Dr. Whitney: Hi everyone. Welcome back to the Modern Mommy Doc Podcast. I'm your host, Dr. Whitney Casares, and I am here today with a fellow pediatrician with Dr. Lindsey Garbi, Chief Medical Officer and co-founder of Blueberry Pediatrics. And so we're gonna talk all about telehealth, we're gonna talk all about making health work for working moms. Dr. Garbi, thanks so much for being here.

Dr. Garbi: Thanks so much for having me. Very excited to get into this.

Dr. Whitney: Alright, so let's start first just with your journey. How did you decide that Blueberry Pediatrics needed to be on the scene? What were the needs that you were seeing from parents and patients?

Dr. Garbi: Yeah, so I guess I'll give you two perspectives. One, which I think is the most important one, is the mommy one. Just a little more background on me. I am a board certified pediatrician. I'm also a mom of three kids, in the real thick of it. So, seven-year-old, four-year-old, one-year-old. And when we were creating our practice, I had just the seven-year-old. He was maybe one. So I was facing those new mommy questions, issues, fears. Questioning my own parenting. And as a pediatrician, I know a little more about this stuff, but I still have all those same fears and questions that other parents do.

Dr. Garbi: But I think, as a parent, that really just speaks to my answer. Your kid has a fever in the middle of the night and you're scared. It is scary. And a lot of the times I wondered if my child was okay. It was also secondly, what support system do I have? What do I do right now? I felt very alone and that's a horrible feeling. I have a great pediatrician for my kids, but even knowing that I was going to be waking them up in the middle of the night so they could answer my call. And then you question what fear is valid to raise in the middle of the night to wake your pediatrician up.

I feel like every parent really deserves a hand to hold in those situations. And no matter how big or small the issue is, being able to reach someone who knows you know more than just Dr. Google and ask things like, “My kid has a fever of 103. When is it too high? Do I need to go to the ER?” So I wanted to give parents a place to be able to ask these questions and have a hand to hold. When you're reaching out to Blueberry, it's always going to be a board certified pediatrician you're reaching. So whether we're gonna tell you it's okay and give reassurance, that reassurance is worth just so much in terms of what it gives that parent or to know what to look out for.

So at least I have the parameters in my mind as the parent at home, nervous about what's happening. Do I need to wake him up every few minutes? Do I need to keep taking the temperature? When should I wake him up to give him medications or should I just let him sleep. So many questions. So you get all those answers and we don't go away. You always are frazzled on the phone or whatever it is, but we can continue to be present and answer questions and that's why we make ourselves available 24/7. So the long answer is support to parents that I think is deserved. Kids do not come with a manual and they don't follow the rules of even whatever you might read online. I think giving parents a doctor in their pocket who was almost like family was just so important.

Dr. Whitney: Absolutely. And the board certified pediatrician part matters so much. I mean, it matters to me so much as a clinician, right? I see patients part-time in my clinic and then also do my Modern Mommy Doc stuff. And when people come to me and say, oh, my friend told me to do this, or this other healthcare provider person told me. But they don't really know what their credentials are. To have a board certified pediatrician be able to say, this is the thing to do is a really big deal. Now there's lots of other pieces and parts of a healthcare team and of a community, but there is something about having that reassurance from an expert that makes a huge difference for parents.

You know, one thing really struck me about what you said. Parents feel alone more and more and more. That is the crux of the issue that I feel it comes down to, for moms specifically. So what I find is when I put up a post, for example, on Instagram that's funny, it has Paul Rudd and it says something about, this is me with my friend because of life and the second shift and kids' illnesses and school breaks. And it's Paul Rudd and somebody else going, oh my gosh, we got together. Oh my gosh, we did it. We're really here. We did it. That's funny. But I think that speaks to this feeling of moms feeling like 99% of the time, they're doing it on their own. Dads feel like they're doing it on their own, that they are alone in the world. And that's probably what our society has done to us. It's created a lot of isolation. But what I see you saying is technology can also be the thing that makes it so people don't feel totally alone all the time.

Dr. Garbi: Yeah, absolutely. There's no need to feel like that with technology now. We have each other. We have a resource for you to reach out to. I've experienced that feeling myself. It's a terrible feeling. No one has to go it alone. There are resources, there are ways, there are answers to questions and hopefully Blueberry can provide that. That's our goal.

Dr. Whitney: The other thing you talked about was this idea of parents feeling maybe a little bit unsure of themselves about whether this is the moment that I actually should reach out to a pediatrician. Is this worthy of a call? So I think that's huge as well, because a lot of people don't wanna bother people if they're sleeping. But Blueberry, because it's set up as being 24/7, it's basically like you're not bothering anybody because this is their job at this moment to be available to you. Can you talk about what the majority of calls are that you get? Is it mostly sick calls? Are you getting behavioral calls? Do you get a lot of calls at three o'clock in the morning? Because I wanna reassure parents who might be thinking about adding you to their team and reaching out to you of the things that are totally normal for you to get calls about and that you feel happy taking care of.

Dr. Garbi: So many points I can touch on there. So what do we get called about? And yes, we are getting messages in the middle of the night for sure. It really runs the gamut, but I think viral symptoms are the most common things for when you have a young child or even older. But for the most part it's that runny nose, cough, congestion, ear pain, eye gunk, the lingering cough. These are things that happen all the time to everyone, especially if they're kids around in the world and daycare, school, whatever it is, camp. Now those are all very common.

Through Blueberry, you can reach us two ways. One is through a visit where you're going to end up speaking with a pediatrician and you can send over videos and messages and just extra little pieces of information. We send home a kit, so that you have an otoscope, which is what you use to look in an ear like your pediatrician's office to see the eardrum and the canal. We send home a pulse oximeter, so that tells us how much oxygen there is in the blood and the heart rate and we send home a thermometer. So with those tools, we're able to make more diagnoses from home.

The second way to reach us is by messaging. So you text as if you're texting with a friend. And so that's actually the greatest avenue for the parents who are like, I don't know if this is worth it. Or I just have a little question and I don't need a trip to a pediatrician. I just need to ask, how do I figure out the dosage of Tylenol? Or is this little picture of how I nicked my kid's finger when I cut the nail, is this okay? Or maybe it's, do I need to start a whole visit and have you on the phone and send you images, because I'm not sure. So that's the perfect modality for these other questions. My passion is that sweet spot of that new mom. Even if it's not your first time being a mom, you have a baby and that time can be very intimidating to a lot of parents. So to be able to answer the little one-off questions about sleeping, about nippling, about how they play tummy time. Yeah, those are for sure where we get a ton of questions and we're so happy to be able to field those as well.

Dr. Whitney: Yeah, I love that. Honestly, there are times when at our office with in-person pediatrics where people have questions, they either A) feel bad about asking the question because they feel like they're bothering someone or B) the question that they're asking is something simple like, how much tummy time does my baby need? Or how do I actually make them like tummy time? They hate tummy time. What are some ways so I'm not torturing them? How long do I do tummy time? And to be able to not have to wait on a response for a day, but instead be able to text in real time with someone about that question before you forget to send the email is huge. It's so much more convenient on a phone or on an app, or on a desktop feature to be able to get the response right then, because as moms, we have so much on our brains, so much of that mental load that sits with us. I mean, half the time you forget to send an email or to ask the question when you're on the visit anyway, you know.

Dr. Garbi: Yeah, absolutely. I mean I couldn't agree with you more. I would love to just touch on the point about having board certified pediatricians. A portion of the population for Blueberry that we're so proud to be able to help and serve is people who are in rural communities who don't have access to pediatricians as easily. We are helping people who are one hour from a doctor's office who are adult trained or an urgent care versus three hours to a child pediatric hospital. When resources are limited, we're so happy to help. A lot of people don't know that when you go to the urgent care down the street, you're not always guaranteed to be seen by a person who's trained in pediatrics.

We always say in pediatrics, children are not little adults. They are a very separate and specialized population that we as pediatricians train for three years in residency. And then even subspecialization is three years beyond that. It's a really important thing to see someone who's pediatric trained. So maybe there’s an urgent care down the street and maybe they're staffed with someone, but you also never know what you're gonna get when you walk in anywhere. So at least you can have us in your pocket, should you have to go in person, as that first layer of support. We are there, we're reachable, we're gonna get back to you super fast within an hour., And then we can help you navigate the medical field around you as well, which is completely valuable within itself too.

Dr. Whitney: Yeah. How does that work with the kit? So in terms of the otoscope specifically, I'm wondering, does it take a picture and that gets sent to you or do the parents learn how to use the otoscope? Are they able to look at it themselves and describe it to you? How are you guys using that?

Dr. Garbi: Yeah, so it's actually a wireless scope that is put in the ear and can see the image that it's reflecting. It's just like you're taking a video with the camera. It's just the camera's tinier than the ear and then video is recorded and then they just upload it to our site so that we can look at it and make the judgment call as to whether there's an infection or not. It can be very difficult even in office for a pediatrician to get into an ear depending on the child, the situation and the parents. It can be difficult sometimes. So we do give coaching, we send pictures, but it's certainly a valuable tool if we're able to get the proper images.

Dr. Whitney: Oh my gosh. When you have a child who's sick and who's febrile and who's not feeling good and having terrible ear pain, to get them in an office to let someone look in their ear can be traumatizing for the patient. But if the parent is actually able to get a good enough image that the person doesn't have to leave the comfort of their home to go to a visit, that's amazing. Now, I know that you also collaborate with other pediatrics offices, so that obviously it's not a replacement for all things pediatrics. You want people to be with a primary care physician. It can add an extra layer of care, an extra part of that team. Is that correct? Am I getting that right?

Dr. Garbi: Yes, that's exactly how I would put it. It's an extra layer of help and support. We very much wanna focus on keeping families within their medical home, which is a pediatrician. Hopefully out of the ER, hopefully out of urgent cares, especially those that are not staffed with pediatricians. And we love to collaborate with pediatricians. They usually will get a report if the parents have given us their consent so we could send the information to the pediatrician about the child. We absolutely are not meant to be a replacement for the pediatrician. We are augmenting that.

Dr. Whitney: I really feel so deeply in my heart and my soul that this has to be the wave of pediatrics. If we really want care to be patient-centered, it needs to be with things like you are doing, where there's augmented care outside of normal hours. Outside of hours where parents are working and maybe they only have two seconds to get home and get that picture of the ear or have their childcare provider take the picture of the ear and then be able to send it to them and they can send it to you. I think that you have to be thinking outside the box if we actually wanna meet parents where they are and to be able to speak the language of parents.

Dr. Garbi: I agree. We work so hard, as parents with kids with work, to provide for those who have jobs outside the house. Often they're taking a half day or even a whole day for a sick kid to get to the office. I've experienced it myself with my own kids to have to do that. Some parents are home with three kids and then what do they have to lug all three kids into the office for that one sick child? Which is just so hard. So yes, there are better ways. I agree. I think that this is just the beginning of the wave of the future.

Dr. Whitney: Yeah. That's so great. What is up next for Blueberry Pediatrics? I don't know how many providers you have or how you're growing. I'm hoping that you're getting all kinds of funding because what you're doing is so powerful. I mean, on a basic level, providing care, but also I think on a empowerment level and a bigger societal level of, again, creating change and more support for working parents in particular.

Dr. Garbi: So right now we're available in 18 states. We're working on opening up in 11 more, so that would cover 29 states across America. And that covers, I think, I don't wanna say the wrong number, but it's upwards of 75% of the population of children across the country. So we're working on that. We also would love to create more partnerships with insurance companies. We think there's a big win-win there to keep children out of the ER and urgent care, lower the cost of medical care, and reduce the burden on pediatricians. So I think that there's a lot of work to be done. We are so excited about how we could contribute to the medical field of pediatrics and help families across America.

Dr. Whitney: Yeah, absolutely. If people wanna find out more about signing up for Blueberry Pediatrics, tell us about that. Does it have to be through an employer? Can it be an individual person who accesses Blueberry Pediatrics? How can they get involved?

Dr. Garbi: So we are primarily direct to consumer, which means you just go to our website and you sign up www.blueberrypediatrics.com. We're $20 a month, which is for unlimited access to a board certified pediatrician. There's a one-time kit fee and then nothing else added. So you have unlimited access to us. And then you can look at us on Instagram and Facebook, Blueberry Pediatrics, on both of them. We are available through some employers, not many. And then right now, we are starting to become available through insurance companies but that will take time.

Dr. Whitney: Yeah, absolutely. Well, it takes time. I think the healthcare insurance companies have to see the data, right? Well, like, show me the money. So we have to show first that this will, in fact, reduce hospitalization and it will reduce ER visits, reduce healthcare costs. Although, obviously, it's a no-brainer. The middle of the night, the weekends, the days when people cannot come in to see us, those are the times when people are utilizing the ER because they're scared, because they feel alone, because they need help right then, because they have to get back to work, because they're paying for childcare, and they don't wanna miss out on the opportunity for their child to be there if they don't have to. So I'm so excited about what you guys are doing and I'm so happy that you were here today.

Dr. Garbi: Thank you. Thank you so much. I'm so glad I could be here.

Dr. Whitney: Yeah, tell me exactly where people could find you. So tell me what the Instagram handles are, where people can find you on the internet.

Dr. Garbi: Yeah, so our Instagram is @blueberrypediatrics, and then if you're on Facebook, it's just Blueberry Pediatrics. And then at the website, www.blueberrypediatrics.com. There's a list of states where we're available in the FAQ at the bottom if you wanna look that up.

Dr. Whitney: Awesome. Thank you so much Dr. Garbi, really appreciate you being here.

Dr. Garbi: I so appreciate the invitation. Thank you.