Archived NEws


To Our Patients and Parents:

We hope you are enjoying the summer.  In this letter we have four announcements.

In the past year and half Ashley Flynn, LMHC, has been a member of our practice to provide consultation to our patients and families on a variety of behavioral and psychological issues.  She helped our patients tremendously by counseling in the areas of ADHD, anxiety, depression, parenting, and the like.  Ashley now will be moving elsewhere and taking another position by the end of August.  We are grateful for what she has given to our patients and will look forward to a future replacement counselor to fill her position.  In the interim, we will utilize other mental health counselors in the area for our patients.

We are excited to announce that we will be changing our electronic medical record/information system to a new, more advanced system called Epic.  This will begin at the end of August, 2017.  As we are part of the PPOC, we will join many other pediatric practices around Boston in making this change.  The decision was based on an agreement that a new system would help us deliver better service for patients.  We are currently training for Epic and will make our best attempt toward a smooth transition.  We ask our patients to be mindful of this as we work out the transfer of patient information.  We may, during your next visit, need to update items such as insurance and contact information.

We have been providing free books to our patients starting at age 6 months until 5 years of age during the well child visits as part of the Reach Out and Read program.   The purpose of the program is to promote reading by parents to children to encourage the joy of reading as well as language development.  The program’s major source of funding in the past came from the state, while contribution from our own practice accounted for some 10-15% of the books.   Then since the beginning of 2017 the state eliminated the funding entirely.   Our practice is now shouldering the entire cost of the books.   We are hoping that the state  may renew the funding for 2018.  Until then, I hope that some of our parents may donate some old children’s books that your children no longer read and help us sustain this program.   You may bring the books in a paper bag and inform our front desk, so we can acknowledge your kindness.

We developed a new logo for our practice, as shown below.  We hope you approve.


Pediatric Associates of Malden


Greetings to our patients and patients’ families.  This newsletter is intended to provide an update on our practice and recommendations for our patients.

First, it is that time of the year for flu vaccine again.  Please do call and make an appointment for the vaccine.  This year the flu vaccine in the form of nasal spray is no longer recommended for use because recent studies on its efficacy showed that it was not effective. Therefore, all flu vaccines recommended for this year are administered by injection.   Is the vaccine safe?  Rare adverse events may occur, such as Guillain-Barre syndrome, but it is more likely to occur with the actual flu infection than the vaccine.  The vaccine does not weaken the immune system, but trains the immune system to be stronger and more prepared for the real infection.  Is the vaccine necessary? Usually a viral infection such as a common cold can induce a fever response that lasts 2-4 days.  The flu tends to induce a fever that lasts longer.  So each time a school aged child has a respiratory infection such as flu, there is a good chance he/she may miss school for 4 days or more.  Each day a child is sick means a day of school is missed (for the child), and a day of work/wage is lost for the parent who has to stay home to care for the child.    The cough, nasal congestion and runny nose can last 2-3 weeks.  Other people who are close to the sick child can catch the virus and get sick as well.  Therefore, even from a financial point of view, vaccination against flu makes sense.

Second, we have been teaching first- and second-year medical students from Tufts Medical School and nurse practitioner students from Regis College and elsewhere.  With your consent, we teach the students on how to obtain a medical history, take vital signs, do a physical examination, analyze the problem(s), make a diagnosis, and then prescribe a treatment.  However, we feel that such “teaching” visits benefit our patients as well, because sometimes a student may ask questions about a patient’s illness that a parent, patient or physician has not thought of and may help in the diagnosis and treatment.  Therefore, it is a process of learning for them and for us, and extra time may sometimes be needed for a patient visit.

Third, Ashley Flynn, a Licensed Mental Health Counselor, has been providing counseling to our patients since March at our office.  She can provide advice to parents about how to deal with children with behavioral problems at home or at school.  She can offer advice to patients with attention deficits disorder, and she can offer counseling on grief, anxiety and depression. The advantage of having her available on site is that we physicians can talk to her about a patient’s needs directly and we can also get feedback from her more conveniently.  We believe that her presence allows us to be a more complete Medical Home for our patients.

Fourth, another person who is vital to the Medical Home is the Medical Home Care Coordinator.  We are fortunate to have Kelly Daugherty, who joined us in October to fulfill that role.  Kelly had previously worked in a similar role in Medford and Lynn.  She will help our patients with special needs to get appointments with specialists and to obtain services through various government or private agencies.  She will also send out reminders to our patients who are due or overdue for an annual well visit, and she will reach out to families who may have barriers to obtain healthcare for their children.

Fifth, a schedule of preventive health, or “well-child” visits has been recommended by the American Academy of Pediatrics, and those visits are all covered by health insurance plans.  During these visits, we have screening questionnaires for patients/parents to fill out and for the physician to review and to address any concerns raised by the questionnaires.  We usually review a child’s growth, nutrition, dental health, school readiness/performance, physical activities, habits, safety, mental health, and family situations, and we will address any existing medical problems, such as asthma, allergies, diabetes, etc.  Therefore, please do raise any concerns you have during these “well-child” visits, even if they are not on the questionnaires.  Eventually, when we adopt a new electronic medical record system next year, we will be able to have these questionnaires sent via internet to our patients/families so that they can be filled out on-line 1-2 days prior to the visit.  We recommend that you schedule your next well visit before you leave the office every time.


Tien-Lan Chang, M.D.

Pediatric Associates of Malden

Fall, 2015

Policy On Vaccines

Greetings to Our Patients and Parents,

It is already middle of the fall season. We are administering influenza (flu) vaccines to our patients during well and sick visits, and we have added staff on Saturday morning and Tuesday afternoons for patients who come just for the flu vaccine.  This year all flu vaccines are provided by the state of Massachusetts.  We recommend the vaccine to all children 6 months and older unless there is a medical reason against it.   The reason for vaccination is to protect children from serious illness and complications caused by the flu virus, which account for many emergency room visits, hospitalizations and deaths.   Although most people will recover from the illness, they will still be affected by losses in time and money due to school absences for patients and missed work for parents. This year the flu vaccine contains 4 strains of the flu virus.  If the flu virus strains that come around this winter season are among the strains contained in the vaccine, then those who are vaccinated are likely to be protected by the vaccine.  Your decision about whether your child should be vaccinated should be based on these facts, not based on false myths or fears such as “the vaccine causing flu symptoms” myth, or that there are chemical poisons in the vaccine.

Second, starting November 2015, our Electronic Medical Record  (EMR) system will be linked with the Massachusetts Immunization Information System (MIIS), a confidential, web-based system.  Vaccine records for Massachusetts residents of all ages will be collected and stored by the Massachusetts Department of Public Health.  This system will allow us to access the vaccine record of patients who had moved from another part of the state to our practice or who had vaccinations at a school or a pharmacy.   Similarly, if you go to an emergency room with an injury, the physician there can check the MIIS to find out if you are up-to-date with the tetanus vaccine.  Additionally, school nurses are able to access MIIS, making school registration more efficient for parents.  Parents who are concerned about privacy of vaccine information will have the right to opt out of sharing vaccine information with other facilities by signing a waiver form, though the vaccine information will still be registered with MIIS.

Third, I encourage those families who have not yet signed up for patient portal to do so.  With our current EMR system, patients can access laboratory results and vaccine record via patient portal, request appointments, refills, and referrals, as well as email your non-urgent questions through this portal.  To register, simply call the office during regular business hours and our staff will gladly help you through the process.  Please understand, due to Massachusetts privacy laws, parental access to medical records is restricted to children of ages 12 years and younger.

Last, but not least, I want to announce that by the spring of 2016, we will likely have a mental health counselor at our pediatric office.  Establishing this service at our location is exciting for all of us because it will more comprehensively serve our patients by providing convenient, accessible counseling for many mental health issues including those related to anxiety, depression, school difficulties and bullying. We here at Pediatric Associates of Malden look forward to give the highest care for all patients that come to us. Stay tuned for further updates and important notices.

Sincerely, Tien-Lan Chang, M.D.

January, 2015

We recommend vaccines to children, because vaccines are the best way to prevent infections. This recommendation is based on solid, evidence-based scientific research on the safety and efficacy of the vaccines. An unvaccinated child is at higher risk of getting an infection that is vaccine-preventable compared to a vaccinated child, and that child, once infected, also increases the risk of infection for other children. We welcome thoughtful questions and discussions on the vaccines, so that we can share educational information with each other. However, we want our patients to know that we try our best to provide a safe environment in our medical office. Therefore we have adopted the policy of not accepting any patient whose parents refuse all vaccines.

Tien-Lan Chang, M.D.