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Has Your Child Outgrown Their Pediatrician?

Adolescents experience many milestones on their road to adulthood, such as learning to drive or graduating high school.  One key milestone is the graduation from pediatric to adult health care.

The American Academy of Pediatrics recommends that adolescents and their families have regular conversations with their pediatrician, as early as age 12, to discuss the best time to transfer care to adult providers.

Many pediatricians have a written transition policy with guidelines around adolescent confidentiality and privacy as well as an expected age of transfer.

Pediatricians often recommend that their patients transfer to adult care between the ages of 18-22 years.

Some pediatricians who are specially trained in adolescent & young adult medicine may continue to provide care into the mid-20’s. Youths with complex chronic conditions may need extra support or time to transfer their care.

Encouraging Adolescents to Take Charge of Their Health!

The pediatrician can coach families to help adolescents prepare to take charge of their own health. Skills that adolescents should learn include:

  • Preparing questions for medical appointments and spending some time alone with the pediatrician at each visit
  • Knowing the names and contact information of every health provider, including the dentist
  • Knowing the names of any chronic medical conditions that they have
  • Knowing the names of any medications that they take. Also, understanding how to take the medications and any possible side effects
  • Knowing what they allergies they have
  • Understanding what to do in a medical emergency
  • Asking questions about any health problems that run in the family
  • Understanding how health insurance works and carrying an insurance card
  • Making choices about their healthcare

Transitioning from Pediatrician to Adult Primary Care

Not all care needs to transfer at the same time.

Some patients will transfer their pediatric specialists first while staying with the pediatrician; others seek out adult primary care first and transfer their specialty care later.  When it is time to transfer to an adult primary care provider (PCP), patients should consider:

  • Do I want a doctor, a nurse practitioner, or a physician assistant?
  • Do I want an internal medicine (adult) provider, or a family medicine (all ages) provider?
  • Does my pediatrician have any recommendations?
  • Do my family and friends have any recommendations?
  • Which providers take my insurance?
  • Are the appointment times convenient to my work/school schedule?
  • Does this provider use an online portal or mobile app?
  • What happens if I get sick at night or on a weekend?
  • Can this provider accommodate any special needs that I have?

What to Bring to Your First Adult Primary Care Appointment

For the first appointment with an adult PCP it is important for patients to bring all of their health information, including their insurance card, prescription bottles, vaccine lists, and a copy of their pediatrician records. For patients with chronic medical conditions it can be very helpful to bring a 2-3 page medical summary that highlights their key health information. Being prepared can help patients and providers get the most out of that first appointment.

And remember to celebrate! Moving on from pediatrics is an important life milestone. With some planning and preparation, the transfer to adult care can happen smoothly.

About Frances Catherine (Kitty) O’Hare, MD

Dr. Kitty O’Hare is a pediatric physician and Medical Director of the WakeMed Pediatric Primary Care practices. Her clinical interests include children, teens and young adults with chronic medical conditions; transition to adulthood; immigrant health and community health.