Primary Care for Young People: A Personalized Approach for Teens and Young Adults
The adolescent and early adult years can be challenging for teens and their caregivers alike. Not only are teens learning to navigate new social situations and increased responsibilities, they’re also learning a great deal about who they are and what they want out of life, all while their bodies and brains are undergoing tremendous change. With this rapid period of growth, teens often have questions that they don’t feel comfortable asking their adult support-people, or that caregivers may not know how to answer.
A healthcare provider is an available resource for questions about development, risk-taking behavior, and transition to adulthood. Some adolescents have a strong and trusting relationship with their existing provider from childhood and are comfortable asking questions in that setting—in this case, they are in good hands as they move towards adulthood, and there is no reason to seek a new provider. For others, their childhood provider might not be a comfortable person to ask about more detailed, private questions specific to adolescent behavior and development—for these teens, transition to a primary care team focused specifically on adolescents and young adults can help.
How does adolescent primary care differ from pediatric or family medicine primary care?
Any medical clinic that delivers healthcare to adolescents will likely be able to provide clinical care, resources, and information, and allow an opportunity for teens and parents to ask questions about the changes they experience through puberty and young adult development. However, an adolescent-specialized primary care team has more training and expertise in this specific age group. The adolescent medicine clinic is completely focused on supporting people as they transition from childhood to early adulthood, and providers and staff who work in this setting enjoy helping with the challenges that can arise for patients and their caregivers during this time of change.
What can an adolescent primary care team provide?
In addition to delivering standard healthcare (physical exam, vaccines, sick visits, etc.), an adolescent primary care specialist provides expertise in adolescent-centered mental, behavioral and emotional health. For example, adolescent medicine providers have special training in risk-taking behaviors, eating disorders and body image concerns, menstrual evaluation and management, gender affirming care, and sexual/reproductive health questions. Visits are slightly longer than in most pediatric and family practice settings to allow time to discuss and facilitate decision-making and support wellness. During each visit, caregivers are involved in the discussion, but the adolescent also has time alone with the medical provider to allow for privacy (when appropriate) and empower independence-building.
Support for teens' mental health
Adolescent primary care involves cultivating a safe and confidential space for teens to comfortably discuss any of their health concerns, including mental health. In addition to regular mental health screening for things like anxiety, depression, and eating disorders, adolescent medicine providers talk with young people about their support systems, relationships with others, goals for the future, and activities that promote resilience and joy. Adolescent medicine providers speak directly with teens about substance use including vaping, marijuana, and other drugs, help them identify how use might impact development, and support them to set goals for reducing or stopping use.
Sexual, reproductive health, and gender health care
The adolescent years are a time many teens begin to explore their sexuality. Comprehensive, gender-inclusive sexual education and reproductive health services are a significant part of an adolescent primary care center's practice. Providers can help teens explore questions related to sexual or gender identity, and understand pregnancy prevention options, how to reduce the risk of sexually transmitted infections and safe sexual practices. Providers can also evaluate and manage painful or irregular menstrual cycles, and deliver cervical cancer/HPV preventive care.
Getting teens involved in caring for their health
Helping teens understand and manage their health through informed, supported decision-making is one of the hallmarks of adolescent primary care. To do this, adolescent medicine providers strive to create an environment of respect, empathy, and confidentiality. Earning a patient's trust is key to helping them feel comfortable discussing any health issue that comes up, including those that prompt curiosity, embarrassment, or shame. While caregivers are critical supports for adolescent wellness, teens must develop comfort with their own healthcare over time in order to successfully transition to adult care. Adolescent medicine providers help prepare young people for adult healthcare settings by empowering skills and confidence in managing their own healthcare needs in a developmentally appropriate way.
The Adolescent Medicine program at Lifespan aims to meet the healthcare needs of adolescent and young adult patients and their caregivers in a safe, supportive environment. Learn more about our program on our website or call 401-444-5980.
About the Author:
Abigail A. Donaldson, MD, and Jack C. Rusley, MD, MHS
Dr. Abigail Donaldson is an adolescent medicine specialist with expertise in eating disorders and their treatment. She leads the team of providers in the Eating Disorder Program at Hasbro Children's Hospital.
Dr. Jack Rusley is a board-certified adolescent medicine specialist and adolescent health researcher. He provides primary care and specialty care to adolescents and young adults at the Adolescent Healthcare Center.
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