He’s 26 years old but still sees a pediatrician: Why some young adults don’t move on.

This child is the right age to see a pediatrician, but some young adults aren't moving on from their childhood doctor. Photo: LWA/Dann Tardif/Getty Images/Blend Images RM

When Joann Alfonzo, a pediatrician in Freehold, N.J., walked into her office recently she mentally rolled her eyes when she saw her next patient: a 26-year-old car salesman in a suit and tie.

“That’s no longer a kid. That’s a man,” she recalls thinking.

Yet, Alfonzo wasn’t that surprised. In the past five years, she has seen the age of her patients rise, as more young adults remain at home and, thanks to the Affordable Care Act, on their parents’ health insurance until age 26.

“First it was 21, then 23 and now 26,” Alfonzo says. “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.”

The idea of young adults continuing to see their longtime pediatricians has been around for quite some time – it was a laugh line on “Friends” in its last TV season in 2004. Rachel takes her child to a pediatrician, she sees the child’s father, Ross, in the waiting room and realizes he’s still a patient.

But these days that’s pretty realistic, Alfonzo says. “We have people who have had children, and they still see us, so we’re seeing the parents and their children, concurrently,” she says.

So when is it time to leave your pediatrician? Talon Manfredini, 22, says he only left his pediatrician, who is a woman, this year because he moved from his family home in New Jersey to begin a new job in Miami.

But he didn’t think twice about continuing to see her, even though he’d finished college. “She just felt like a regular doctor,” he says. “It didn’t feel odd at all or different or weird or anything like that.”

Debbie Weinberger DeFrancesco, 41, a regional sales manager for Tyson from Marlboro, N.J., says she continued to see her pediatrician until she was about 27.

“The thing I remember very clearly, especially towards the end of my time there, was how the moms were the same age as me – and not thinking that I was too old for the doctor but that they were too young be having babies,” she says.

She finally decided it was time to get an “adult” doctor when she got married. “I thought it was a good idea for my husband and me to share the same doctor and have our files under one roof,” she says.

Aside from some potentially awkward moments in the waiting room, is there anything wrong with pediatricians continuing to treat their patients once they become adults?

A little, Alfonzo says.

“We’re now treating people for adult diseases, things we weren’t trained to treat,” she says, such as adult hypertension, Type 2 diabetes, high cholesterol, pregnancy, even depression and anxiety. If she encounters something she can’t handle, Alfonzo says she will refer the patient to a specialist.

“Actually, I think it impacts them more in a positive manner, because I think pediatricians are very thorough in their assessment,” she says.

It’s certainly more thorough than an urgent care center, which is where many 20- and 30-somethings wind up when they don’t have insurance and are no longer seeing their pediatrician, Alfonzo says.

The American Academy of Pediatrics (AAP) attempted to address the issue of transition from pediatric care into adult care in a policy statement in 2017 and concluded “the age of transition” should be based not on a number but on the patient’s individual needs.

The decision “should be made solely by the patient (and family, when appropriate) and the physician and must take into account the physical and psychosocial needs of the patient and the abilities of the pediatric provider to meet those needs,” the policy statement said. In addition, it said that ‘the establishment of arbitrary age limits on pediatric care by health care providers should be discouraged. Health care insurers and other payers should not place limits that affect the patient’s choice of care provider based solely on age.”

Read More
%d bloggers like this: