Like most parents of a young adult, you’ve probably spent many hours in the pediatrician’s office over the years. Whether you took your child in for a “well visit” or a medical concern, you were there for most of the visits and made most of the decisions.
At some point, between 18 and 21 years old, your young adult will need to transition from pediatric healthcare to adult-oriented healthcare. It’s easy to choose a new doctor, transfer medical records and fill out new patient forms. But it’s hard to let go of making your child’s healthcare decisions. Letting go is particularly difficult if your young adult has a chronic disease or disability.
Preparing Your Child
How can you prepare your child to assume responsibility for her own healthcare? Cody Godfrey, DO, a family medicine doctor with Baylor Scott & White in Austin, advises: “Talk to your child about the importance of maintaining health as we grow older. Beginning in early adolescence, give your child increasing responsibility in making her own healthcare decisions. This will foster independence and help her build confidence in her healthcare decision-making ability. As children move through adolescence, providers spend more one-on-one time with patients, but parents are usually involved. Once children reach adulthood, they are typically at appointments by themselves without a parent there to guide them.”
The Importance of a Medical Home
A “medical home” is not a place—it’s a health partnership with a trusted, compassionate healthcare provider. The provider and family work together to make decisions. The medical home provider and care team coordinate all the child’s healthcare needs, including well visits, sick care and behavioral health needs.
Dr. Godfrey recommends that young adults have a medical home after they transition from pediatric care. He notes the following reasons:
- “Most young adults are healthy and don’t need to see the doctor for a chronic disease. When they do see a doctor, it’s usually for a minor illness or injury. Both primary care doctors and urgent care doctors can manage the minor issues without a problem—but if the illness is more severe or requires follow-up, having an established medical home gives the young adult a point of contact to guide her on the road to recovery.”
- “When a young adult goes to her medical home provider with an acute concern, unlike an urgent care or emergency room, the provider already knows the patient and can more easily personalize the treatment to meet the patient’s needs.”
- “Children with chronic conditions or disabilities often go to pediatric specialists. Pediatric specialists usually only see patients until age 21. It can be difficult for many young adults to find an adult specialist to continue their care as they grow older. Having a medical home can be extremely helpful during this time. The medical home provider can be a great resource during this transition and help bridge the gap.”
- “Finally, having a medical home makes financial sense. Going to the medical home provider for an acute visit is usually half the price of an urgent care visit and can be hundreds of dollars less than an emergency room visit. Also, doctors who do not know a patient may need to order extra tests to better understand the patient’s problem. These tests may not be needed by the medical home provider.”
The Transition Process
Once the young adult is ready to begin making her own healthcare decisions, the transition is easy. Dr. Godfrey says, “There is not as much involved in the transition process as you might expect.” Here are the steps he outlines:
- Locate a provider. The young adult may find one based on recommendations from the pediatrician or from friends.
- Transfer medical records. If the young adult has a history of medical problems, get a copy of those records to the new doctor. The young adult may ask her pediatrician to send the records to the new doctor, or the new doctor can request them.
- Make the initial appointment. During this first appointment, the new doctor and young adult will get to know each other. This is a good time for the young adult to discuss any questions or concerns.
- See the doctor for annual visits and as needed. Annual visits are important for promoting a long and healthy adulthood. In addition to basic health problems, young adults have a high incidence of mental health illness and sexually transmitted diseases. Early detection and treatment of these or other problems are extremely important.
Dr. Godfrey tells parents, “Take a deep breath and pat yourself on the back! You have helped your children navigate the health system throughout their childhood years and have prepared them for success as adults.” It’s now time for your children to make their own decisions. But be ready, and be there for them when they come to you with questions. af
Brenda Schoolfield is a freelance medical writer who splits her time between Austin and Seattle.