April 22, 2022
April is National Child Abuse Prevention Month, so we’re highlighting OPS Member Margaret Miller, MD, FAAP. Dr. Miller is a pediatric hospitalist and the former medical director at Juliette’s House, a McMinnville-based Child Advocacy Center. She has practiced in both general pediatrics and child abuse pediatrics for more than 20 years.
Margaret Miller, MD, FAAP, became involved in her local Child Advocacy Center (CAC) in 1997. The McMinnville-based CAC, Juliette’s House, arose that year as a response to community need, and several local emergency department physicians were key in forming the center. At the time, Dr. Miller was new to the community and working as a primary care pediatrician. She said she was looking for an area for community involvement, and felt that Juliette’s House needed a pediatric presence.
Dr. Miller began doing medical/forensic assessments at Juliette’s House on days off from her primary care practice. “I really learned on the job,” Dr. Miller said. “I learned from trainings, readings, mentors at CARES Northwest, and from the kids and families.”
Since those early days of child abuse work, Dr. Miller became a certified child abuse pediatrician, and was the Medical Director at Juliette’s House for more than 12 years. Since 2016, she has been a pediatric hospitalist at Willamette Valley Medical Center, where she is available for ED consultations and is involved early in children presenting with serious injuries. As she winds down her career, she is no longer on the regular schedule at Juliette’s House, but she continues to consult on complex medical cases there.
Recently, Dr. Miller was an advisory board member for a new pilot training on child physical abuse for primary care providers, presented by OPS and Oregon Child Abuse Solutions. The virtual training launched in March and is designed to help child health providers build and sharpen clinical skills in child physical abuse identification and reporting. The four-session training is led by child abuse pediatricians working within Oregon’s CAC system, and about 20 primary care providers throughout the state are part of the first virtual learning cohort. “I’m eager to hear the first students’ responses to the pilot course,” Dr. Miller said. “All pediatricians could benefit from this training to empower them to be the best advocates for their patients’ safety.”
When reflecting on how her child abuse prevention work has informed her practice, Dr. Miller said that understanding trauma and its effects on kids and families has made her a better pediatrician. She also said it’s been helpful to know about community resources, as well as the roles of ODHS and law enforcement.
Dr. Miller has observed tremendous growth in the child abuse pediatrics field during the past 25 years. “The science has become much more sophisticated, including the Child Abuse Pediatrician subspecialty recognition,” she says. “Our knowledge of best trauma-informed care practices is evolving. The awareness of how ACEs affect kids and families over a lifetime and the factors to support resilience are now better informing our treatment plans.”
Because of the emotionally exhaustive nature of her work, Dr. Miller notes the importance of self-care. “I have a regular yoga group, and get refreshed with outdoor activity and gardening,” she says. “Also, my co-workers at Juliette’s House are very supportive of each other and that’s essential with tough cases.”