Adolescent medicine

Adolescent medicine or hebiatrics is a medical subspecialty that focuses on care of patients who are in the adolescent period of development, generally ranging from the last years of elementary school until graduation from high school (some doctors in this subspecialty treat young adults attending college at area clinics, in the subfield of college health). Patients have generally entered puberty. In developed nations, the period of adolescence is extended both by an earlier start, as onset of puberty is beginning earlier, and a later end, requiring more years of education or training before economic independence from parents.[1]

Issues with a high prevalence during adolescence are frequently addressed by providers. These include:

Gay, lesbian and bisexual young people

Adolescents who are gay, lesbian or bisexual tend to demonstrate more risky health behaviors and have worse health outcomes compared to heterosexual youth, including:[2]

  • Substance abuse
  • Suicidality
  • Eating disorders and body image
  • Sexual behaviors, including unintended pregnancy involvement (Contrary to assumptions, gay, bisexual or lesbian youth are more likely to report involvement in pregnancy compared to their heterosexual peers)[3]
  • Homelessness, which affects health and access to care

Chronic conditions

The rising dominance of chronic conditions over acute conditions, along with dramatic improvement in life expectancy, has made the management of such chronic conditions in adolescence of greater importance: Chronic conditions and adolescent development are mutually impactful.

Chronic conditions often cause delay in onset of puberty and temporary or permanent impediments to growth; conversely the growth and hormonal changes can destabilize treatment for the chronic condition. An increase in independence can lead to gaps in self-management, for example, in the decreased management of diabetes.[4]

Young peoples' access to health care

In addition, issues of medical ethics, particularly related to confidentiality and the right to consent for medical care, are pertinent to the practice of adolescent medicine.

Marginalised young people’s access is affected by their ability to recognize and understand health issues; service knowledge and attitudes toward help seeking; structural barriers; professionals' knowledge, skills, attitudes; service environments and structures; ability to navigate the health system; youth participation; and technology opportunities.[5] Marginalised young people’s healthcare journeys can be supported by advocates that help them navigate the health system.[6]

Training

Adolescent medicine providers are generally drawn from the specialties of pediatrics, internal medicine, med/peds or family medicine. The certifying boards for these different specialties have varying requirements for certification, though all require successful completion of a fellowship and a passing score on a certifying exam. The American Board of Pediatrics and the American Board of Internal Medicine require evidence of scholarly achievement by candidates for subspecialty certification, usually in the form of an original research study.

In the United States, subspecialty medical board certification in adolescent medicine is available through the specialty boards of American Board of Internal Medicine, the American Osteopathic Board of Neurology and Psychiatry, the American Board of Family Medicine, the American Osteopathic Board of Family Physicians, the American Board of Pediatrics, and the American Osteopathic Board of Pediatrics.[7]

List of adolescent health centers in the United States

Many subspecialists practice as part of general specialty clinics or practices, or in high school or college clinics. In addition, many major metropolitan areas have clinics that offer adolescent-specific care. A partial list includes:

San Antonio

Dallas

  • Adolescent and Young Adult Clinic at Children's Medical Center (Dallas)
  • Windhaven Adolescent Medicine Clinic at Texas Health Presbyterian Hospital (Plano)
  • Girls to Women Health and Wellness (North Dallas)
  • Young Men's Health and Wellness (North Dallas)

Kansas City, Missouri

Indianapolis, Indiana

New York City

  • The Adolescent Health Center at Mount Sinai Medical Center (Manhattan)
  • Adolescent clinic at Children's Hospital at Montefiore Medical Center (the Bronx)

Rochester, New York

Los Angeles

San Francisco area

Boston

Philadelphia

Columbus

Seattle

Cincinnati, Ohio

Richmond, Virginia

  • Adolescent Medicine at Children's Hospital of Richmond

Fayetteville, North Carolina

List of adolescent health centers in Australia

These hospitals offer adolescent-specific care:
Sydney

Melbourne

Professional organizations

In addition to membership in the organizations for their various specialties, adolescent medicine providers often belong to The Society for Adolescent Health and Medicine and/or The North American Society for Pediatric and Adolescent Gynecology.

Founded in 1987, the International Association for Adolescent Health (IAAH) is a multidisciplinary, non-government organization with a broad focus on youth health.

Publications

See also

References

  1. ↑ "Child and Adolescent Health, Credo Encyclopedia". Retrieved October 27, 2013.
  2. ↑ Coker, TR; Austin, SB; Schuster, MA (2010). "The Health and Health Care of Lesbian, Gay, and Bisexual Adolescents". Annual Review of Public Health. 31. doi:10.1146/annurev.publhealth.012809.103636.
  3. ↑ Saewyc, EM; Poon, CS; Homma, Y; et al. (2008). "Stigma management? The links between enacted stigma and teen pregnancy trends among gay, lesbian, and bisexual students in British Columbia". Can J Hum Sex. 17.
  4. ↑ Michaud, PA; Suris, JC; Viner, R (2007). "The Adolescent with a Chronic Condition: Epidemiology, developmental issues and health care provision" (PDF). World Health Organization.
  5. ↑ Robards F, Kang M, Usherwood T, Sanci L, How marginalized young people access, engage with, and navigate health-care systems in the digital age: Systematic review Journal of Adolescent Health, First online Feb 2018, .
  6. ↑ Robards F, Kang M, Tolley K, Hawke C, Sanci L, Usherwood T, Marginalised young people’s healthcare journeys: Professionals’ perspectives, Health Education Journal, First online Feb 2018, .
  7. ↑ "Specialties & Subspecialties". American Osteopathic Association. Archived from the original on 2015-08-13. Retrieved 25 September 2012.
  8. ↑ "Adolescent Medicine - Pediatrics - IU School of Medicine". iu.edu. Retrieved 9 April 2018.

8. https://ukgynecomastia.co.uk/

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