The majority of doctors see patients until age 21. Here’s what parents need to know about their children’s ongoing care and what age is too old to see a pediatrician.
Getting started with a pediatrician is simple for the majority of parents. There is a good chance that before giving birth, you studied board-certified pediatricians and chose one for your unborn kid. The hardest thing is recognizing that it is time to say goodbye to a doctor whom everyone has undoubtedly grown to adore.
Many parents and children on the verge of adulthood question when it is suitable for them to cease seeing their pediatrician. Are you in the same boat? We consulted experts to obtain the answer, as well as answers to a few additional questions you may have when it’s time to leave your family pediatrician.
Is There a Maximum Age to See a Pediatrician?
The American Academy of Pediatrics (AAP) proposed in 1969 that pediatricians see patients until age 21. This recommendation was based on illnesses such as sickle-cell disease, which can kill adolescents as early as 20. Yet, as a result of the medical achievements over the previous four decades or more, individuals are living longer and will eventually require adult care.
However, the AAP’s position is a recommendation, not a mandate, thus the age at which a physician will counsel a patient to seek adult care will vary from practice to practice.
New York-based doctor and medical director at Gramercy Pediatrics, Dr. Dyan Hes, adds, “Some pediatric offices discontinue seeing young adults at an arbitrary age, such as 18 or 21 years old. Numerous pediatric emergency rooms immediately transfer anyone over the age of 18 to the adult emergency room. In some cases, the adolescent is required by insurance regulations to switch to an adult physician at the age of 18.”
Two Reasons to Continue Seeing a Pediatrician
Although it may appear that some adult patients continue to see their pediatrician out of mere laziness or convenience, there are a few significant reasons why patients may delay choosing an adult care provider:
When adolescents leave home to pursue further education, they may be unable or unable to deal with the stress of finding a new physician. They are content to visit the student health center on campus and their pediatrician once they return home.
Daniel Ganjian, M.D., a pediatrician at Providence Saint John’s Health Center in Santa Monica, California, endorses this practice, stating, “I encourage patients to continue to see their pediatrician throughout college for checkups during breaks and to visit the college doctor for any urgent or sick visits. There are numerous changes linked with the college years. We need not burden our children with the responsibility of finding a new practitioner.”
2. Some chronic illnesses and impairments.
Those with congenital heart problems, sickle cell disease, or cystic fibrosis may find it particularly difficult to adapt, according to a 2017 PBS article.
A Pediatrician’s Point of View
Dr. Hes explains that pediatricians’ willingness to see older patients is typically a matter of personal preference. “Some pediatricians believe they were not educated to deal with the more adult challenges a 21-year-old faces, but I believe this is the exception,” she says. “Most U.S. pediatricians are exposed to adolescent medicine during their training. Some clinicians in some offices enjoy treating infants, whilst others prefer the psychosocial aspects of teenage health care.”
Dr. Hes believes that turning away a patient based on their age does the young adult a disservice. “In our office, if the patient chooses to remain with us, we follow them through college,” she explains.
Young adults with chronic illnesses such as chronic asthma, sickle cell disease, the majority of congenital diseases, or intellectual disabilities are also prime candidates for “better care from their pediatric provider, who is more familiar with the illness and has known the patient for many years.”
For instance, Dr. Hes sees autistic patients even beyond the age of 21. “I have one autistic patient who enjoys watching baby cartoons on his smartphone, despite being a young adult,” she explains. “Many young adults with exceptional disabilities perform at the elementary school level.
Their parents find it difficult to take kids to adult professionals who do not comprehend their behavior and have less patience. Many young adults with special needs cannot sit in a waiting area for an extended period of time. Pediatric offices are significantly more accommodating. We are accustomed to noise, song, play, and sobbing.”
In contrast, Gina Posner, M.D., a pediatrician at MemorialCare Orange Coast Medical Center in Fountain Valley, California, recommends that patients begin seeing a family medicine or internal medicine physician at age 21. “This is the age at which women should begin pap tests, therefore, they should be sent to an OB-GYN,” she explains. “But, some begin to feel uncomfortable at a pediatric office before that age, so I inform them that it is perfectly acceptable to make the transfer at age 18.”
Signs It’s Time for a Change
Dr. Ganjian observes that your adolescent may be ready to transition away from pediatric care if he or she dislikes waiting in a waiting room with a group of little children, does not enjoy sitting on an exam table shaped like a fire truck, or just wants to see an adult doctor.
And if they face unique adult health issues, they would be well to move on. Dr. Posner explains, “When kids begin experiencing more complex diseases like diabetes (type 2), hypertension, and high cholesterol, these are indications that they are ready to seek the medical guidance and care of a general practitioner and/or specialist.”
The decision to switch to an adult doctor must be based on both the doctor’s comfort in treating young people and the patient’s willingness to remain in practice. Dr. Hes explains that once a patient has adult medical concerns, a “competent pediatrician will propose that it is time to transition.” “We frequently maintain relationships to adult practices where our patients ‘graduate.'”
Although she finds it bittersweet to witness the maturation of her patients, she finds it satisfying. Ultimately, this sentiment should apply to the patient as well. Age-appropriate health care is, after all, beneficial to them as well.
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