When to switch from a pediatric to adult GI

[kimmidwife]

Caitlyn's doctors office is over an hour away. She is also a single practitioner and when she goes out of town it is an issue. I Was thinking is she old enough to switch to an adult GI if we can find one closer to our house? Will an adult GI be as understanding and kind? Will insurance let us switch or do you have to be over 18?

 

[Clash]

C was 15 when diagnosed and it was by an adult GI, the insurance wasn't a problem. At the start the nurse had to talk to the GI and see if he would see someone under 18, but he agreed.

We decided to switch to Ped GI after the dx, so he only saw the adult GI a total of 3 times, once for consult, once after MRI and then in recovery after scope.

 

[Maya142]

I know there are many (adult) doctors that don't see patients under 18. I also know of some that won't even see patients under 21! We haven't see an adult GI yet but we've seen adult and pediatric rheumatologists, and I've found the pediatric ones to be much more responsive and much kinder. They also provide much more support. That said, I'm sure if you can find really wonderful adult doctors too.

 

[my little penguin]

^^^ yeah that
Most adult Gi will not see kids at all

 

[Tesscorm]

We didn't spend a lot of time with a ped GI as Stephen was almost 17 when diagnosed. I did find his ped GI was a little 'softer around the edges' and a bit more gentle when discussing meds' side effects, my concerns, etc. I find Stephen's adult GI more no-nonsense and, perhaps, not as interested in 'knowing the patient' rather he's more interested in strictly the illness. (if that makes sense...). But, having said that, he's always answered all our questions patiently, doesn't rush our appointments and has tried to take in account that Stephen is out of town and has tried to arrange apptmts/tests around his visits home.

 

[cm710]

Some IBD centers see children. I found the switch from pediatric to adult difficult and went through a couple GI's not specialized in IBD but finally ended up at an IBD center, which are amazing and many are really emphasizing patient care. However, there are very few out there.

 

[Patricia56]

The research strongly supports staying with a ped GI for as long as possible- even to age 23. The medical outcomes are much better.

Adult GI's (as a group) expect their patient to be an adult and so they spend much less time tracking meds, labs, side effects. They seem to believe that their patients will tell them if there are problems and keep track of meds themselves. They are much less wiling to spend time with the patient explaining things and making sure the patient understands.

There are of course exceptions to this but there have been a couple studies now that validate staying with a ped GI for as long as possible.

But I hear you. We travel about 2 hours (plus rush hour SF Bay Area traffic) to see Badger's ped gi. Their policy is that they will continue to see patients after age 18 provided the patient is medication compliant. If they are not medication compliant then they boot them off their service. Out into the "cold hard world of adult GI" as our ped GI nurse practitioner told our son at his last visit when she discovered he was not being med compliant (I squealed on him). He has since been med compliant so I guess he took her at her word.

 

[upsetmom]

Kim we had a similar problem with my daughter recently. She wanted to see an adult GI closer to home as we travel an hour and a half to see the pediatric GI. In the end l decided to stay where we were till she turns 18.

Good luck with your decision.

 

[LittleChloe]

I'm thinking about the same thing because Chloe turns 18 in the spring. The thing is I don't know how easy it will be to find another GI who will prescribe ldn. I guess that day will come but until it does we will prob stay where we are.

 

[Jennifer]

When I saw my pediatric GI he said I could stay with him as long as I wanted (he also said that he knew a guy who saw his ped GI until he was in his 40's). He was 4 hours away. I saw him up until my mid twenties. We did most of the med adjustments over the phone when I got older and moved away for college. Once I needed tests done then I had to find one that was closer (since I moved away for college I was closer to 8 hours away from my GI).

I stayed with him because he was an awesome doctor. If you have a good GI then try to stay with them for as long as possible. Trying out new GIs was never fun after I left mine (even my current one isn't as good).

 

[Dexky]

I don't think it's just an issue if a GI will or will not see patients over/under 18 but there are license restrictions and different certifications required for ped vs adult docs. I know this is true for GP's, I just assume it would be across the board. Many do both, but not all.

 

[kimmidwife]

Thanks everyone for the advice. I think I am going to have a discussion with her GI when she gets back about the best way to handle things. My biggest issue with her current GI is the lack of good back up when she goes out of town. I think I am going to see if maybe I can put a plan in place together with her regular pediatrician on what to do if Caitlyn gets sick and her GI is out of town