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, which typically begins between the ages of 11 and 13 for boys.
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.
Issues with a high prevalence during adolescence are frequently addressed by providers. These include:
- Sexually transmitted disease (working with specialists in pediatric endocrinology, adolescent obstetrics and gynecology, immunology infectious diseases, and urology and reproductive medicine)
- Unintended pregnancy (working with specialists in adolescent obstetrics and gynecology, especially in neonatology and maternal-fetal medicine; many – though not all – are medically risky or high-risk cases or to those with psychosocial, environmental, and socioeconomic challenges)
- Birth control (there is currently[when?] a drive in the United States federal government's health care policymaking to ensure access to any and all prescription or non-prescription contraceptive methods to adolescent minors who request them, especially if they are over a certain age)
- Sexual activity (such as masturbation, sexual intercourse and sexual abuse)
- Substance abuse
- Menstrual disorders (such as amenorrhea, dysmenorrhea and dysfunctional uterine bleeding)
- Acne (working with specialists in dermatology who treat adolescents)
- Eating disorders like anorexia nervosa and bulimia nervosa (working with nutritionists and dieticians, and also specialists in pediatric mental health counseling, clinical psychology, and pediatric psychiatry, who work with adolescents)
- Certain mental illnesses (especially personality disorders, anxiety disorders, major depression and suicide, bipolar disorder, and certain types of schizophrenia; in concert with mental health counselors, clinical psychologists, and pediatric psychiatrists specializing in adolescent health care)
- Delayed or precocious puberty (often working with specialists in adolescent pediatric endocrinology, urology, and andrology)
Gay, lesbian and bisexual youth
Adolescents who are gay, lesbian or bisexual tend to demonstrate more risky health behaviors and have worse health outcomes compared to heterosexual youth, including:
- Substance abuse
- 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)
- Homelessness, which affects health and access to care
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.
Young peoples' access to health care
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.
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:
- Adolescent and Young Adult Clinic at Children's Medical Center (Dallas)
- Windhaven Adolescent Medicine Clinic at Texas Health Presbyterian Hospital (Plano)
Kansas City, Missouri
- Adolescent Clinic at Children's Mercy Hospital (Kansas City, Missouri)
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
- The Adolescent Health Clinic at University of Rochester
- 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
- Division of Adolescent Medicine at Children's Hospital Boston
- 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
- Adolescent Health at Nationwide Children's Hospital
- Department of Adolescent Medicine at Seattle Children's Hospital
- Division of Adolescent Medicine at Cincinnati Children's Hospital Medical Center
- Adolescent Medicine at Children's Hospital of Richmond
List of adolescent health centers in Australia
These hospitals offer adolescent-specific care:
- 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
- The Centre For Adolescent Health Royal Children's Hospital Melbourne
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.
- 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)
- "Child and Adolescent Health, Credo Encyclopedia". Retrieved October 27, 2013.
- 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.
- 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.
- Michaud, PA; Suris, JC; Viner, R (2007). "The Adolescent with a Chronic Condition: Epidemiology, developmental issues and health care provision" (PDF). World Health Organization.
- Chown P, Kang M, Sanci L, Newnham V and Bennett D (2008) Adolescent Health: GP Resource Kit. Enhancing the skills of General Practitioners in caring for young people from culturally diverse backgrounds, 2nd edition, NSW Centre for the Advancement of Adolescent Health and Transcultural Mental Health Centre. Available at: [http://www.caah.chw.edu.au/resources/#03. Accessed on: October 14, 2008.
- "Specialties & Subspecialties". American Osteopathic Association. Retrieved 25 September 2012.
- Office of Adolescent, U.S. Department of Health, Health and Human Services
- Adolescent Medicine: State of the Art Reviews
- The Society for Adolescent Health and Medicine
- International Association for Adolescent Health
- The North American Society for Pediatric and Adolescent Gynecology
- The American Board of Pediatrics
- The American Board of Internal Medicine
- The American Board of Family Medicine
- The American College Health Association
- NSW Centre for the Advancement of Adolescent Health
- Teens Homepage, Nemours Foundation