First Pediatric Aerodigestive Clinic in SC Provides Multi-Specialty Care in One Visit

Kat Hendrix
February 11, 2021
Exterior of the R. Keith Summey Medical Pavilion
The R. Keith Summey Medical Pavilion

Children with pulmonary and digestive issues can now receive care from multiple specialists in a single visit to the pediatric Aerodigestive Clinic at the Medical University of South Carolina (MUSC). In establishing the state’s first multidisciplinary clinic of its type, MUSC Children’s Health brings pulmonary, ear nose and throat (ENT), gastrointestinal (GI), respiratory therapy, speech pathology, and nutrition specialists together in one location to improve patient outcomes and access to care. “Originally, we developed this clinic for complex tracheostomy and ventilator-dependent children. However, we realized that there are many other children and families who can benefit from seeing all of these specialists in a one-stop-shop,” says Shean Aujla, M.D., pediatric pulmonologist and Director of MUSC’s Pediatric Pulmonology, Allergy, and Immunology Division.

The clinic treats a wide range of conditions from airway anomalies and disordered breathing to aspiration, esophageal dysmotility, and swallowing dysfunction. Because the upper-respiratory and digestive systems share the throat, diagnosing some conditions can be complex. “For example, a child with chronic cough may have reflux, asthma, or a swallowing problem leading to aspiration, and it may even be a combination of these problems. Taking a subspecialty team approach helps us determine the correct diagnosis and best management plan.”

The Aerodigestive Clinic has access to a spectrum of additional providers who are available to see patients with other underlying diagnoses as well, and patients can be referred for any necessary additional testing on the day of their visit. Clarice Clemmens, M.D., a pediatric ENT with the clinic explains, “Many of our patients are premature and ultra-premature infants with under-developed lungs who were intubated and ventilated for prolonged periods at birth which may result in damage to the airway and difficulties with feeding and swallowing. Because we’re all here–in the same place, at the same time–care can be streamlined in one visit instead of multiple separate visits, which improves efficiency and convenience for families, particularly those from out of town.”

There are other reasons that offering coordinated care in a single location makes a lot of sense for these families. “Many of our patients are technology dependent which means they have a lot of equipment they have to bring with them. Packing up everything and leaving the house can be very challenging,” says Aujla. “Being able to see multiple providers at one visit makes it much easier.”
The clinic also provides virtual check-ups between scheduled, in-person appointments. Lydia Redden, an ENT nurse practitioner, is in charge of coordinating virtual visits. “We see these patients about once a month online, and I think that has really improved their care,” says Redden “We can see what they’re doing at home and the environment where the child is living every day. It lets us help the family optimize how they’re doing things at home to make it easier and medically more sound for the child.” More frequent contact also gives families a chance to ask questions and trouble-shoot problems as they arise, rather than waiting for their next in-person visit. “Taking a holistic approach is really important,” says Redden. “Our job isn’t just giving families the technical, medical information and skills they need to care for their child–it’s also to make sure they’re able to fit what we’re asking them to do into their lives. We really want to give them the resources and support they need to be successful, so their child will do well at home. We want to make sure the families know that they have our full focus and attention.”

Arriving at a personalized treatment plan by including families as members of the healthcare team is the central philosophy of the Aerodigestive Clinic. “I believe in shared decision making,” says Clemmens. “The parents should be included in the decision-making process because they know their child best and not every decision in medicine has a straightforward answer.” Aujla agrees, “The concept that the physician comes in and just tells you what to do is outdated. I believe that it’s best to determine a treatment plan together–one that parents and caregivers are able to do and that they feel comfortable with.”

The pediatric Aerodigestive Clinic is located at MUSC’s R. Keith Summey Medical Pavilion in North Charleston. If you are a physician and would like to refer a patient, please call 843-876-0444. If you are not a physician, please work with your primary care provider or MUSC pediatric specialist for a referral to the Aerodigestive Clinic.

About the Author

Kat Hendrix
Ph.D.

Keywords: Childrens Health, Pulmonary, Lung Care