It's a question all parents face: When is the right time for your child to move from pediatric to adult healthcare?
It's an important decision that deserves thought and advance planning. Then, of course, your child will need to find another primary healthcare provider. There's a lot to consider. But here are 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., is a pediatric specialist and national medical director for HumanaOne. As he explained, "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.
"A lot of kids may feel comfortable with someone who has known them their whole lives. Of course, some young adults don't want to go to a doctor with zoo animals on the wall. It's very much an individual decision."
On the flip side, how young is too young to switch from a pediatrician? Your son may be six-foot-two. But if he's just 15, he will be better served by staying with his pediatrician.
"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 whether 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.
Experts in it 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.
Dr. Francine Kaufman is a pediatrician associated with the University of Southern California. In a recent NIH News in Health article, she 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. That means you might not be there to hear information important to your child's health. Your child will have to learn to remember important information. Your child needs to learn to make appointments, keep records and manage other details.
"You have to prepare them for this transition," said Kaufman. Keep in mind, too, that in most cases, patients 18 and older are considered 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. It's important not to wait until there's a problem. Find someone you can transfer your child's records to. Make an appointment with the new doctor. Don't wait until your child leaves the care of the pediatrician.
- Having a primary care physician your child can trust and be comfortable with is vital. Here are a few things to consider:
- A primary care doctor is usually an internist or family medicine physician.
- If you have a family doctor you like, that's someone your child may want to consider. 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.
Check to see if the doctor is covered by your child's insurance. This may be your plan. Today, some young adults may stay on 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.