General Physician

Your pediatrician has been with you and your child through colic, earaches and the ups and downs of puberty. But now, your teen’s all grown up, and you’re wondering if it’s time to start seeing a family doctor or general physician instead. “There’s no fixed age to make the switch from your pediatrician,” says Jesse Hackell, MD, a pediatrician in Pomona, NY and vice president of NY Chapter 3 of the American Academy of Pediatrics. “It’s very individualized, as every child and young adult is developmentally different.” Here’s what to think about before making the change:


“Your whole life as a parent is about preparing your kids for the next step in life. Their health care is no different,” says Maritza De La Rosa, MD, medical director of the NJ Family Practice Center at Rutgers New Jersey Medical School. “You want to get them accustomed to the idea that eventually, they’ll be doing this independently. For example, teach them to speak up and tell the doctor if they feel like something isn’t right.”


By the time your child hits his early teens, your pediatrician may begin to direct questions more frequently to him. “We want the child to know we’re his or her advocate and he or she is the patient, not the parent,” says Hackell. “As the child gets older, I also may ask the parent to step out of the room for short periods of time, too, so we can talk to the kids about alcohol, substances, smoking and risky driving behaviors.” Understandably, kids sometimes open up more if a parent isn’t around.


Some kids stay with their pediatrician until graduating from college because they’re comfortable with someone they’ve always known. In addition, “it’s sometimes helpful to have a medical home when they come back on college breaks,” says Hackell. Other kids are ready to leave the pediatrician’s office by the time they hit their teens. There’s no set recommendation, and every family decides together with the doctor, says Hackell. Your pediatrician can also recommend a doctor that’d be a good fit for your child.


If your child flat-out says he or she doesn’t want to go to the pediatrician with the Mickey Mouse décor and Paw Patrol toys in the waiting room, pay attention. “That’s valid and shouldn’t be ignored,” says Hackell.


Some insurers set limits on the age range your child can receive care from a pediatrician, so read your policy to understand what’s ahead. In some multispecialty practices, there’s a built-in process to transition kids to the adult medicine segment of the group. Essentially, your child will shift to a different doctor in the same practice, which can ease the transition.


In some areas, access to care, especially for young adults or those with developmental delays, is limited. If your child has a chronic health condition or is a young adult with disabilities, you may want to stick with your pediatrician for a longer period of time, says Hackell.


A family practice sees kids through senior year of high school, so it’s a good idea if you want one medical home for the whole family. Internists focus on adult medicine, though some won’t take patients younger than 18. “If you have a rapport with your own doctor, that’s another option,” says De La Rosa. But don’t make assumptions; sometimes kids want to assert their independence, so let them decide if they want to see your doctor. Some kids also have a preference about whether they want to see a male or female physician.


It’s a good idea to arrange an acquaintance appointment with the new doctor (that’s solid advice for any switch). “You want to make sure the doctor and the office are a good fit for your child and your family,” says De La Rosa. “Have your child make a visit when they’re well, instead of having to see someone new for the first time when they’re really sick.”

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