Every pediatrician knows the children who follow the expected pattern when respiratory illness strikes. Their symptoms flare, improve with treatment, and resolve on schedule. But another group does not respond so predictably. These are the children who cough for weeks after each virus, cycle through urgent care every winter, struggle during gym class or sports, or continue to wheeze despite what should be appropriate therapy. Families grow anxious, physicians grow concerned, and the pattern repeats.
Atlantic Health’s pediatric pulmonology division, led by Gurpreet Phull, MD, is designed for that group of patients. The program has expanded significantly, not by accident but by design, to support physicians who need deeper diagnostic capability and families who need clarity after months or years of uncertainty. For many clinicians in the region, it is becoming a go-to resource for children with persistent, unexplained, or severe respiratory symptoms.
Dr. Phull describes the division’s clinical reach in practical terms. Pediatric pulmonology, he notes, spans asthma, pulmonary dysplasia, chronic cough, recurrent pneumonia, neuromuscular respiratory disorders, cystic fibrosis, and both upper and lower airway disease. The team also manages complex technology-dependent patients, along with infants and young children who have limited pulmonary reserve after premature birth.
Many of these children have been struggling for years before they arrive. “We see everything from simple asthma to children who were premature and have less pulmonary reserve to kids with muscular weakness who need technology to breathe,” Dr. Phull explains. “And we see many families whose concerns have gone unrecognized. That might be a child who coughs for weeks, or one who has repeated pneumonias, or one who keeps ending up in urgent care. Those are the cases where a deeper evaluation changes the picture for everyone.”
A Comprehensive Pediatric Pulmonology Program Across Care Settings
Atlantic Health’s pediatric pulmonology service line spans outpatient clinics, inpatient consults, the NICU, the PICU, and procedural environments. Children may come in for evaluation of chronic cough, asthma that is not responding to therapy, or recurrent lower respiratory infections. Others require bronchoscopy to clarify airway structure or behavior. The team performs pulmonary function testing across ages, sleep-related evaluations when appropriate, and advanced exercise diagnostics that go far beyond what most regional programs offer.
For pediatricians, this breadth matters. It means that regardless of where a child enters the system, the pulmonology team can support respiratory diagnosis and management in a consistent and coordinated way. It also ensures continuity, which is especially important for children with complex respiratory conditions.
When Primary Care Physicians Should Refer to a Pediatric Pulmonologist
Many physicians naturally try to manage pediatric respiratory symptoms in the primary care setting first. Dr. Phull encourages this, but he also outlines clear thresholds for when he believes specialty support is essential.
Referral is appropriate when:
- Symptoms persist long after a viral illness
- A child requires multiple courses of oral steroids
- Bronchodilator use is needed frequently in office
- Pneumonias recur or follow unusual patterns
- ED or urgent care visits become routine
- Families experience significant disruption despite adherence to treatment
- Standard asthma or airway management protocols do not produce control
“If a child keeps coming back, or if the pediatrician is doing all the right things and still not seeing improvement, that is the moment when we should see them,” he says. “The goal is to improve outcomes for the child and ease the burden on the family and the physician.”
This guidance aligns with how physicians triage asthma that is uncontrolled, chronic cough that is unexplained, or recurrent pneumonia that needs a deeper workup. It also reinforces that early specialty involvement often prevents escalation later in the season.
A Treatment Philosophy Built on Normalcy and Long-Term Function
Dr. Phull measures success in concrete terms. He wants children to function like their peers, regardless of their underlying respiratory condition. Normal school attendance, stable symptom control, fewer emergency visits, and the ability to participate fully in daily activities are the goals that anchor his approach.
“We want to make sure that when children get sick, it looks no different than any other child in the classroom,” he says. “No repeated absences, no cycles of antibiotics or steroids.”
He also emphasizes simplicity. “We aim for the least amount of medication that still provides complete control,” he says. “What matters is effective, sustainable management that fits the child and the family.”
For physicians, this offers reassurance that treatment plans will be thoughtful, measured, and tailored.
High-End Diagnostic Capabilities Rarely Available in Pediatric Pulmonology
Some of the most compelling features of the program are its advanced diagnostic capabilities, which bring a level of precision unusual in community or even academic pediatric pulmonology.
High Altitude Stress Testing for Children
A high altitude stress test is performed for children at risk of desaturation during air travel, including those with bronchopulmonary dysplasia, chronic lung disease, pulmonary hypertension, restrictive lung disorders, or chest wall abnormalities. Cabin pressure simulates a higher altitude environment, which can stress vulnerable physiology.
This test is rarely available in pediatric settings. Dr. Phull recalls a recent referral from a major academic center in Philadelphia where the test could not be completed. “It became clear that we were offering something unique,” he says. “It validated the direction our program has been moving.”
Cold Air Exercise Challenge Testing for Pediatric Athletes
Many pediatric patients have symptoms only in cold environments, particularly athletes. Traditional treadmill testing cannot replicate these triggers. Atlantic Health’s cold air exercise challenge recreates real environmental conditions that provoke airway reactivity.
“No other center in New Jersey is doing it,” Dr. Phull notes. “It reflects the actual conditions where many children are having trouble, especially in fall and winter sports.”
These tests give physicians answers that can replace months of trial and error.
Communication That Keeps Primary Care at the Center
When it comes to patients who have been referred, Dr. Phull has made communication with pediatricians a clear priority. Swift, structured follow-up helps referring physicians maintain continuity.
“Closed loop communication is extremely important,” he says. “Within one to two days after we see a patient, we send a summary back to the primary provider. And if the pediatrician has a question, we talk directly.”
This level of responsiveness supports shared decision-making and prevents families from feeling caught between different care teams.
A Vision for Expanding Pediatric Respiratory Care in New Jersey
Dr. Phull often reflects on the potential of the program. “There is so much we can do,” he says. “My vision is to expand our reach throughout New Jersey and continue raising the level of care for children in our communities.”
For referring physicians, the impact is immediate. Atlantic Health offers a pediatric pulmonology service that combines comprehensive clinical capability, rare diagnostic tools, and a collaborative approach that keeps primary care at the center of each child’s care.
When respiratory symptoms stop following expected patterns, or when families are running out of answers, this program provides the clarity and coordination children need.
To learn more about the pediatric pulmonology program at Atlantic Health or to refer a patient, call 973.971.4142.