Transition to Adult Care

Mortuma Murry uses two fingers to check a young adult’s neck during a physical exam at OHSU.
Mortuma Murry works with hematology-oncology patients at OHSU Doernbecher Children’s Hospital who are moving from pediatric to adult health care.

Growing up brings changes, including changes in your health care.

As a child and teen, you get care from pediatric providers. Parents or caregivers make medical decisions for or with you. They often manage your health care, including appointments, medications and bills.

Once you turn 18, you may start to see adult providers, make your own medical decisions and take charge of your care.

We call these changes the transition to adult care.

Planning for this transition helps:

  • Prepare you to manage your condition as an adult.
  • Reduce anxiety.
  • Give you time to find new providers.

Transition to adult care at OHSU

The OHSU Doernbecher Pediatric to Adult Transitions in Health Care (PATH) Program supports all pediatric patients and families.

We will:

  • Talk with you and your family about what to expect.
  • Do activities with you to help you prepare for adult care.
  • Help you decide when you’re ready to move (transfer) to an adult provider.
  • Find out what you already know and still need to learn about moving to adult care.
  • Connect you with resources

Providers at OHSU Doernbecher Pediatric to Adult Transitions in Health Care Program

Moving to adult health care: What families need to know

How pediatric and adult health care are different

Pediatric care Adult care
A parent or caregiver goes to appointments with you. You go to appointments alone. You can ask someone to go with you.
The doctor talks to you and the adult with you. The doctor talks directly to you.
A parent or caregiver sets up your appointments. You may be told what to expect during visits and what the next steps are. You set up your own appointments. You may be expected to know what’s going to happen and what to do next.
Your doctor specializes in pediatric conditions. Your doctor may have little or no experience with conditions that start in childhood.
Your doctor’s office is designed for pediatric patients. The staff is trained to work with children and teens. Your doctor’s office is designed for adults. The staff may not know how to work with patients at different levels of development.
You may see your doctor several times a year. You may not see your doctor often.
You may have a long visit with several doctors. You may have shorter visits with one doctor at a time.
If you need to see another doctor for your condition, your doctor may help connect you. If you need to see another doctor for your condition, you may have to find them yourself.
Your parent or caregiver has access to your electronic health record (in Oregon, until you turn 15). Only you and your doctor can see your electronic health record. If you want anyone else to see it, you have to give permission.

When to transition to adult care

Transition to adult care takes place over years. Planning can start as early as age 11 or 12. Patients often move (transfer) to an adult provider between ages 18 and 23.

The best time to transfer is different for each person. Timing depends on:

  • How much you know about your condition
  • How comfortable you feel managing your condition
  • How stable your health is
  • What age limit your pediatric doctor sets for patients
  • How ready you are to set health care goals and practice health care skills

For patients and families

Resources

For providers

Frequently asked questions about transition to adult care

Do I have to transition to adult care?

Yes. Adult providers understand how your condition and any medications you take can affect your adult body. They can help you become confident and independent in taking care of yourself.

When you transfer to an adult provider, you make room for your pediatric provider to see new patients. 

What should I ask my pediatric provider about transition to adult care?

It’s important to ask:

  • How long can I be your patient? When do I have to move (transfer) to an adult provider?
  • Will you refer me to a new provider?
  • If you don’t refer me to a new provider, can you make recommendations for finding one?
  • How will you help me get ready to see a new provider?
  • Will you work with the new provider to help them get to know me?
  • Do I need to take any materials from you to a new provider?

When should I start looking for an adult provider?

It’s best to start looking while you have a pediatric provider.

It can take a while to become a patient (establish care) with an adult provider. Ask your pediatric provider how long you can stay as their patient. Try to stay with them until you have an adult provider so you don’t have gaps in your care.

If your pediatric provider hasn't talked about looking for an adult provider, we encourage you to ask about it.

How do I find an adult provider? If my pediatric provider recommends an adult provider, do I have to see them?

Ask your pediatric provider if they can recommend an adult provider. If you have health insurance, you can call your insurer or use their website to find adult providers who are taking new patients.

Choosing a provider is personal. You can always choose a different provider from the ones recommended. You can meet with several providers before choosing one. It’s important to find a provider who you feel is a good fit for you and will listen to your concerns and questions.

What should I look for in an adult provider?

Look for a provider who:

  • Is taking new patients
  • Has a location that is convenient for you
  • Has experience with your condition, including advanced training
  • Understands your medical history
  • Makes you feel comfortable
  • Spends enough time with you
  • Explains things in ways you understand
  • Gives you a chance to ask questions and bring up concerns
  • Respects your decisions about your health

Questions to ask:

  • Do you take my insurance?
  • Who will see me if you’re not available?
  • Do you offer evening or weekend appointments?
  • Do you offer virtual visits?
  • How long does it usually take to get an appointment?
  • Which hospital do you use?
  • Can I get lab work and imaging done at your office?
  • What if I need to cancel an appointment?

What do I do if I can’t find an adult provider?

If you can’t find an adult provider who understands your condition, ask for help from your insurer or support groups for people with your condition.

it’s important to keep getting care while you keep looking. This may mean staying with your pediatric provider a little longer or using same-day care.

When do I stop seeing my pediatric provider?

It depends.

You may be scheduled for a transfer visit to meet your new adult provider. You may be able to bring a parent or caregiver. Your pediatric provider may attend. After the transfer visit, you will start seeing the adult provider.

If you don’t have a transfer visit, your pediatric provider will likely tell you when you will no longer see them for care.

Is it normal to feel scared about transition to adult care?

Yes. The thought of leaving your pediatric provider for someone who doesn’t know you may feel scary or unsettling.

Transition feels easier when you start talking about it early and create a plan. We are here to help you.

Skills for making the transition to adult care

We encourage you to talk with your family and doctors about how you can learn each of these skills.

Health conditions

  • I can explain my condition, symptoms and medical history.
  • I can get medical help when needed.
  • I know what tests I need and why.
  • I know what to do if my symptoms get worse or I have new symptoms.

Medications

  • I can explain what medication I take, when I take it and how.
  • I can refill a prescription.
  • I know my medication’s possible side effects and interactions.
  • I know what to do if I run out of medication and my pharmacy is closed.

Health appointments and information

  • I understand what appointments I need, when I need them and why.
  • I can schedule, cancel and reschedule an appointment.
  • I know what questions to ask at an appointment.
  • I can fill out forms at appointments.
  • I know where my medical information is and how to get to it.

Billing and insurance

  • I can pay my medical bills or get help paying them.
  • I know how to get health insurance.
  • I can check whether a doctor takes my health insurance.

Living with a condition

  • I know how to ask for support for my condition at school or work.
  • I can manage my medication or medical device if I travel.
  • I can reach out to others who have my condition and understand what living with it is like.
  • I know how to learn about nutrition and physical activity for my condition.
  • I know how pregnancy, alcohol, tobacco and drugs may affect my condition.

Questions?