“Aging Out”: Transitioning from Pediatric to Adult Healthcare

At 18, you’re legally an adult, but your pediatric endocrinologist can’t see you anymore. The children’s hospital that’s been your medical home for years no longer feels welcoming. Adult providers expect you to manage complex conditions independently, but no one taught you how to advocate for yourself in a system designed very differently from pediatric care. This transition, often called “aging out,” represents one of the most vulnerable periods in healthcare for young adults with chronic conditions.
The communication skills that worked in pediatric settings may not translate directly to adult healthcare environments. Adult providers have different expectations about patient engagement, documentation, and decision-making autonomy. Understanding these differences and preparing strategically for this transition can mean the difference between seamless care continuation and dangerous gaps in treatment during a critical developmental period.
Why this matters in real appointments
Adult healthcare operates under fundamentally different assumptions than pediatric care. While pediatric providers often communicate directly with parents and take more time explaining decisions, adult providers expect patients to arrive prepared with complete information, ask specific questions, and make informed decisions independently. Time constraints are often tighter, and the relationship dynamic shifts from family-centered to patient-centered almost overnight.
Young adults transitioning from pediatric care often struggle with this new dynamic, leading to miscommunication, incomplete information transfer, and treatment gaps. Adult providers may not understand the nuances of conditions that began in childhood, while transitioning patients may not know how to effectively communicate their complex medical histories. Poor preparation for this transition can result in medication errors, missed symptoms, and delayed care when continuity is most critical.
Practical strategies you can use today
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Create a comprehensive health summary before transitioning: Work with your pediatric team to compile a complete medical history document that includes diagnoses, hospitalizations, surgeries, medication trials, allergies, and family history. This becomes your foundation for communicating with new adult providers who won’t have access to years of pediatric records.
Try saying: “I’m transitioning to adult care soon. Can you help me create a comprehensive summary of my medical history that I can share with my new providers? I want to make sure nothing important gets lost.”
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Practice self-advocacy skills while still in pediatric care: Start taking the lead in appointments while you still have pediatric provider support. Ask to speak directly with providers about your symptoms and concerns, practice explaining your condition to nurses, and begin managing your own medication schedules and appointment scheduling.
Try saying: “I’d like to practice being more independent in managing my care before I transition. Can I start taking the lead in our appointments and handling my own questions?”
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Research adult providers before you need them: Don’t wait until your last pediatric appointment to find adult specialists. Research providers who have experience with your condition, understand their communication preferences, and schedule meet-and-greet appointments before you need urgent care. Ask your pediatric team for specific provider recommendations.
Try saying: “Can you recommend adult specialists who have experience treating patients with my condition? I’d like to meet with them before I officially transition to understand their approach to care.”
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Understand your new privacy rights and responsibilities: At 18, you gain complete control over your medical information and decisions. Your parents can no longer access your records or speak with providers without your written permission. Learn how to grant or restrict access and understand the implications for family involvement in your care.
Try saying: “Now that I’m 18, I want to understand my privacy rights and how to involve my family in my care appropriately. Can you explain the consent forms and access permissions I need to consider?”
Navigate the relationship shift
Adult healthcare relationships are typically more direct and less nurturing than pediatric relationships. Providers expect you to come prepared with specific questions, understand your medications and dosages, and make decisions about your care independently. This doesn’t mean adult providers care less; they’re operating within different time constraints and relationship expectations.
Prepare for this shift by practicing clear, concise communication about your symptoms and concerns. Adult providers appreciate patients who can articulate their medical history efficiently and ask specific questions about treatment options. Don’t interpret more businesslike interactions as dismissiveness; instead, focus on building trust through consistent self-advocacy and active participation in your care decisions.
Make it stick this week
- Request a complete copy of your medical records from all pediatric providers and organize them in a portable format.
- Create a one-page health summary that includes your key diagnoses, current medications, and important medical history.
- Research three adult specialists in your area who treat your condition and check their credentials and patient reviews.
- Practice explaining your condition and medical history in 2-3 minutes without relying on parent input.
Disclaimer: This article provides general information about communication and advocacy. It is not medical or legal advice. Consult a qualified professional for guidance on your specific situation.