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Adulting 101: Transitioning from Pediatric to Adult Health Care

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Teenagers experience many milestones as they transition to adulthood. There are dating and proms, learners permits and drivers licenses, first jobs and checking accounts. But one milestone that is often missed is the transition from pediatric care to adult health care.

“Most older teenagers and young adults are healthy, so they don’t feel an urgency to find an internist or adult family practitioner” says Rachel Klein, MD, assistant professor in the departments of Medicine and Pediatrics at UAB Medicine. “But should you get sick, having an adult medicine physician who knows you and your medical history is a much better alternative than visiting the emergency room or urgent care.”

Primary care doctors manage preventive health services, age-appropriate cancer screenings, and vaccinations, in addition to chronic medical conditions. They also can help with wellness issues like quitting smoking and healthy lifestyle changes.

“Just like a child stays up to date with pediatric well-child visits, an adult receives checkups from an internist or family practice doctor,” Dr. Klein says. “Your primary care doctor can manage most health issues, like hypothyroidism, high blood pressure, and type 2 diabetes.”

Setting the Stage

Teaching teenagers to manage their own health care is an important step in making sure they have a smooth transition to adulthood. “Doctors on the adult side do a lot less handholding than pediatricians, and the typical internist speaks to the patient, not to their parents,” Dr. Klein says.

Dr. Klein recommends that parents begin allowing their teens to have more autonomy in directing their health care around the age of 13-14. “Be there to help your teens when they have questions,” she says, “but over time, loosen the leash until they are managing their own needs and health care.”

Parents can use the prompts on a standardized Transition Readiness Assessment Questionnaire (TRAQ) to help educate their teens about medical care. However, making sure your teenager knows the following is a good place to start:

  1. The names, quantities, and doses of their prescribed medications
  2. Allergies to medications
  3. Their medical history and vaccination record
  4. How to fill and refill prescriptions
  5. How to make a doctor’s appointment
  6. How to obtain lab work and X-rays
  7. The location of the emergency room and medical offices
  8. How to communicate what they’re feeling
  9. How to ask questions to doctors and nurses

Making the Move

Timing the move from pediatric care to adult health care isn’t an exact science.

“With the average patient – including children with medical conditions such as asthma or ADHD (attention deficit hyperactivity disorder) – there’s generally no formal transition process,” Dr. Klein says. “While some pediatricians will continue seeing patients into their 20s, typically a young adult should transition to an adult provider by 19.”

For adolescents with complex medical issues, Children’s of Alabama, in partnership with UAB Medicine, offers the Staging Transition for Every Patient (STEP) program to help patients move from pediatric care to adult health care.

“STEP connects the patient to all of the appropriate subspecialties in adult medicine and serves as a primary care provider for young adults with more complex health conditions,” Dr. Klein says. For many teens and young adults with a particular medical condition, such as type 1 diabetes or sickle cell disease, the pediatric specialty department may have a built-in process to transition the teenager to adult care.

According to Dr. Klein, some teenagers are already set for life. “At UAB Medicine Leeds and UAB Medicine Gardendale, dually trained internal medicine/pediatric physicians see patients from birth through old age,” she says.

Teenagers moving away to college usually can get their primary health care at their university. “They can establish with a physician at the student health center and then transfer when they move back home,” Dr. Klein says.

When choosing a doctor who practices adult medicine, Dr. Klein recommends doing your research. “The best place to start is asking your pediatrician for a recommendation,” she says. “Talk with friends and relatives, but do your own research to find a doctor who is a good fit for your specific needs. It’s also important to make sure that the adult medicine doctor is covered by your insurance.”

The important thing is to understand that switching from pediatric care to adult health care is a milestone you don’t want to miss.

“Don’t wait until you need medical care to switch,” Dr. Klein says. “You want the doctor to know you and your medical history.”

To learn more or to make an appointment with a UAB Medicine provider, please visit uabmedicine.org.