When your child is a baby or a toddler, there’s no better health care partner than a trusted primary care physician. Whether a pediatrician or a family physician, your child’s first doctor is essential for preventive care, well-child visits and help through ear infection season.
As your child grows, you continue to rely on their doctor for yearly visits and other supportive care. If your child’s doctor is a pediatrician, technically, your child can continue to receive care from them until they become an adult. But at what age is it appropriate to transition your child from pediatric care to the care of another type of physician?
What age is too old for pediatric care?
Since 1938, the American Academy of Pediatrics has maintained and updated a policy statement on the “age limit of pediatrics.” In its very first statement, the AAP considered pediatric care appropriate until the “16th or 18th year of life.” Throughout the years, this policy changed to include patients from birth up to age 21 — with exceptions for older patients with special health care needs.
Most recently, the AAP left the decision on upper age for pediatric care to the patients and physicians. According to the 2017 statement, “Among the considerations is growing evidence that brain development does not reach adult levels of functioning until well into the third decade of life. Financial and developmental reasons also are noted, and the policy acknowledges the growing number of children with special health care needs surviving into adulthood whose only access to specialized services is through their pediatrician.”
Instead of following an age-specific rule, parents and kids can collaborate with their physicians to make the decisions that work best for them. Because health care is unique to each patient, this approach allows for flexibility and an individualized approach to ongoing care.
For young teens, a first visit to a pediatric gynecologist may be appropriate between the ages of 13 and 15. This relatively new subspecialist of physicians are trained to work with a younger population. Young women may be more comfortable asking questions about hygiene, periods and puberty in the privacy of a doctor’s office than talking to adults in their lives.
What if your child has a chronic condition?
If your child has a chronic condition and receives ongoing care from a pediatric subspecialist, you may wonder how and when they will move to an adult-focused practitioner. A smooth transition is especially important when children have conditions that require an adult’s help, like monitoring blood sugar levels.
Key programs at UChicago Medicine are proactive about helping patients make this transition. With a goal to help shift the role of everyday management from the parent to the child, these programs are designed to be educational and supportive.
One UChicago Medicine Comer Children’s program supports children with inflammatory bowel disease (IBD). This disorder affects 70,000 U.S. children, the National Institutes of Health reports. There’s no cure for IBD, so individuals work to manage and control their symptoms. The Pediatric IBD Health Maintenance and Transition Clinic at Comer Children’s helps pediatric patients learn to successfully manage their health.
This specialized clinic is the only program of its kind in the Chicagoland area that focuses on health maintenance and education as transition preparation. The clinic is available to Comer Children’s patients (and children referred from other hospitals) ages 10 and up.
The transition process for pediatric patients with IBD can span up to eight years and includes a customized education and treatment program. Physicians work to build trust with young patients, to close the often-wide knowledge gap between parent and child.
“It’s really important for kids and adults to understand their body so that they can be involved in the decision-making, advocate for themselves and be comfortable navigating the medical system,” says Meredith McIntee, MSN, APN, RN, Director of Comer Children’s IBD health maintenance clinic.
Ongoing education and support
For kids and teens with diabetes, the transition process is ongoing thanks to diabetes care and education specialists embedded in all levels of care for all ages, according to Amy Hess-Fisch, MS, RD, LDN, BC-ADM, CDCES, a certified diabetes care and education specialist and program coordinator for the Teen and Adolescent Diabetes Transition Program at UChicago Medicine.
In a departure from traditional pediatric diabetes care that ends when a patient reaches 18, UChicago Medicine recognizes the need for ongoing education and assistance with diabetes self-management.
Through a specialized program of the Koller Diabetes Center at UChicago Medicine, diabetes experts work with pediatric and adult endocrinologists to help teen patients as they learn to manage their diabetes care and assume increased responsibility.
The program, called In Transit, focuses on self-care specific to young adults. With support and education, teen diabetes patients can take over for their parents and families with self-management skills they learn from the experts at UChicago Medicine.
From the point of diagnosis, transition is a concept that evolves. “What transition care really involves now is determining how to build on age-related self-management responsibilities to provide the skills necessary to increase independence,” Hess-Fisch says.
Bridging the gap for cancer care
UChicago Medicine’s unique Adolescent and & Young Adult (AYA) Oncology Program addresses the many challenges teens and young adults kids face when diagnosed with cancer.
By offering coordinated cancer care led by adult and pediatric hematologists and oncologists, the program provides support for young adults ages 15 to 39 to enable them to take an active role in their care as they transition through adulthood. The program provides emotional support and referrals for fertility counseling and many other services.
UChicago Medicine physician-scientists lead clinical trials specific to young adult patients.
The hospital system also provides long-term post-treatment care through the Childhood Cancer Survivors Center. Cancer can strike at any age, so this integrated program for pediatric and adult survivors of childhood cancer brings together oncology specialists for both age groups. The focus is on prevention of recurrences and treatment of long-term issues associated with cancer therapy.
Expertise brought to you by UChicago Medicine. Learn about UChicago Medicine and Comer Children’s unique approach to caring for women and children. Discover UChicagoMedicine.org.
