They grow up so fast, don't they? Some time between graduating middle school and graduating college, an adolescent should also graduate from pediatric to adult medical care. A new clinical report from three organizations recommends that such a transition should be planned in advance.
A successful, well-designed plan reflects the needs of the individual and involves the family and the medical providers on both ends--the ones who treated the kid, and the ones who will treat the adult--in order to develop the patient's ability to assume the responsibilities of self-care.
In preparing young people to be treated as adult patients, pediatricians should have a written policy spelling out the expectations of health-care transition, and they should bring up the subject with parents.
Doctors should develop individual plans jointly with the patients and their parents, ideally by the time the kids are 14, and earlier if they have special needs. The plan should be reviewed regularly by caregivers and parents to ensure updates are made before the transition occurs. And the pediatrician should communicate directly with the new adult health-care providers about the patient's history and needs.
The report offers six steps for parents and providers to effect a smooth transition (that is, as smooth a transition as anything adolescent-related can be).
- 1. Ensure that all young people with special health-care needs have a health-care professional to address them.
- 2. Identify core educational needs related to transition and integrate them into health-care professionals' training and certification requirements.
- 3. Prepare and maintain a current medical summary that is portable.
- 4. Create a written health-care transition plan for each patient by age 14.
- 5. Apply the same primary and preventive-care guidelines to all adolescents and young adults.
- 6. Ensure affordable, continuous health-care insurance for young people with special needs through adolescence and adulthood.
The report, scheduled to appear in the July 1 issue of Pediatrics, discusses a study showing that adult survivors of childhood diseases increasingly seek in-patient care at childrens' hospitals, which suggests that "systemic barriers" thwart the transition of some patients to adult care. But proactive parents in conjunction with enagaged pediatricians can overcome obstacles that would loom larger if left longer.
In comparison with the transition from puberty to sorority, transitioning your kid from pediatrician to the general practitioner is a walk in the parental park.