Dental caries are a significant problem for children. The risk of developing caries can be decreased by using fluoride. In 2014, the American Academy of Pediatrics issued a policy recommending fluoride treatments for babies. In our office, we apply topical fluoride every 3-6 months starting when the first tooth erupts. During all of your well child checks, we also address dental health and proper dental care that is age appropriate. We also will recommend home treatment with fluoride supplements when medically necessary.
Need advice from a nurse? Our highly trained nursing staff is available to answer your questions and concerns 24 hours a day. Each day our nurses provide advice on a wide range of topics from fevers, respiratory problems, to medication dosing. During business hours, our experienced in house nurses will be answering your concerns. Each of our LPNs and RNs take turns providing advice. Cindy in Cary, Tina in Apex, and Jennifer in Fuquay-Varina are some of our most experienced nurses providing triage with 82 years of combined experience!. After hours, we have contracted with WakeMed to provide nurse advice.
We are excited to have partnered with Kids in Parks and Walk with a Doc starting in the Summer of 2017. Kids in Parks is an exciting organization that has created a network of trails throughout the area with self-guided brochures that teach kids about nature while being outside. The Walk with a Doc organization works with local doctors to encourage behavior change and healthy living by connecting the physician with their patients outside of the office. The support of these organizations is amazing. Every few months we organize to have several of our doctors, nurse practitioners, nurses, and administrative staff come together for a hike. We invite our patients an their families to join us. The hikes are so much fun and our families love them. Another great aspect about Kids in Parks is that children earn prizes for tracking their adventures outside! You can sign up on their website http://www.kidsinparks.com.
Below are some helpful handouts on the dosing of the most common over the counter medications that we recommend. Please remember that if your child is less than 2 months old and has a fever >100.4, please call our office prior to giving any medications.
In an ongoing effort to improve the care we give our patients and their families, Cary Pediatrics is engaged in a number of projects to look at our practice. Some of these involve our clinical decision making and following clinical guidelines, and some with patient satisfaction.
We are pleased that patients are happy with our practice, and would refer others to see us. But we have heard that our biggest barrier is time waiting in the office to be seen. We have worked with our scheduling staff to ensure that appointments that are made have enough time to discuss the concerns the parents have. We are also working on streamlining the use of our EHR to expedite orders and the gathering of information. We also could use your help: when you call to make an appointment, either a sick visit or a checkup, if you have specific questions or concerns that may require a prolonged visit with your provider, please let us know beforehand, so we can budget time, and be able to give your child as much time as they need, and help keep us on schedule.
We also learned that we are doing a good job with having patients with special health care needs see their primary provider, to ensure consistency and continuity of care. But we also see that we can do better. We have highlighted in our scheduling programs and in our EHR a primary provider for patients with special needs. In this way, we should be able to do even better maintaining that important relationship. Below, blue means a patient saw their primary provider.
We are proud that all three of our office are performing similarly, showing we are all on the “same page” in our approach to our patients.
When you are seeing your provider, you might also hear us mention things like “it is recommended that…” or “guidelines or the American Academy of Pediatrics suggest…” We do our best identifying areas of our practice that have been identified by national agencies as areas of emphasis to improve care, both in the short term and in the long term.
Examples in the past year or two include: following industry standards in vision screening in younger children; cholesterol screening in school-aged children; immunizing children, especially those with asthma against influenza; maintaining appropriate appointment schedules for children on chronic medications; tracking newborn screening to ensure complete results; keeping kids on schedule for their yearly checkups.
We also try to review the medications that we are prescribing. For example we know that cost is very important to parents when it comes to medical care. We also know that generic medications tend to cost less than brand name medications. Unfortunately prescribing generic medications is not always possible, but we want to keep the percentage of generic medications as high as possible while prescribing the best and most effective medications for the patients. Below is the percent of brand name medications we have prescribed for the month of September the past two years.
We strive to continuously improve our practice by reviewing current literature and practicing evidence based medicine. The providers meet frequently throughout the year to discuss the latest literature to ensure that we are all practicing up to date medicine.
We also actively seek feedback from our patients at regular intervals. Formally, we will send out surveys via email after visits for our patients to give us feedback. Our questions on the surveys will change depending on our goals, but mostly involve making sure you were satisfied with all aspects of your visit from making the appointment, to your time with your nurse, and the time with you spent with the provider. We use this feedback to make changes in our workflow and procedures. Listening to our patients is one of our most important goals, so that we can provide the best care and service to our patients.
Cary Pediatric Center is proud to announce that in June 2017 it was recognized by the NCQA Patient-Centered Medical Home (PCMH) 2014 Program. What does this mean, and what does it mean for you as our patient?
The patient centered medical home (PCMH) is a promising model for transforming the organization and delivery of primary care. It means that you will be surrounded by a dedicated team of health professionals, working together with you, to optimize your health goals using the best evidence-based medicine and resources available for you today. Helping and empowering you to take responsibility for your health and giving you the self-management support that you need to succeed.
If dropping off a form, please complete the parent portion of the form prior to bringing to the office. After 5 days, your form will be available in the office and on the portal.
At each well visit we will provide you with a handout of important information that is specific to your child’s age and development. You will receive a hard copy with their growth documented in the office but you can also download them here in PDF format.
Moms Supporting Moms is a community-based resource, and is a “…peer-led, judgment-free support group for women struggling with issues related to pregnancy, delivery and early motherhood.” As it says very appropriately on their website:
“The adjustment to new parenthood sometimes can be difficult. Irritability, anxiety and even sadness over changes in lifestyle can be expected as parents settle into a new routine of caring for an infant.”
If you or someone you care about is having difficulty adjusting to the changes surrounding motherhood, please reach out during your visit to our office to a provider or nurse, or call for guidance.
They can be reached at 919.454.6946 and can found on the web at Moms Supporting Moms.
With the flu season just around the corner, we have a few things to keep in mind.
First, and most importantly, we recommend that all children 6 months and older receive the flu vaccine. This is the best and most effective way to prevent your children from getting the flu. If you haven’t already, please call one of our offices to schedule a nurse visit to receive the flu vaccine. Bear with us as our supplies of the flu vaccine are changing daily.
At this time of year, we receive lots of letters from urgent care clinics in the area stating that a child has been diagnosed with the flu and been given Tamiflu, usually appropriately, but sometimes inappropriately. Tamiflu is ONLY indicated in children 2 weeks and older who have been symptomatic for LESS THAN 48 hours. When given in the first 48 hours of the illness, Tamiflu has been shown to reduce symptoms by only 1-2 days. Therefore, do not expect your child to improve immediately after being given Tamiflu.
After 48 hours, there is no evidence that Tamiflu has been shown to be effective and should’t be given unless your child is critically ill from the flu (meaning your child is in the ICU in the hospital). There are only a few, rare, reasons to give Tamiflu to children who have been exposed to influenza. We can explain those situations to you if this case should arise.
Just like antibiotics, inappropriate use of Tamiflu can lead to increase in resistance, decreasing the effectiveness of Tamiflu. If you have more questions refer to the CDC web site or call our office.
Clinical advice is available 24/7 by calling the office during regular hours or after hours with our triage service or physician on call.