AAP Voices

I’m a primary care pediatrician at the Mayo Clinic, which closed down all elective surgical procedures and specialist visits. We remained open for care but were adapting almost hour-to-hour as we reviewed evolving information about the virus and the need to protect both patients and staff.

One of the first changes we made was to protect our trainees and conserve PPE. Medical students were removed from all rotations. As director of the pediatric residency clinic, I followed our residency leadership’s direction in temporarily closing clinic and elective participation. We used a core group of senior residents to train in telemedicine, as our attending staff was simultaneously gearing up. 

We learned the ins and outs of this new technology right alongside our residents. Ensuring that our inpatient residents could focus on our sickest patients without worrying about cross-contamination — and protecting our core of backup residents, who continued to learn from home in line with our state‘s stay-at-home order— was key to our short- and long-term planning. 

As staff, we separated into a COVID Control Center team that saw sick patients in one clinic; prescreened children determined to be low risk for COVID-19 infection at another; and took newborn visits at a third location. 

For a few weeks, we did well-child care via telemedicine, followed by a nurse-only visit for immunizations, and measurements to limit time spent in clinic. 

We also worked to ensure that our non-English-speaking families could participate in telemedicine by getting them signed up for the online patient portal and having interpreters available via phone and Zoom.

We are gradually transitioning back to doing full well-child visits in person again, but we still have careful social distancing measures in place to avoid crowded waiting rooms and traffic jams at our scheduling desk. 

Everyone wears masks, except for infants and toddlers, so we are getting used to face shields and extra cleaning measures for all of our exam rooms.

At a time when many pediatric practices are struggling, I am so grateful that our care teams and leadership were nimble and able to rapidly adapt, relearn and stabilize necessary care for our patients. I am even more grateful to our patients and families for their patience with us as the situation changed regularly. 

Ultimately, even though I’m not the one caring for the sickest patients in an ICU, I feel the gravity of this role and immense gratitude that the skills I’ve learned over years of training can be applied both remotely and in person to help people. 

I often wish that primary care was valued more in a system that prizes high-tech specialty care. But this pandemic is a reminder to me that our unique expertise as outpatient pediatricians is just as critical for the larger population that still needs preventive care and management of chronic conditions. Because asthma, depression and other illnesses don’t take a holiday, even during a pandemic.

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