Q&A With Director of Duke’s Adolescent Medicine Program

Article

Although typically the healthiest age group of all, many adolescents face complex health challenges related to acute illness and injury, chronic diseases, difficulty transitioning from pediatric to adult care and achieving independence, and various other factors. A dynamic program at Duke provides primary and specialty care for adolescents transitioning into young adulthood, offering treatment and support for patients aged 12 to 26 years.

Richard Chung, MD, director of the Adolescent Medicine Program, discusses this crucial time of life and how providers can determine when a patient would benefit from the program.

Q: How is the program structured to care specifically for adolescents?

A: The program is a hybrid between classic primary preventive care and specialty care, with a range of services that fall into 4 main categories: general primary care, reproductive health services, care for patients with complex medical conditions, and behavioral health care. Although we provide specialized services for a range of problems in these categories, our program is less about specific diseases or conditions and more about the stage of life of our patients. We are committed to caring for any and every issue that might arise during this important time of life; if it matters to the teen in front of us, we take it quite seriously.

Q: What are some of the common issues that arise during this time of life?

A: We see many patients for reproductive health issues, eating disorders, substance use, depression, and anxiety. Another large category is patients with childhood-onset chronic conditions who are transitioning into adulthood, including teens with diabetes, congenital heart disease, sickle cell anemia, cerebral palsy, and a broad range of other neurodevelopmental disabilities. Also, we support patients facing a variety of psychosocial problems that often arise during pubertal transitions and emerging independence.

Q: What is the role of a parent in his/her child’s care in the program?

A: Parents and guardians are typically involved, at least to some extent, until patients reach their late teens or early 20s, and many remain involved even longer if their child has a serious illness. But it’s important to note that even with patients as young as age 12, our providers spend time alone with them to hear their perspectives, gauge their level of maturity, and support them in actively engaging in their own health care as much as possible.

Q: If an adolescent doesn’t have a specific medical or psychological condition, do you accept him/her into the program?

A: Yes, we provide primary care services for any teen who seeks our care. Some teens may choose to transition from their pediatrician to one of our adolescent medicine providers if they desire additional support in certain aspects of their health and development. Adolescents often engage less effectively in their health care when their parents stop making them see their pediatrician, which can lead to serious health problems. We hope that by providing services geared to their specific age and experiences, we can help teens stay engaged throughout this important time. In addition, teens with complex diseases can really struggle when they reach this age because they’re suddenly tasked with managing complex care needs, so we help them develop the skills to be independent and to navigate available resources. We’re eager to partner with providers in any way we can to help build a continuum of care for adolescents and keep them engaged in their care as they become young adults.