How old is too old to see a pediatrician. When should a child transition to an adult doctor. What factors determine readiness for adult healthcare. How to find the right adult healthcare provider.

The Evolving Age Limits in Pediatric Care

The landscape of pediatric healthcare has undergone significant changes over the years, particularly concerning age limits. In 2017, the American Academy of Pediatrics made a groundbreaking decision by eliminating the upper age limit for pediatric care. This shift marked a departure from previous norms, where the age limit was initially set at 18 and later raised to 21 in the 1960s.

Why was this change implemented? The rationale behind this decision stems from the recognition that transitioning to adult care should be tailored to individual patient needs rather than being dictated by an arbitrary age. This patient-centered approach allows for a more flexible and personalized healthcare journey.

Historical Context of Pediatric Age Limits

• Pre-1960s: Age limit set at 18
• 1960s-2017: Age limit raised to 21
• 2017-present: No definitive upper age limit

This evolution in pediatric care guidelines reflects a growing understanding of the complexities involved in transitioning from childhood to adulthood, especially in terms of healthcare management.

Factors Determining Readiness for Adult Healthcare

Transitioning from pediatric to adult healthcare is not solely determined by age. Several factors come into play when assessing a patient’s readiness to make this significant shift. Dr. Emily Avis Redwood, a pediatrician at Columbia Primary Care, emphasizes that the decision should be a collaborative effort involving the patient, their family, and the pediatrician.

What are the key indicators of readiness for adult healthcare?

1. Understanding of personal health situation
2. Ability to manage medications or chronic conditions
3. Comfort in communicating with healthcare providers
4. Independence in scheduling and attending appointments
5. Capability to make informed health decisions

Dr. Redwood states, “A child who can fully take charge of their health is ready.” This readiness encompasses not just physical age, but emotional maturity and practical skills in managing one’s health.

The Transition Process: Building Independence

The journey towards healthcare independence begins long before the actual transition to an adult provider. Columbia pediatricians employ a gradual approach to foster this independence, starting in early adolescence.

How do pediatricians facilitate this transition?

• Directing questions to patients instead of parents
• Encouraging solo doctor visits
• Educating patients about their health conditions
• Promoting self-management of medications and treatments

This step-by-step process aims to empower young patients, giving them the confidence and skills necessary to navigate the adult healthcare system effectively.

Special Considerations for Chronic Conditions

For patients with chronic conditions that extend into adulthood, the transition process requires extra attention and care. These individuals often have complex medical needs that necessitate a well-coordinated handover to adult specialists.

How do pediatricians handle transitions for patients with chronic conditions?

1. Early preparation and education about the condition
2. Gradual transfer of management responsibilities to the patient
3. Identification of suitable adult specialists
4. Coordination between pediatric and adult care teams
5. Extended transition periods when necessary

Dr. Redwood notes, “Kids with chronic, developmental, or neurological conditions are living longer, better lives. It’s a great thing.” This positive outlook underscores the importance of smooth transitions to ensure continuity of care and maintained quality of life.

Emotional Aspects of Healthcare Transition

The shift from pediatric to adult healthcare is not just a practical matter; it often carries significant emotional weight for both patients and their families. Many young adults feel a strong attachment to their pediatricians, who have been a constant presence throughout their formative years.

Why can this transition be emotionally challenging?

• Long-standing relationships with pediatric providers
• Comfort and familiarity with pediatric care settings
• Anxiety about managing health independently
• Parental concerns about “letting go”
• Fear of the unknown in adult healthcare systems

Dr. Redwood acknowledges this emotional aspect, recounting instances where patients express relief at being able to continue with their pediatrician through college years. “Continuity during what’s often a tough time is key,” she emphasizes, highlighting the importance of a supportive transition process.

Finding the Right Adult Healthcare Provider

Selecting an appropriate adult healthcare provider is a crucial step in the transition process. This decision can significantly impact the quality and continuity of care a young adult receives.

What factors should be considered when choosing an adult doctor?

1. Recommendations from the pediatrician
2. Specialization in relevant health conditions
3. Acceptance of the patient’s insurance
4. Accessibility of the office location
5. Wait times for appointments
6. Comfort level and rapport with the provider

Dr. Redwood suggests, “Sticking with adult providers in the same practice as your pediatrician can be beneficial.” This approach can facilitate easier consultations between pediatric and adult providers if needed, ensuring a smoother transition of care.

The Role of Adolescent Medicine

For young adults who are not quite ready to transition to fully adult care, adolescent medicine offers a valuable bridge. This specialized field caters to the unique needs of patients in their late teens and early twenties, providing a middle ground between pediatric and adult healthcare.

What does adolescent medicine offer?

• Extended care up to age 25
• Focus on issues specific to young adulthood
• Gradual introduction to adult healthcare concepts
• Support for managing chronic conditions
• Guidance on sexual and reproductive health

Columbia Pediatrics, for instance, offers adolescent medicine services for patients up to age 25, providing a safety net for those who need more time to transition fully to adult care.

Navigating Healthcare During College Years

The college years present a unique challenge in healthcare management. Many students find themselves in a transitional period, often still covered by parental insurance or school health plans, but with limited access to regular primary care.

How can college students manage their healthcare effectively?

1. Utilize campus health services for routine care
2. Maintain communication with home-based healthcare providers
3. Learn to manage prescriptions and refills independently
4. Understand insurance coverage and how to use it
5. Develop skills in self-advocacy for health needs

This period often serves as a practical training ground for young adults to take charge of their health management, preparing them for full transition to adult healthcare post-graduation.

The Importance of Continuity in Care

Continuity of care during the transition from pediatric to adult healthcare cannot be overstated. It ensures that important medical history is not lost, that ongoing treatments are maintained, and that new healthcare providers are fully informed of the patient’s needs.

How can continuity of care be maintained during transition?

• Comprehensive transfer of medical records
• Clear communication between pediatric and adult providers
• Patient education on their medical history and needs
• Gradual handover of care responsibilities
• Follow-up appointments to ensure smooth transition

Dr. Redwood emphasizes that pediatricians are often happy to remain involved to some degree, offering support and guidance even as patients move to adult care. This ongoing connection can provide reassurance and ensure that no aspects of care fall through the cracks during the transition.

Empowering Patients in Their Healthcare Journey

The ultimate goal of the transition process is to empower young adults to take control of their health. This empowerment goes beyond just managing doctor’s appointments; it involves developing a comprehensive understanding of one’s health status, treatment options, and preventive care measures.

What skills should young adults develop for healthcare independence?

1. Understanding and articulating personal medical history
2. Knowledge of current medications and their purposes
3. Ability to recognize warning signs of health issues
4. Confidence in communicating with healthcare providers
5. Skills in navigating health insurance and billing

By fostering these skills, healthcare providers and parents can ensure that young adults are well-equipped to manage their health effectively as they move into adulthood.

The Future of Pediatric-to-Adult Healthcare Transitions

As medical care continues to advance and lifespans increase, the process of transitioning from pediatric to adult healthcare is likely to evolve further. The elimination of age limits by the American Academy of Pediatrics is just one step in a broader trend towards more personalized, patient-centered care.

What might the future hold for healthcare transitions?

• More specialized transition clinics
• Enhanced use of technology for care coordination
• Greater focus on mental health during transition periods
• Development of transition-specific healthcare roles
• Increased research on long-term outcomes of different transition models

As our understanding of adolescent and young adult health needs continues to grow, we can expect to see more innovative approaches to ensuring smooth, effective transitions from pediatric to adult healthcare.

In conclusion, the transition from pediatric to adult healthcare is a complex process that goes far beyond a simple age cutoff. It involves a careful assessment of a patient’s readiness, consideration of their individual health needs, and a collaborative effort between patients, families, and healthcare providers. By focusing on building independence, maintaining continuity of care, and addressing both the practical and emotional aspects of this transition, we can ensure that young adults are well-prepared to take charge of their health as they move into adulthood.

How old is too old to see a pediatrician?

March 10, 2022

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The upper age limit for pediatric care was eliminated by the American Academy of Pediatrics in 2017. Deciding when a child is ready to see an internist or other “adult doctor” is best determined by the patient, her family, and the pediatrician. Photo: Getty Images.

A teen looks at jelly nails on TikTok, while a toddler climbs a colorful mini chair beside her. When a child looks like they could be the parent of another patient in a toy-filled pediatrician’s office, is that a sign the older child should find an adult doctor?  

Age is a factor but more important is determining if a child is ready to take charge of their own health, says Emily Avis Redwood, MD, a pediatrician with Columbia Primary Care. “We love staying with someone we have known since childhood. Those relationships are why we got into health care,” says Avis Redwood. “But a goal is to help every patient transition safely to an adult provider. ”  

There is no age limit for seeing a pediatrician 

Originally defined as age 18, raised to age 21 in the 1960s, the upper age limit for pediatric care was eliminated by the American Academy of Pediatrics in 2017. The rationale: Transition to adult care should be specific to patient needs, not an arbitrary number. Deciding when a child is ready to see an internist or other “adult doctor” is best determined by the patient (and/or family) and the pediatrician. 

When patients reach early adolescence, Columbia pediatricians start directing questions to patients, not their parents, to help build up independence. Over time they see patients without a parent present. Anyone under age 18 needs parental consent for things like vaccines, but teenagers are encouraged to visit doctors alone to develop their own relationships and become comfortable talking about any issue.  

“We want to empower children to take charge of their health care, understand their own health situation, and manage their medications or disease,” Avis Redwood says. This is especially true for children who have a chronic condition that will extend into adulthood. 

How to know the time is right

“A child who can fully take charge of their health is ready,” says Avis Redwood. If your child has a good understanding of their health situation and can manage it, the next step is seeing a family or internal medicine provider.

It’s okay if a child is not ready, up to a point. Most practices set age limits. Columbia Pediatrics sees existing patients up to age 21. They also offer a bridge for patients still not ready—adolescent medicine—where specialists sees patient up to age 25.  

When patients reach early adolescence, Columbia pediatricians start directing questions to patients, not their parents, to help build up independence. “We want to empower children to take charge of their health care, understand their own health situation, and manage their medications or disease,” says Emily Avis Redwood, MD. Photo: Getty Images.

“The transition to adult care can be emotional,” says Avis Redwood. She recently made the day of a senior in high school hoping to stay on as a patient into college years. The answer was yes, and the relief was palpable.  

“Continuity during what’s often a tough time is key,” she says, noting parents can have a hard time with these transitions, too, even when they understand how important they are. And pediatricians are happy to remain involved. Plus, during college years, many students are still on their parents’ insurance or the school’s health plan and do not have regular access to primary care.  

How to find an adult doctor

Pediatricians have recommendations for internists, like they do for any specialist referral. And for children with complicated conditions and needs, pediatricians often know the right network of physicians that can handle the transition. “Kids with chronic, developmental, or neurological conditions are living longer, better lives,” says Avis Redwood. “It’s a great thing.”  

“Sticking with adult providers in the same practice as your pediatrician can be beneficial,” Avis Redwood says. She notes her own practice is steps away from adult providers, who can consult with her about former patients if ever needed. 

Other criteria to consider: Is the internist taking new patients? Do they accept your insurance? Is the office accessible by your child’s preferred mode of transportation? How long do you wait to get an appointment?  

Above all, your child should feel comfortable with whomever they see next.  

References

Emily Avis Redwood, MD, is assistant professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeons and a Columbia Primary Care pediatrician focused on evidence-based medical care and advocating for her patients. 

How Old is Too Old to See a Pediatrician?

Published Apr. 14, 2022

Tags:

• Kids’ health
• Your health
• Family & parenting

Choosing to switch from a pediatrician to an adult doctor is a big decision.

Visiting the pediatrician is a normal part of any child’s life. But as they age, they might not feel comfortable seeing the same doctor who treated them when they were a baby. If your child feels like they’re too old to see a pediatrician, switching to a different provider may be the answer. 

“Your child’s health changes as they grow, so it’s important to find a doctor who can give them the best care for their stage of life,” says Dr. Michal Maksimak, a pediatrician at Geisinger’s Woodbine clinic.

When to switch from a pediatrician to a family doctor

So, how long can you see a pediatrician? That depends. Knowing when it’s time to move on may happen naturally. 

Your child may decide on their own to stop seeing their pediatrician around age 12 or 13. Others may choose to wait longer. Or their provider’s office may give them a gentle nudge.

“We start encouraging kids to look for a new provider between 18 and 21,” says Dr. Maksimak.

If your child feels like they’re ready to move on, consider an adolescent medicine specialist. These providers typically care for kids and young adults between ages 10 and 25.

And if your child continues to see a pediatrician, their doctor may ask you to leave the room during their visit. “As children age, they need privacy to discuss things they’re dealing with,” Dr. Maksimak says. And they may not be comfortable bringing them up in front of you.

Helping your child navigate their health 

Giving your child the tools they need to navigate the medical system effectively will set them up for success.

Make the process easier for your child by:

• Finding a provider that accepts your insurance
• Helping them access their own medical records in MyChart
• Teaching them how to schedule their own appointments
• Discussing any chronic medical conditions or allergies they may have
• Educating them on the names and doses of any medications they take

“If your child is moving to a new provider, we encourage them to keep track of their medical records,” says Dr. Maksimak.

Making the transition to adult medicine

Moving on from pediatrics is a gradual process. And that transition looks different for everyone. “The age to switch varies, based on your child’s comfort level and individual health needs,” Dr. Maksimak says. 

If your child sees multiple specialists to manage health conditions, their provider will also discuss that part of the transition. 

Once your child is ready to move into the next level of care, their provider can help build a care transition plan. This plan will help them gain independence in making medical decisions. And it will arm them with the information they need for a smooth transition.

As your child grows, start the conversation about the next steps with their pediatrician. They can help with the transition and answer any questions you or your child have along the way. 

Next steps:

6 tips for having “the talk” with your child
Find a pediatrician near you
Meet Michal Maksimak, MD

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When should I contact a pediatrician? (Sergiev Posad)

Materials prepared by pediatrician Sineva Elena Alexandrovna

ATTENTION: Online consultations of doctors are available (more than 18 specialties).

Pediatrician is a doctor who deals with the diagnosis, treatment, and prevention of diseases in children from birth to 18 years of age.
Pediatrician is the first doctor in the life of every person after discharge from the maternity hospital. One of the main tasks of a pediatrician is disease prevention, which does everything possible to bring up the most healthy generation.

The meeting between the pediatrician and the child begins immediately after the child is discharged from the maternity home, during the first 3 days. At this meeting, the doctor talks about how to properly: feed, care for the baby, bathe, what parents should pay attention to. This moment of life is also called the “Newborn Period”. Its duration is 1 month. At this time, the doctor visits the child at home. The important days of this month are the first 10 days and 21 days for the obligatory examination by a doctor at home. In the first month of life, there are a number of symptoms in which you should immediately call a doctor home:
1. Any fever
2. Refusal to feed
3. Intense crying, restlessness for more than 3 hours
4. Vomiting, frequent spitting up after each feed
5. No stool for 24 hours
6. Rash on the body of the child
7 Redness or discharge from the umbilical wound
8. Heavy breathing, coughing
9. Discharge from the eyes, nose
10. Changes in the skin – pallor, cyanosis, jaundice
11. Presence of blood in the stool

infant or breast. This period is from 1 month to 1 year. At this time, the child is undergoing intensive growth, active emotional, neuropsychic development. At this point in life, it is easier to prevent a disease than to treat it. At this stage, a monthly visit to the pediatrician is mandatory. This is not only control over the correct physical and neuropsychic development of the child, but also the prevention of such diseases as: anemia, rickets, diathesis, malnutrition. For this period of a child’s life, the maximum number of prof. vaccinations according to the national vaccination schedule. Before vaccination, an examination by a pediatrician allows the child to transfer the vaccine without complications. When visiting a doctor, parents will find out not only the weight and height of the child, but also in what time frame and how to introduce complementary foods to the baby, how to harden the child correctly, the doctor will prescribe tests in a timely manner, undergo additional diagnostic methods, such as ultrasound, egk, will tell you which bottlenecks to visit specialists The purpose of such professional examinations is to prevent health disorders in children, timely detection and treatment of diseases in the early stages of their development.

The baby is growing and the next stage is the age – 2-6 years.
Preschool age is the stage of socialization. The child begins to attend kindergartens, various circles, developmental ones, begins to actively communicate with peers, the formation of speech is underway. How to avoid allergies, frequent colds? What to do with worms? How to feed a toddler? The pediatrician will answer these and many other questions, give recommendations on how to adapt the child to new living conditions – life in an organized team.
In this period of life, you need to visit a pediatrician if it is a professional examination – for 2 years – 1 time in 3 months, for 3 years – 1 time in 6 months, starting from 4 years 1 time per year.

But now it’s time to go to school. The pediatrician will help assess physical development, biological maturity, determine the child’s readiness for school, health group, physical education group, correct violations in the child’s health in the early stages, send him for tests, to narrow specialists in time. It will help at an early stage to identify an enlarged thyroid gland, impaired posture, select a balanced diet with excess weight, and much more. Also, children of this age begin to actively attend sports sections, swimming pools, go to health camps and sanatoriums. And here you can not do without a pediatrician. In addition to identifying health disorders at the earliest stages, the pediatrician prevents outbreaks of infectious diseases in organized groups.

Don’t miss a very important period – puberty. Due to endocrine restructuring, emotional instability, an exacerbation of many diseases is possible at this time. For example, frequent headaches, jumps a / d. At this age, some children already have such adult diseases as chronic gastritis, chronic pyelonephritis. A pediatrician will also help you figure this out. To prevent the disease from progressing, he will prescribe preventive treatment, send him for tests, ultrasound, and a consultation with narrow specialists. During this period, sanitation is important. foci of infection, i.e. a visit to the dentist, ENT doctor.

And of course, leaving school is an important period in the life of every young person. A pediatrician will help you correctly navigate when choosing a profession, given the presence of xp. pathology, developmental features of the child.

All this refers to the preventive work of a pediatrician.

Well, of course, there is no question of visiting a pediatrician when the child is already ill, and at any age. The temperature has risen, a cough or runny nose has appeared, the stomach hurts or constipation is tormented. Be sure to contact your pediatrician. Do not self-medicate. Only a specialist can understand the variety of symptoms of the disease, which means correctly diagnosing and prescribing adequate treatment, which will quickly lead to the recovery of your child.

Thus, we see that the pediatrician is your child’s friend throughout childhood. The main goal of a pediatrician is to help raise a healthy child, and you to be happy parents.

With care for your health, Paracelsus Medical Center

Visiting a pediatrician for children of different ages: features of admission – Clinic of Modern Technologies

Visiting a pediatrician by children of different ages: features of admission

A pediatrician is a specialist who looks after children from birth until they reach the age of 18. He studies the features of the formation of the child’s body, diagnoses various diseases, prescribes treatment, recommends visiting doctors in other areas. The specifics of the appointment with a pediatrician largely depends on the age category of the patient.

Visiting a pediatrician with a child from 0 to 12 months

Examinations of a baby up to a year old are carried out quite often. During this period, the formation of body systems takes place, the foundations of future health are laid, so it is extremely important not to miss even small deviations from the norm.

In the first month, the participation of a pediatrician in the life of a child consists in his general examination, the issuance of recommendations on feeding, daily routine, comprehensive consultations on caring for the baby. The pediatrician must prepare a referral to the surgeon, ophthalmologist, neurologist.

When the child is three months old, a second examination by specialists is scheduled. At this age, pathologies of the development of the motor and other systems may appear. Timely measures taken will make it possible to avoid serious consequences.

The next important milestone is six months. The pediatrician, together with colleagues, assesses the condition of the child. If pathologies were previously identified, specialists analyze the degree of effectiveness of the prescribed treatment, decide on its adjustment.

Examination at 1 year

Examination at 12 months – summing up the first results. Not only the family pediatrician takes part in it, but also other specialists:

• surgeon;
• ENT;
• ophthalmologist;
• dentist;
• psychiatrist.

Comprehensive medical check-up helps to prevent serious health problems, to find gaps (for example, missed vaccinations if the child is vaccinated).

Pediatrician’s appointment at the age of three

Kindergarten is an important stage in the life of every child. To make sure that there are no contraindications for visiting a preschool educational institution, you need to make an appointment with a pediatrician and be examined by specialized specialists.

At this age, children often begin to lose sight and form an incorrect posture. The doctor will pay attention to this, prescribe an examination, recommend ways to solve the problem. You may be advised to enroll your child in a specialized kindergarten.

Visiting a pediatrician after six years

If there are no health problems, the next scheduled check-up with a pediatrician will take place before entering school. You will again have to undergo a comprehensive examination with your child. This is necessary to adjust the diet, determine the group for physical education.

At the age of 10, children are shown to a gynecologist and urologist-andrologist. If weight problems are observed, the pediatrician will write a referral to an endocrinologist. In the future, a visit to a medical institution, as a rule, occurs only when necessary (obtaining certificates, consultation, etc.).

Would you like your child to be examined by an experienced pediatrician? Contact the “Clinic of modern technologies”.

The network of medical centers “Clinic of Modern Technologies” in Khabarovsk provides a wide range of professional medical services in various fields, including: cardiology, gastroenterology, ophthalmology, gynecology, urology and many others. The multidisciplinary center “KST” has all the necessary certification, a friendly atmosphere, as well as the latest equipment and experienced professionals who will help you at affordable prices in Khabarovsk. Contact us by leaving a request on the website or call us at +7 (4212) 48-88-88

Our specialists

The Clinic of Modern Technologies is staffed by experienced professionals. Diagnostics and treatment are carried out by doctors working in such areas as surgery, neurology, urology, pediatrics, endocrinology, cardiology, etc. Despite the high level of professionalism, our employees continue to polish their skills and knowledge, regularly improve their skills. Entrust your health to experienced doctors!

The “Clinic of Modern Technologies” is very attentive to the formation of staff. We have real professionals who are always ready to help patients. They will be able to find an approach to both an adult and a child. Accurate diagnosis, competent treatment, successful rehabilitation – all this is possible when contacting the “Clinic of Modern Technologies”. We stand guard over your health.

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