Clark Avenue Connection

Jamila Fletcher, M.D.

RCAM Today: 4th of July Weekend Notes

Written by Jamila Fletcher, M.D.

It’s 4th of July Weekend, July 3, 4, and 5, 2020

  • This Friday, Saturday, and Sunday we will be available by phone and in the RCAM TeleHealth Clinic
  • After 8:00am, our answering service will begin to take messages for the weekend nurse working with the Pediatricians on-call
  • Our nurse will begin returning calls at 9:00am

Newborn Clinic

  • We will plan a morning clinic to follow-up with some of our well infants born over this past week

TeleHealth Visits from Home

  • You can see an RCAM pediatrician via video chat for a TeleHealth visit for a sick visit
  • The RCAM pediatrician will use methods available to them at that time to assess and make recommendations about how best to treat your child
  • There is a charge for using this clinic; typically that charge is covered in some way by your health insurance plan (usually similar to how that plan covers in-person visits)
  • Beyond the TeleHealth Visits, we do not plan to have our typical in-person sick clinic this weekend

The Weekend Line Up

Important Numbers

  • Urgent calls outside regular hours: 919-781-7490
  • After hours backup number: 919-831-5526
  • Poison Control: 1-800-222-1222

Todd Harris, M.D.

July 2, 2020 – Important office holiday schedule alert:

Tomorrow, Friday, July 3, 2020, is an official RCAM office holiday.

  • Our office will be officially closed this Friday, July 3 in observance of the Independence Day holiday
  • Like everyday, one of our pediatricians will be on call to help with your child’s urgent health needs
  • There will be a morning clinic to follow-up with some of our well infants born over this past week
  • On holidays and weekends – due to the ongoing coronavirus pandemic – sick patients may be scheduled to see our on call Pediatrician for a TeleHealth visit; we will not be able to see sick patients in person

Jamila Fletcher, M.D.

June 18, 2020 – Our office mourns with our community.

The owners, the pediatricians, the nurses, and the administrative staff of Raleigh Children & Adolescents Medicine – our entire RCAM-ily – we all mourn.

We grieve the murder of George Floyd and too many other black men and women whose lives have senselessly been taken. We are listening to the voices within our community and to those across the nation who are protesting racial injustice.

We have devoted our careers to caring for children. This is what we believe:

  • Every child deserves to feel safe
  • Every child deserves the chance to thrive and live their best life
  • Every child deserves to be treated fairly and with dignity

We condemn systemic racism and discrimination in all forms. Racial discrimination casts a lifelong shadow that undermines the health and well-being of our children and prevents us from realizing the full promise of our community.

We stand together with our community against racism, fear, and social injustice. We want to stand up for one another to end discrimination. We want to move toward one another to find our common humanity and bring healing. We uphold human dignity for all our families.

How do we talk to our children about race and racism? Here are a few ideas to start the conversation:

Most importantly, our children are listening to and watching you and they are listening to and watching us. Our words and our actions will matter.


Todd Harris, M.D.

UPDATE: Now Scheduling Well Visits for Any Age

Written by Todd Harris, M.D.

June 9, 2020 – You may now call and schedule your child’s well visit – previous restrictions on which well visits we can schedule have been removed.

Let’s review where things are now with RCAM Pandemic Mode:

UPDATE: SCHEDULING A VISIT

  • All well visits are scheduled to be seen at our Duraleigh office
    • RECENT CHANGE: Now scheduling well visits for children of any age
  • Medication follow-up visits are scheduled for out Duraleigh office
    • RECENT CHANGE: We are moving these from TeleHealh visits back to in-office visits
    • Examples of this type of visit: ADHD follow-up, Asthma follow-up, follow-up of any condition where our pediatricians are prescribing ongoing medication
  • Any illness – any symptoms that need evaluation: there are 2 ways to initiate an evaluation
    • Option 1: call and speak to one of our nurses
    • Option 2: call and schedule a TeleHealth evaluation with one of our Pediatricians via a video link
    • If further evaluation is needed following one of the above options, the nurse or pediatrician may recommend an in-person visit at the Brier Creek office
      • In person inside the Brier Creek office (illness without typical symptoms of COVID-19)
      • In person outside the Brier Creek office in the Curbside Clinic (typically if symptoms include fever, cough, or shortness of breath)

UPDATE: FOR YOUR SAFETY, THE SAFETY OF OUR STAFF,  AND THE SAFETY OF OTHERS

  1. Wear a Mask: everyone coming inside our office over the age of two years is expected to wear a mask
    • We know there are some situations where wearing a mask is impossible – we understand and that’s okay
  2. Sick individuals may not accompany a visit (no sick siblings; no sick parents; everyone in your party needs to be well)
  3. When possible, only one parent accompany the child being seen
  4. To limit your time / exposure while in our office, call from the parking lot when you arrive – when your room is ready, we will call you to come into the office

Ben Meares, M.D.

RCAM Today: Memorial Day Weekend Notes

Written by Ben Meares, M.D.

It’s Memorial Day Weekend, May 23, 24, and 25, 2020

  • This Saturday, Sunday, and Monday we will be available by phone and in the RCAM TeleHealth Clinic
  • After 8:00am, our answering service will begin to take messages for the weekend nurse working with the Pediatricians on-call
  • Our nurse will begin returning calls at 9:00am

Newborn Clinic

  • We will plan a morning clinic to follow-up with some of our well infants born over this past week

TeleHealth Visits from Home

  • We’ve added an option that is popular and consistent with current goals of “social distancing”
  • You can see an RCAM pediatrician via video chat for a TeleHealth visit for a sick visit or a well concern
  • The RCAM pediatrician will use methods available to them at that time to assess and make recommendations about how best to treat your child
  • There is a charge for using this clinic; typically that charge is covered in some way by your health insurance plan (usually similar to how that plan covers in-person visits)
  • Beyond the TeleHealth Visits, we do not plan to have our typical in-person sick clinic this weekend

The Weekend Line Up

Important Numbers

  • Urgent calls outside regular hours: 919-781-7490
  • After hours backup number: 919-831-5526
  • Poison Control: 1-800-222-1222

Todd Harris, M.D.

UPDATE: Teenage Well Visits

Written by Todd Harris, M.D.

May 6, 2020Six weeks ago began “RCAM: Pandemic Mode” as summarized below:

RECAP

  • Only sick patients seen at our Brier Creek office or our Curbside Clinic
  • Only well patients seen at our Duraleigh office
  • We limited our well visit schedule to appointments that were time-sensitive (for example: most newborn care, visits associated with vaccines)
  • Two weeks later we started offering TeleHealth Visits.

We appreciate everyone’s cooperation. Your support of our office during a challenging time has meant a lot.

WE WOULD LIKE TO ADD THE FOLLOWING…

At this time, we will begin to also schedule well visits for all children ages 11 years old and up.

[SIDE NOTE ABOUT SICK VISITS – Sick visits will continue to follow the plan set up in this post from March 22nd – NOW BACK TO WELL VISITS]

These are the well visits we are now scheduling:

  • Any well visit associated with a required vaccine (that includes most well visits under 2 years old and the 4 or 5 year old who need their pre-kindergarten vaccines)
  • Any well visit ages 11 years old and up

ABOUT YOUR WELL VISIT APPOINTMENT

To try and limit exposure to illness for your child and our staff, we will require the following with all well visits:

  1. Sick individuals may not accompany the well check (no sick siblings; no sick parents; everyone in your party needs to be well)
  2. Everyone above the age of two years old needs to wear a mask or face covering when they come to our office (we know it may be a challenge for some, but do the best you can)

Lots of Helpful Information at the CDC Website


Todd Harris, M.D.

April 20, 2020 – This past weekend RCAM lost one of our giants.

Alan Goldman, MD passed away late Friday night after battling an extended illness.

RCAM Pediatrician from 1971 to 2007

I have been lucky to have worked with some talented, good people. Alan most definitely was one of the most talented and one of the best.

He worked as a pediatrician at RCAM for 36 years.

He went to Harvard University for his undergraduate degree. Anyone who knew him found that easy to believe, because he was smarter than the rest of us. You picked up on that because it was obvious, not because he ever flaunted it.

He was an accomplished pediatrician. He was the first pediatrician in Wake County who had specialty neonatology training and helped to advance neonatal intensive care in this area.

Never a Negative Word

Alan had a very pleasant and calm demeanor. I never saw him frazzled, and I never heard him say a bad or even negative word about anyone the entire time I knew him.

I will write that again just to be clear. I never heard him say a bad or even negative word about anyone.

We worked together for 11 years. There was a time when we shared an office. I saw him plenty away from work – typically, it involved some carpentry (one of his many talents).

Never. A. Bad. Word.

He Brought the Party

Alan was fun, and he was almost always working on something that would bring people together for the sake of entertainment.

So many of us have been regaled by something Alan planned: Poker nights, Christmas party games, Super Bowl games, March Madness brackets. The list goes on and on…

I knew Alan to always be preparing for the next gathering where everyone would be entertained by some sort of quiz, riddle, or trying to remember the words to “Good King Wenceslas” (How many Jewish men know all the words to “Good King Wenceslas”? Alan did.).

Our Hearts Are Heavy

Words are difficult at times like this. Alan was truly one of the RCAM greats.

He set a high bar for excellence in skill, attitude, and community.

Alan meant so much to our office, but – alsohe meant so much to so many others.

Our hearts ache for the Goldman family.

UPDATE 4/21/2020: Dr. Goldman’s family wrote a beautiful remembrance that you can find here


Todd Harris, M.D.

April 13, 2020 – So imagine that today is your birthday.

Imagine that the candles are already lit when you realize that you’re in the middle of a pandemic, and – as a pediatrician – your whole day has been about limiting the spread of germs.

In other words, there could be no “blowing out the cake.”

At that moment, we needed a hero…

Someone needed to save the day

…And it was that someone’s birthday.

Happy Birthday Dr. Gessner! You are just as quick on your feet as you ever were!


Sarah Owrey, M.D.

RCAM Today: Easter Weekend Notes

Written by Sarah Owrey, M.D.

It’s Easter Weekend, April 10, 11, and 12, 2020

  • This Friday, Saturday, and Sunday we will be available by phone and in the RCAM TeleHealth Clinic
  • After 8:00am, our answering service will begin to take messages for the weekend nurse working with the Pediatricians on-call
  • Our nurse will begin returning calls at 9:00am

Newborn Clinic

  • We will plan a morning clinic to follow-up with some of our well infants born over this past week

TeleHealth Visits from Home

  • We’ve added an option that is popular and consistent with current goals of “social distancing”
  • You can see an RCAM pediatrician via video chat for a TeleHealth visit for a sick visit or a well concern
  • The RCAM pediatrician will use methods available to them at that time to assess and make recommendations about how best to treat your child
  • There is a charge for using this clinic; typically that charge is covered in some way by your health insurance plan (usually similar to how that plan covers in-person visits)
  • Beyond the TeleHealth Visits, we do not plan to have our typical in-person sick clinic this weekend

The Weekend Line Up

Important Numbers

  • Urgent calls outside regular hours: 919-781-7490
  • After hours backup number: 919-831-5526
  • Poison Control: 1-800-222-1222

Todd Harris, M.D.

Banner Change: Spring 2020 Edition

Written by Todd Harris, M.D.

April 8, 2020 – Spring began a few weeks ago and – particularly after this past weekend – it became clear it was time to say Goodbye to Three Girls on a Sled whose carefree ride in the snow takes us back to a time before we had ever thought much about coronavirus and COVID was NO-VID.

Typically, our spring banner includes outdoor, spring activities (duh), but Young Girl and Online School seemed – given our present circumstances – to be a better fit.

[Aside: Of course, if your home is more like mine, this picture would need to include another, younger sister and some dispute about one of them “breathing too loud” and a father – numb to the sibling conflict – working feverishly to be sure the WiFi will produce enough bandwith for school and his office’s Zoom meeting that is scheduled to begin now.]

What Can You Say About This Past Month?

On March 5th we put up our first post about coronavirus disease / COVID-19 when Wake County announced its first case.

Over the last month, we have been gathering as much information as possible and processing it as a group. We have made plans and then remade plans as new information came available..

Medicine is always changing – changing plans is not necessarily a new thing. We always try to do things based on the best and most current information available.

The new thing was the speed of the changes – typically happening over years – these changes were happening over days and in some cases hours.

Let’s review all the changes at RCAM that are still current:

  • All well care is moved to the Duraleigh office – only well children accompanied by a well adult are seen for well visits at Duraleigh
    • We are scheduling only “essential well visits” at this time – those are well visits that have a vaccine associated with them
    • If you had some pressing things you wanted to discuss at a well visit that is on the delayed list, consider scheduling a TeleHealth visit (see below)
  • All sick child care was moved to the Brier Creek office – with a few twists:
    • Twist #1 – Curbside clinic was initiated for children with symptoms suspicious of possible coronavirus
    • Twist #2 – TeleHealth visits are becoming our new normal as a way to safely evaluate patients without the fear of increasing potential exposures
  • All RCAM staff are now wearing masks and gloves – at both offices – add to that lots of hand washing and not touching your face and cleaning rooms after every patient

All of these changes were made to be as safe as possible yet still available to our patient families, to reduce exposures, and to slow the spread of coronavirus / COVID-19.

TeleHealth Medicine

TeleHealth Visits have some limits though I am surprised at how typically they can identify something treatable or rule out the need to come to our office or the Urgent Care or the Emergency Department.

We have spots available. Call and schedule a visit. The steps are laid out here.

Easter Holiday is Coming Up This Weekend

Good Friday is an official RCAM office holiday, so this Friday the 10th we will operate like we have on recent weekends:

  • We will have an early clinic for newborns who need to be followed up from the past week
  • All sick patients will be evaluated through TeleHealth visits

Meanwhile, The Brian Carter Era Began at RCAM

Brian Carter is our new office manager.

He began to learn the RCAM secrets when he started in December but he didn’t take the reins completely until after February 28th when Debbie Maness retired as our office manager after 42 years (!).

He hit the ground running. Brian would probably describe it more like a chase – as in it felt like he was being chased by a lion – as his first week on the job was highlighted by a pandemic.

Brian has been great. More about him later, but it is about time we introduced him to our extended RCAM-ily.

If you see someone in our office wearing a tie that doesn’t feature Sponge Bob (Dr. Sena) – that is more than likely Briangive him a big Hello and Welcome.

Given the circumstances of his first month, he could probably use the encouragement.

Thank You

I am sure that everyone could use some encouragement.

The response of our administrative staff and nurses has been spectacular. The general day-to-day pressure on a pediatric staff is underrated, and now they quite suddenly have found themselves on one of the front lines of a pandemic.

They have handled some tough circumstances with a lot of grace and professionalism.

As pediatricians, we’ve had to work together even more than we usually do – Zoom meeting almost daily – making new plans and changing protocols that we just wrote. We have found another gear with how we work with and relate to one another and personally that has been great.

Patients and their families have even asked if they can help.

We have been gifted at least one box of N95 masks and numerous homemade masks.

Finally, the Raleigh pediatric medical community really stepped up. Specifically, Oberlin Road Pediatrics and Carolina Kids Pediatrics both sought us out directly. As it turns out, we didn’t need the help, but it meant a lot to hear from them, and we hope to return the favor sometime.

That’s how we’re all going to get through this – finding ways to help each other out.

Epilogue: Somewhat Related

For anyone still reading this, I had this post all ready to go late Sunday night.

I saved it to my computer and walked upstairs to say good night to my daughters.

When I returned, my screen looked entirely different.There were characters I had never seen before – and about 80% of my original post was completely gone. I tried to pull up the post I had saved, yet somehow that had been updated to the now-80%-gone post.

Buddy Caught Red HandedSitting two feet away from me was the cause: Buddy, our orange tabby cat.

He has a penchant for getting comfortable in odd places – for example, he loves climbing and lying on top of backpacks.

He is also well known in our house – as pictured here in what I call “Exhibit A” – for getting comfortable on my computer keyboard.

The post finally got done and I believe I have been forgiven for the words that came out of my mouth that night.

Happy Easter to everyone!

Try to enjoy what you can about being locked down with people who are likely pretty important to you – and try to ignore all of their loud breathing.