March 13, 2019 12:55 pm Chris Crawford – A new 30-minute podcast breaks down the updated joint clinical report on the health care transition from adolescence to adulthood in the medical home that the AAFP, American Academy of Pediatrics (AAP) and American College of Physicians (ACP) released last October.
During the podcast, AAFP representative Laura Pickler, M.D., M.P.H., joins ACP representative Carol Greenlee, M.D., and AAP representative Patience White, M.D., to provide a general overview of the evidence related to health care transition, the clinician's role, special considerations for youth and young adults with intellectual or developmental disabilities (IDDs), and tips for implementing health care transition processes in practice.
Pickler is chief of family medicine at Children's Hospital Colorado in Aurora and was a member of the group that wrote the 2018 joint clinical report, as well as its 2011 predecessor.
"The people talking (during the podcast) actually do this work in their daily lives," Pickler told AAFP News. "There is nothing academic or glossed over about it. You don't have to take notes, there is no test and you shouldn't have to wonder about the ivory tower here. It is intended to get physicians thinking about their own practice environment and what quality improvement types of activities they might think about implementing that could have a positive impact on the adolescents and young adults in their care."
Family physicians are unique in that patients won't necessarily be leaving their care when they become adults, although some will leave their family medicine practice behind to follow career aspirations or educational goals, she said.
"In addition, family physicians are important in that they are preparing children and adolescents to become self-advocates and partners in their health care as adults," Pickler noted, although it's also true that family physicians may be receiving adults into their practices with varying degrees of this preparation and might need to be intentional about getting them up to speed, she added.
Furthermore, said Pickler, "They may also be the quarterbacks of care coordination for specialists and other contributors to someone's personal health care plan in the context of the medical home neighborhood."
Some practices are fantastic at these functions, but others may still be exploring the role they play in the care of transitioning young adults, Pickler said.
"Growing up is hard -- in any direction you spin it," she said. "It would be nice if figuring out the health care system wasn't as difficult for young people whose lifestyle and health choices can have long-term effects on their morbidities as older adults. This patient population gives us a chance to highlight prevention and not just treat chronic disease after it has occurred. The clinical report and the podcast offer tools and a road map to help practices along the way."
Pickler added that the discussion during the podcast about patients with IDDs came about because of her special interest in this patient population.
"I know that there are other family physicians who also are passionate about patients with IDDs, and I just can't talk about transition without mentioning some of the nuances these patients and their families need to be successful," she said.
Finally, Pickler said the podcast offers those who tune in an informal discussion on an important topic that can be applied in every family physician's practice.
"A practice's success with the transition process is a good way to take the temperature of the medical home in the practice," she said. "A patient-centered medical home, when it's working as intended, is the type of care we all aspire to give -- and receive when we're the patient. Putting effort toward doing this right is definitely worth it for everyone involved."
Related AAFP News Coverage
Guidance Updated on Transition of Youth to Adult Health Care