The pediatrician's role in a multidisciplinary pediatric cardiology team


Carissa M. Baker-Smith, MD, MPH, explains how a multidisciplinary team works together to diagnose and treat hypertension, as well as obesity in children.

"We're not going to find the solutions to these problems by working in isolation within our respective fields or offices, we need to get out, include the patients, the community and the decision making, and very importantly, the general pediatricians," said Carissa M. Baker-Smith, MD, MPH, director, Pediatric Preventive Cardiology, Nemours Children’s Health Delaware, in this Contemporary Pediatrics interview highlighting pediatric hypertension and overweight and obesity.

Coming off the 2024 American College of Cardiology (ACC) meeting, Baker-Smith spoke with Contemporary Pediatrics about how the general pediatrician plays a role in a multidisciplinary team when it comes to diagnosing and treating hypertension.

Contemporary Pediatrics:

How can providers approach a difficult conversation with parents regarding overweight and obesity, knowing a multidisciplinary team may need to be involved?

Carissa Baker-Smith, MD, MPH:

I always approach challenging conversations explaining to the parent, why we're having a conversation, and really giving them the information. Sometimes I take more of a bird's eye view than dive in, especially if I understand the scope. I think sometimes once individuals understand the scope of the conversation, like obesity, for instance, why we're having this conversation about obesity, but really what we're talking about is wellness, right? We're talking about balance. I think that it's all in the phrasing too, how you describe these issues so that they're more palatable. You're not trying to hurt or damage or make a child or a parent feel less than, because, honestly, the majority of us, either in ourselves or families, are facing some of these same issues.

Every situation is unique, and so what you're trying to do is to share information, open up the door for dialogue to occur, to find out where are there positive things that are happening, and where the work still remains, and coming to some agreement about how to approach that. That's been my approach. It takes time. I know pediatricians don't always have that time. There's sort of a rule of thumb for a behavioral change, especially for something like obesity, it takes 52 contact hours. So sometimes I'll say "it takes 52 contract hours, no provider has that time. So in order to give proper time to this issue, we're going to bring in this team, so we'll have our exercise physiologists, we'll have our nutritionist, we'll have the pediatrician, we'll have the weight management specialist, we'll have the cardiologists," and so on and so forth.

In another recent interview with Contemporary Pediatrics, Baker-Smith provided a brief recap of ACC and highlighted several aspects of pediatric cardiology.

Click here to watch.

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