As your Medical Home, we are committed to creating an experience of well-being for your child and family. Together, we will pursue your health goals and dreams.

Metropolitan Pediatrics

Sports Physical or Well Check: Is one better than the other?

Young american football player running back breaking away from an attempted tackle.

If your child or teen plans to participate in fall sports, now’s the time to schedule a well check. When we say well check, we don’t mean a sports physical – the two are actually quite different. Let’s go over the differences, and why you should consider a regular well visit to make sure your young athlete is healthy enough to play!

A sports physical is a very limited exam that only focuses on a patient’s current and past medical conditions, which might affect sports participation. During a regular well check, we assess your child’s overall health and well-being, addressing many topics and concerns that a sports physical would skip. We’re talking important things like growth, development, puberty, immunizations, academics, sexual activity, and social-emotional issues. And we’ll answer any questions you or your child may have regarding health and wellness.

Our friends at Dayton Children’s Hospital put together an eye-opening list of some pretty serious things that could be overlooked during a brief sports physical:

  • A 17-year-old female who has migraine headaches, menstrual cramping, and questions about birth control could be cleared for sports without talking about any of these issues.
  • A 14-year-old male who has school difficulty due to bullying, and who has not started puberty, could be cleared for sports without addressing any of these issues.
  • A 12-year-old female whose family has a rare form of genetic cancer, but is not personally having any symptoms, could be cleared for sports without any additional screening.
  • A 15-year-old male who is feeling pressured by his friends/teammates to smoke marijuana, but is scared of saying no or finding new friends, could be cleared for a sports physical without talking about it.

Here’s a side-by-side comparison of a Well Check and a Sports Physical (also from Dayton Children’s):

Well Check Sports Physical
  • All medical problems, including personal and family medical history
  • Full physical exam
  • Monitor year-to-year growth compared to peers
  • Review all developmental issues appropriate for age
  • Age-appropriate screening labs
  • Vaccinations
  • Referrals if needed for any of the above
  • Medical problems, which affect sports participation (e.g., old injuries, chronic conditions like asthma)
  • Inherited problems, which affect sports (e.g., genetic heart conditions)
  • Check for specific findings, which affect sports
  • Check height, weight, and BMI
  • Review common subjects related to sports (e.g., signs of concussion, proper nutrition, hydration)
  • As needed labs
  • No vaccinations
  • Referrals if not cleared for sports

Here at Metropolitan Pediatrics, we want your child to be at his or her healthiest (and happiest, too!). Regular well checks help ensure that kids are growing and developing as they should. And they are more thorough, allowing us a chance to find and address concerns early – not just those related to sports. Bonus: Annual check-ups are 100% covered by most insurance plans, and also fulfill the requirements of a sports physical.

Save Time. Save Money.

If your child has been seen for a well check within the past year and has no major medical concerns, we will complete and sign the Medical Provider portion of the participation forms, free of charge. Parents or students must also complete their portion, but it’s quick – we promise! An additional sports physical or appointment is not necessary.

Recommended Insect Repellents

žWhen used as directed, Environmental Protection Agency (EPA)-registered insect repellents are safe and effective for children as well as pregnant and breastfeeding women. Learn more about using insect repellents safely and effectively here. Our pediatricians and advice staff are also happy to answer any questions you may have.

Below are some highly rated products for safely repelling mosquitoes, ticks, and other insect pests:

Product Active Ingredients
All-Terrain Kids Herbal Armor Soybean oil, 11.5%; citronella oil, 10%; peppermint oil, 2%; cedar oil, 1.5%; lemongrass oil, 1%; geranium oil, .05%
Avon Skin-So-Soft Bug Guard Plus Picaridin Picaridin, 10%
Avon Skin-So-Soft Original Bath Oil None stated
Ben’s 30% DEET Tick and Insect Wilderness Formula* DEET, 30%
Burt’s Bees Herbal Castor oil, 10%; rosemary oil, 3.77%, lemongrass oil, 2.83%; cedar oil, .94%; peppermint oil, .76%; citronella oil, .57%; clove oil, .38%; geranium oil, .19%
California Baby Natural Bug Blend Pure essential oils of cymbopogon nardus (citronella grass), 5%; cymbopogon schoenanthus (lemongrass), .5%; Cedrus atlantica (cedar), .5%
Coleman SkinSmart IR3535, 20%
Cutter Natural Geraniol, 5%; soybean oil, 2%; sodium lauryl sulfate, .4%; potassium sorbate, .1%
Cutter Skinsations DEET, 7%
EcoSmart Organic** Geraniol, 1%; rosemary oil, .5%; cinnamon oil, .5%; lemongrass oil, .5%
HOMS Bite Blocker BioUD Mini Trigger 2-undecanone (CAS #112-12-9), 7.75%
Natrapel 8-Hour Picaridin, 20%
OFF! Deep Woods VIII DEET, 25%
OFF! FamilyCare Insect Repellent I (Smooth and Dry) DEET, 15%
OFF! FamilyCare Insect Repellent II (Clean Feel) Picaridin, 5%
Repel Lemon Eucalyptus* Oil of lemon eucalyptus, 30% (approximately 65% para-menthane-3.8-diol)
Repel Scented Family DEET, 15%
Sawyer Picaridin* Picaridin, 20%

*Indicates a top 3-rated product for repelling Aedus and Culex mosquitoes and ticks according to Consumer Reports.
**Does not contain certified organic ingredients.

Adapted from: Contemporary Pediatrics (June 2016). Zika virus: Top mosquito repellent recommendations.

Zika Virus


Key Facts:

  • Zika virus disease is caused by a virus transmitted by Aedes mosquitoes.
  • People with Zika virus disease usually have symptoms that can include mild fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, or headache. These symptoms normally last for 2-7 days.
  • There is no specific treatment or vaccine currently available.
  • The best form of prevention is protection against mosquito bites.
  • The virus is known to circulate in Africa, the Americas, Asia, and the Pacific.

[Source: World Health Organization]

What is Zika?

The Zika virus is primarily a mosquito-transmitted infection, but it can also be passed from person-to-person via sexual contact or from mother to child during pregnancy or birth. First discovered in Uganda’s Zika forest in 1947, the virus is relatively common in Africa and Asia. Last May an outbreak occurred in Brazil, and now the virus is making its way throughout the Western Hemisphere.

What does it do?

For most people, Zika does not cause any symptoms or permanent damage. About one in five people experience a brief, mild flu-like illness that lasts up to a week.

In pregnant women, the virus has been linked to microcephaly, a serious birth defect of the brain characterized by an abnormally small head. Another population of concern is individuals who develop temporary paralysis—called Guillain-Barré syndrome—after exposure to the virus.

Signs and Symptoms

  • Mild fever
  • Skin rashes
  • Conjunctivitis (red eyes)
  • Muscle and joint pain
  • Malaise (general feeling of being ill)
  • Headache

People generally recover well at home and are likely to be protected from future infections. Death from Zika virus infection is extremely rare.

Where will Zika go?

World health authorities expect the outbreak to eventually reach South Florida and the Gulf Coast to northern Argentina and Chile. Hawaii is also expected to be affected.

In the United States, all Zika cases reported as of April 1, 2016, have been travel-associated—no cases have been acquired locally from infected mosquitoes.


The best way to prevent Zika is to prevent mosquito bites! You can do this by:

If you can’t delay travel to these places, take the following safety precautions to reduce your risk:

  • Wear clothing that covers your arms and legs.
  • Use air conditioning or window/door screens to keep mosquitoes outside.
  • Apply insect repellent if going outside.
    • žWhen used as directed, Environmental Protection Agency (EPA)-registered insect repellents are safe and effective for children as well as pregnant and breastfeeding women. Learn more about using insect repellents safely and effectively here.
  • Use mosquito netting if you can’t use other means of protection: Cover cribs, strollers, and baby carriers!
  • Treat clothing and gear with permethrin or purchase permethrin-treated items.

If you have Zika, protect others from getting sick:

  • Avoid mosquito bites during the first week of illness.
  • If you are sexually active, use condoms every time you have sex.
    • Not having sex is the best way to prevent others from acquiring sexually transmitted Zika virus!

When to call us:

If you have two or more of the associated symptoms—mild fever, skin rashes, conjunctivitis, or muscle and joint pain—and you have recently traveled to an affected area within the past two weeks, please call us! We’ll help you take appropriate measures to reduce the risk of local Zika virus transmission.


Back to School Presentation

Back to School_p

Is your child’s school year off to a rocky start? The back-to-school transition period can be challenging for parents and children alike. In this informative presentation, we’ll discuss how to manage school anxiety and help your child build friendships, what to do if your child is being bullied, organization, nutrition, and MORE! We will be focusing on children in kindergarten through 5th grade, though many of the ideas presented may also be applicable to older children.

Thursday, September 24
6:30-7:30 pm

Metro Pediatrics
Happy Valley

Driving Directions

Jenny Williams, LCSW:

First Pediatric Practice in Oregon to Earn STAR Patient-Centered Primary Care Home Designation


Metropolitan Pediatrics Northwest recently received the state’s first STAR rating for a pediatric practice from the Oregon Health Authority.

Metropolitan Pediatrics is pleased to announce that its Northwest Office has received STAR Patient-Centered Primary Care Home (PCPCH) recognition from the Oregon Health Authority (OHA). This accolade is awarded to clinics and practices that deliver an advanced level of care – where patients come first, care teams involve the patient and their family, and treatment embraces the whole person. With this accomplishment, Metropolitan Pediatrics Northwest becomes the first STAR pediatric clinic in Oregon.

Being recognized as a STAR Medical Home is an important designation as it shows Metropolitan Pediatrics’ commitment to high quality, patient-centered care and building strong, collaborative relationships with patients and their families. Although Metropolitan Pediatrics is among more than 500 PCPCHs in the state, it is only the third practice to receive STAR designation, which the OHA reserves for “trailblazers in practice transformation.”

To earn STAR designation, a clinic must demonstrate its ability to provide comprehensive services that support patient needs, such as convenient access, clear communication, and involvement in care. In addition, applying clinics must also successfully pass a site visit, verifying that all of the PCPCH Standards attested to are being met.

In the coming months, Metropolitan Pediatrics’ additional locations in Gresham, Happy Valley, and Beaverton will each undergo site visits to determine whether they too meet STAR criteria. Metropolitan Pediatrics’ ultimate goal is and will always be to provide the best, most complete care for every patient, every day, at every Metropolitan Pediatrics clinic.

What’s up with the color PURPLE, doc?

Whats up doc

April is National Child Abuse Prevention Month, and here at MP, this is near and dear to our hearts. As parents, pediatricians, and humans, we want all kids to be safe and happy in environments free from abuse.

So what exactly does the color PURPLE have to do with child abuse?

It is an acronym to help parents understand specific characteristics of an infant cry, and while it can be trying and frustrating, it’s most often normal and most importantly, temporary! Parental stress, frustration, and isolation are among the highest risk factors for child abuse, according to the American Academy of Pediatrics (AAP). Acknowledging that your child’s behavior during the PURPLE crying period is normal can help reduce this risk.

Peak of Crying – Crying peaks during the second month, decreasing after that

Unexpected – Crying comes and goes unexpectedly, for no apparent reason

Resists Soothing – Crying continues despite all soothing efforts by caregivers

Pain-like Face – Infants look like they are in pain, even when they are not

Long Lasting – Crying can go on for 30-40 minutes at a time, and often for much longer

Evening Crying – Crying occurs more in the late afternoon and evening

Check out this link to hear our very own Drs. Malcom and Powers talk about PURPLE crying!

Additional Resources

What’s up with my teen being so tired all the time, doc?

Whats up doc

We all know life can be rough when we don’t get enough sleep. This holds true from infancy into adulthood. Newer studies are examining what lack of sleep does to the teenager specifically, and surprise, surprise… teens need more sleep! Generally, about 8½ to 9½ hours each night on average. As any teen or parent knows, this can be difficult to accomplish, particularly when football, band, swimming, dance, theater, girl scouts, and [insert any number of extracurricular activities] keeps your child from even getting home (let alone asleep in bed) before 10:00 p.m.!

The good news? Delaying school start times can help your teen get enough sleep! The American Academy of Pediatrics recommends middle and high schools start at 8:30 a.m. or later, giving teens a chance to catch up on some of that sleep.

The adolescent biological clock is different than yours, moms and dads! Getting the recommended amount of sleep reduces the risk of depression, obesity, and car accidents, and sets your child up for improved quality of life. So catch some more zzz’s, my friends!

For more info, check out:

What’s up with meningitis, doc?

Whats up doc

Meningitis, an infection in the fluid surrounding the brain and spinal cord, is scary stuff! You have likely heard about the current outbreak of bacterial meningitis at the University of Oregon (since January, one student has died and five others have become ill with meningococcal disease).

What does this mean for your child?

Meningitis is rare (about 1,000-2,000 cases a year in the U.S.), which is great news. Whew!

HOWEVER, between 7-10% of people who contract the disease die, and about 30% will have long-lasting damage such as deafness, seizures, kidney failure, and brain damage. Meningitis is caused by both bacteria and viruses, and while both are contagious, viral meningitis is less often fatal.

Infants and adolescents/young adults, specifically those entering college or living in dorms or other close-contact situations, are at highest risk for contracting either type of the disease. Generally, it is transmitted through direct contact with body fluids while doing things like sharing a cup, kissing, or coughing. Symptoms of meningitis often mimic those of the flu – with fever, cough, neck pain, and fatigue being common – and often a rash later develops. This can make it tough to diagnose.

How can this be prevented?

There is no vaccine to prevent viral meningitis, but fortunately we have vaccines to protect against the most common causes of bacterial meningitis! Your infant will be (or was already) vaccinated with the Prevnar and Hib vaccines, which provide protection from pneumococcal and Haemophilus influenza type b disease, respectively. Currently, vaccination against the strain of bacteria (meningococcal type B) that is the culprit at the U of O is only recommended for a specific population of high-risk children with underlying medical conditions and those in the midst of the outbreak. That would be YOU, current U of O students!

The Menactra vaccine we provide in our clinic protects against 4 of the other most common strains of meningococcal disease, and should be given between 11-12 years of age with a booster at age 16. Ask your pediatrician if you aren’t sure your child has received this vaccine yet, and talk to us about ways to reduce their risk of illness!

What’s up with the measles, doc?

Whats up doc

Not-so-happiest-place-on-earth? The current explosion in media coverage regarding the measles, vaccination, and complications of the disease is directly related to an outbreak traced back to the theme park where most of us have fond childhood memories, Disneyland. As of the latest data (from mid-February), there have been 141 cases of measles across the US in 2015 – over 85% of which have been tied directly to Disney theme parks.

With measles still being quite prevalent in other countries and airplanes making travel to all parts of the world convenient, it is easy-peasy to bring measles back to our neck of the woods, which is why vaccination is more important than ever! Additionally, measles is soooo contagious (it can hang out in the air for 2 hours!) that 9 out of 10 people who are not protected will contract the disease if they come into close contact with an infected person!

The American Academy of Pediatrics, the American Academy of Family Physicians, and the Centers for Disease Control and Prevention all recommend that children receive the MMR vaccine at age 12 to 15 months, and again at 4 to 6 years. The most common side effects of the MMR vaccine are a fever and occasionally a mild rash. One dose of the measles vaccine is 93% effective, and two doses are about 97% effective in measles prevention.

Measles facts:

  • Measles is a leading cause of death among children, despite the availability of a safe and effective vaccine for the past 50 years!
  • Over 1 billion children have been vaccinated since 2001, yet 300 children still die each day from the measles.
  • Measles can be serious! Complications from measles can include pneumonia and encephalitis, which can lead to long-term deafness or brain damage.
  • About 2 or 3 in every 1,000 cases of measles in children results in death, even with the best care.

Initial symptoms (which appear 7-14 days after exposure) include:

  • Fever
  • Runny nose
  • Red eyes
  • Rash appears 3-5 days after the other symptoms

Your child’s health is a priority for us.

Call us if you are concerned your child may have been exposed to, is showing symptoms of, or needs to be vaccinated against measles!