Much of my day-to-day work routine involves seeing patients in our outpatient office suites. Interestingly, and purely by chance, the building containing the pediatric cardiology clinic and the building that houses the adult congenital heart disease clinic happen to be directly across from one another—across the parking lot, as I like to say.
When is this important? Well, when it comes to transition, this may make all the difference in the world.
I think back to my own cardiology care over the years. Like many of you out there, I had routine pediatric cardiology care, and as I got older and seemed to be “doing fine,” the follow-up became less and less frequent, until at some point during college, I realized that I hadn’t seen a cardiologist in, well…. a long time. At that time I was no longer a kid, and my pediatric cardiologist had long since retired.
Having no real ties to pediatric cardiology, I asked my primary care doc where to go and he sent me to the local adult cardiology practice, the same practice where I am sure he sent all of his 80-year-olds with coronary disease.
Let’s just say that the visit was a resounding failure—at least in my mind—and I left the office determined to find someone who knew something about CHD and had the ability to convince me that they knew what they were doing. Thanks to the help of the internet, I was eventually able to find a solid ACHD program for my own care, and the rest is history, at least for me.
But for many, the door to ACHD care is just being opened. Transition has become quite the buzzword in the ACHD community, and many places talk about their “transition programs” to bridge the gap between pediatric cardiology and ACHD care.
Transition is easy to talk about, but harder to actually achieve.
In brief, transition is not just a single event, but a process that guides young people through a host of issues with the ultimate goal being a well-rounded patient who understands his or her medical problems and is capable of medical decision-making.
I’ve found that many of my young adult pediatric cardiology patients are somewhat hesitant to make the leap to ACHD care, and I try to convince them that it really will be OK. In many respects, it’s actually better!
For example, the waiting areas and staff are oriented to adult patients, and not just kids. Our ACHD program also focuses on different aspects of care; certainly the nuts and bolts of cardiology care don’t change much between the two clinics, but the focus is now on adult issues like employment, family planning and pregnancy. We can now have candid adult discussions about things like alcohol consumption, body art and sex without first having to ask parents to step out of the room, or simply ignoring these important discussion points.
Most importantly, we talk to the patient, not to the parent—something that may not always happen in a pediatric cardiology office.
To all of the ACHD patients out there who may still be receiving pediatric cardiology care, I leave you with the following—why not take a walk across the parking lot? I promise you'll be glad you did!
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