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news News Tuesday, January 2, 2018 Tuesday, January 2, 2018 8:55 AM - Tuesday, January 2, 2018 8:55 AM

Q & A with Chief of Pediatrics Carlos Duran, M.D.

By Matthew M. Hazlehurst, executive assistant

Q & A with Chief of Pediatrics Carlos Duran, M.D.

How did you decide upon your field?
While in engineering school prior to medical school, I enjoyed fields that had strong foundations in mathematics and models that could explain physiology. When entering med school, I considered orthopaedics and surgery. Shortly after entering school, I realized I wanted to do something with an ongoing patient relationship and from that point on, I preferred treating children. When I was a child, my sister suffered from asthma and I would see her receive treatments and improve. After seeing my sister get treatment for her asthma as a child, I was drawn to pediatrics.

Do you think the demand will change for critical care and burn physicians in the future?
In critical care and burns, we will always need physicians. As units specialize or add on services, additional help will be sought from other health professionals, such as nurse practitioners and physician assistants. Knowledge is constantly evolving and growing in the health profession due to the demand to stay current and keep up with research requirements in pediatric care.

What is the most significant change you have seen in your career?
For a long time, the success of the ICU was based on the survival of the patients. This system of grading has been passed on to the new generation of health providers for years and pediatric survival rates in the ICU have always been higher than adults. However, over the past 15–20 years, the focus has changed in the pediatric field. Now, we are focused on the quality of life, measured by the effectiveness of our treatments with less testing and intervention. This is a great change in our field. The change allows us to reach our goal of giving patients a quality life after the ICU and minimizing the number of tests they have to endure. As a result, we will lower the emotional impact of treatment on patients.

How does technology play a role in your field?
Technology is fantastic when used properly. In the era of MRIs, CAT scans, newer vents, and smart pumps, we still need the human to check all of these things. The goal is always to restore the patient to that great quality of life prior to the ICU admission. In order to do so, the least amount of technology possible should be used, requiring clinical observations from nurses and physical therapists. Provider input allows us to make estimations of how good these technologies will assist in improving the patient's care. We want to match the patient’s acuity to the amount of testing. When patients are improving, we can obtain as much from clinical observation as from testing.

What has been your greatest experience as a physician?
After being involved in medicine for over 20 years, I always think back to my first patient, a sick baby, in my first year as a pediatric ICU fellow. Initially, I believed the outcome would be poor given how sick the child was and because the baby needed heart and lung support on his first day. However, after two weeks of many teams working together, the child was discharged from the hospital. It was amazing to be a part of the first stage of that little boy’s care and see how all the decisions and days caring for him resulted in a great outcome.

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