Dr. Jalayne Lapke is program director for the Pediatric Residency Program at the University of Illinois College of Medicine at Peoria, where she’s also an associate professor of clinical pediatrics.

Additionally, Lapke is an examining physician with the Pediatric Resource Center and spends time as pediatric inpatient service attending at the University of Illinois College of Medicine at Peoria and at the Children’s Hospital of Illinois/OSF Saint Francis Medical Center. She was also named a Caterpillar Faculty Scholars Fellow last year.

Some of Lapke’s many professional and community service positions include being a member of the Pediatric Resource Center committee at the University of Illinois College of Medicine at Peoria; a member of the Swain Endowed Lectureship at UICOMP; and a member of the Children’s Hospital of Illinois Steering Committee, Advisory Committee, and Pediatric Peer Review Committee.

She and her husband, Bob, have one daughter.

Tell about your family, schools attended, etc.

I’m an only child, born and raised in Mt. Vernon. I was active in my school and church growing up-yearbook editor, cheerleader, student council, church choir, and church youth group president-and worked in the summers as a swimming and diving instructor and later as a nurse’s aide. I went to Millikin University in Decatur, majoring in psychology and biology. I also studied philosophy, pottery, and piano there, and learned more philosophy and creative writing-and snow skiing-during my winter terms.

I received my MD degree from the University of Illinois College of Medicine in Peoria and completed my internship in pediatrics at the University of Michigan. I completed my pediatrics residency at the University of Illinois College of Medicine in Peoria and have been here ever since. For the first several years, I served as associate program director, and for the last 12 years as program director for the Pediatric Residency Program.

I met my husband, Bob, on a Peoria Ski Club trip to Salt Lake City, Utah. He works as a senior project engineer for Caterpillar, Inc. We have one daughter, Jennifer, who’s 12 years old and going to be a seventh grader at Peoria Academy. Jenny and I are both in Peoria Community Theatre’s Bye Bye Birdie this summer. I spend my spare time being a room Mom, a gym Mom, scrap booking, gardening, quilting (in spurts), and playing and skiing with my family.

Who or what influenced you to become a pediatrician?

I owe my basic self-confidence and "I can do that" attitude to my parents, who provided me with love, unconditional support, and encouragement every day of my life. There were two other specific influences-the first a psychology professor at Millikin, Dr. Gordon Forbes, who was a wise and caring counselor. He helped me realize my initial hesitancy in pursuing medicine was wisdom-based rather than the red flag I assumed it meant. He encouraged me to follow my heart. The other is Dr. William Albers of Peoria-teacher, mentor, scholar, and friend. As a medical student and resident, I witnessed the relationship he had with his patients and their families-truly caring. To this day, I want to be like him-an excellent pediatrician, scholar, and teacher.

What surprised you the most as you went through the process to become a physician-or after you began practicing?

It surprised me that medical school was so much fun and that I could help people even at that early level of training. I think I expected it to be grueling, and the rewards would come afterward. It was hard work, and being a pediatrician is even better than I anticipated it would be. The other surprise is the sheer volume of paperwork required to practice medicine in this day and age.

What does your job as program director of the Pediatric Residency Program at the College of Medicine at Peoria involve?

I’m responsible for the education and wellbeing of the physicians who are training to become pediatricians. I don’t do this alone, of course. There are many others who provide significant education-patients, families, nurses, faculty, etc. I help establish and maintain the residents’ learning environment so each resident becomes a good, independent pediatrician by the end of his or her three years of specialty training. This involves teaching, supervising, modeling professionalism, enlisting faculty participation, listening, celebrating, encouraging, and sometimes crying with residents. I’m proud to help shape and share in this very important time in their professional lives.

How is your role as academic different from your role as a practitioner? What are the challenges and rewards of both?

Most people know what a pediatrician does as a practitioner. I do those things too-make rounds in the hospitals, see new babies, and see patients in the office for both check-ups and illnesses. I listen and advise. I consider what I do as a pediatric practitioner mostly teaching-teaching parents and adolescents how to recognize and care for common illnesses, recognizing normal from abnormal, how to promote health, when to seek care, how to treat common illnesses, and when to worry. My biggest reward as a practitioner is the relationship I have with the children and their families. It’s a real privilege to be a part of their lives.

My life as an academic pediatrician revolves around being the program director. It includes teaching residents, developing and overseeing an overall plan for resident education, guiding and organizing the faculty toward the same common goal of excellent training for physicians who’ve just graduated from medical school to become specialized pediatric doctors, advocating for the residents’ needs, and role modeling. When I think of "academic" I hear "curious, inquisitive, up to date with the current literature, and researcher." I try to emulate all of these qualities. My greatest reward as an academic pediatrician is seeing inexperienced, enthused, newly-degreed physicians blossom into competent, confident pediatricians. I feel honored to be a part of their lives and careers.

Our community is privileged to have the Children’s Hospital of Illinois located here. How important is that to a community?

The Children’s Hospital of Illinois (CHOI) is definitely a benefit to our community and to the health of the children throughout the 28-county area of North Central Illinois that we serve. The Children’s Hospital, in conjunction with the University of Illinois College of Medicine, attracts pediatric specialists, elevating the standard of care to levels found only in larger cities. The Children’s Hospital is a major referral center for both inpatient and outpatient services for children and teens. We have outstanding pediatric subspecialists, surgeons, nurses, rehabilitation specialists, therapists, and counselors.

Some of our University physicians are doing cutting edge research and are national-and even international-leaders in their fields. Our critical care services for children of all ages, including newborns, along with the talents of pediatric surgeons and pediatric subspecialty surgeons, provide excellent emergency care for Peoria and our entire region. In fact, we’ve been designated a Pediatric Critical Care Center by the Illinois Department of Public Health.

The Children’s Hospital and the College of Medicine are part of what makes this community a great place in which to live. To have this level of care here in Peoria means our patients can stay close to home for excellent care, including very specialized services.

How has the specialty of pediatrics changed in the last 10 years? In diagnosis? In family situations? In regard to insurance coverage? Well-baby checkups, etc?

The practice of pediatrics has remained constant in one very important way-pediatricians care and advocacy for children’s health. There have been changes, though: more paper work; insurance-guided or restricted providers and referrals; more rules requiring more documentation on charts; more rules governing privacy of patient information and records; more electronic charting and record-keeping; more antibiotic resistance (the bacteria that cause many of our infections aren’t killed by our current antibiotics, as they used to be); more public advertising of medicines and formulas; more patient-directed education via the Internet; less trust of physicians and the medical system; markedly higher malpractice insurance rates; more mental health problems among children; less trust of vaccines by parents; more empowered parents partnering with pediatricians in the care of their children; more nurse practioners and physicians’ assistants; more working moms; more appreciation for the significant impact community (family, neighborhood, school, religion, etc) has on children; more bio- and information technology; babies born very prematurely surviving and doing well; more ADHD recognized; more judicious use of antibiotics by both parents and pediatricians; more quotas for pediatricians (patients they’re expected to see per day); more pediatricians employed by hospitals; more information readily available to parents via the Internet; more obesity; more and better allergy and asthma medicines; more evidence-based practice guidelines; less state and federal money for educating medical students and residents; more genetic information via the Human Genome Project; more laparoscopic, less invasive surgeries; more fast food and obesity; more travel and mobility; and less extended family readily available.

Some of these changes are good; some aren’t. Many of these changes reflect how our society has changed and require a societal solution to promote health in children and their families.

Is there a shortage of physicians entering the specialty of pediatrics?

In general, the USA has sufficient pediatricians, but they aren’t all distributed in the areas that are needed. There’s been a shortage of certain subspecialists across the country-pediatric neurologists, psychiatrists, and endocrinologists.

We’ve recently read that obesity in children is a growing concern. What’s the most common diagnosis seen in pediatrician’s offices today?

Yes, obesity is a growing concern (no pun intended) among American children. There are more prepackaged or fast food meals, more high-calorie snacks advertised on TV, more TV time, and more computer time. The most common diagnoses seen in the office today, other than well children there for check-ups, include allergies, asthma, ADHD, and common acute illnesses such as colds, sore throats, ear infections, vomiting and diarrhea, fevers, and rashes.

You’re a member of the inaugural class of Caterpillar Faculty Scholars at the College of Medicine at Peoria. Tell about that program.

I was honored to be selected to become a Caterpillar Scholar. Several years ago, Caterpillar donated money to promote faculty development in the primary care medical specialties (pediatrics, internal medicine, family practice). Drs. Gordon Woods, Gwen Lombard, and Lynne Meyers and their steering committee decided an important way to promote primary care medical education was to empower and train faculty leaders in these fields. They began this fellowship to do just that-enhance faculty development in the areas of leadership, research, and education.

The fellowship is 16 months long, and each of us is required to conduct an original project of interest to us. We attend lectures one half day per week and work on our projects in addition to performing our regular duties. It’s been very educational, and I’ve already applied some of the things I’ve learned in my teaching and leadership. My project involves redesigning the curriculum on community pediatrics and advocacy-or training pediatric residents to advocate for the health and wellbeing of children within a community.

You’ve presented on the "Prevalence of intrauterine drug exposure in a Midwest community." How common is that in the Peoria area, and what are the long-term effects for the child?

I performed this prevalence study in 1991, and at that time, the Peoria area had a very low prevalence of intrauterine cocaine exposure (less than 1 percent of all births at all three Peoria hospitals). There hasn’t been such a study since. At the time of my original study, others in some large cities reported that up to 25 percent of all births were to mothers who used cocaine during pregnancy. All studies showed that babies born to cocaine-using women were more likely to also have Hepatitis B and other sexually transmitted diseases, and speech delay if the baby remained with the drug-using mother. If the mother no longer used drugs, or if a loving, non-drug-using family reared the child, he or she wasn’t at risk for developmental delay or speech delay.

It was estimated that up to one-third of children exposed to cocaine during pregnancy were later diagnosed with ADHD. When one author tested mothers and their children, the IQ and diagnosis of ADHD were similar in the mother and the child, indicating that perhaps the ADHD was inherited rather than caused by the intrauterine drug exposure. In our follow-up study of how children who had been drug exposed developed, there was also a higher incidence of eczema. Even though there are higher incidences of certain conditions in those children exposed to cocaine in utero, most children were normal. All of the children we studied were in foster care. A longer follow-up study of the outcomes of these children will answer many of the remaining questions of what these drug-exposed babies grow up to be as adults.

What would you most like parents to know in regard to their children’s health? How can they best influence healthy lifestyles in young children?

Love them. Spend time with them. Treat them with respect. Expect good things from them. Teach them to mind you and other adults. Teach them to disagree respectfully once they’re 12 or older. Read to them early and often. Offer healthy foods-they learn to like what they’re familiar with. Limit TV and computer time to one hour a day (both are isolating and sedentary). Exercise as a family. Play together as a family. Promote education. Let them make some choices. Teach them what you expect from them. Praise them often, but be sincere. Tell them you love them often. Listen to them. Have meals together, and share your day’s events. Discuss your values and religious beliefs. Listen to theirs. Let them try things they think they can do. Ask their opinions. Hug them often. Immunize them. Model healthy habits-eat right, get plenty of sleep, exercise regularly, and live your beliefs. Say "no" when appropriate. Let them go when it’s time.

What trends in pediatrics do you see in the future?

The care of children’s health in the future may involve more nurse practioners and HMO-directed care. I believe there will be more division of labor with specialists in outpatient care and more specialists in hospital care. More consultations will be performed via the Internet, with transmittance of videos, photos, and "face-to-face" conversations via the Internet rather than many patients traveling hours to see a specialist.

Pediatricians will be handling patients with complicated mental health problems. Pediatricians will find it necessary to partner with community agencies, schools, churches, and caregivers to help the communities help their children. I expect electronic records will be the standard, and technology will help bring the pediatrician more to the children, rather than to the paperwork (let’s hope so).

Pediatricians will always care for children-doing their best to diagnose and treat illness, promote health, and teach parents-and children as they get older-how best to care for themselves. Pediatricians go into pediatrics for many reasons, but I’ve never known anyone who didn’t truly value the caring, helping, teaching relationship they developed with children and their families. I doubt that will ever change. TPW