When a patient moves from one medical team to another, it's called "Transitional Care". The goal is for a patient to have a smooth change, with full access to care at all times.
With pediatric urology, children will one day grow too old for their pediatric urologist. They will benefit from the care of an adult urologist. This is true for things that may become more important as a person becomes an adult, like issues of fertility or of sexual function. It is also true for urologic problems that need ongoing care.
Many urologic issues treated during childhood need attention over the child's lifespan. These can include a kidney problem, neurogenic bladder, bladder exstrophy, Eagle-Barrett syndrome (prune belly), and other congenital conditions that affect the bladder, kidneys and genitalia.
Changing medical teams can be a big deal. It helps to plan ahead and help your child shift to adult care with trust.
How is Pediatric Urology Different from Adult Urology?
Pediatric urologists treat patients from birth through the teen years. They focus on the urologic health issues found in children. Their goal is to treat the condition and to allow a child to become the healthiest possible adult. As children grow and change, adult urologists have the skill to deal with the medical problems in older teens and adults.
Why Transition to Adult Urology Care?
Hospitals and medical systems often have age limits for care to young adults. Teens will at some time be asked to work with an adult provider.
If you or your child feels nervous about transitioning, you can take steps to plan for this event. It's normal for older children and teens to feel nervous about sharing personal issues with a new care team. For this reason, it helps to talk with your current doctor first. You can ask for trusted referrals and ask them to work closely with you to find a good fit.
It may take time to find a specialist who can care for your child's specific needs. You can talk with a few medical teams until you find one that you all like and trust. Not every adult provider may feel comfortable caring for a young adult with a lifelong urologic problem. The best step is to ask the pediatric urologist for some recommendations. They are often familiar with adult urologists who have both an interest and the skill to keep you or your child healthy.
When Should Planning for Transitional Care Begin?
You can start asking about this change when your child is about 11 or 12. Still, many people get serious about it later, at age 14 -16. Change can happen from as late as age 18 to 21.
Be aware that moving from one medical team to another can take time. You may need to have many visits with both your current team and the new team during the transition process.
What Should We Keep In Mind About Transition?
Your pediatric urologist should work with you to help you find your next care team. Aim to find providers that are
convenient and take your insurance. To prepare for the change, keep in mind these things:
- Communicate openly and keep records. Talk with your teen and primary care doctor about the main points of your teen's health. Learn what questions to ask a new provider and what to look for. Your new doctor's office should collect the appropriate information about your child's health history and medical records. Keep copies of treatments and surgeries.
- Teach your child independence. Help your teen start taking charge of their care, as they are able. Show them how to schedule appointments, manage medicine, and learn about health insurance. Take small steps to give them the comfort and skills they need to direct their care and talk about concerns directly with their medical team.
- Learn about insurance. Talk with your teen's health insurance policy or Medicaid to learn what services are covered for future needs, and what isn't. Teach your child about coverage and how to handle payments. Learn what to do when the family's insurance coverage ends.
- Respect privacy. Your teen mayl want privacy. They may want to know that you trust them to make personal decisions on their own. For example, your child may not want to talk to the doctor about sexuality while you're in the room. Allow your child the option to speak alone with the doctor.
- Special tips for rare diseases: If your child has a rare or complex condition, it may take time to find the right specialist. Conditions like neurogenic bladder, exstrophy, hypospadias, congenital and chronic kidney diseases and issues that affect sexual function may need lifelong care. Work with your current doctor to find the right specialist for future care.
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