Adolescent medicine

Adolescent medicine is a medical subspecialty that focuses on care of patients who are in the adolescent period of development. This period begins at puberty and lasts until growth has stopped.[1] Typically, patients in this age range will be in the last years of elementary school up until high school (some doctors in this subspecialty treat young adults attending college at area clinics, in the subfield of college health). In developed nations, the psychosocial period of adolescence is extended both by an earlier start, as the onset of puberty begins earlier, and a later end, as patients require more years of education or training before they reach economic independence from their parents.[2]

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:[3]

  • 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)[4]
  • 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.[5]

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.[6] Marginalised young people’s healthcare journeys can be supported by advocates that help them navigate the health system.[7]

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.[8]

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

  • Adolescent and Young Adult Medicine Clinic at Fort Sam Houston

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

  • Adolescent Clinic at Children's Mercy Hospital (Kansas City, Missouri)

Indianapolis, Indiana

  • Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine [9]

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)

Dayton, Ohio

  • Division of Adolescent Young Adult Medicine at

Dayton Children’s Hospital


Rochester, New York

  • The Adolescent Health Clinic at University of Rochester

Los Angeles

  • Teenage and Young Adult Health Center at Children's Hospital Los Angeles

San Francisco area

  • Adolescent Medicine Clinic at Lucile Packard Children's Hospital at Stanford
  • Adolescent Medicine Clinic at UCSF

Boston

  • Division of Adolescent Medicine at Children's Hospital Boston

Philadelphia

  • Adolescent Medicine Clinic at Hospital of Philadelphia
  • Adolescent Medicine at St. Christopher's Hospital for Children
  • Teen Health Center at Temple University Children's Medical Center
  • Teen Health Center at Albert Einstein Medical Center

Columbus

  • Adolescent Health at Nationwide Children's Hospital

Seattle

  • Department of Adolescent Medicine at Seattle Children's Hospital

Cincinnati, Ohio

  • Division of Adolescent Medicine at Cincinnati Children's Hospital Medical Center

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

  • The Department of Adolescent Medicine at The Children's Hospital at Westmead
  • The Department of Adolescent Medicine at Westmead Hospital
  • Youth Consultancy & the Chill, at Royal Prince Alfred Hospital

Melbourne

  • The Centre For Adolescent Health Royal Children's Hospital 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
  • Journal of Adolescent Health (published by the Society for Adolescent Medicine)
  • Journal of Pediatric and Adolescent Gynecology (published by the North American Society for Pediatric and Adolescent Gynecology)
  • Adolescent Medicine: State of the Art Reviews (published by the American Academy of Pediatrics)

See also

References
  1. Behavioral medicine : a guide for clinical practice. Feldman, Mitchell D.,, Christensen, John F., (Fourth ed.). New York. ISBN 9780071767705. OCLC 897078390.CS1 maint: extra punctuation (link) CS1 maint: others (link)
  2. "Child and Adolescent Health, Credo Encyclopedia". Retrieved October 27, 2013.
  3. 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.
  4. 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.
  5. Michaud, PA; Suris, JC; Viner, R (2007). "The Adolescent with a Chronic Condition: Epidemiology, developmental issues and health care provision" (PDF). World Health Organization.
  6. 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, .
  7. 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, .
  8. "Specialties & Subspecialties". American Osteopathic Association. Archived from the original on 2015-08-13. Retrieved 25 September 2012.
  9. "Adolescent Medicine - Pediatrics - IU School of Medicine". iu.edu. Retrieved 9 April 2018.

8. https://web.archive.org/web/20170813230803/https://ukgynecomastia.co.uk/

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