Introduction		Adolescents are a group of patients that are generally healthy. We're talking about kids between the ages of 12 and 21. Some of the newly trained pediatricians, including myself, feel pretty comfortable taking care of kids up to the age of 21. Not everyone does, but generally you will be expected to be able to take care of a child of that age. This is a generally underserved group of people. They fall in between the cracks of the pediatrician and internist. Some family doctors care for them, but many times these kids get no care at all. There are multiple barriers to health care for adolescents: Scheduling - many adolescents don't like to miss school and can't come in until late afternoon. Many practices are not equipped to take extra time to extend their hours into the evening. I have done it and it works great. Perhaps we will be headed into that area in the future. Exam room/Waiting area design - the environment should be adolescent-friendly with age-appropriate posters and reading material. Confidentiality (will be discussed later) Billing - many times practices are not set up in a way that caters to adolescents, in terms of billing and confidentiality. This is a big factor for many kids. They don't want their parents to find out about a bill for "vaginitis", so they just don't go. They don't even bother looking for alternative places for care other than their main pediatrician. Time - the visits are longer and they are more complex. In Adolescent Clinic, it is easy to spend 30-60 minutes with an adolescent and most of the time they really deserve and require that kind of time. Inexperience/Lack of training - there are some pediatricians and other physicians who simply don't feel that they can broach some of the sensitive topics that occur in the period of adolescence. So, consequently, many pediatricians may limit the age of their patient population to 12 or 13 years. Return to top of page