Parents all face this question when their child gets to a certain age: When is the right time for my child to move from pediatric to adult healthcare?
It's an important decision that deserves thought and advance planning. There's a lot to consider, such as finding a new primary healthcare provider for your child.
Here are some expert tips that can help make the transition a healthy, positive experience.
What's the best age to make the change?
Albert Tzeel, M.D., a pediatric specialist and national medical director for HumanaOne, explains, "First, it's important to know that there is no set answer. Much depends on the individual and the comfort level of the young adult with seeing a pediatrician.
"For many people, age 18 is a pivotal time. Kids are generally graduating from high school. They're moving on to college or a job. It can be a natural time to make the transition. But age 18 is definitely not a hard and fast rule."
"The American Academy of Pediatrics is comfortable with a pediatrician seeing patients through age 24," Tzeel said. "Many pediatricians cover the college years. They see kids when they come home from school, and for a few years after.
"Kids are not little adults, especially through adolescence and puberty," Tzeel said. "There are a lot of physiological, endocrine and social changes going on. Most kids are still growing. I would say that kids under 16 are too young to move from their pediatrician's care."
Another thing to consider is if the child has a condition within the pediatric realm. If so, they may stay under the care of a pediatrician for a longer time. Or they may see a pediatric specialist well into adulthood. Dr. Tzeel offered this example.
"Say a child was born with a heart condition that required surgery. Even after the heart is repaired, it is still a little different. It is something a pediatric specialist sees more often and may better understand. Where I trained, they had a pediatric cardiology clinic. They regularly had a special day when they saw adults up to age 35."
Teenagers need privacy
Even while kids are still seeing a pediatrician, care should start to change around age 13. The Chicago Tribune recently reported about aging out of a pediatrician's care, and said teens should have some private time with the pediatrician. The parent can be called in for a discussion after the exam.
Young patients may have questions about sexuality or substance abuse. Those are subjects they may not want to discuss in front of a parent.
"I usually ask the mom or dad to step out and give the child privacy," Tzeel said. "Otherwise, the doctor may not get the full story from the teen."
Plan ahead for the transition
In a recent National Institute of Health News in Health article, Dr. Francine Kaufman, a pediatrician associated with the University of Southern California, advises parents to prepare for the transition.
"Pediatric and adult healthcare are very different," Kaufman said. "In pediatric care, there's really an interaction and a focus on the parents as well as the child."
In adult care, it's likely that the parents are excluded and won’t hear information important to the child's health. Your child will have to learn to remember important information as well as learn to make appointments, keep records and manage other details.
"You have to prepare them for this transition," said Kaufman. Patients 18 and older are adults. In order for a doctor to share information with a parent, the child has to give written consent.
Kaufman says to talk about the transition and its timing with your pediatrician in advance.
"Children need a couple of years' practice before they can fully participate in their care," Kaufman said. "They can start by being more vocal during their appointments. Have the child come in with a list of questions and concerns."
Finding a new primary care doctor
The next step is finding a new doctor. Kaufman advises choosing a primary care doctor in advance, don’t wait until there's a problem.
It is vital that your child feels comfortable and trust their new primary care physician. Here are a few things to consider:
- A primary care doctor is usually an internist or family medicine physician
- You may want to consider your own family doctor, but some kids want a doctor of their own
- Your child should be able to get an appointment quickly when needed
- He or she should feel comfortable with the doctor
- Make sure that the doctor is covered by your child's insurance. Today, some young adults are able to stay on their parents' plans until age 26
- Help your child find a new primary adult healthcare provider if possible. Or, plan the process he or she will have to go through after moving to a new school or area
Planning ahead and making this process a smooth transition is very important. It can help your child build a good relationship with a primary care physician. And that can have a positive effect on your child's health for many years to come.