When should you stop taking your child to the pediatrician?
By Jennifer Larson
When does your child become an adult? Is it when they turn 18? When they head off to college or start working full-time?
With questions about adulthood also come questions about when they should receive different medical care. When exactly is the right time to stop taking your child to the pediatrician?
“I think it depends on the practice you go to,” says Tanya Kadrmas-Iannuzzi, DO, a pediatrician in Stratford, New Jersey, and acting chairperson of Pediatrics at Rowan University School of Osteopathic Medicine. “And [also]... it depends on the needs of your child.”
In the past, the American Academy of Pediatrics recommended an upper limit of age 21. But in the most recent policy statement “Age Limit of Pediatrics,” the AAP changed directions and said it was discouraging arbitrary age limits on pediatric care.
So, it may boil down to what your child’s pediatrician decides is the age limit for his or her practice. If you don’t know what the practice policy is, just ask.
But you might not have to rush your child off to a new doctor right after they receive their high school diploma as many practices still take patients until they turn 21. That’s good news for parents who may be worried about finding an internist for their fledgling college student while also fretting about finding extra-long twin sheets for their dorm room bed.
And while it’s common for practices to take patients until they’re 21, many pediatricians don’t have a hard-and-fast age limit.
“We keep people through college, through the end of college,” says Kerry Fierstein, MD, CEO of Allied Physicians Group in Melville, New York. “At that point, a lot of them are going to be moving someplace else or will have to start with a new physician anyway.”
Ask your child
If your child’s doctor gives you the nod to stay with the practice a while longer, that can be helpful. But don’t forget to ask another person how they feel about continuing the relationship for a while longer: your child. They might have an opinion that surprises you.
“Ask ‘where would you like to go for your checkups and when you get sick?’,” suggests Jesse Hackell, MD, vice president and COO of Pomona Pediatrics in New York.
Dr. Hackell, who co-authored the AAP’s most recent policy statement on the topic, believes it’s important to get your child’s input. Some older teens may be ready to bid farewell to the waiting rooms full of babies, toddlers, and toys. But others may feel comfortable sticking with a familiar doctor who knows them and their healthcare concerns very well.
“Find out what your child’s opinion is because that’s who the patient is,” he advises.
If you have a child with special healthcare needs, it may be entirely appropriate for your child to remain under his or her pediatrician’s care for a while longer anyway. This might include conditions such as congenital heart disease, asthma, a seizure disorder, cystic fibrosis, or cerebral palsy as well as ADHD, autism, or depression.
As long as the child’s pediatrician feels comfortable continuing to manage those medical conditions, there shouldn’t be a problem, Dr. Hackell explains.
Making the transition
There are two things you and your child might want to do when it’s time to move on: Ask for referrals for internists or specialists who care for adults, and ask for a copy of your child’s medical record, including their immunization history. You might not even have to ask, as many pediatricians offer to help with or handle these issues.
Dr. Fierstein also likes to talk to her older patients about managing any ongoing health issues that require medication, like allergies, and understanding their health history well enough to complete the paperwork for a new doctor.
“The goal would be for it to be a transition for the child, where they start to learn how to take over their own health,” says Fierstein.
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