Monday, June 20, 2011

Graduate, But You Don't Need to Leave!

Not a day goes by without a blog, email, listserve post, journal article or query in my office about how best to transition older teens and young adults to "adult" medical care. This is especially of concern for patients with special health care needs, or SHCN, the acronym that is currently in vogue. SHCN include medical diagnoses such as diabetes, cystic fibrosis, and congenital heart disease; emotional illnesses such as depression, eating disorders, and anxiety; and developmental disabilities such as autism spectrum disorders, mental retardation and learning differences.

Last week the New York Times published an article   by Perri Klass, a Boston pediatrician who frequently writes about current medical topics, called "The Graduation that May  Carry Unnecessary Risk" referring to graduation from the pediatrician with nowhere to go and no help in transitioning. 

This article is woefully lacking in understanding of what Adolescent Medicine physicians do.  As a board certified specialty, adolescent medicine physicians fill exactly the role that Dr Klass is calling for.  In her article she gives parenthetical mention to adolescent medicine physicians as managing reproductive concerns but fails to mention that most adolescent medicine physicians are trained to and capable of --and actually enjoy--caring for the special needs of all patients as they age up. This includes primary care, psychological counseling for the patient and the family and communication with the myriad of specialists involved in complex care.

In my practice in White Plains, not only are we committed to this transition (up to age 26) but we are organized physically (with a separate space for teens and young adults) and medically (with board certified care available for all older patients) to respond to this growing need.  As the waiting rooms of internists fill with the aging population, young adults--especially those with SHCN,  require a comprehensive program that can address all their concerns. We have that, right here.

1 comment:

  1. I do agree with your response. I did read the article last week and felt the same. Perri Klass should know better.

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