Dr. Schwartz. The physical exam and laboratory tests should simply “confirm what you know” based on parent and patient interviews.


“Almost everyone remembers their pediatrician, almost like your first-grade teacher,” he says. “With adults, you’re undoing diseases, and generally dealing with people who haven’t taken care of their body. But with children, you can really make a difference and promote health at an early age. We work with kids from diapers to the time they go off to college. Our job is to do our best to keep them healthy and get them to 18—encouraging them to learn good habits along the way.”


Jennifer Updike is a freelance writer based in New Hope.