Pediatric Nephrologist Helps Patients Cross Language and Healthcare Transition Barriers

A visit with her own childhood pediatrician is always on the schedule when Anita Tambay Perez, M.D., Assistant Professor of Pediatrics and a pediatric nephrologist at MUSC Children’s Health, goes home to Miami. “He’s one of the reasons I was inspired to go into medicine,” says Perez. “He was such a wonderful pediatrician and person. He seemed to enjoy his work so much, it made me think, ‘Wow, this looks like a good thing to do’,” says Perez. “Every time I go back home, I try to stop by to see him. He gets such a kick out of having someone he treated as a child follow in his footsteps. I want to build strong relationships with my patients and their families the same way he did.”

Perez comes to MUSC from Children’s National Hospital in Washington, DC, where she completed a fellowship in pediatric nephrology. Prior to that, she completed medical school at Ponce Health Sciences University in Ponce, Puerto Rico and a residency at Cohen Children’s Medical Center of New York/Northwell Health in Long Island.

It was a sense of community and family that drew her to MUSC. “I love the energy in this department. They’re family-oriented people who love what they do,” says Perez. “Their enthusiasm for their patients is contagious, but they also value work-life balance. You can’t do the best for your patients if you’re not taking care of yourself. When your work culture doesn’t value the same things you do, it can lead to dissatisfaction. Many of my colleagues have been at MUSC for a long time, which tells me that they feel supported and happy here.”

This culture of mutual support underpins the multi-disciplinary, holistic approach to care that is a hallmark of MUSC Children’s Health. “We work with nutritionists, social workers, and nurse patient advocates taking care of our patients as a team,” says Perez. “Primarily, we manage kidney disease which is quite complex and requires long-term care and, sometimes, many clinic visits and hospital admissions. We consider all aspects of the patient’s health–their cognition and neurological progress, how much school they’re missing, and how their treatment is affecting their siblings. We end up being almost like primary care physicians for some of our very ill children.”

One of the things Perez likes most about pediatric nephrology is the variety. “We see a wide spectrum of patients–some are relatively healthy and have smaller complaints while others are in the ICU (intensive care unit) or on dialysis,” Perez says. “We form a strong relationship with the patients and families we see for several years. That’s really important because I value being honest and up front with the family–especially when we have to discuss a difficult diagnosis like renal failure or the need for dialysis or transplantation.”

Perez clearly remembers the patient who turned her path toward nephrology in medical school. “I did a research program one summer at the Albert Einstein College of Medicine. There was a patient in clinic one day who was 17 or 18 and transitioning to adult care. She was diagnosed with kidney disease as a toddler and had been transplanted. Now she was going off to college and moving to adult care,” says Perez. “Seeing the connection with her healthcare team as she thanked them for everything they’d done for her was so moving. They’d watched her grow up and helped manage her disease for her whole life. When I saw that, I knew this was the subspeciality for me. I want to be able to make that kind of an impact on a family.”  

Perez is particularly interested in helping patients navigate the transition from pediatric to adult care. She hopes to work with her MUSC colleagues to optimize this stage of care for chronic kidney disease patients. “In pediatric care, we hand-hold a lot and patients get a lot of one-on-one attention. But, when they transition to adult care, they become one of hundreds of patients in a practice. I want to help them move to adult care smoothly and avoid any medical problems during that shift,” says Perez. At MUSC Children’s Health this transition is also a multidisciplinary effort. “While they’re still under pediatric care, we help them start forging a relationship with the adult team. Long before we let them go, we start saying things like, ‘In two years, you’ll be going to adult care.’ Little-by-little, we give them more responsibility as they’re able to handle it to ensure their transition goes well.”

ADVERTISEMENT

Perez is also bi-lingual which is a distinct clinical advantage since many Spanish-speaking patients usually receive healthcare through a third-party translator. “It’s not the same as speaking in your native language directly to the physician. When they don’t have to use an interpreter, it improves our relationship and builds trust, and their outcomes improve.” Perez hopes to carve out a clinical practice niche providing care to Spanish-speaking patients and families. “I’d like that to become my special corner of the clinical world. It could ease the burden on other providers and make the process of care more efficient for the patients as well.”

Perez is currently accepting new pediatric outpatients at MUSC's R. Keith Summey Medical Pavilion in North Charleston. If you would like to make an appointment with Dr. Perez or refer a patient, please call 843-876-0444.