A day in the life of a pediatrician

By Dr. Rei Tosu, a CHOC Children’s pediatrician

I’m a board-certified pediatrician at Los Alamitos Pediatrics, part of the CHOC Children’s Primary Care Network. I’ve been a pediatrician for 18 years and chose pediatrics because I love working with children. I feel that I can have the most positive impact on the health and development of my patients when I start taking care of them from day one.

Here is a typical workday for me.

6 a.m. — My alarm goes off. Most days, I’m able to forgo the snooze button and wake up the first time, mostly because I don’t want to be woken up by my alarm twice! I take a shower and make a hearty breakfast. I grew up with the idea ingrained in my head that breakfast was the most important meal of the day and I have continued to enjoy a hearty breakfast through my adult life. My husband usually leaves earlier than I do, but I wait for the kids to come down one by one and we eat breakfast together, going over the day’s schedule and making sure everyone is set for the day.

8:05 a.m. — I get into the office before my first patient is scheduled in order to give myself time to get ready for the day. I look through my email inbox, check my voicemail for messages that need to be returned and handle prescription refill requests that may need to be sent. This morning, I have a voicemail from the parents of a 13-month-old about his diet and transitioning from formula to milk. I notice in his chart that he has not had his 12-month well-check yet. I call the parents back and after addressing their questions, I ask them why they hadn’t brought him in for the 12-month checkup. They share with me their concerns about bringing their baby into the office during the pandemic, and I reassure them that it is safe to bring the baby in, that we have taken extensive safety precautions, and that it is in the baby’s best interest to keep up with their visits and their vaccines. The parents then ask that I transfer them to the front office staff so they can schedule their appointment, and I happily oblige.

8:25 a.m. — One of our nurses lets me know my first patient is ready to be seen. It’s a six-month well check. In the mornings, I tend to see a lot of well-checks, especially the younger ones who are not yet in school. Mom tells me that he has started eating solids and I can see during his exam that he is now sitting well on his own. He seems to be growing and developing well! I talk to the mom about child-proofing the home, since the chances are good that this little boy will be mobile before his next visit. During this visit, he receives his 6-month vaccines plus the flu vaccine. Flu season is upon us and it’s important for everyone to be vaccinated against influenza., Since babies and children who are receiving their first flu vaccine need two doses, they will come in another time for the second dose. I’m looking forward to seeing this baby again during his next well-check. He will have grown so much!

10 a.m. — After seeing a few other patients for their well-checks, I notice a telehealth appointment has been added to my schedule. Our office, just like many other offices around the country, started doing more of these virtual appointments this year in light of the COVID-19 pandemic. Not all medical appointments can be conducted virtually, but for the ones that can, it is a helpful way to promote physical distancing. This particular appointment is a follow-up for a 6-year-old patient with eczema. My patient finds it intriguing to see me on her parent’s laptop screen, and she proceeds to show me her room and tell me about her stuffed animals. After a tour of her room, we eventually talk about her eczema. Her mom points the camera at all the girl’s lesions so I can take a better look and we ultimately decide on a regimen for her eczema.

12:30 p.m. — Time for lunch. Before the pandemic, sometimes I would go out to lunch with co-workers or we would have lunch brought in for meetings or trainings. Most of the time, however, I bring my own lunch and eat in the office. Although current physical distancing guidelines prohibit us from all gathering in the same room and eating lunch together the way we used to, I am eager to get back to those shared meals with my colleagues. It’s a nice time to catch up with everyone and relax a little bit in the middle of hectic workdays. Many of the doctors and staff members have been working in the office for a long time and have become a tight-knit work family.

1 p.m. — I have a little bit of time before my afternoon appointments begin, so I take the opportunity to prep the charts for the following day. I go through the list of patients scheduled for tomorrow and notice I have a 3-year-old new patient. I go into her chart and notice she has had multiple specialist visits. I spend some time reading to find out she was diagnosed with kidney cancer and has been under treatment but is now in remission. One of the advantages of being part of CHOC’s Primary Care Network is that the electronic medical record platform is the same for all CHOC providers and I am able to access notes from her CHOC specialists and studies that have been done. Even though I will be meeting this patient for the first time tomorrow, I already feel well-versed with her medical history and feel comfortable taking care of her.

1:30 p.m. — I get ready for another telehealth appointment on Zoom, this time with a pregnant mom for her prenatal consult. She is expecting a baby boy next month, and I answer some questions she has about newborn care and circumcision. It’s nice for both sides to put faces to names before we meet for the first time when the baby is delivered.

2 p.m. — My first in-person patient of the afternoon is a 15-year-old healthy girl here for a sports physical. I know many teens come just because they need their forms filled out, but these appointments are nice opportunities to make sure not only that they are healthy enough to participate in sports, but also to find out how they’re doing in school, how they’re coping emotionally during the well-known turbulent adolescent years, and to make sure they’re up-to-date on their vaccines. This particular teen I have seen since day one of her life in the hospital when she weighed just under 5 pounds. Today, she towers over me and is a competitive rower. This is one of the most enjoyable and rewarding parts of what I do, getting to know the patients and their families, watching them grow from an infant to a young adult, and being able to take part in their journey.

4 p.m. — My last patient of the day is a 13-year-old boy with anxiety. Unfortunately, we’re seeing increasing numbers of patients, at younger and younger ages, with mental health issues. While we may refer some of these patients to our mental health colleagues, our job as the pediatricians is to be the first landing spot and a gateway for the specialists. We share a few tears, but I am glad that he has taken the first step to come see me and to talk about his issues.

5:30 p.m. — I finish updating my patients’ charts from today and head home.

6 p.m. — As I walk into my house, I can hear the familiar sound of a bouncing basketball. My 12-year-old daughter must be out in the backyard practicing again. I start cooking, my husband gets home, and we all sit to eat together. I believe it is important to eat together as a family and am grateful that we get to do that almost every night. After dinner, we are treated to a viewing of the latest production by my 14-year-old son who is a budding video editor.

7:30 p.m. — As my kids have gotten older, I have more of my own time in the evenings and have gotten better about self-care. Tonight will be a yoga night for me.

9:00 p.m. — Before bed, I get some reading in. More often than not these days, I’m reading books recommended to me by my 17-year-old son who is an avid reader.

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