Winding Down Outside, Car Visits

Over the next month we’ll be transitioning to all indoor visits. Outdoor visits have been a mixed blessing but were never intended to be a long term plan. Outdoor visits are certainly not the standard of care utilized by other medical practices, especially with broader vaccination coverage and better awareness of hygiene and mitigation measures that can be employed safely- for both patients and staff alike.

All of the infectious diseases we see are potentially contagious- the COVID pandemic has just magnified this concern. For those that know us, I hope you see how we attempt to maintain as clean, safe and appealing office setting as much as possible.

We have thought long and hard how we can see all our patients- both sick and well - from babies through teens - in a safe environment and at times that are convenient for you. This is no small task for a smaller practice with space constraints that includes a separate newborn room and behavioral health space.

As such, we will certainly maintain our core protection factors- mask wearing for all of us > 2yo- all the time - inside our facility. Our waiting room will be open for well visits and vaccination patients. For all other appointments, patients will be asked to wait in their vehicle and will be lead directly to their room once it is ready. Enhanced cleaning measures are utilized. We ask that you limit the number of family members to as few as possible. We will follow CDC guidelines for cleaning precautions and will try to expedite check-in/check-out to minimize time inside our office.

We are adjusting our schedule and room usage to separate visit types as such as possible but also have appointment times available that can meet your needs. Thank you in advance for working with us - meeting all these needs is raising a high bar.

Some families may not be comfortable with these changes despite all our best measures to minimize risk. We understand but we need to push ahead. Outside car visits are just not feasible nor as comprehensive as we would like. All of our staff are very dedicated to helping you but are also stretched thin. Assisting in patient care in addition to running vaccine clinics, keeping our rooms clean and, of course, answering phone calls does not allow for detailed triage or phone problem solving. We will continue to employ telehealth as a visit option. We are not unique. The medical care system is very stressed - we’re trying to do a lot under trying circumstances.

I certainly hope that our families understand how hard we work to pull off all that we do and that a clean environment is a #1 priority- for all of us, understanding, however, that ultimately that is what medical practices do - take care of sick patients (and promote preventive care to keep all of us healthy)!

Let’s take care of one another!

Dr. Lee

Our Summer Theme - Getting Back on Track

Well it’s nice to report that we’re finally making some headway on the pandemic front.

In fact it’s almost whiplash with some of the changes we’ve experienced in just the past few weeks: teens getting vaccinated, masking recommendations and group gatherings restrictions being eased, schools returning to full time in the fall. Hurrah!!

So are we ready to return to what once was? Hopefully so but it will take some adjustment. We were living with lots of rules and restrictions

and anxieties and those feelings don’t just disappear overnight. And I suspect we’ve all gotten into some bad habits and ruts.

And that’s what our summer theme is all about - getting back on track and maybe hitting the reset button. That can mean different things to different people. For us at Fredco, it can mean helping our families getting caught up on missed physicals, school forms and vaccinations (and hopefully more and more COVID shots!) On the family / home front, that can mean taking on the technology monster and correcting that imbalance between being outdoors and indoors, just to give a couple examples.

So the summer may be a great reset time for all of this as

we approach “more normal times” in the fall. But we also know this is more easily said than done. Changing habits is hard, especially when there has been some leniency and “comfort food” to ease those pandemic worries.

So here are some pointers, admittedly usurped from other parenting experts, that may point the way or give some encouragement:

1. Promote getting outside and make it fun!

2. Do it as a family and ask for suggestions to get buy-in. A hike might sound like work but a scavenger hunt could be cool. A picnic or ice cream reward at the end never hurts!

3. Be proactive. Talk as a family and do what works for you. Everyone gets (and deserves) input!

4. Be present. What does that mean? It means that nothing is more important than connecting and enjoying being with your family. This is important!

5. Change is hard! Negativity and oppositionality is also part of human nature. People (even kids) don’t like being told what to do. Validate negative feelings. Listen - that’s what connection is all about!

6. Be patient. We can’t change things overnight but we’ll get buy-in o

er time if we’re sincere, sensitive and committed.

And you know what else? It’s the right thing to do! We’ve all gone through and continue to process a difficult ordeal. It may have uncovered fissures in our coping mechanisms or set off some anxieties that we’re trying to overcome. We don’t always get chances for a reset. Mulligans are OK in putt-putt but they’re not a guarantee in life. This summer may be the time to start that reset. I want you to know that you’re not alone and I truly consider this a priority. Family well being and family mental health is critical to both our children’s emotional and physical well being. I’ll keep hammering this message home as we get back to the old normal, or new normal, or some normal - hopefully a happy and coping normal. Let’s do this!

-James P. Lee, MD

Integrated Behavioral Health

4/26/21 Personal Statement- Dr. James Lee

It’s both with pride and some amazement that I can introduce a truly new component to our practice: integrated behavioral health. Opportunities like this come very infrequently- like once a career- so it’s almost like being in the newborn room taking in the amazement of a new baby- full of joy and just a touch of apprehension!

What is integrated behavioral health? At a basic level, it means we work side by side with our behavioral health team - one office serving multiple needs. But it’s deeper than that. It’s about understanding and exploring the interrelationship between how we act and behave to how we feel and function. And it’s imbedded in pediatrics because prevention, education and support is so much better than the consequences and sequela of doing too little, too late.

For me, behavioral health is more than promoting a new service or listing all the diagnosis’s we can better assist in "treating"; it’s about getting to the root of the problem earlier, hopefully, than later. It’s peeling away the stigma that something is “wrong” or needs to be “fixed” to how we can better understand and function as a person and a family.

For all the services and consults and interventions that will be available, the most important one, in my opinion, is yet to be developed- understanding our interrelationships to our children, our families and ourselves. We’ve learned so much in the past 20 years about the biology of the brain and development in children and how it relates to attachment, parenting and family functioning. Each of these are critically important and I can’t wait to share that with you, with our team, and also by reviewing the amazing literature that has been written on parenting and family functioning. There are lots of "how to" guides out there but they’re just words if you don’t understand the why.

I headlined this as the new age of pediatrics and in fact it is. But I want you to know that behavioral health can and should be so much more than fixing a problem or managing a condition. It’s about insight, self reflection and maybe some vulnerability. It’s OK to say I don’t know, it’s OK to seek answers, it’s OK to apologize. We can be a safe harbor for your child and your family. I also want to say thank you, in advance, for entrusting your care to all of us working together to make our patients, our families and our communities better, as best we can. That has always been my vision and this is a core mission of pediatrics that I’ll always stay committed to.