The transition from adolescence to adulthood is full of changes. One of those changes is the transition from a pediatrician to a doctor who specializes in adults.
“Transition to adulthood is multifaceted and does not just exist in health care,” says Traci M. Kazmerski, MD, MS, pediatric pulmonologist and health services researcher in the Division of Adolescent and Young Adult Medicine at UPMC Children’s Hospital of Pittsburgh. “Young adults are simultaneously transitioning educationally or vocationally, legally, socially, and emotionally. As medical providers, we must recognize that health care transition does not occur in a vacuum and we have to help our patients navigate the transition from pediatric to adult care.”
When to Transition From Pediatric to Adult Care
The patient/provider relationship is special. Trust between the patient and doctor is developed over time, especially when it comes to young children. Similarly, as your children grow older, transitioning from pediatric to adult care isn’t something that should happen overnight.
As parents, this process should start when children are in pre- to early-teenage years by helping your child better understand their own medical conditions, medications, or allergies.
“Transition is a process that begins in early adolescence by partnering with patients and families to prepare them for adult care,” says Dr. Kazmerski. “Good communication between patients and providers, as well as between pediatric and adult care systems, is key throughout the transition.”
Got Transition, the federally funded national resource center on health care transition (HCT), has resources on health care transition timing, including a sample transition timeline for parents and caregivers.
When a child turns 18, they are legally responsible for their own care and, unless the young adult agrees, parents cannot access medical information or attend doctor’s visits. Encouraging involvement early on in their own care helps them be more comfortable making their own decisions when the time comes.
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How Can Parents Help With the Health Care Transition?
During the appointment
“The biggest thing that parents can do to make transition easier is encourage their teen to take ownership over their own health,” she says. “Starting at age 13 or so, self-visits (without parents in the room) are encouraged to allow teens to get comfortable in the clinic space.”
If your teenager is not yet comfortable with a full visit on their own, there are other ways to empower them during a doctor’s visit.
“Self-visits can help improve self-efficacy in patient-provider communication, but simply ‘turning the visit over’ to the teen or young adult also can be effective,” Dr. Kazmerski says.
Outside of the doctor’s office
Being proactive on their own visits to the doctor is impactful, but it’s not the only way to help a child gain confidence in managing their own medical needs.
Learning more about any medications they may be on is equally as important. This not only includes instructions on how and when to take them, but also things parents might take for granted, such as how to refill a prescription.
In addition to calling in and refilling prescriptions, teens also can learn how and when to make doctor’s appointments.
Other ways to help your teenagers with the health care transition:
- Have your teen carry their own insurance card.
- Educate your teen on their insurance coverage and help them understand how it works.
- Go over a list of questions your teenager should cover with their doctor ahead of a visit.
- Work with your teen and their doctor to make and share a medical summary.
- Encourage your teenager to ask their current doctor for help in finding a new doctor.
- Make sure they understand how to check whether a potential new doctor is covered by their insurance.
Patients With Special Health Care Needs
Not all transition plans look the same. Some children with special health care needs may need a unique transition plan.
One option for young people with special health care needs is called the Progressive Evaluation & Referral Center (PERC). PERC is a clinic within a clinic through the UPMC General Internal Medicine Office (GIMO) for patients with multiple complex medical conditions, technology dependence since childhood (e.g. ventilator, tube feeds, wheelchair, etc.), and/or intellectual or developmental disabilities.
Communication Between Providers
The health care transition isn’t all on the patient and their family. Pediatric providers also play a role in ensuring a smooth handoff to their successors.
“Pediatric providers often provide a summary to adult providers to create the best transition,” says Dr. Kazmerski. “These summaries allow the adult providers to understand the patient’s health and well-being and get to know them a bit before the first visit. Additionally, the electronic medical record (EMR) often allows adult providers to view notes, studies, and lab work from prior visits throughout the UPMC system.”
Cooperation between providers doesn’t stop there, either. Pediatric doctors in the UPMC system make themselves available to answer questions from your new provider even after the transition. This creates the best care possible from your medical team.
Adolescent to Adulthood Transition Care Program at UPMC Children’s Hospital
The Transition Task Force at UPMC Children’s is working to improve the process of transition to adult healthcare for all patients and families.
Established in 2017, the Transition Task Force partners with adult and pediatric health care providers, primary care practices, community organizations, and patient groups to:
- Educate patients, families, and providers related to transition care.
- Optimize clinical care to improve transition readiness and transfer to adult providers.
- Research effective strategies to measure and improve transition.
- Advocate to ensure that transition care is prioritized.
The goal is to equip all patients and families with the skills they need to manage their health as they enter adulthood.
For an appointment to discuss transitioning to adult care or if you have general questions, please call 412-692-6677, leave a message on the nurse option, and someone will call you back.
Interview with Traci M. Kazmerski, MD, MS, Assistant Professor at the University of Pittsburgh School of Medicine in the Department of Pediatrics and Division of Adolescent and Young Adult Medicine Adolescents.
Headquartered in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and 800 doctors’ offices and outpatient centers, with locations throughout Pennsylvania, Maryland, New York, West Virginia, and internationally. We employ 4,900 physicians, and we are leaders in clinical care, groundbreaking research, and treatment breakthroughs. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside as one of the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. We are dedicated to providing Life Changing Medicine to our communities.