Selecting a pediatrician is serious business; you want to make sure that you start out on the right foot in terms of picking the best doctor to entrust with your child’s health. Parents typically do some heavy vetting in order to choose the doctor or practice that they feel is best to be responsible for their child’s well-being.
A relationship with your child’s pediatrician is often a long-term one, sometimes spanning from your child’s infancy until the end of their adolescence.
Or even longer, apparently.
More & more adult patients are still relying on their pediatrician to serve as their primary care doctor, despite being well above the doctor’s typical patient age range.
According to an article recently featured in The Washington Post, many young adults are continuing to stay with their pediatrician despite being well out of their teens.
More & more pediatricians are finding patients in their waiting room that are the same age as the parents of their other patients.
Young adults typically live home with their parents longer than decades past, which is part of the lack of motivation for finding an adult practitioner; they’re comfortable with what they know. Many of them have seen the same doctor since infancy, & are reluctant to face the unfamiliar.
Changes to the healthcare system have contributed to young adults relying on their parents’ health insurance plans longer. The Affordable Care Act has allowed individuals to remain covered by a parent’s insurance plan up to the age of 26.
Since many millennials are not always offered health insurance by their employer, staying on their parents’ plan is an appealing option.
There’s no shame in taking advantage of coverage readily offered by the umbrella of your parent’s health insurance- I wish I’d had the same option after graduating college.
I found myself in the gap, no longer covered by my parents but with no plan of my own. A case of mononucleosis soon followed, & my medical bills soared.
It can be difficult at best to secure your own health coverage as a young adult. As pediatrician Joann Alfonzo explained to The Washington Post:
A lot of them can’t afford to live on their own and get their own insurance, or even afford the co-pay.
And if insurance is offered at work, there’s generally a cost share involved, if insurance is provided at all.
But while young adults can be covered until the age of 26, they are not required to remain under their pediatrician’s care until then… yet many still do.
Young adults typically live home with their parents longer than decades past, which is part of the lack of motivation for finding an adult practitioner; they’re comfortable with what they know. Many of them have seen the same doctor since infancy, & are reluctant to face the unfamiliar.
Dr. Karen Soren, director of adolescent health care at New York-Presbyterian Morgan Stanley Children’s Hospital, explains that she’s seeing more patients having difficulty “leaving the nest”, so to speak.
She cites the example to the New York Times of one of her female 20-something patients that returned to her pediatric practice after a year with an adult internist:
I made an appointment for her with the new doctor. She went once, but said she went into the waiting room and there were all these ‘old people.’
A year later she came back to refill her birth control pills, so I began seeing her again.
Despite chronologically being an adult, many young adults are reluctant to pry themselves from the care of a doctor that knows them well, having invested years into the doctor-patient relationship.
But the issue extends beyond the potential social stigma of seeing a “kid doctor”. Pediatricians are specifically trained to deal with children’s medical issues, not adults.
While pediatricians are obviously trained to deal with a wide variety of ailments in medical school, their lack of specialty in adult-related conditions can be problematic.
As Dr. Joann Alfonzo pointed out to The Post, treating adult patients requires a familiarity with adult on-set diseases such as hypertension, Type 2 diabetes, high cholesterol, or pregnancy:
We’re now treating people for adult diseases, things we weren’t trained to treat.
Some doctors have even resorted to establishing clear age restrictions to minimize patients from staying in their practice once they’re reached adulthood. Some doctors urge patients to find an adult primary care doctor once they’re reached the age of 18. Some opt for that transition once the patient had graduated from college.
And some practices, due to patient enthusiasm, have upped their age limit higher. MUCH higher.
Dr. David Bell of the Young Men’s Clinic at New York Presbyterian explained to The New York Times that when he started the practice 16 years ago, the age limit was 24. Now?
I pushed it up to 27, then 30, and now 35. I’m kind of sticking to 35.
I can understand the reasoning a bit, because I remember how traumatic it felt to have to choose a new primary care doctor when the one I’d seen for years eventually retired. The doctor-patient relationship is ideally a trusting, mutually comfortable one, & it can feel daunting to embark on a new one after years of seeing the same doctor.
BUT- adulthood brings many new responsibilities and life transitions, and evolving out of your pediatrician’s care should definitely be one of them.
Embracing life as a fully functioning adult means being independent and adapting to life outside of a parental/pediatric comfort zone.