Taking Care of Kids, Solving Problems:
Five Questions for Scott Krugman, DMS '95

 Just two years out of his pediatrics residency at Johns Hopkins, Scott Krugman was named associate chair of pediatrics at Franklin Square Hospital in Baltimore. In 2002 he became the hospital’s youngest department chair. In his 12 years at Franklin Square, Krugman has been part of the hospital’s transformation from one of questionable quality to a top-quality community hospital that has earned recognition from US News and World Report and whose pediatric department was honored with the 2010 Health Care Delivery Award from the Academic Pediatric Association.

In addition to his clinical, administrative, and teaching responsibilities, Krugman is medical director of Franklin Square’s child protection team, which evaluates over 250 children each year, and he is deeply involved in issues relating to child maltreatment at the community, county, and state level.

Krugman visited DMS in March of 2010 to talk with students about his experiences in medicine, hosted by the DMS Bridging Program. Questions and answers have been edited for brevity and clarity.

Q: Why did you choose to go into pediatrics?

A: I come from a pediatric family. My grandfather was a pediatrician and my Dad is a pediatrician. When I was in high school, he ran the Kempe Center in Denver, which is a child abuse treatment and prevention center. Our family dinner conversations were about babies who had been shaken and had subdural hematomas and kids who were sexually abused. It’s a bit odd for dinner conversation, but it got me sensitized to what a vulnerable population children are.

I love pediatrics because you get to do the whole scope of medicine. And kids are amazingly resilient—they bounce. You can have the sickest kid about to crump on you, and three days later they’re walking out of the hospital smiling. It’s very rewarding.

Q: What stands out about your DMS experience?

A: I think the best thing I took from DMS was the opportunity to make a difference in the community. In my second year, I ran the community service committee. We did smoking cessation programs in schools and education at the senior centers to help senior citizens understand their medications. It was an empowering experience. We felt strongly that community service has to be part of your medical education—not just something you do in your spare time. The skills and motivation I took from DMS have translated into how I’ve kept doing things.

Q: What are some of the changes you’ve led since joining the staff at Franklin Square Hospital?

A: Three of us were hired right out of residency to create the pediatrics program at Franklin Square in 1998. We started a hospitalist program, and within two years our inpatient census fell to an average of three patients because of our improved efficiency and quality of care. In 2004, we created a combined pediatric emergency room and inpatient unit. It allowed us to free up space for the hospital’s orthopedic unit, and the kids didn’t have to be in the adult ER anymore. It used to be stroke patient, drug patient, two year old—not a good setting for kids. Now we’re the busiest pediatric ER after Hopkins in the state of Maryland. It’s a great way of delivering care.

Another major accomplishment for our department has been the development of a pediatric curriculum for our family practice residents. It’s been fun to be given the freedom to do things like this. Every time I come up with an idea, someone says, ‘Sure,’ and then we make it happen. This is what I love – taking care of kids and solving problems.

Q: Tell us about your work with child abuse treatment and prevention:

A: In the first two years I was at Franklin Square, we had five kids who were victims of abusive head trauma. At the same time, the ER seemed to be missing cases because no one was really trained. Our hospital is on the east side of Baltimore County, where there’s a lot of poverty, a lot of substance abuse, and a lot of child abuse. So we started the child protection team and got grant funding to hire a social worker to be available 24/7 to support the ER staff in handling cases where abuse is suspected.

We’ve been doing that for about 10 years now, and it’s been very effective. But after all those kids came in with head trauma, I figured we needed to work on prevention, too. So in 2005 we introduced an education program for new parents to teach them how to cope with crying, which we modeled on a program in Buffalo, New York. It turns out we haven’t had an infant shaken since 2006. That’s pretty big.

I’m also involved in a number of community and statewide organizations working on child maltreatment. I’ve been chair of the American Academy of Pediatrics Maryland Chapter Child Maltreatment Committee, I’m a member of the State Council on Child Abuse and Neglect, and I’m on the board of The Family Tree, which is a non-profit child abuse prevention organization.

Q: How do you see your role as an advocate for children?

A: There’s a lot of advocacy in pediatrics because kids don’t vote. No one is out there speaking up for kids except for advocacy groups for kids. And for the most part, kids are dying preventable deaths. I co-chair the Baltimore County Child Fatality Review Team, which is important, because if you know why kids are dying, you can fix it.  If you come with ideas about how to solve problems rather than just complaining, then all of a sudden you’re part of the solution and you get involved.

August 2010