Dear Yum Pediatrics Families,
For the past two and a half years I have enjoyed the privilege of taking care of so many lovely patients in this practice. Getting to know my young patients and their families is something I cherish, and I am grateful to all of you for allowing me to be part of your children’s young lives.
As many of you know I am also extremely passionate about my work with The Doctor Yum Project, a nonprofit organization I founded in 2012. Our mission is to teach families the connection between good food and good health with nutrition education and cooking instruction. Being able to learn from my patients in the exam rooms at Yum Pediatrics allows me a unique insight into how to help our greater community become healthy with good food.
Many of you also know that I am a wife and mother to two young boys. My husband and two sons have been incredibly supportive and understanding of the time and energy I put into my patients and my nonprofit work.
Managing my responsibilities as a physician and nonprofit director along with spending time with my family is challenging. As our practice has grown, I have been looking for ways to be able to give more time to my family and nonprofit work while still taking excellent care of my Yum Pediatrics patients.
It is for this reason all of us at Yum Pediatrics have decided to close the practice each Thursday starting September 22nd.
We feel that this is the best decision for all of us, our staff included, to find the balance we need to continue to take care of our patients in the best way we know how.
While we are closed on Thursdays, our phones will be answered by the Mary Washington Healthlink nurses as they are on the weekends. If you have urgent needs you may reach them at our usual phone number. You may send non-urgent messages through the portal, which will be checked once during the day. If you feel your child needs to be seen, we recommend the Peds Xpress on Salem Church Rd or the emergency room for more urgent needs.
We hope that you will not be inconvenienced by our new schedule and that you understand how dedicated we are to provide you the best care possible.
Dr. Fernando and the Yum Pediatrics Staff
At Yum Pediatrics we have made the decision that we are no longer able to provide injection visits for alternative vaccine schedules. We have accommodated some alternative vaccine schedules in the past, but as our practice is growing and changing it is no longer possible for us to do so.
Here are a few of the reasons for this decision:
- I am the only physician here at Yum Pediatrics. Many of you have chosen this practice because you want your family to know one physician and for that physician to know your family well. However, accommodating alternative vaccine schedules takes an enormous amount of my time and resources, which makes me less available to my patients. I love to be able to see patients for same-day sick appointments when they need me. However if many families request to receive shots over 2-4 visits when they can be done in one visit, it leaves less time in my schedule to see necessary same day appointments.
- Offering vaccines is incredibly costly. It is by far my biggest monthly expense. While most plans will cover the cost of the vaccines, it is never a guarantee and the reimbursement does not cover the specialized staff I need to administer vaccines safely, the price of the equipment, the upkeep to store and monitor vaccines, or the supplies to administer them. We also spend an enormous amount of unreimbursed time doing paperwork and site visits so that we can be certified to deliver vaccines to families who self pay or have state insurance. Offering alternative vaccine schedules multiplies these expenses, making the cost of providing vaccines unaffordable.
- By far the most important reason for this decision is that I feel I am not providing the best care for my patients when I agree to alternative vaccines schedules. The vaccine schedule endorsed by the American Academy of Pediatrics and the CDC is the most well studied way of providing vaccines and is proven to be safe. I would not recommend this schedule to my patients if I did not have overwhelming evidence that it was in their best interest. It is the reason that my own children are vaccinated according to the AAP approved schedule. My experience and training have proven to me that the recommended schedule is safe and provides vaccines in a way that minimizes vaccine visits, which are often a fearful experience for children. We have put a lot of thought into making this practice a fun place for kids and feel that increasing shot visits makes kids more scared to visit us. Also, when we delay key vaccines we leave unnecessary gaps in immunity to vaccine-preventable illnesses. As a physician I have a duty to provide the best medical care that I can, and when I use vaccine schedules that are not studied I don’t feel like I’m doing my best job for my patients.
Because we realize that parents have a lot of questions we have gathered information about vaccines from The Children’s Hospital of Philadelphia, a center that is a leader in information about vaccine safety. If you are interested in reviewing that informational packet give our office a call and we would be happy to provide it to you. If you decide that you would still like to pursue an alternative schedule then we may be able to suggest other practices that have the ability to provide that service.
Thanks for your understanding.
Nimali Fernando, MD, MPH
As a pediatrician I’ve enjoyed the power that social media has given me in communicating information to my patients and my community. However, recently I have been dismayed by the number of articles and videos I see shared on social media involving vaccines and vaccine safety. Many of these are videos and articles that discuss half-truths and even made up information about vaccines.
As the founder of The Doctor Yum Project I spend a lot of my time helping families prevent illness with a whole food diet. But as solo practitioner I have also made the decision to prevent illness by providing vaccines to my patients. I am comfortable with this decision because my training and experience has provided me too many opportunities to witness the consequences of contracting a vaccine preventable illness. I have seen first-hand the devastation of pneumococcal meningitis, cervical cancer, dehydration from rotavirus, and pertussis, just to name a few. I have also heard the stories from my older colleagues of much worse times when other infectious diseases took even more lives before new vaccines were developed.
This decision to provide vaccines is not easy from a personal and financial standpoint. The upfront cost to stock vaccines is staggering, and is the single largest cost to my practice. The slim profit margin that insurance provides does not cover the staffing, administration, refrigeration and infrastructure needed to provide those vaccines. And yet, many of us physicians are still hanging in there, bearing the burden and doing what we can to protect our patients. To make things even worse, steady increase in social media postings has made this job seem insurmountable. It’s rare for me to meet young parents that don’t ask about “mercury” in vaccines or whether they can do a “delayed vaccine schedule.” This extra counseling is time-consuming, but entirely worth it in my opinion. I understand their trepidation, and so I have spent a lot of time compiling information from credible sources so families can make informed decisions. After reviewing this information and consulting with me, most of these families have been able to come up with a vaccine plan that is comfortable for them.
However, every day I see people posting information on social media that works against my efforts. I understand that families may have concerns about vaccines. I understand that parents may have hesitation and may want more answers so they can do their best to protect their children. But conversations about these concerns should, in my opinion, be kept PRIVATE. When people publically post pseudo-scientific articles and personal opinions about vaccinations, it can be very easy for other parents to get spooked. It is only because of herd immunity that children who are not vaccinated can be protected. This herd immunity is established by hard working physicians who make sure that most of the community is vaccinated. Parents who choose not to vaccinate are only putting their own children at risk by breaking down that herd immunity with the flood of vaccine hysteria on social media. This is happening slowly and steadily with every article and video posted. As a pediatrician I ask that all parents keep their decision to vaccinate or not vaccinate a PRIVATE conversation within their family and with their physicians, so that other parents can be open to the peer-reviewed articles, scientific data and professional experience that their own medical providers can offer them. Let other parents make their OWN informed decisions. It would certainly make physicians’ lives a little less complicated as we strive to protect our communities.
Spring is here and with sports getting underway, it is important to think about the kinds of foods we are putting into our little athletes’ bodies. As a pediatrician I encourage kids to be active, and organized sports are one way to keep up that activity. However, as a parent with kids in sports I have noticed that after the game kids are often offered a lot of unhealthy high calorie snacks and high sugar sports drinks with many artificial ingredients. The average young athlete’s after-the-game snack may equal 2-4 times the amount of calories burned during the game.
This spring, consider talking to your coaches and teammates’ parents about a no-snack policy. If parents are still interested in bringing snacks consider a fruit and water policy. Only about half of children in Virginia are getting the recommended daily servings of fruits and veggies a day. Why not make game time an opportunity to get in another serving! Generally, water is a good rehydration drink for average play, but fruits and other whole foods help to provide some of the electrolytes that kids may lose by sweating on really hot days.
If your team chooses to give fruit, try fruit skewers in a rainbow of colors or fresh whole fruit. Virginia strawberries are plentiful in May, and make a sweet treat treat after the game. After taking healthy alternatives to my son’s games I can tell you that the kids were just as happy getting delicious local fruit!
Yum Pediatrics, the office of Dr. Nimali Fernando, and the entire Yum Pediatrics team are always trying to come up with ways to inspire kids to eat nutritious foods. That’s why we are pleased to announce our first ever Veggie Art Contest. Throughout the entire month of March you can submit your children’s artwork to a Yum Pediatrics panel of judges for display and a grand prize.
The topic is “What is your favorite Vegetable?”
Kids of all ages can submit artwork highlighting their favorite vegetable. The artwork can depict them eating the vegetable, growing it, or any other theme involving the vegetable.
Kids will be judged by the following age categories:
1) 4 years and under
2) 5-7 years
3) 8 years and older
We will be judging on creativity and artistic use of materials. A variety media (paint, pencil, crayon, marker, mixed, etc.) will be accepted.
Kids can submit works size 8.5 x 11 inches to 16 x 24 inches
Artwork can be submitted by March 31st in person or by mail to:
10482 Georgetown Drive
Spotsylvania, VA 22553
Please include this paperwork which you can obtain by clicking here:
A winner in each category will be announced the first week of April.
Winners’ artwork will be framed and displayed at Yum Pediatrics or The Doctor Yum Project Kitchen. Winners also get a personalized cooking lesson with Doctor Yum at the Doctor Yum Project Kitchen!
Also, visit us our table at the Fredericksburg Health and Wellness Expo on March 29th where and kids can work on their art and submit their finished pieces.
Yesterday, Yum Pediatrics and The Doctor Yum Project hosted a one-of-a-kind workshop with two amazing speakers, Dina Rose, PhD. and Melanie Potock, MA, CCC-SLP.
Melanie Potuck, Dr. Dina Rose and Dr. Nimali Fernando
These two nationally-known speakers came to our Instructional Kitchen to talk to area parents about how to establish healthy eating habits. Dr. Rose just released a fantastic new book, It’s Not About the Broccoli, which we have on the wellness shelves in our waiting room (take a look next time you are in!) I love their practical, hands on advice which takes the pressure off the daily nutritional battles we all fight as parents, and gives us a wider perspective on raising kids with healthy habits.
Melanie gives a great talk on the 7 senses
Melanie Potock of My Munch Mug. began the workshop with her talk, “Eating with 7 Senses. ” It was a thought-provoking talk about all the senses we use when we eat. She offered practical tips on how to set kids up for success with eating, including proper seating, how to introduce new tastes, and how to look at the whole child when approaching feeding. She was just fantastic.
Dr. Dina Rose also spoke about establishing healthy eating habits by focusing less on day to day nutritional intake and instead looking at the broader goal of establishing healthy lifelong eating habits. Her unique perspectives were really well-received by the 40 guests who attended our workshop, and there were a lot of great questions from the audience. Jabberwocky, a local Fredericksburg bookstore was on hand to sell signed copies of Dina’s wonderful new book, It’s Not About the Broccoli.
Dr. Dina Rose’s new book “It’s Not About The Broccoli”
I shared some of the things that I do with the Tiny Tasters from doctoryum.com and my cooking classes to inspire them to cook and taste. Special knives, chopsticks, aprons and more. We discussed food passports and my “Yum Score“, which encourages kids to try food.
We were so happy to see many of our “Yum Pediatrics” patients at the event. We hope to offer more of these types of experiences for our patients and the Fredericksburg community.
Many thanks to Melanie for coming out from Colorado and to Dina for visiting from New Jersey. What a treat! Thanks to the Harvest Market for providing a beautiful spread of healthy food too!
Thanks Harvest Market!
Stay tuned for our upcoming events!
-Nimali Fernando, MD MPH