When Your Child Outgrows the Pediatrician
We all want the best for our children, no matter what age. That includes good health and quality of life.
As we help them on their journey to adulthood, the best thing parents can do for children is help them receive the health care they need. So what happens when they’ve reached the age when it’s time to switch from pediatric to adult care?
There are things parents can do to help make this a smooth transition.
First, it’s important to know the difference between transition of care and transfer of care. Transition of care is the shifting of responsibility, understanding, and power of care from a parent to a child over time, while transfer of care is the nuts and bolts of switching a patient from a pediatric to adult provider. This distinction helps parents understand that transition should actually start very early on, as it lays the groundwork for an eventual transfer of care.
This is especially important when a chronic illness is involved. Conversations between the family and provider typically start when a child is very young. This helps the family understand a child’s illness, what a chronic diagnosis means, and what to expect in the future. It also helps the child to accept responsibility when it’s time to make the change.
However, it can’t hurt for all parents and providers to start discussions sooner than later. Physicians start teaching these basic concepts to all school-age kids to help ease the future transition. Together, patients and families really need to be actively involved in the child’s care to ensure his or her needs are met throughout the growing process.
We advise parents to start considering and mentally preparing for this transitional phase when a child is about 10 to 12 years old, with more emphasis on the late teen years. While it varies by practice, transfer of care usually occurs between ages 18 and 21. How complex a child’s care may be has a direct impact on the transfer process. In complex cases, such as with pediatric cardiology, it’s not uncommon for a patient to reach his or her early 20s or older before changing physicians.
Tips for ensuring a smooth transfer of care
- Ask early and often about what’s expected when planning a transition and transfer of care.
- Be sure you have a clear understanding of your child’s diagnosis and his or her medications (including what they are for and how to access them) and encourage your child to do the same.
- Begin the transfer of care process at least one year in advance, as there could be delays in connecting with an adult provider and/or transferring necessary records, particularly with complex chronic conditions.
By keeping a child’s health care needs top of mind, parents can get a jump start on exploring options for adult providers who can and will accept a transferred patient. Sometimes it may be a parent’s own physician. The longer one waits, the harder the process becomes for both parent and child.
About the Author:
Sara Ford, MD
Dr. Sara Ford is a pediatric cardiologist with the Pediatric Heart Center at Hasbro Children’s Hospital. She also sees patients at Hasbro Children's Hospital's Pediatric Specialty Clinic in Fall River.
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