Transitioning from Pediatrician to Family Physician - What Is the Right Age?

Introduction

Many parents are comfortable consulting the same pediatrician who treated their children from the time of birth. Pediatricians too have good knowledge about the child as they consult them at various ages. Changing to a family physician may be influenced by finances, location, trust, and future plans. Though parents may prefer consulting a pediatrician till their early 20s, teenagers and young adults may feel embarrassed to sit in a pediatrician’s clinic surrounded by toys.

What Are the Benefits of Consulting a Family Physician?

Family physicians as the name suggests, provide healthcare to the whole family and are well-known to the family members. In many cases, the family physician will be nearby and this excludes the need to travel long in search of a pediatrician.

Why Do Few Adults Continue Consulting a Pediatrician?

Few adults even in their middle age prefer to consult a pediatrician for their health issues. This can be due to several reasons:

• Adults with developmental or intellectual disabilities feel comfortable in continuing the consultation with their pediatrician. Shifting to a family or general physician can be traumatic for them.

• Since few adults have developed a comfort zone with their pediatrician they do not get into the idea of consulting a family physician.

• People with health issues present at birth like congenital heart disease (birth defects that affect the normal functioning of the heart), sickle cell disease (a group of disorders in which the red cells change their shape and break down), and so on continue consulting their pediatrician since the pediatrician has a detailed understanding of their medical history.

What Is the Upper Limit of Treating Pediatric Patients?

The American Academy of Pediatrics in 1938 fixed the upper limit of treating pediatric patients as 18 years. In 1969, this age limit was increased to 21 years. Since then, the outcome of pediatric health conditions has improved and there have been fewer childhood deaths.

When to Switch From Pediatrician to Family Physician?

There is no specific age to shift from a pediatrician to a family physician. Few parents prefer to continue their adolescent’s consultation with a pediatrician as few insurance policies cover pediatric care for up to 19 or 20 years. Adolescents may not want to discuss sensitive topics like sexual identity, depression, anxiety, or relationship safety in front of their parents with a pediatrician. A family physician is capable of diagnosing and addressing broad issues like obesity, and diabetes, and counseling adolescents about the need for safe driving, healthy relationships, alcohol, and substance abuse.

What Are the Advantages of a Family Physician Over a Pediatrician?

A family physician treats the entire family and is quite aware of the hereditary conditions and is well acquainted with the family history. Making a transition to consult a family physician can help the child or adolescent to be comfortable in a way as they know each other and the physician has prior knowledge about the family history. The disadvantage of family physicians is that they do not spend too much time rendering special care to the children like a pediatrician. A primary care physician is trained to treat adults and medical care differs in adulthood.

How Can Parents Help Adolescents to Make a Transition to a Primary Care Physician?

Parents can help in the following ways:

• Adolescents can be taught to make appointments and obtain prescription refills.

• Pediatrician’s opinion can be obtained on when to switch to a primary care physician.

• Adolescents need to be taught what and how to ask questions to a primary care physician and understand what the doctor says.

• Provide knowledge about the insurance policies and what type of healthcare is covered in these policies.

• Adolescents must be asked about their preferences such as a male or female physician, older or younger physician, and so on.

• Let them know if supplemental insurance is required to cover the healthcare offered by the school or college.

• Adolescents should be allowed to have a one-on-one consultation with their physician. This helps them to discuss their health issues frankly.

• They must be made to understand their chronic health problems so that they know their health condition and associated consequences preferably at or before 18 years of age.

• By the time the child attends high school, they should know the names and dosages of their regular medications along with their purpose. They must be encouraged to let the parents know when the medicines get over so that they become responsible.

• Adolescents must know about their allergies.

How to Obtain the Pediatrician’s Help to Switch to a Family Physician?

The pediatrician can be approached as follows:

• The pediatrician should be asked about when the transition can be made. This should be done at least one year before as it may take time to find a new primary care physician or enable the teen to get adapted to a family physician.

• Ask the pediatrician to refer a primary care physician known to them as it can make the communication and transfer of medical history easier.

• Ask the pediatrician if the child requires special needs like mental health counseling, occupational therapy (a therapy that helps the individuals to carry out their day-to-day activities), or physical therapy (a therapy that aims to restore functional movements like walking, standing, and moving various body parts). This can be helpful to search for the therapist ahead of time.

What Information Should Be Shared During the First Visit to a Family Physician?

The following should be shared during the first visit of the teen to a family physician:

• The adolescent’s health and immunization records. These can be submitted to the doctor prior to the first visit so that the doctor goes through the records.

• Previous health conditions or history of allergies that were known only to the pediatrician.

• The equipment used like an asthma inhaler, over-the-counter medications, and their dosage.

• Providing information about the pharmacy or the medical supply company may minimize refill delays and helps to renew the teen’s medical needs.

What Questions Should Be Asked to a New Primary Care Physician?

A few basic questions mentioned below can be asked to a new primary care physician especially if the physician consults patients based on appointments.

• Find out whether the hospital admits new patients or treat patients who are of the age of adolescent because few general physicians treat patients starting with those who are in their early adulthood.

• For how many days or weeks one must wait to get the first appointment?

• Ask whether the new physician accepts the insurance coverage and check whether they are listed in the existing insurance plan.

• Who will treat the teen and whether there is a team of doctors to cater to the various health needs?

• Whether the physician will be available on weekends and what are the hospital timings?

• How can the physician be reached out after hospital hours in case of emergencies?

• Whether missed appointments are chargeable.

• Has any paperwork to be completed before the first appointment?

• Is the clinic or hospital nearby and whether they can be reached with ease?

• At what hospital does the physician carry out certain procedures and sees admitted patients?

What Tips Should Adolescents Follow During Their Visit to the Family Physician?

A few tips are as follows:

• The physician’s instructions should be listened to attentively and if necessary the physician can be asked to write down the needed instructions or healthcare changes.

• Maintaining a medical file at home and filing the new prescriptions with the old ones.

• The physician can be asked to write down the date of the follow-up appointment and the same can be noted on a calendar at home so that it can be remembered.

• The physician must be informed beforehand if the adolescent is unable to make it to the appointment.

• A card containing medical details such as name, health conditions, emergency contact numbers, physician’s name, contact number and address, names of medicines, and emergency treatment if any should be kept in hand.

Conclusion

There are no hard and fast rules to switching from a pediatrician to a family physician. Adolescents can let their parents know if they are grown up enough to consult a family physician. The final decision is based on the child’s health needs and their willingness to consult a family physician or a primary care physician.