Minnesota Chapter of the American Academy of Pediatrics

Word from the President

<img loading="lazy" decoding="async" class="wp-image-4559 alignleft" src="http://wp.mnaap.org/wp-lib/wp-content/uploads/2024/05/Screenshot-2024-05-23-at-9.31.52 AM-208x300.png" alt="" width="193" height="278" srcset="http://wp.mnaap.org/wp-lib/wp-content/uploads/2024/05/Screenshot-2024-05-23-at-9.31.52 AM-208x300.png 208w, http://wp.mnaap.org/wp-lib/wp-content/uploads/2024/05/Screenshot-2024-05-23-at-9.31.52 AM.png 225w" sizes="(max-width: 193px) 100vw, 193px" />I recently read an article in the New York Times about an account on X (formerly known as Twitter) where a child policy consultant, with a background in early childhood, comments about child development. The account posts videos from public social media accounts with commentary on developmental milestones as well as the fascinating learning that babies and young children are doing every day. From language skills to social connections to the importance of play (instead of screens), the videos highlight what every pediatrician knows-that kids are amazing!


The videos shared in the article are so good in so many ways. Equally important is the commentary about what skills you can nurture or just to recognize your child’s unique ability to learn by curiosity and how much is gained from human-to-human connection.



The videos are such good examples of everyday interactions. Many of them capture the exact moment of realization; the second the child accomplishes the “thing”, whether reciprocal verbalization, overcoming their fear of jumping into water or getting the strawberry piece onto the spoon and into their mouths.



As a bonus, the videos show experiences that don’t require fancy educational toys. Many of the videos are of parents/grandparents/aunties/uncles spending time with a baby or young child talking, singing or reading to them. I’m sure you experience and probably model these strengths for families every day in your offices. The article, X account and accompanying videos remind me, yet again, of the tremendous privilege and joy it is to work with children and their families. The trust and relationships that each of us builds, over many years, is what makes the practice of pediatrics the best.



<a href="https://x.com/DanWuori/status/1764282393634988091">Watch the video here. </a>

Word from the President: Eileen Crespo, MD, FAAP

<div id="attachment_3918" style="width: 160px" class="wp-caption alignleft"><a href="http://www.mnaap.org/word-from-the-president-eileen-crespo-md-faap/dr-eileen-crespo/" rel="attachment wp-att-3918"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-3918" class="wp-image-3918 size-thumbnail" src="http://www.mnaap.org/wp-lib/wp-content/uploads/2022/10/Dr.-Eileen-Crespo-150x150.jpg" alt="" width="150" height="150" /></a>Dr. Eileen Crespo, MNAAP President</div>
Autumn anxiety is a term I heard recently. It is the feeling of upheaval that comes when shifting from a relaxed, carefree summer mode to the many changes that come with fall, such as back-to-school, cooler weather, and a fuller and more hectic schedule of events and activities.
I’ve had a few friends and colleagues undergo significant shifts recently. Some are just cutting back on their schedules and some are making radical changes to their lives and careers. It is a good reminder of the saying, “The only constant in life is change.” 
As physicians, we not only adapt to change, but we help our patients and families navigate adjustments as well. Sometimes they are undergoing a developmental shift in their child or teen; other times they may be coping with the news of a diagnosis that feels like it came out of nowhere.
I believe it is our reaction to change that makes it feel better or worse. In situations where we cannot alter our circumstances, we have power over our emotional response. That control can give us a sense of confidence or peace as we move through the change.
I hope as we head into the fall months, you don’t have a case of autumn anxiety, but if you do, know that you are not alone. If your feelings are more than a reaction to a change of pace or the new season, please seek support. We have a list of physician resources at www.mnaap.org/physician-burnout-recommended-reading-and-resource-list/ and you can also contact your employer to discuss how help is available to you. 
Here’s to managing the ups and downs of this crazy roller coaster of life we’re all on.
&nbsp;
Eileen Crespo, MD, FAAP
MNAAP President

<a href="http://www.mnaap.org/word-from-the-president-eileen-crespo-md-faap/dr-eileen-crespo/" rel="attachment wp-att-3918"><img loading="lazy" decoding="async" class="size-medium wp-image-3918 alignleft" src="http://www.mnaap.org/wp-lib/wp-content/uploads/2022/10/Dr.-Eileen-Crespo-169x300.jpg" alt="" width="169" height="300" /></a>It is no secret that I am a fan of the summertime. In Minnesota, while weather is the universal topic of conversation, summer is the winner. What’s not to like? The warmer weather and the longer days give us a feeling of permission to relax a little and not be so go-go-go with our lives.
Our chapter has certainly earned a little time to catch its collective breath. The legislative session that wrapped up just a few weeks ago proved to be an incredible turning point for many of the priority issues we have been focused on for years. The health and wellbeing of children, teens, and families in Minnesota advanced in ways that will be meaningful and measurable. Thank you to all who helped this legislative session.
The only trouble with summertime is that it sometimes feels too short. Has anyone else already seen school supplies out in the store aisles?! So while I hope you can find pockets of time to enjoy your favorite summer activities and past times, I want to let you know that the next few months hold more excitement for you as a chapter member:
The MNAAP annual meeting will take place Thursday, Sept. 21, from 5-8 p.m. in Minneapolis. We will have a formal program starting at 6 p.m., but otherwise, this is an opportunity for you to connect with colleagues from around the state who you haven’t been able to see in person over these last few years.
The Twin Cities Pediatric Update conference will cover a wide variety of pediatric hot topics on Thursday, Sept. 21, and Friday, Sept. 22. Dr. Roy Guerrero, the pediatrician from Uvalde, Texas, will be one of the keynote speakers. I personally saw his presentation at the AAP national conference and it was so powerful and moving. It is not to be missed.
The annual MNAAP member survey will be sent to you in July. I know a survey request can feel taxing on an already busy schedule, but this is one of the most important opportunities for you to have your voice heard. We use the results of the survey to guide many decision points throughout the year, including setting legislative priorities, seeking CME opportunities, and partnering with collaborators on projects. This year we are working to make the survey quick and easy – I promise you can finish it in less time than it takes for a popsicle to melt!
Be well and enjoy your summer months, and thank you for all you do for Minnesota’s children and teens.
Eileen Crespo, MD, FAAP
MNAAP President
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When is the last time you had fun? I mean smiles all around and a real feeling of delight in what you were doing. I wanted to reflect here on the joy that has come from…pickleball. You may have heard about the fastest-growing sport in the U.S. with the funny name. Today, I wanted to focus on the FUN part.



Pickleball began as a pandemic activity for my husband and I; a way to get outside and socially-distance in those dark days of the beginning of COVID where there was nothing but uncertainty. The sport has a dedicated following, and some people take pickleball very seriously. I, however, have found pickleball to be one of the best ways to maintain and rekindle social connections.&nbsp;



Because pickleball has such a low barrier to entry, any age and physical condition can play pickleball if they want to. All you need is a paddle and court shoes. Despite what you might think, it isn’t just middle-aged or older people playing pickleball. I’ve seen parents playing with their kids, as well as a large number of teens and young adults trying pickleball, too. &nbsp;



Most importantly, pickleball has reminded me of the simplicity of the childhood invitation, “do you want to play?” To do something without judgment or the embarrassment that stops us from trying new things.&nbsp; You are a little lost, you learn and you can laugh a little or a lot. It really is the best medicine.



Eileen Crespo, MD, FAAP



MNAAP President



eileen.crespo@hcmed.org

<div class="wp-block-image"><figure class="alignleft is-resized"><img loading="lazy" decoding="async" src="http://www.mnaap.org/wp-lib/wp-content/uploads/2022/10/Dr.-Eileen-Crespo-576x1024.jpg" alt="" class="wp-image-3918" width="144" height="256"/><figcaption>Eileen Crespo, MD, FAAP</figcaption></figure></div>



I’ve had the opportunity over the last few months to get involved in the work of pediatrics on the national level. Through the most recent American Academy of Pediatrics Annual Leadership Forum (ALF) and even a few weeks ago at our annual legislative priority meeting for MNAAP, I saw the great passion with which pediatricians view their work. We all know this instinctively, however, to see hundreds of pediatricians gather in a (large) room and hammer out the issues that are important to pediatricians right now was meaningful.&nbsp;



The ALF process was particularly impactful to me. Dozens of resolutions are submitted on a wide range of issues that affect child health and the practice of pediatrics.&nbsp; The resolutions are whittled down through spirited discussion, an amendment process, and adoption or not. All of the attendees then have an opportunity to rank the adopted resolutions, selecting the top 10. This is exceedingly difficult given that the adopted resolutions included topics such as supporting children orphaned by COVID-19, expanding education to care for transgendered children and increased transparency regarding equity, diversity, and inclusion outcomes in medical school pediatric departments.



After considering many impactful resolutions, the number one resolution endorsed was supporting our pediatric advocates experiencing adversity. Multiple pediatricians present gave testimony on how they had been harassed after advocating for science at state legislatures and reported that some of the most negative interactions occurred at school board meetings. As one of the pediatricians who was targeted via online, telephone, and even postal harassment, I felt seen.



We are passionate about the work we do because it literally affects children’s quality of life, their families, and their futures. Who can feel that way and be complacent?

Word from the President | Eileen Crespo, MD, FAAP

<figure class="wp-block-image"><img decoding="async" src="http://www.mnaap.org/wp-lib/wp-content/uploads/2022/10/Dr.-Eileen-Crespo-150x150.jpg" alt="" class="wp-image-3918"/></figure>



Fall is upon us and that means we have just wrapped up the best time of the year. Summer in Minnesota is my favorite season and July 4th is always a highlight. I was thinking about how much I enjoy fireworks and thinking about how they are so representative of what we do in pediatrics.&nbsp;



Fireworks often originate on some mysterious barge out on a darkened lake, streaking upward to explode into a dazzling display of twinkling lights. Sometimes they even form shapes or smiley faces. Who could imagine something could undergo such an amazing transformation? Pediatricians can.



Pediatricians handle special cargo all the time. Some of our “packages” can go off without warning, melting down into a full-blown tantrum right before our eyes. Pediatricians know we need to do our work with special care.&nbsp;



Every child exam begins not with the “business at hand” but rather an attempt to establish some commonality. Either commiserating with the exhausted parents of a newborn to talking about the latest animated phenomenon (Bluey, anyone?), pediatricians strive to make a connection with our patients and their families. We know it is important to not just be able to get through the current visit but to establish goodwill for the next encounter. 



Pediatrics is the long game. Each visit builds on the relationship between child and pediatrician so that from time-to-time, a previously sickly toddler or a child who has survived cancer treatment comes in for a camp physical or pre-college form completion and you think to yourself, “that is amazing.” Because like a good firework display, it is. 



Eileen Crespo, MD, FAAP, began her two-year term as MNAAP president in July 2022. Dr. Crespo practices at Hennepin Healthcare and is the vice president of medical services at Delta Dental.

<div id="attachment_3070" style="width: 160px" class="wp-caption alignleft"><a href="http://www.mnaap.org/wp-lib/wp-content/uploads/2020/10/2020-Berkowitz-Head-Shot.jpg"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-3070" class="wp-image-3070 size-thumbnail" src="http://www.mnaap.org/wp-lib/wp-content/uploads/2020/10/2020-Berkowitz-Head-Shot-150x150.jpg" alt="" width="150" height="150" /></a>Sheldon Berkowitz, MD, FAAP</div>
IIt is hard for me to believe, but this will be my final column as president of the Minnesota Chapter of the American Academy of Pediatrics. The two years of my term have gone by rapidly and they were incredibly busy. I want to dedicate this space for my reflections and thanks. 
Many, many years ago I took a wilderness medicine course on Mt. Shasta in California (those were the days!). In addition to learning wilderness medicine skills, we also learned some mountaineering skills and had the chance to climb Mt. Shasta. I didn’t make it to the summit as I had some problems with high altitude sickness (headaches) and had to turn back. I was really disappointed, but one of the guides pointed out that nature is not to be conquered but lived with. I think being president of our chapter is the same.
When I took on the presidency my goals were to try and visit pediatricians around the state and help to get two pieces of legislation passed: repeal of the personal belief exemption from the vaccination legislation and get common sense gun violence prevention laws passed. Due to the pandemic and our divided legislature neither of those were accomplished, but may be works-in-progress for our next president, Dr. Eileen Crespo and our board moving forward, if they desire. 
As I have written about in my previous columns, George Floyd’s death in May 2020 and the COVID-19 pandemic have changed everything for us these last two years. Just the other day, I was listening to Grand Rounds at Children’s Minnesota and four research projects were presented: two of which dealt with racial disparities in health care. Being aware of such disparities and trying to address them has become increasingly common in health care – which is a great thing. We need to be looking at how not our patients and families of color, as well as our colleagues in pediatrics and health care, are treated differently. This discrimination is an issue that needs our constant attention and efforts to improve.
I would direct your attention to the recently released AAP Policy statement, ”Eliminating Race-Based Medicine” which gives a wonderful recounting of Race-Based Medicine and what can and is being done about it. 
COVID-19 has changed so much in health care. New diagnoses and therapeutics, a worldwide pandemic and its effect on every aspect of our lives, and “doing more with less” has become a mantra that none of us want to hear or deal with in our professional lives. For many of our younger colleagues, they will grow up professionally not knowing a world without COVID-19, but for those of us who are older it has been a game changer. Even getting children in for well child visits and routine vaccinations has been negatively impacted by the pandemic. 
Finally, the partisan political landscape, both in Minnesota and nationally, has made it increasingly difficult to get much-needed healthcare and social legislation passed. We are also seeing increasing attacks on many aspects of providing health care and keeping our patients and their families safe, including repeated attacks on our LGBTQ youth. Our efforts on advocacy have never been greater.
Yes, we have a lot of work ahead of us, but our MNAAP is in good hands. Dr. Eileen Crespo will take over as president on July 1 and will do a great job. She is backed up by a super board of directors and executive committee, as well as great staff. 
I want to thank several people here – although in all fairness, I need to thank our entire executive committee, board, work group leads and champions and chapter members for the outstanding work you all do and support you have given me during my term as president. Dr. Lori DeFrance as our past president and Eileen Crespo as our vice president have been huge sources of help. Jeff Bauer stepped in last year as our new executive director and hasn’t stopped running since. He has taken ownership of the position and has been great. Chad Fahning has also stepped into the role of chapter lobbyist and is doing a wonderful job trying to fill the huge hole left with Eric Dick’s death. And Bethany Venable is our outstanding communications manager whose ability to word things in the best possible way has been immensely helpful with all the letters, documents, articles, weekly emails and newsletters over the last two years. Finally, I want to thank my wife, Carolyn, for all her support these last two years. 
It has been my great honor and pleasure to serve as your president and I want to wish you all the best.

Word from the President: Sheldon Berkowitz, MD, FAAP

<a href="http://www.mnaap.org/board-members/2020-berkowitz-head-shot/" rel="attachment wp-att-3070"><img loading="lazy" decoding="async" class="size-thumbnail wp-image-3070 alignleft" src="http://www.mnaap.org/wp-lib/wp-content/uploads/2020/10/2020-Berkowitz-Head-Shot-150x150.jpg" alt="" width="150" height="150" /></a> When I was approached about running for MNAAP chapter president in the spring of 2018, I mentioned that I would be turning 65 years old when my term as president would start and that I planned to retire from my clinical practice at that time, while continuing my administrative Medical Director role at Children’s Minnesota. I was assured that would not present a problem and that my 35 years of pediatric experience would be very useful in my role as president. We obviously didn’t predict what would happen in early 2020, right before my term as president began, including the beginning of the COVID-19 pandemic and the murder of George Floyd. 
The events that followed George Floyd’s murder pushed all of us to reexamine how society, and our own chapter, have treated anyone who is not white/Caucasian. My age at the time of this event and all the work that has been done and continues to be done around becoming anti-racist, did not hinder my ability to be involved in this reexamination of how we all function.  Perhaps what I had already lived through over six decades helped me to understand how far we still need to move to make this better. 
However, the limitations of being retired throughout the pandemic that started that spring of 2020 and continues to this day have definitely made some of my work more difficult. While I had been alive during the final surges of polio in the late 1950s and have lived through the entire HIV/AIDS epidemic that started while I was in medical school and continues to this day, as well as outbreaks of H1N1 and Measles, none of that prepared me to deal with all the aspects of COVID-19.
On a macro level, all of us in medicine (retired or not) can appreciate the horrific morbidity and mortality of this pandemic, the importance of getting out clear public health messages, and supporting one another in healthcare. 
I feel that as your president, even at 66 years old, I have been able to work with other health care and government leaders to help craft important policies affecting our children and schools and get the important messages out about what we can all do to get this pandemic under control. 
At the same time, I have been at a definite disadvantage when it comes to knowing about and answering questions about what is happening in the exam rooms with patients and their families. Often before doing an interview with the media, I find myself reaching out to my former colleagues to learn what they are seeing and hearing when they are with patients and their families. Are the vaccine hesitant parents saying something different than what we have been hearing in discussions about routine (not COVID-19) vaccinations for the last decade and thus, is a different approach needed? How many patients with COVID-19 are they currently seeing (daily according to my former clinic colleagues and “too many” from my hospitalist and PICU colleagues)?
I am also at a disadvantage, due to being retired, to truly appreciate the toll that this pandemic is taking on my colleagues with whom I used to work side-by-side. Before our recent board meeting, I was talking with one of our board members who was recovering from COVID-19 and she mentioned that four of her clinic colleagues were also out sick with it, which is obviously having a huge impact on her practice. I hear all the time about the lack of support staff to allow our chapter members to function efficiently and the increased burden this has placed on all of them to do more with less. While no one is blaming the pandemic on causing the burnout many of our colleagues have been dealing with for years, it has clearly exacerbated it. 
There are no easy answers to figure out how to get more people vaccinated against COVID-19 and to receive their boosters, or to wear masks and distance ourselves from others, especially outside of our homes – all of which could help to bring the pandemic under control. Nor are there any easy answers how to deal with the emotional toll all of this is taking on our chapter members and everyone in healthcare. There is a teaching in Judaism that says, “It is not your duty to finish the work, but neither are you at liberty to neglect it.” We must all keep working to help solve these problems we face.

Word from the President | Sheldon Berkowitz, MD, FAAP

<div id="attachment_3070" style="width: 160px" class="wp-caption alignleft"><a href="http://www.mnaap.org/board-members/2020-berkowitz-head-shot/" rel="attachment wp-att-3070"><img loading="lazy" decoding="async" aria-describedby="caption-attachment-3070" class="wp-image-3070 size-thumbnail" src="http://www.mnaap.org/wp-lib/wp-content/uploads/2020/10/2020-Berkowitz-Head-Shot-150x150.jpg" alt="" width="150" height="150" /></a>Sheldon Berkowitz, MD, FAAP</div>
Down Syndrome – not Trisomy 21 – but rather, Down Syndrome. That was what the call I received from a nursery nurse was about 30 years ago. They had a newborn that they thought had Down Syndrome and while stable, they were wondering if I wanted to come see the baby that night and talk to the mom – who by the way, was a single mom. I did come in and examine the newborn and agreed with the nurse’s assessment that the child probably did have Down Syndrome and then proceeded to talk with her mom. I walked in the room and introduced myself and before I said anything more, the mom – who it turns out was a former NICU nurse – said, “I think my baby has Down Syndrome.” No tears, just a statement from a new mom. I told her I thought she was right and then we talked about how beautiful her daughter was and what we should watch for in the following days and months. No doom and gloom – just anticipatory guidance and joy for her now being a mom. That evening started a wonderful relationship I have had with this now-grown woman and her mother for 30 years.
So why I am writing about this now? As it turns out, the mom developed pancreatic cancer over 4 years ago and just recently died. I was invited to her Celebration of Life in mid-October and gladly attended – as glad as you can ever be to attend something like this. Not only did I get to hear more about her life than I had known, but I also got to see her daughter shine as she spoke about her mom. It reminded me of several things I have learned during my career by caring for a variety of patients with not only Down Syndrome, or more accurately Trisomy 21, but other chromosomal problems or complex health care needs. 
First, don’t make assumptions about your patients or their families or the diagnoses they may have. Get to know them and learn about their goals and abilities and needs. Second, all children need at least one caring, involved parent or guardian to help them to thrive. 
While I know that for kids with Trisomy 21 there is a wide range of functional ability, I also believe that the more involved their parents or guardians are, the better they do. I have frequently shared this with all the parents of my special needs children. Finally, despite all of our medical knowledge, our patients will still often surprise us with what they are able to accomplish. This particular patient, who a year ago got married, had to deal with her mom dying. But she was able to stand up in front of a room with well over a hundred people and talk beautifully about her mom and their relationship. 
It was sad saying goodbye to this mom when I last saw her several months ago and again at this Ceremony of Life, but it was a beautiful tribute to the outstanding job she did raising her daughter. For those of us that have been in practice for a long time – we have all probably had many patients and families that have touched us like this. For those of you just starting your pediatric careers, you will have an incredible journey as you grow with your patients and their families. Enjoy it. It’s a wonderful opportunity we are given as pediatricians. 
It is hard to believe we are turning a corner into another year of the COVID-19 pandemic, but I am hopeful that as vaccination numbers of our pediatric patients continue to increase that we will head into a new phase and a better one of this pandemic.
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When I look in my backyard, it’s clear that Spring is nearly here. The t<img loading="lazy" decoding="async" class="size-thumbnail wp-image-490 alignright" style="margin: 5px;" alt="SueBerry" src="http://mnaap.org/newsletter/wp-lib/wp-content/uploads/2015/08/SueBerry-150x150.gif" width="150" height="150" />ree has bright green buds so it won’t be long. And it won’t be long until our chapter has a new president. This is my last letter as president to you, the members of the Minnesota Chapter of the American Academy of Pediatrics.
A lot has happened in these two years! Our work groups have been very energetic and a lot of activities have moved forward. You’ll be hearing more about this at our annual meeting, coming up May 20. We will be focusing on ways that we can take concrete steps to reduce health disparities for the kids that we care for. We will be talking about access to mental health services.

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Our immunization work group has been front and center in creating MOC materials for pediatricians to increase HPV vaccination. This project is impacting not only our Minnesota children, but also increasing immunization in the upper Midwest through partnerships with multiple states. Leadership from our chapter has been influential in accomplishing this collaboration.
We are fortunate that it’s been a relatively quiet year in the legislature, giving us time to anticipate and plan how we can best support children’s health at the Capitol. Anticipate work on improving Minnesota’s relatively weak&#8230; immunization laws that have insufficient rigor in expecting immunization in next year’s session. Our Pediatricians’ Day at the Capitol was very successful with an eager and vigorous crowd of people that “the kids sent.” You can see how much fun everyone had looking at the Twitter feed from this: #PedsDay2016.
Some of you know that when I started my time as president, I was a new grandmother. My little granddaughter “Sprout” is now more than 18 months old and a happy, very tall, active toddler that loves books and her puppy. I count myself as extremely fortunate in her health and promise for the future.
Let’s do everything we can to make opportunities better for all of Minnesota’s children!
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New Leadership in Bloom

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BC/BE Pediatrician

We’re excited to announce an opening for a Communications Manager at the Minnesota Chapter of the American Academy of Pediatrics (MNAAP). This part-time, remote role is a unique opportunity for a communications professional with at least five years of experience, who is passionate about advancing child health through advocacy, education, and special projects.

Word from the President Updates