[00:00:00] Speaker A: May is PFD and ARFID awareness month and Feeding Matters will be celebrating and.
[00:00:06] Speaker B: Engaging the community with weekly themed content. We'll have expert led, Instagram lives, podcasts, resources and a whole lot more. We're going to get informed, get deep, get loud and get local about pediatric feeding disorder and avoidant restrictive food intake disorder. So join us on on eatingmatters on Instagram.
Presented by Feeding Matters with host Jacqueline Peterson and Dr. Haley Estrom.
Feeding DOES Matter.
[00:00:42] Speaker A: Welcome to Feeding Does Matter. I'm Jacqueline Peterson. I am here with my host, Dr. Haley Estrom. Haley, it's my great pleasure to introduce you to Dr. Ron Serbin. Dr. Servin is here with us today to give a pediatrician's perspective on pediatric feeding disorder and all feeding differences and also just share a little bit about screening and barriers to screening. So Dr. Serbin, welcome. So great to have you here.
[00:01:12] Speaker B: It's a pleasure to be here. Really admire what Feeding Matters has been able to advocate for the families and the children with feeding difficulties and the progress they've made. So anything I can do to contribute to the cause, I'm here for you guys.
[00:01:27] Speaker A: Well, we are just incredibly grateful to you because you've been such a huge part of our history and you were our visionary award winner at the end of last year.
It's just amazing to be able to work with a community based pediatrician that really understands feeding and all the things that we're trying to shout from the rooftops about feeding. And so that's why we wanted to bring you in and give a little bit of your perspective and how to best support pediatricians because we know you're limited with time. You've got so much that you've got to do with your patients. And so we're here to learn more from you and I think just to get us started, maybe share a little bit about your background and how you got into the work that you do and maybe even how you found feeding as a particular special interest of yours.
[00:02:15] Speaker B: Sure. So I grew up with a family, physicians. My father, my uncles were physicians. And so that's my background into like my foot into the door of having the idea of, well, I think this looks like a professional, a profession that I might be interested in.
So then when I graduated from high school, my Spanish teacher at Central High School in Phoenix invited me to work at Encano Swimming pool, which today is still the best job I ever had in my life. But when you work at a swimming pool, you work with kids and families. And so that was my first Real where I found, like, you know, working with kids and families is it's just a pleasure. And so that's my foot into the door to medicine and then pediatrics. So I was fortunate to go to the University of Arizona College of Medicine in Tucson, trained at Phoenix Children's and Maricopa Medical center, which is the combined pediatric training program.
Then I joined a pediatric practice in Phoenix where one of the physicians had a large interest in taking care of kids with special needs.
I fell into that type of practice.
If he wasn't around or wasn't available, the other doctors in the practice took care of those kids. And so eventually I developed an interest in taking care of kids with special needs. And so a large portion of kids with special needs have feeding difficulties. So that's kind of how I fell into feeding. How I found Feeding Matters was I was at a Phoenix children's conference, annual conference, and there was a booth there. I can't remember how many years ago, but it was one of the first years of the Feeding Matters was in existence. So they weren't Feeding Matters, as. As you were aware, it was called the Popsicles.
[00:04:18] Speaker A: Popsicle Center. Yeah.
[00:04:21] Speaker B: So I went and talked with the three moms, probably the founding moms of Feeding Matters, and we started talking, and I recognized that I probably. I have an interest in this subject, but also I can contribute from the physician side of things. So that's how the connection started.
And so over the years, I was invited to be on the medical advisory committee of Popsicles Feeding, which is now Feeding Matters. And so I was able to have the experience of watching Feeding Matters grow from a Phoenix local group to. Which is obviously now an international group, but also getting the experience of interacting with other experts in the field, because when you're a pediatrician in the community, you're kind of in your bubble in your office, taking care of those families and kids. And so I got to work with, you know, the. The people with Feeding Matters. Those.
The.
The visionaries behind starting Feeding Matters, but also at these conferences and at meetings, the experts. To me, that's like the feeding therapist and the gastroenterologist and the other specialists and so forth.
And so what Feeding Matters has contributed to me is that I've transitioned to my practice. So in addition to taking care of patients and patients with special needs, I learned how to advocate in the field of pediatrics more than just Feeding Matters. Feeding Matters is probably special to my heart because that was my first real experience with advocacy. But now I work in other fields as well. I consult for the Birth to Five program for the state of Arizona.
I, I'm on the board of the Arizona Academy of Pediatrics. I work with different hospital foundations.
Behavioral health stuff. So. But. But really was the seed in all this and learning that, that I had a voice that mattered was, Was feeding matters. And so, so what, what I, what I've learned is my role as a pediatrician. And I think we all, we all have our own roles, whether it's a pediatrician or anyone else in the community is I have my job where I take care of the kids in my office. But I. So that's like a local thing. But then I have. The broad term is finding those issues that I can have an input to help the children and the families in the community.
[00:07:04] Speaker A: Yeah, Yeah. I think you've always been such a helpful guide in that role.
Not only kind of directly for your patients, but also what your role means to kind of like population health and the community at large.
Because I think that's. That's been the challenge as we've tried to figure out and identify what can we do to get kids access to care earlier.
You've always been there to be a voice to us to help share, like, what is helpful versus maybe what isn't helpful in how we try to talk with and engage with pediatricians.
[00:07:49] Speaker B: So I've been in practice for almost 30 years, and each year I have different ideas that come to my mind. And by the way, the first idea I ever. When I was in my first month of my training, I learned the concept of listen to the mom. It's really beneficial to. To the practice of being a pediatrician, but it's actually so valuable. So that's the first idea that I ever learned is my first month of internship. I also listen to dads and other family members too, by the way, so fast forward. And so what I've learned from Feeding Matters is that life isn't perfect and smooth. And so there always isn't a right answer. I guess to take a step backward, when I was in college, I took a writing intensive course from a biology professor. And he asked me the question of why do you like science? And my response was, well, there's always a right answer. And he laughed at me. And looking backwards, I understand why he laughed at me. Because in high school and grade school and even college, there was the A, B, C, D, E, or none of the above answer. And life isn't that easy. There's lots of grays involved. And so from Feeding Matters, what I've learned taken Forth from that concept is when there are those questions that are not so easy to answer, and there's those issues that we need to solve, they are solvable within a team approach. So you. So what I learned from Feeding Matters is they've identified. Well, we have this issue of there's kids and families. Well, kids with feeding difficulties, families who are trying to help those kids with those feeding difficulties.
And when you can't feed, find a solution.
How can we work together as a community to develop programs so we can solve those answers? And I've observed Feeding Matters do that. And what I mean by that is, for example, developing the idea and then developing the diagnosis of a chronic pediatric feeding disorder and also a code so that physicians can code for that, because that's part of the game we have to play to, from a physician standpoint, to make it so that it's meaningful in the community.
When I started practice, that idea didn't exist. And Feeding Matters developed that idea and then made it come to fruition.
What I've learned from that is that we have a role and there's a voice, and we all have different perspectives. I have my pediatrician perspective. You guys have your Feeding matters perspective. Yeah, but. But one of the other ideas I've learned is that if we work together, two or three brains or more work better than one brain. So we can solve problems that way.
[00:10:30] Speaker A: Yeah, we for sure can. And I think that type of collaboration is something that we've tried to really, like, share more broadly, especially because of how complex feeding is.
And you realize how challenging that can be, though. Like, I've even heard that as we've shared all of the different domains of pediatric feeding disorder between the medical, feeding skill, nutrition, and psychosocial, that. That's overwhelming even of itself to say, like, oh, you need to talk to this subspecialty. This subspecialty. This subspecialty. Talk to me more about, like, as you're working with families and knowing the need for collaboration, but also kind of seeing the family in front of you, how do you kind of navigate that as their medical home?
[00:11:14] Speaker B: It takes time and effort from all involved.
One of the. If we talk about. I think we're going to talk about barriers, but one of the barriers is you have to make an effort and make time.
Not everyone has that time or has the ability to make that time, but if you really want to do your job in the best way possible to help the families, you need to make the time.
It's a matter of determining what.
What is the Etiology of what this child and family is going through. So you have to identify what the problem is.
And then once you identify the problem, then you can develop a medical plan as to going forward.
Then you have to put the pieces to the puzzle together.
There's theory and there's reality. So theoretically, I know that what some of my patients need and families need for that care, they need, but sometimes the access to that care is not available. And so getting over that challenge of trying to put all those pieces of the puzzle together.
[00:12:21] Speaker A: Yeah. And it takes you kind of knowing that. And it sounds like you walk alongside your families as they are figuring and navigating that out.
[00:12:32] Speaker B: Yeah. So I think if we work together, we can help the families, but it takes effort.
And so I guess by sometimes one of my other theories in my brain is not what you know, it's who you know. So if you develop relationships in the community. So through my advocacy work, I've developed those relationships, whether it was with Feeding Matters or the other organizations I work with. So then I have my contacts and I can.
And I can help the family. So as an aside, I talked with a mom today who is a child on the autism spectrum. And I have the psychiatrist that she was helping with her child isn't available. He left the practice and she can't find anyone else to take care of this kid. Well, I have contacts in the community where I can reach out and say, help. How can we help this family? So that's an example of, you know, working together and with experience and building relationships and kind of the world we live in now where there's so much animosity. You know, people have their opinions on things, which obviously they're entitled to.
We all have our perspective and opinions, but we can make the world a better place if we can recognize other people's perspectives, but also recognize, work together to try to solve those issues, whether it's with feeding issues or whatever else is in the political arena.
[00:14:01] Speaker A: Yeah, sure. In that type of collaboration, it sounds like a little bit easy for you because of those built up relationships, you're able to kind of like jumpstart getting a family access to care. I just jumped ahead of myself in terms of like assessing pfd. But one thing that I did want to talk to you about was screening for PFD and the use of our infant and child feeding questionnaire. Because I think even before you get to that point, you're doing those questions in your head or with your families. How do you approach even knowing that you need to Talk to a family about feeding in general, because I think we find that a lot of. We get told that a lot of times it's maybe kind of a part of the conversation, but more of an offshoot conversation than an actual guided conversation around feeding development.
[00:14:49] Speaker B: So. Yeah, so in our training as pediatricians, we don't get, and I guess probably physicians in general, we don't get the most optimal training in nutrition and on feeding. So that's one of.
We got information about, like in the. In the infant, like, you know, breastfeeding. Not really on lactation, though. So, like, if a mom's struggling with breastfeeding, the education on lactation was minimal in that particular. If you start at infancy as a pediatrician, you can get education and lactation, but it's like on your own effort.
Then you step forward to introduction of solid foods and you get the basic lecture. But it's all learning through experience. Then you progress to older kids if everything's going well. And with a lot of families, everything's going well and their kids are growing and eating, it's easy. But when you have a child who's having difficulty, that's where the challenges arise, obviously.
So how I approach screening is I have learned that if you ask a parent, how is your kid feeding?
And you approach it as a yes, no answer, that's not a proper way to screen for feeding difficulties. So what we're looking at is ability.
And then also is the kid getting the appropriate nutrients in?
And then what are those? Is there any medical issues that might be a barrier to those?
So part of the tools I think of when I'm examining kids, and I guess we see kids to generalize in two different aspects. We see them for their general well, child check, and then we see them for sick visits.
Sick visits can be runny noses and coughs. It could be addressing complicated issues.
The bread and butter of a pediatrician is to see the child for the well, child check. That's our opportunity to screen.
In my toolbox, to screen, I have the history.
I think in the first week of medical school, you learn history is the most important part of seeing a child history. But you have to look at the child to see do they look healthy or not. We use a growth curve to see is the kid growing well.
Then I ask specific questions like in addition to how is the child feeding, what is the child eating, and how long does it take? And is there any negative experiences the child occurring when the child's feeding, for example, coughing, choking and gagging.
And so if A mom or a parent says, oh, you know what this is going on, then that's the dialogue that I had that, oh, okay, I might need to address, there's something else going on. Even if this kid is growing on the growth curve. Well, if they're choking, coughing and gagging when they're feeding, that's not normal.
One of the concepts that is difficult for physicians to understand is that if the child's growing well in the growth curve, they assume that they're not having a feeding difficulty.
That's one of the. And so in my experience with working with the parents at these interactions at the Feeding Matters conferences, you hear all the time that concept, oh well, the child's following the feeding, the growth curve, don't worry about it. And the parents know all along there's something going on. So that's one of the ideas that if there's any pediatricians listening to, listen to the parent, not just look at the growth curve.
[00:18:51] Speaker A: Yeah, because I think oftentimes too we hear that parents are doing things, extraordinary things to make sure their children are staying on the growth chart. And so it is kind of that listening for beyond the answer. Because I do think that oftentimes the feeding conversation is like, oh, is feeding going well? Yes or no. And it's like, oh, there might be a little bit more that we gotta like dig into.
[00:19:13] Speaker B: So 15 years ago, this mom was the mom who taught me this concept of I, I can't just ask, you know, how's the baby feeding? Because when I asked, is the baby choking, coughing or gagging? She said oh yeah, all the time. And she just thought that was normal for that baby and it wasn't normal. And that kid actually had a, had a medical reason for this child's feeding difficulty. And so if I wouldn't have explored it eventually it would have been, you know, found out because the mom would have came back, something's not right. But, but I was able to identify earlier and this kid actually doesn't have it. The sibling doesn't have a feeding difficulty anymore. I don't know if it's because we identified it earlier or not, but obviously the earlier you identify a problem, the earlier you can address it and hopefully address and fix the problem.
[00:20:00] Speaker A: Yeah, that's, I think the goal for everybody is that early identification.
Feeding Matters Infant and Child Feeding Questionnaire was developed as an evidence based tool to promote early identification of feeding disorders. Developed by internationally recognized feeding experts, this online questionnaire, available in both English and Spanish, can help you better understand your child's Feeding differences and needs. Take it online for free
[email protected] that's questionnaire feeding matters. Org or type ICFQ in your search bar now. Dr. Serbin, one of the things that I think is so natural about how you approach your patient population is you're used to asking a lot of those questions and they're kind of like they're on the tip of your tongue as you're engaging with every patient is how their feeding is developing. But something that we've been trying to do with our infant and child feeding questionnaire, like the six question type of screener that we have, is really trying to figure out what's the best way to help those questions be part of, well, child visits. And I know you and I have talked about barriers in the past, but any barriers that you see in terms of either integrating those questions into, well, child visits, but also even just more broadly and generally, how can we be thinking about how screening is happening for any sort of feeding development that's going different than we are expecting?
[00:21:31] Speaker B: Yeah, so one of the, a major barrier pediatricians have is we have a short time limit in our appointment. So in my office our well, child checks are 10 minute appointment.
[00:21:44] Speaker A: Yeah, that's such a short amount of time.
[00:21:46] Speaker B: And the pediatricians down the street hopefully are a little bit longer than that. But and so if you only have a limited amount of time, that limits obviously the type of screening tools you can do. And so we're already asked to do screens for other issues and they're appropriate developmental screens, screens for anemia, for lead exposure, autism, depression, so forth. And so to add another developmental screener, that's one of the barriers as pediatricians are like, not another one. So that's one barrier.
The second one is when you have a screening tool and then you identify a problem, then you have to deal with it.
That is the reason for a wall child check, by the way. But it's so easy just to go in and out and see all these kids without any problems.
But when you identify a problem, then you have to deal with it. And that takes time and effort like we've already discussed. And so that's another potential barrier, unfortunately.
And then once you have to deal with it, then you have to determine, okay, what are my resources to help this kid and this family with the feeding difficulties, what do I do? And so if you're not educated on all the resources out there, that might be a disincentive to do the screen in the first place.
[00:23:20] Speaker A: Yeah, you Almost feel like you don't have an answer for a question. So you want the question to come up in general.
[00:23:25] Speaker B: Yeah, so.
So, so at the end of the day, it's all about education in terms of educating, obviously families, but also physicians in terms of. We have this. So, so I guess take a step backwards. So the screening. So when you have a screening tool, you want it to be, be able to get the bang for your buck. So a short screening tool that's easy to give and that's going to pick up.
So you want to pick up those kids with difficulty feeding and not identify kids that don't have a feeding problem. But they answer this question and they don't really have a feeding problem. But the answer, yes to a positive response to a question.
I was involved in the initial discussions about this topic of, you know, how do we get a screening tool into the pediatrician's office? And if you look at those six questions, it's pretty straightforward. But it took time and effort, probably at least 10 years to develop the screening tools. It wasn't so straightforward, but yeah, it.
[00:24:30] Speaker A: Was a really long time.
[00:24:31] Speaker B: But, but it is, once you look at the screens, it's, there's, there's six questions that are pretty simple. And so what I think, how I perceive it, how I look at it is it creates dialogue between me and the family. So if everything's going fine, that's great. But if there's a concern from the parent or if there's a positive screen in the questionnaire creates dialogue and then you can determine is there really a problem or not. Because that's the purpose of a, well, child preventative exam.
[00:24:59] Speaker A: Yeah. And so having that screen and being able to then have a deeper dive conversation about feeding is, I think what we would have, you know, love to see happen at all well visits is like if there is something going awry, that we're having a deeper dive conversation about it. But I know there are barriers to that. Are there other ways since you do have a new idea every year that you're out in pediatrics, are there other ways that you think that this can be part of the conversation, that it's, it's not just all falling to pediatricians to be our, our main source of identification?
[00:25:33] Speaker B: Well, so in my particular practice, I found that when I've brought up whatever the topic is, you know, maybe we should implement this into our practice. Whether it's a well child check or whatever the case may be, the pediatricians in practice are stuck with their ways. And so, and I'VE already told you about the limit of the barriers of time. So my first thought is we need to educate the medical students and the residents in their training so that it's like, it's a no brainer. This is what we do as a pediatrician.
[00:26:09] Speaker A: Yeah. It's just kind of accepted that this is a thing that happens.
[00:26:11] Speaker B: Yeah, this is what we do.
Yeah. And I know that there are training programs who know about this screening tool. Like, I've had conversations with the head of the feeding clinic at Phoenix Children's, and she told me, by the way, we are doing that with our residents. So once they reach the community, then it's not a barrier anymore, it's just what you do.
[00:26:42] Speaker A: Yeah, that's so true.
One of our ideas is like, if we can't get it currently, how can we get it further up the. Up the path? And so residency and medical school is definitely an area we've got our eye on in terms of some more education around this.
There have been a couple studies that have shown that. Oh, I'm sorry, go ahead.
[00:27:09] Speaker B: There have been a couple studies that.
[00:27:11] Speaker A: Have shown that early indicators for autism have been shown to be feeding problems. So that's just another reason to be screening for feeding.
[00:27:22] Speaker B: Yeah.
Taking care of kids in the autism spectrum is another one of my interest.
Every child who I see who has autism, I ask, by the way, how is the child feeding? Any issues there? Because one of the difficulties kids on the autism spectrum can have is feeding difficulties.
[00:27:40] Speaker A: Yeah, Just more of a reason to have that prevention lens on things.
And as we kind of narrow in our time and focus here, I know one question that Haley, you were looking to ask was about the PFD diagnosis itself. And Dr. Sherman, you mentioned that a little bit earlier of like having the code and actually like naming it. Did you say any differences in access to care or conversation or practice once PFD became an official diagnostic code, or are we still seeing some barriers there?
[00:28:14] Speaker B: So I think from my perspective, it hasn't changed the way I practice personally. But when that code was being developed, what I heard the main issue was was that getting treatment for kids was a huge problem because insurance companies were denying care for kids. So denying their therapeutic care. So specifically like feeding therapist or the whatever. Yeah. They were limiting to them because they could deny it by saying, well, this isn't a code that we're gonna pay or give services to, so I would assume it's impacted that group more.
But once again, once you have a clear cut diagnosis and a definition to the Diagnosis too, with the domains.
Once again, it brings awareness and then it brings that dialogue. So that helps with whether we're educating or advocating or treating kids.
So personally, it hasn't affected me, but I think my situation is a little different because I've kind of been involved, so I didn't need the diagnosis.
[00:29:34] Speaker A: Yeah, you don't have, like, your level of awareness has, like, grown as we've grown and was even there before we were a thing.
[00:29:45] Speaker B: But it's not about me, it's about the community. And so most importantly, it's developed this diagnosis now that hopefully for other pediatricians, it brings awareness so that we have a dialogue so we can address the issue.
I guess an example I will give you is years ago, we had what we call lunch and learn. So we had an educational lecture at my office, one of the feeding therapists in the community, where they brought lunch, and it was about kids with feeding difficulties. One of the doctors approached me in the hallway and said, is this about eating disorders? Meaning bulimia, anorexia? And so.
So hopefully that will. That kind of perception of what a feeding disorder is will not be confused with children who have eating disorders, because obviously they're two separate issues.
[00:30:37] Speaker A: Yeah, that would be our hope as well. I think those worlds have operated so separately that it was like, oh, yeah, we're not an eating disorder. But then you realize that is like kind of. That's the first thing that people think about when they think about any sort of eating is eating disorder.
So I get why that was their question.
Now, anything else, like, as you share your perspective or as you talk about being an advocate and being out in the community in that way, anything that you think we missed in terms of what you wanted to share with the listeners, whether they are other pediatricians themselves or others in the field, or even parents themselves.
[00:31:13] Speaker B: I think with parents, from the pediatrician's perspective, some of the situations when I'm. Like when I'm seeing a child with whatever their condition is, if I. If my brain is thinking simplistic, I think of the situation as pieces to a puzzle. And the more pieces we have to the puzzle, the better. So the more information a parent gives us, the better. And one of my other ideas is that I always tell parents, like, if they say, oh, sorry, I have a question to ask, or, sorry, I have one more question. And my response is always, if you don't ask that question, I cannot answer the question. So don't be afraid to ask the question, because the time you spend, even if it's that 10 minute appointment that I'm talking about, it has value. And so you need to get the value out of the service that we as pediatricians should be providing.
I think from the pediatrician perspective, there's two folds. There's decreasing that barrier. So educating pediatricians, whether they're residents, medical students or pediatricians well established in the community and trying to figure out ways to, to brighten that awareness and then, and then educate pediatricians so they don't feel intimidated or they feel comfortable taking care of these issues.
[00:32:33] Speaker A: Yeah, that makes sense. And I love that you share that with families, that if you don't ask the question, you can't answer it.
[00:32:40] Speaker B: Yeah.
[00:32:40] Speaker A: Because I do think that, like, we're kind of in there and we're like, worried about your time and like our, our questions. And I think you almost like, forget your list of questions sometimes as a parent coming into the office.
[00:32:50] Speaker B: Yeah.
And there, there are times where, like, I know after I get off, finish this podcast, I always, you know, whenever, whenever I'm interviewed, I'll think, oh, why didn't I talk about it from this.
[00:33:03] Speaker A: Oh, yeah, totally.
[00:33:05] Speaker B: So, so, so, I mean, if that's the case, reach out and. Oh, I have one more question and I'm sure there are pediatricians who may come across that they don't want that extra question, but most of us are pretty nice people and we went into the profession for obviously the reason that taking care of kids and families. And so once again, ask the question. If you don't ask, we can't answer.
[00:33:28] Speaker A: Love that. Thank you so much, Dr. Serbin. This has been just a really incredible time with you. We really appreciate all, all of the work that you do as a pediatrician and taking care of your families and your kids and all of the work that you've done historically for Feeding Matters and building us to where we are now and where we're headed.
You've really been integral to our work and have served on lots of projects with us. We were even talking earlier.
[00:33:54] Speaker B: Yeah. So I guess to end, when I'm involved in those different organizations that I'm involved with, whether it's Feeding Matters or whether it's on the Birth to Five program, I have my role, my perspective as the physician, and you guys have your role as working with Feeding Matters.
And what I've learned, working with the Birth to Five program, what that is is that children in the state of Arizona up to 5 years of age, if the parents have any kind of developmental question, they can call this hotline. And then there's social workers who then help these families with whatever those issues are. And so my role is I meet with them twice a month to give them the doctor perspective, like, oh, there's this kid with this condition, what's going on, or so forth. And we try to brainstorm and solve these issues. But what I've learned is that they get my medical perspective or expertise, so to speak. But I learned from them, too. And so I learned from all these resources in the community that I'm not aware of or a different way of thinking from the social worker standpoint. And so once again, it's my philosophy of if we work together to identify these issues, we work together, we can. They're not easy issues to solve by any means, but if you don't try to solve them, you're not going to be able to solve them.
[00:35:16] Speaker A: Yeah, but it takes all of us, you're right. All of our different perspectives, it's at all aligned.
[00:35:20] Speaker B: It takes a village.
[00:35:20] Speaker A: So definitely.
[00:35:24] Speaker B: And so. But Feeding Matters was the.
My work with Feeding Matters made me recognize the power I have from a pediatrician's perspective and the influence I can have. And that comment doesn't mean I have a better perspective because I'm a physician, because some physicians may have that ego, but it's my power from my perspective as a pediatrician that my voice that I can give because we all have a voice. And so that's the pediatrician perspective, voice and influence that I could have.
[00:35:57] Speaker A: Yeah, I love that. Dr. Sarbin, I think that that's a little bit about what makes you special as well, is like you are coming in.
In that space of really sharing and collaboration. Because I think sometimes that is what prevents people from being able to collaborate with physicians is they're worried about any sort of like, not territory, but just different ego in play, different levels of education and kind of the power hierarchy that's involved. And so you're really disarming in terms of how to have a conversation and how to collaborate and what that looks like.
[00:36:33] Speaker B: Yeah. And I've also learned that in my voice. So if I identify in my work with the hospitals, I've identified issues that I think that need to be addressed. And it's not like I'm saying you're doing it wrong or you guys are bad for doing it, but if you identify those issues, once again, you can try to solve those.
Try to solve the problems that are there to be solved.
[00:37:00] Speaker A: Yeah. Amazing. We really appreciate you.
[00:37:03] Speaker B: And I appreciate Feeding Matters for I was amazed at the conference, the International Conference.
[00:37:10] Speaker A: Oh, did you like being out there? It was like, so different than previous conferences.
[00:37:15] Speaker B: Yeah, well, the cool thing about it was that, well, obviously the knowledge, but like I said, it's not what you know. And so I got to reconnect with the people who were involved with feeding matters from previous years, but also meet new people.
And I even met people who just learned about the conference like a month prior and they made an effort to come. So it was really powerful to be around people and kind of interact.
Remind me of the old days.
[00:37:48] Speaker A: Yeah, no, that makes sense because there was. I mean, we hadn't been in Arizona together for several years, and then you were able to see other people from Arizona and elsewhere, and there's so many new people now too. That's amazing in working with us.
Well, as we close out, we have one last question that we ask all of our guests, and that is, what do you see as a barrier to patient and family centered research and what's a potential solution? I know we talked a lot today about barriers to screening, and that's maybe part of this, but one of the things that we're really focused on is we know that PFD being an emerging field, and even ARFID being an emerging field, we need more research. And so is there anything that you think, and maybe something that helps you as a pediatrician that could be potential barrier to patient and family centered research or solution?
[00:38:45] Speaker B: The lack of knowledge of how to do research. So as a pediatrician who practices medicine and doesn't research, it's that lack of knowledge. And so for the people who do have knowledge to do research or develop research protocols or ask the question and then try to solve the answers. For me personally, it's the knowledge of how to do research in general. And then the other issue for me, obviously, is the time I've been asked to do other small projects in my office. And then they say, oh, you need five minutes to answer this question. And well, I already told you I have 10 minutes to see a kid, so that's just not going to work. So I think it's the knowledge and then the time.
[00:39:36] Speaker A: Yep. No, I think that's a great answer because I think as we're trying to get more people involved in the research of the field, we need those stakeholders that are every day out there in the trenches that aren't necessarily doing the research themselves, but still contributing in a way that's meaningful and that fits within a very limited time frame and very limited schedule. Like, you don't have a lot of time. You already shared all of the boards that you're on and all of that. So I think that's a really great answer.
[00:40:05] Speaker B: But that's the unique part of the feeding questionnaire is that it's a short, easy questionnaire to administer.
[00:40:15] Speaker A: My hope is that it's quick and easy.
[00:40:17] Speaker B: Quick and easy and then hopefully create dialogue. And there's always an issue that comes up in a pediatrician's office, whether it's a feeding difficulty or another that that's a bump in the road and you have to deal with.
So, but, but hopefully the, it's, it's about, you know, about the early identification like we've already talked about.
[00:40:39] Speaker A: Yeah. No, thank you. Dr. Serbin. Really appreciate you being here with us today.
[00:40:45] Speaker B: Yeah, my pleasure. Whenever I get a call from Feeding Matters, I'm always excited to work with you guys because it's. I'm dear to my heart.
[00:40:51] Speaker A: Oh, thank you. You're dear to ours, that's for sure.
[00:40:54] Speaker B: Feeding Matters is a nonprofit organization that works with corporate sponsors to support its mission. The following sponsor ad is not an endorsement of the company its products or services.
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