Written by Emily Freehling

Dr. Richard Erwin started serving patients with Mary Washington Pediatrics more than three years ago. He and his colleagues, Drs. Blair Ryland and Rhonda Winchester, provide care for children from birth into their 20s from their office at 2632 Salem Church Rd. in Spotsylvania County. In addition, Dr. Daniel Trementozzi serves patients at Mary Washington Family Medicine and Pediatrics in Ladysmith. Dr. Trementozzi also speaks Spanish. These board-certified physicians are all accepting new patients.

Mary Washington Pediatrics helps fulfill Mary Washington Healthcare’s overall goal to provide comprehensive care for women and children throughout the Fredericksburg area. Pediatric patients can interact seamlessly with Mary Washington’s OBGYN, maternal and fetal care, including the region’s only Level III NICU, and a 24/7 partnership with Children’s National Hospital. Access to records (including your child’s immunization dates) and appointment scheduling continue to be made simpler through MyChart, MWHC’s user-friendly patient portal.

Dr. Erwin spoke with Fredericksburg Parent and Family Magazine about the importance of pediatric visits, and how crucial it is to keep them up, even amid the Covid-19 pandemic.


Q: How important are regular well checks for children, and what are some good questions for parents and children to ask at those visits?

Dr. Erwin: Well checks are super important. Even if a child hasn’t had a lot of illness since his or her last appointment, it’s still important to take a look things like growth and development, and other things parents might not be thinking about on a daily basis. If a child is veering from the normal path of growth or development, early intervention can make a big difference.

As a parent, when you walk in for a well visit, think about your child’s development and ask yourself, “Do I feel like they are doing the things other kids their age are doing?” Think about their language skills, gross and fine motor skills as well as social skills.

These kinds of developmental questions are part of the “Ages and Stages” developmental screens that we do in the office. These days, we are actually working toward getting those started ahead of time through the MyChart patient portal. We are working on that right now as a way to make these visits even more efficient.

Other things to think about are:

  • How has school been going? Is your child happy at school?
  • Is your child happy at home?
  • Is your child fitting in socially, and are they making friends?
  • Does your child have any significant worry or sadness, or issues adjusting to any changes going on around them at school or at home?

Q: What is beneficial about having an established pediatrician who sees your child as they grow at these regular visits?

Dr. Erwin: The relationship is really important. In the early years, it’s important from a parent perspective to get to know me and develop that comfort level. As the years go on and a child gets older, it’s important to develop that relationship so that they feel comfortable as an adolescent coming to me with any mental health concerns or concerns related to puberty or sexual health. It’s important to feel comfortable and safe and create that environment where we can have a dialog.


Q: What would you want parents to know about keeping up with regular pediatrician visits during the pandemic?

Dr. Erwin: Mary Washington Pediatrics has put protocols in place to ensure everybody is safe. This includes setting aside specific hours for well visits, so that sick and healthy patients are separated, thorough cleanings in between visits, temperature checks, health screenings and many other measures to keep everybody safe.

It’s important that we make sure people feel safe, because we all realize—backed up by larger groups like the American Academy of Pediatrics, that regular well checks are so important to children’s health. Many health issues have gone unaddressed during earlier periods of the pandemic, and it’s so important that we stay on top of these things. It is important to realize that other disease processes and health concerns have not paused, and we still need to keep up with our regular exams and immunizations.

Q: What should parents know about getting flu shots at this time that we are also dealing with Covid-19?

Getting the flu shot this year is even more important than ever. We want to keep our general population as healthy as possible right now. So the more that we can limit influenza, the more we will potentially keep children out of the doctor’s office, keep kids from spreading flu and other infectious diseases, which can compound and worsen other viral processes, including Covid-19. The more we can keep everybody healthy this winter, the safer we will be and better able to handle the healthcare needs that arise within our population.


Q: What should parents know about their role at doctor’s visits as their children grow, and at what age should children go into the visit by themselves?

Dr. Erwin: Even as young as 4 and 5 years old, it’s important for parents to at times during the visit take a backseat and let the kids answer and interact. It helps facilitate a good relationship between the patient and the doctor. Typically around 12 years old, depending on a child’s maturity level, we aim to have some private confidential conversations, and the point of those is to create a safe place where an adolescent can feel comfortable and express any concerns he or she may have about any aspect of their mental or physical health. This is not about shielding things from the parent, but it is about helping the child to build that safe space where they can begin to communicate with their healthcare provider as an independent adult, because as we get to those adolescent years, we do start to encounter those adult issues. An adolescent may feel more comfortable talking to a pediatrician on a one-on-one basis. For example, I had a teen the other day ask me some questions about vaping, whereas if mom was in the room, he might not have felt comfortable asking this.

Q: How can parents help their children learn how to get the most out of their doctor visits?

As children get older, it’s important for them to realize that they need to start taking ownership over their own body and their own health. Parents aren’t always going to be around to show us how to eat healthy or protect us on a daily basis. It’s my role to help teens realize that and help empower them and give them the tools to make healthy decisions about their own bodies, whether it’s relating to mental health or diet and nutrition or sexual health, any of those things.


Q: At what age is a young person ready to transfer from a pediatrician to a primary care physician?

Dr. Erwin: Usually, I’ll see kids through their college years. Usually around 18-20 is when you start thinking about finding an adult primary care physician, especially if you are developing any chronic adult health issues. We can help our patients find somebody who is a good fit for their personality and preferences.


Q: What do you like about being a pediatrician?

Dr. Erwin: I have always loved working with kids. I come from a big family and have a lot of nieces and nephews and cousins. With pediatrics, I like that I can have a positive impact on families, and watch children grow, overcome challenges, and develop through the years. All of us at Mary Washington Pediatrics really like to go the extra mile, because we really do care about these children’s health going forward.

On a personal level, I have an 18 month old boy and my wife and I are expecting a newborn girl any day now so I am definitely able to relate well to my young families and what they are going through; it makes these interactions with young families all the more real and meaningful.


To learn more about Mary Washington Pediatrics, visit practices.mwhc.com or call 540-899-3440 to schedule an appointment. Providers are also scheduling virtual visits.

Stay tuned to the Fredericksburg Parent and Family Facebook Page and YouTube channel for a video in October featuring Mary Washington Pediatrics.