For Jason Maxwell, pediatric medicine is not only about treating what might go wrong. It’s also about appreciating the energy and perspective of young people—how Maxwell, a self-described “kid person,” brings liveliness and compassion to everyday medical interactions.
After graduating from the Mayo Graduate School of Medical Education in 1999, Maxwell completed his residency in pediatrics at the University of Minnesota Amplatz Children’s Hospital in 2002. He currently serves as the HealthPartners Chair of Pediatrics and practices at the HealthPartners Como clinic in St. Paul.
The 2020 Minnesota Monthly Top Doctor‘s approach is family centered. In his role as a pediatric clinician at the Como clinic, he educates parents and guardians so families can make the best health decisions—even if that means going over time. “If I’m running 30 minutes behind, it doesn’t matter; I will take the time that you need today,” he says.
As an adamant believer in the assets of workplace diversity—and as a person of color himself—Maxwell also understands the power of giving underserved demographics attention. “If we give every single child in our population the ability to succeed,” he says, “it will make us a stronger nation.”
How has COVID-19 affected your day-to-day responsibilities and treatments?
Coronavirus has completely and fundamentally changed the way that we do medicine. As a doctor, you strive to know as much as possible, but we need to have humility, and sometimes tell our patients, ‘We just don’t know.’ We’re also doing a lot more telemedicine. Now a patient can get a telephone or video visit at the drop of a hat. This new model of care—in both the immediate and long-term—is a huge win for our patients. No matter where you are in this entire state, you can call us and get an appointment with me. The third way is that it helps us focus on what’s important. Some people have found the joy of cooking, or the importance of social connections. It’s the same thing for me. Not being able to see some of my patients for a month or two made me understand how much I love my patients. I have the best patients in the world.
Because of COVID-19, many families are delaying pediatrician visits. What are the risks?
The only thing I can think of that’s worse than a coronavirus pandemic is a coronavirus and a measles pandemic together. As pediatricians, we look with significant alarm at the collapse in vaccination rates that’s happening during this pandemic.
In addition to that, a big part of our jobs is to focus on social and emotional well-being. There is very strong evidence that shows that if we can keep a child on track from a developmental standpoint, that child is going to grow up and succeed. People are now facing pressures in terms of their finances—from losing or having decreased work options, and even losing their health insurance. If you have a child that has an issue with development, and if we miss that or if we delay that care, that child can unfortunately be impaired for the rest of their lives.
Why is health equity important?
Everyone should have the best shot to make the best life for themselves. That’s the heart of our country and it’s the core of what I believe. If you restrict a significant number of your population from doing certain things, you have reduced the likelihood that we will be able to achieve anything as a society. We’re excluding parts of the population from being able to achieve their dreams, and those dreams can be significant and can impact our lives tremendously.
If I restrict the access of certain races or cultures or ethnicities from our economy or our overall social fabric, then we are all poorer for that reason. This starts from birth. A person who is healthy is much more likely to succeed. I look at equity as more than a moral issue—it’s a practical issue.
If you look at me, I’m a child of color who grew up in an inner city—very, very impoverished—and I was extremely lucky that people gave me a chance. Because I was given a chance, I am in this position right now, and I think I’ve done a lot of good for the world. If we did not have equity, then I would not be here. Somebody else could be in my place, but they might work differently than how I’m able to.
What health disparities have you encountered in your field?
In a place that is not as affluent, you are going to see a lot fewer hospitals, a lot fewer clinics, fewer subspecialties. If you have good insurance, then you can afford the treatments. If you don’t, then you cannot afford the treatments. I’ve seen children who came in and saw me, and I have the perfect treatment for them, but the family can’t afford it. HealthPartners tries to combat that by maintaining a presence in our more disadvantaged neighborhoods.
In addition, one of the things that personally has affected a lot of people of color were the Tuskegee experiments. For me, they are a blight on our history. As a health system, even though many of us were not alive or practicing during that time, it is a part of our history, and that has caused a barrier in trust. Once you have a barrier in trust, it’s very hard to overcome. Families are coming to us with questions and concerns, and if they cannot trust that we are doing everything in our power to make sure that they are healthy, there’s no way for them to know whether they should follow our advice. In the past, we’ve had significant issues where we’ve lost trust, and deservedly so, of our patients and people of color, and now we have to work extra hard in order to earn some of that trust back.
What have been some exciting advances in treating children with complex needs?
One of the top things is advances in neonatal intensive care. When I started medicine, we were just having surfactant and the use of steroids emerge for premature children. Now, kids who used to have significant medical problems for the rest of their lives can breeze through life with a completely normal life expectancy and life ability.
It’s a little bit more esoteric, but having a more diverse workforce really has helped medicine. By opening up the doctor workplace to women and to people of color, we have significantly expanded the ideas that we can generate. Instead of a bunch of men, all from one demographic, deciding what we should research, we have people of color, we have women, and we have people from LGBTQ communities. We are trying to serve all of our patients, and not just slices of our demographic.
Electronic medical records have really helped reduce fragmentation of care. Now, a patient’s data can follow that patient and we can care for them much better. At HealthPartners, we reformatted all of our Well Child Care, so that no matter where you go in my entire system, you’re going to get the same level of care.
The passage of Tobacco 21 is a huge step in youth lung health. How can families and providers continue to address tobacco and vape use to keep kids safe?
The first part is always education. Then, we need positive role models. It’s not enough for a parent, or even a doctor, to say “smoking is unhealthy.” We need advocates within the community for the teenagers themselves, who can come and talk about the reasons why, from a teenage perspective, smoking and vaping is not the best idea. There’s no question we need to continue with legislation and taxes or surcharges to make things more unaffordable. The key, however, is to leverage the relationships we have with our teenagers. We see the reverse of this happened with vaping. You can see right away why a message that’s coming from parents isn’t going to work—part of the vaping desire is that it’s anti-adult, anti-parent. We need to redouble our efforts to really understand what is in vaping products, and educate our teens and preteens about the risk of nicotine, and we need to collaborate with them to create an effective campaign against initiating vaping.
What has surprised you about working as a pediatrician?
Over time, I’ve forged very deep bonds with my patients. I will do so much for them. If I have to work late for my patient, do the extra thing, come in on the weekend, or skip some vacation, I’m happy to do it, because that’s my family. As I’ve watched these children grow, the bonds I’ve developed with my patients are much more powerful than I was expecting when I was a 26-year-old medical student. When I run behind, my patients are fine with it, because they know that I was present with the person before, and they know that I’ll be present with them.