Meet Our Providers: Susan Fernandes, MD
The CPAN team at The University of Texas Health Science Center at Tyler asked Dr. Susan Fernandes at Genesis PrimeCare Pediatrics in Marshall, Texas, to share her experience using CPAN.
What led you to enroll in the CPAN program?
As a new pediatric attending in a rural setting, CPAN has been instrumental in helping me to gain confidence in my management of pediatric psychiatric cases. As many of you may be aware, rural settings have a dearth of resources for mental health, especially in the pediatric populations. Thus, many pediatricians and family medicine physicians have had to be on the frontlines, screening and caring for this vulnerable population. During my residency, I was fortunate to have the opportunity to work directly with child adolescent psychiatrists for a couple of rotations. However, this was mostly in the inpatient setting and I felt underprepared for the large volume of psychiatric cases in my outpatient pediatric clinic. As soon as I found out about CPAN, I signed up. I wanted to learn as much as I could to better serve my pediatric patients with their psychiatric concerns in a safe, effective manner.
How often do you contact CPAN for services?
At the beginning, I contacted CPAN several times a month on my more complex cases. Initially, I called as I received adolescent patients with multiple psychiatric conditions on high doses of antidepressants, antipsychotics and ADHD medications. I also had cases with children that were unable to be seen by a psychiatrist right away due to the prolonged waiting times (which has worsened during the COVID-19 pandemic) and had other children that had never been diagnosed needing initial diagnosis and management. The information that the child adolescent psychiatrists were able to provide was very helpful in increasing my confidence in treating these cases. I have also had some difficult cases with no clear-cut diagnosis and consulting CPAN really helped me through the process.
What has been most helpful for you when using CPAN?
The ability to speak to a child adolescent psychiatrist quickly. I have had to become the de-facto pediatric specialist due to limited access to pediatric specialists in the area. Though I have mentors and former colleagues who have helped me master complex pediatric diagnoses and management, it has been easier to rely on CPAN to get quick, accurate evidence-based information regarding psychiatric diagnoses and management.
Can you provide an example of how you have used CPAN services?
I can provide a couple that really stood out. I had a case where a child was placed on a psychiatric medication, that was not FDA approved for children, by a non-pediatric provider. I had to work on the weaning dose and the new medication regimen which I was able to do easily thanks to the help of CPAN. For another case of polypharmacy in a complex pediatric psychiatric case, I had initially referred the patient to psychiatry. However, the family ended up returning to see me, as they were unable to be seen for several months. With the help of CPAN, I was able to manage this complex case while they were waiting to enroll with a child adolescent psychiatrist.