How do you do kid doctor stuff after the pediatrician stage?
February 25, 2016 10:42 AM   Subscribe

My kiddo has aged out of pediatric care (he is 19 and in good health). What now? I assume we need to find him an adult primary care physician - does he still need annual check ups? Does your college-aged kid have a doc for annual stuff (do people do annuals any more?), or do they just go to an urgent care office as needed?
posted by Ink-stained wretch to Health & Fitness (17 answers total)
IANAP, but everyone should have annual checkups, always, if you have the insurance to cover it, and probably even if you don't. (Granddaughter of two physicians.)
posted by roomthreeseventeen at 10:46 AM on February 25, 2016 [1 favorite]

IANAP, but everyone should have annual checkups, always, if you have the insurance to cover it, and probably even if you don't.

Current thinking from evidence-based medicine discourages annual checkups for healthy individuals. Don't waste your time and money. He needs his blood pressure checked every 1-2 years and to keep an eye on his weight. If he were a sexually active woman, he would need regular PAP smears. Otherwise, he only needs to go to the doctor if he's sick.
posted by mr_roboto at 10:51 AM on February 25, 2016 [4 favorites]

He needs to find an adult primary care physician so that he will already have a regular doctor in place in case he becomes ill or is injured. Either an internist or someone in family practice would work.
posted by FencingGal at 10:55 AM on February 25, 2016 [11 favorites]

Is he going to school? If so, his primary care physician will most likely be the campus health center.
posted by mr_roboto at 10:58 AM on February 25, 2016 [1 favorite]

I come from a family that has a fair number of hereditary diseases and conditions. Also, I'm a woman. Accordingly, I've had annual physicals since my early 30s. Prior to that, I had annual pap smears from my GYN. According to a friend who is a doctor, men don't generally need annual complete physicals until more or less their late 30s/early 40s.
posted by janey47 at 11:02 AM on February 25, 2016

Hi, 27 year old here (and I am also not a medical professional). When I was in college, I had a chronic health problem for a time, but in that case, not having an established primary doctor wasn't a problem--I just called the campus medical center and they fit me in with a doctor there. Besides that, I didn't have a primary care doctor as an adult until I turned 26, and only then because I had some other health concerns (which turned out to be no big deal, thankfully). They did give me an immunization booster, but other than that there weren't any important exams/tests or anything that I "missed". If he's a healthy young adult in his 20s, I don't think an annual checkup is too big a deal. He should, of course, have health insurance at all times, if possible.
posted by I'm Only Happy When It Rains On Your Wedding Day at 11:04 AM on February 25, 2016 [1 favorite]

Campus health center will only be sufficient if he's in the same city as his school all year. If he's home for summer or breaks, he should still have a primary care physician in his home town. Also, campus health centers vary tremendously in terms of quality and what is offered. I went to one school where the campus health center was terrible (including shaming of sexually active students) and one where it was terrific. Both were at major state universities.
posted by FencingGal at 11:28 AM on February 25, 2016 [2 favorites]

... if you have the insurance to cover it, and probably even if you don't.

In the "even if you don't" category: check with insurance first as to what they do and don't cover. I thought my insurance covered checkups, but a very large bill arrived at my house after a checkup to proved otherwise. You can still do checkups, but make sure your kid knows what they're getting into; at 19 they are going to be the one held responsible for the remainder of the bill, even if it's your insurance.

(I still haven't gotten a straight answer on what constitutes a checkup on my insurance, so even if you do due diligence don't be surprised if the outcome isn't what you can ask the doctor to preauthorize the visit if you're not sure)
posted by AzraelBrown at 11:41 AM on February 25, 2016 [1 favorite]

One other thing that happened as my kids aged out is the HIPAA privacy laws. I was still paying medical bills for my kids while they were in college, but I was not allowed to call the doctor's office and ask any questions about the bills.

I had a talk with my kids and gave them some choices. They could take on that responsibility of calling the insurance company and the doctor to reconcile records when needed, or if they wanted me to keep that job then they had to update their privacy paperwork with the doctor and add me to the list of authorized people for their records. I also agreed in this case that I would not be judgmental about any of their procedures that I became aware of (I have girls - their sexuality is their own business) and would only work on the billing aspects.

When they took on that responsibility after they graduated, they needed a few lessons at reading EOBs and reconciling bills and knowing what to look out for - not just paying anything that came in the mail.
posted by CathyG at 11:48 AM on February 25, 2016 [2 favorites]

It'd also be a good idea to take him to your local health department for a flu shot or something, just to get acquainted. Once he's sexually active, he may avail himself of regular STI screenings there. And I'm not sure about your town, but my local health department does HIV tests for free.
posted by witchen at 11:57 AM on February 25, 2016

Nthing that he should understand what the options are with student health as well as having a primary care physician for when he's not in school.

Two areas to educate him on if he's not up to speed already. First, go through what your insurance covers and what the costs are with him. Most plans have right and wrong ways of doing things, and doing it the wrong way can be very expensive. You don't want either of you to end up on the hook for thousands of dollars because he went to an out of coverage clinic without understanding the nature of the coverage.

Second, make sure he understands that doctors are not infallible and that he has the right to second opinions or switching doctors if they make him uncomfortable. I had negative health outcomes at that age (fortunately mild) because I didn't have the experience to know when to change providers.

P.S. Two dental cleanings per year! And eye exams as needed.
posted by Candleman at 12:41 PM on February 25, 2016

As a college-age person, I've used zocdoc when I needed a specialist or a physician and campus health services was closed. In major cities, it makes finding a doctor that takes your insurance and has availability on the schedule you need very easy. There's never been a situation where I've needed a PCP or a dentist or whatever and had trouble finding to fit my needs. I don't think you need to worry much about finding one in advance unless it's important to him to build a relationship.

This might be specific to my student health, but both of you (if he's in school) should go over the paperwork and understand what costs what because it's not like going to a normal doctor. In my case, every visit was fully covered by my separate student health fee (insurance was irrelevant) except lab tests - but because those tests were covered for those on the school's insurance, it didn't occur to most practitioners to allow me to opt out of nonessential ones. Student health didn't even know how much they'd be in advance so I got some practice refusing them when not strictly necessary.
posted by R a c h e l at 12:46 PM on February 25, 2016 [1 favorite]

I don't think you need to worry much about finding one in advance unless it's important to him to build a relationship.

Depending on one's area and whether there's the flu or whatever going around, being on the books as being a patient can make the difference between getting an appointment later that day rather than several days later.
posted by Candleman at 12:50 PM on February 25, 2016 [1 favorite]

For me I've always needed a PCP and college was rough because I didn't have one.

But I have Asthma and a cold could become a two week ordeal really quick.

My thoughts for a healthy young man:

A PCP who has seen you yearly is more likely to 1)see you quickly when you call and 2)know your baseline as a indicator how sick you are. 3) it can also promote trust in regards to percribing a controled substances (if your son sustains a painful injury).
4) Sometimes school clinics get wierd about 'excusing' days and other political stuff that has nothing to do with actual health care. An advocate/ other medical opinion when that stuff comes up is important.
5) in addition, your son should get an annual flu shot and may need other vaccinations depending on when his next tetanus is due .

And people sometimes just get infections. Flu, the bug, food poisoning, sinus infections, STDs and other whatnot.

I think having a PCP is a good habit to get into when you are young, because something is going to happen eventually.
posted by AlexiaSky at 2:12 PM on February 25, 2016 [1 favorite]

You might ask your son's pediatrician for a recommendation for his next primary care provider and have his records transferred to that office so they'll be there whenever he does need to go in.

I don't think most people get annual physicals at that age but maybe one at the outset would be a good idea so you can see whether the person who was recommended to you is actually a good fit.
posted by lakeroon at 7:23 PM on February 25, 2016

Annual physical checkup may be an empty ritual.

I don't and won't do them. I only go to the doctor if I am sick or want screening.

Also, I get that he's your child, but he's an adult and it's really up to him if he wants to go to the doctor or not. I would have been freaked out beyond belief if my parents had tried to involve themselves in that when I was 19. Unless he asks for your advice, stay out of it.
posted by Violet Hour at 10:15 PM on February 25, 2016 [1 favorite]

He's an adult so he should start taking care of this.

I went in for an annual physical during college (29 now) and the doctor told me that it really wasn't necessary since I didn't have much history of medical problems.

As for medial records, you can have your doctor fax/email/photocopy a set of them for safekeeping. Since he's in college and presumably will move around a bit for the next 6-10 years, I have found it more useful to carry my own medical records. This way there's no hassle of calling up doctors to transfer records, I just walk in with a folder.

My friends and I got along fine with the advice nurse and student healthcare center.
posted by just.good.enough at 6:14 AM on February 26, 2016

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