When your child progresses from pediatric to adolescent medicine, the transition needs something called ‘continuity of care.’

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Dr. Margaret Aranda. Image Mark Burke

While adolescents make up fully 20% of the population, after age 12, there is a steady decline in adolescents’ getting annual evaluations by pediatricians.

Although more adolescents are covered by medical insurance, this drop-off may be due to the thought that a sports or urgent care check-up “counts” as a developmental, comprehensive exam. For any patient, nothing can replace seeing a doctor who is familiar with your past medical history and offers continuity of care.

The concept of continuity of care also applies later on when your adolescent turns 18 and enters a college campus, and whenever anyone moves from one city to another.

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Continuity of Care: A Pillar of Good Medicine

“Everyone wants health care transitions to be smooth. Continuity of care is paramount. Medical students are coached in this manner, American Board Exams test on it, insurance companies and the federal and state governments have regulations requiring it.

The emotional patient-centered experience is ultimately enhanced by quality of the care that leads to improved patient outcome.”

~ Dr Margaret Aranda

Here are 5 Components of Continuity of Care:

  1. Formal “Acceptance.” The new physician “accepts” the care of a teen.
  2. Ease. For healthy teens on no medications and without a significant history of illness or surgery, a “walk-in” appointment may be sufficient for a new physician to start care.
  3. Getting “Report.”For teens with a diagnosis that requires treatment or regular visits, a new physician may only “accept” him after “getting report” from the previous physician.“Report” is a formal oral and/or written presentation of the age, ethnicity and history, allergies, medications, significant physical exam and laboratory/study findings, with a chronology of important events relevant to today. A list of medical problems is given, together with the status of each.
  4. The First Visit. This route may be ‘paved’ by the pediatrician who is no longer going to be seeing the teen. Of course, she is still available to assist in the transition, as everyone wants “Continuity of Care.” This is routine for patients with chronic illnesses, especially when rare or invisible.
  5. The Plan. The Plan for care is important. It is discussed with both physicians, if needed, and the new physician ‘takes over’ as she is figuratively ‘handed the baton’ and is now in charge of optimizing health care.
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Dr Margaret Aranda “What’s the Positive?” with Roland Takyoka.

Depression or anxiety, mental health issues, may continue to be addressed with that doctor. If going away to college, it may be wise to see a new mental health professional when visiting to interview, relocate or move.

Your teen’s new doctor could be what’s called a “Transitional Medicine” expert that sees many teens as they age to maturity. In our next issue we will discuss the various specialties that offer Fellowship training for adolescent or transitional medicine.

Everyone deserves to be seen by an American Medical Board-Certified Physician. Some doctors even do research and write spellbinding articles on the internet, being national Public Figures for your daughter to get to know. Doctors love our youth.

By establishing and maintaining a personal and empathetic patient:physician relationship with a new physician during adolescence, your teen is mindful of personal health care. She will inwardly desire to seek and obtain this same relationship with other lifetime physicians, optimizing continuity of care and patient satisfaction.

Your teen girl’s physician role model can be very important in her life. This is especially pertinent to single fathers raising daughters.

Resources:

American Association of Family PracticeDefinition of Continuity of Care

Continuity of care in the ambulatory sector and hospital admissions among patients with heart failure in Germany Eur J Public Health August 1, 2016 26: 555-561 Abstract Full Text Full Text (PDF)

Mindfulness for Teens: Discovering your Inner Strength

Visit A Quiet Place with Dr. Amy Saltzman now.

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Additional Articles in the Teen Mindfulness Series:

#1. Teen Mindfulness: 10 General Concepts

#2. 5 Facts about Teen Mindfulness and Neuroplasticity

#3. Teen Mindfulness: 10 Concepts on Decision-Making

#4. Teen Mindfulness: Make 10 Good Choices

#5. Teen Mindfulness: 10 Considerations For Girls’ Adolescent Medicine

#6. Teen Mindfulness: 5 Components of Continuity of Care

#7. Teen Mindfulness: 5 Types of Board Certified Doctors

#8. Teen Mindfulness: 10 Steps to Medical Independence