10 August 2010

When Should Your Children Graduate From The Pediatrician?

Tis the season when pediatricians are flooded with families bearing back-to-school medical forms as well as grown teenage patients who have yet to progress from their childhood physician.

When is it the right time for a teenager to graduate from their pediatrician?

The answer is as ambiguous as a kid’s own growth patterns. Most pediatric doctors will continue seeing their patients until they reach the ages of 18 to 21. While some children are ecstatic to consult a new doctor who is considered more age-appropriate, others enjoy the comfort of the friendly pediatric atmosphere, particularly when there is already enough changes going on in their lives.

According the Wall Street Journal's health column, there are in fact a number of pediatricians who are encouraging their patients to remain in their practice's loop until their are finished with college.

However experts claim that this is one health care aspect where it is critical to listen to your kid's opinion and preferences. Several teenagers are much more at ease with a doctor of the same sex as they go through puberty. As for girls, they seem to be getting more choice. Approximately 70% of all residents today in pediatric training programs are female. Additionally, many girls in their late teens are beginning to see a gynecologist. A parallel for boys is non-existent, and many young men may not have the same level of comfort as the growing trend in pediatrics becomes more female dominated.

Concurrently, puberty in boys is arriving earlier than in girls. According to a Wall Street Journal pediatrics study, 10.4% of white, 23.4% of black and 14.9% of Hispanic girls are experiencing breast development by age 7. That is in fact almost twice the number recorded back in 1997. “It’s harder to see with young men, but they’re starting as early as 9 or 10,” says Margaret Blythe, an Indiana University School of Medicine professor of pediatrics and chair of the American Academy of Pediatrics’.

It is more important than ever to discuss the transition of puberty with your pediatrician, even in situations where the physician provides highly specialized medical treatment, such as a pediatric neurosurgeon, or in some cases, a pediatric nephrology specialist. Some valuable questions to ask these types of professionals include: At what age level does the pediatrician usually stop seeing patients? What is the number of teenagers currently in the pediatric practice? What is the practice's policy regarding confidentiality and private discussions? How does the pediatrician handle physical exams with respect to the private parts? And are there any exceptions staying with certain specialized treatment providers, such as an expert in pediatric neurology?

There are some pediatric practices who are sensitive to any confusion or misunderstandings that the patient might have during physical examinations. “It’s a messy issue,” says David Tayloe, former president of the American Academy of Pediatrics. “I don’t think the boy is going to be comfortable if I go get a female nurse to stand there while I examine his testicles.”

Before leaving the pediatrician, medical specialists advise families to ensure their young adults have a primary-care doctor who they are comfortable with and who is willing to accept them for treatment. A growing number of internists are becoming overwhelmed with aging baby boomers, implying lengthy waits for appointments. A Detroit pediatrician is witnessing the influx first hand as the southwest Michigan region has been a primary area for ongoing health care issues.

Melissa Brown, a retired pediatric physician, also recommends to parents: “Don’t say, ‘Little Johnny or Little Susie has decided that it is now time to go to a regular doctor or a real doctor.’ That hurts. What are we, pretend doctors?”

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