When should your child stop seeing a pediatrician?

A doctor listens to a young patient`s heart.

It is common for parents to question when a child should move from pediatric to adult healthcare.

This decision often requires thought and advance planning before finding another primary healthcare provider for the child.

The following tips can help make the transition from pediatric to adult care a healthy, positive experience.

What’s the best age to make the change?

For most patients, the appropriateness to transition to an adult healthcare provider is based on age and development. Your pediatrician will help determine the age to transition care, which is typically between the ages of 18 and 21. It is recommended that your pediatrician begin this evaluation at the age of 14 or 15.1

Teenagers need privacy

Concerns about confidentiality may prevent some teenaged patients from communicating openly with their pediatrician and seeking necessary medical care and counseling.2

Young patients may have questions about sexuality or substance abuse—subjects they may not want to discuss in front of a parent.

Experts recommend that teenagers are given privacy when seeing their doctor.3 Teens should be offered the opportunity for examination and counseling separate from parents or guardians. The parent(s) can be called in for discussion after the exam.

Plan ahead for the transition

Transitioning from a pediatric doctor to an adult doctor requires help from the doctors on both sides, including preparing the adolescent to take charge of his or her own healthcare.4

Prepare your teen for the changes involved in his or her adult care, including your teen’s role in decision making, privacy and consent, self-advocacy and access to information.5 Patients 18 and older are considered adults. In order for a doctor to share information with a parent, the patient has to give written consent.

Your teen should learn to make appointments, keep records and manage other details and important information about your teen’s health. You and your current doctor can help prepare your teen for these changes by encouraging your teen to be more vocal during the appointments.

Treat the transition to adult care as an ongoing, collaborative process.6 Follow these tips to help your teen prepare:

  • Have your teen come to appointments with a list of questions and concerns.
  • Starting at about age 16, ask your current doctor to help prepare your teen for changes in decision making once your teen reaches age 18. Ask about legal resources on supported decision making, obtaining their consent to involve parents/caregivers, etc.

Develop and share a plan of care, medical summary and emergency care plan with your teen.

Finding a new doctor

When you choose a new doctor, select someone you trust and with whom your teen feels comfortable. You should begin the process of finding a new doctor and transfer your child’s records before your child leaves pediatric care.

Here are a few things to consider:

  • Insurance coverage
  • Office hours and appointment availability
  • Gender
  • Office locations
  • Language(s) spoken
  • Hospital affiliations
  • Specialty/specialized medical training

It may be helpful to ask family and friends for recommendations. Most importantly, ask your teen about his or her preferences for transferring to an adult provider and make sure your teen is part of the decision-making process.

Sources:

  1. “Supporting the Health Care Transition From Adolescence to Adulthood in the Medical Home,” The American Academy of Pediatrics Clinical Report, last accessed November 3, 2017, http://pediatrics.aappublications.org/content/128/1/182.full , opens new window.
  2. “Adolescent Health Care, Confidentiality,” American Academy of Family Physicians, last accessed November 3, 2017, http://www.aafp.org/about/policies/all/adolescent-confidentiality.html , opens new window.
  3. “Adolescent Health Care, Confidentiality.”
  4. “Helping Adolescents Transition to Adult Health Care,” American Academy of Pediatrics, last accessed November 3, 2017, https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/Helping-Adolescents-Transition-to-Adult-Health-Care.aspx , opens new window.
  5. “Transition Planning,” Got Transition, last accessed November 3, 2017, http://www.gottransition.org/providers/leaving-4.cfm , opens new window.
  6. “Transition Planning.”