The Link - August 2025

Summertime marks a season of transition for pediatric patients. Those in school are enjoying the weather while the next academic year looms, and others are stepping out of high school into adulthood. It’s a fitting time for clinicians to reflect on another critical transition: the often-fragmented transfer of these patients from pediatric to adult health care. During this process, children with or without medical complexity are frequently lost to the health care system. 

Problematic internet use (PIU) has been highly deliberated in medical and social circles. Despite its general appeal for discussion, it remains a highly nebulous topic without a commonly agreed upon definition of symptoms. This article seeks to provide guidance on how to survey for PIU, its co-morbidity with attention-deficit/hyperactivity disorder (ADHD), and general behavioral recommendations.

Facing uncertainty is one of the few constants in medicine. Clinicians across specialties and professions often face uncertainty in patient care, yet it remains one of the most anxiety-provoking aspects of clinical practice. Humans are uncomfortable with uncertainty and can cope with poor but certain outcomes better than multiple potential outcomes.

In the health care setting, uncertainty in illness has been broadly defined as ‘‘the inability to determine the meaning of illness related events.”¹ Uncertainty occurs due to the inherent ambiguity, complexity and unpredictability of illness, as well as paucity of information about a patient’s illness or its potential consequences.

  A 5-year-old boy presents to the dermatology clinic for evaluation of a progressive rash that began two weeks ago. His mother reports that the rash initially appeared on his abdomen and then spread to his arms, legs and face. The lesions started as small pink-red bumps, which crusted and became scaly. The child is otherwise well with no fever, malaise or systemic symptoms. There is no mucosal involvement. The rash is minimally itchy, not painful, and no new products or medications have been introduced.  

Quality improvement (QI) is essential for all health care providers and staff, as it fosters a culture of excellence and ensures the highest standards of patient care. The American Academy of Pediatrics defines quality as the “right care for every child every time.”¹ Despite everyone’s best efforts, continued research, and treatment guidelines, there remains a quality gap where children do not receive recommended care or have suboptimal outcomes. We have published multiple articles over the last few years on optimizing antibiotic choice, dose and duration for common pediatric infections. If you are wondering how you can apply this evidence in your busy clinic, this article is for you!