Pediatric disease doctor trains others in rare specialty

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As cold and flu season ramps up, Dr. Chokechai Rongkavilit, known as Dr. Chai to patients and colleagues, knows he’ll be called to help tell the difference between these and coronavirus.

“The symptoms are very similar so it will be difficult to tell. We can’t know if they have a stuffy nose, fever, headache, which one it is,” he explained. “And with children we are seeing more gastro-intestinal symptoms like diarrhea with COVID.”

As a pediatric infectious disease specialist Dr. Chai often acts as a disease detective when symptoms are odd, unexplained or reoccurring. There’s only 1,500 doctors like him nationwide and only a handful in the Valley. “I take care of children and teens with any kind of infection. It can be bacterial, it can be a virus or it can be fungus or a parasite,” he explained.

In the Central San Joaquin Valley, Dr. Chai sees more than his fair share of children infected with the coccidioidomycosis fungus that causes Valley fever and babies at risk of syphilis. In 2017 and 2018, Fresno County had the highest rate of newborns with syphilis and while it’s improved, this year Fresno still ranks 59th in the nation for sexually transmitted disease rates. 

He might also be called in to treat a case of meningitis, when botulism or salmonella hits a group of school children, or to diagnose and treat severe respiratory infections like pertussis or tuberculosis.

Dr. Chai said he moved to the Central San Joaquin Valley from Michigan for the weather but has stayed because he sees great health needs here: “This area really needs more physicians and more specialists and I think I belong here.” As a UCSF clinical professor he’s the only one teaching the next generation of pediatricians to do similar medical detective work and treat the most serious infections.

Having access to a pediatric specialist like Dr. Chai reduces hospital stays, complications and healthcare costs and improves the quality of life for children with complex and chronic health conditions. Statewide, children have access to three times as many subspecialists as they do in the Central San Joaquin Valley. There’s one pediatric specialist for every 10,000 – 18,000 children in the Valley compared to 1 pediatric specialist for every 5,460 children statewide, a UCLA Center for Health Policy Research found.

Community has been working to fill that gap with its decades-long partnership with UCSF Fresno to train more pediatric specialists, and through a 10-year agreement with UCSF Benioff signed in 2015 to expand specialty medical care for Valley children.

Under that agreement, Community has added more than 30 pediatric specialists to its downtown Fresno campus, built a 12-bed pediatric intensive care unit and set up telemedicine access to even more pediatric specialists at UCSF Benioff Children’s Hospital, ranked among the nation’s top 20 children’s hospitals.

Dr. Chai said he gravitated toward infectious disease medicine because he “loves microbiology,” but his favorite part of his specialty is “seeing the results right away. I love that gratification when the patient gets well.”

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